My Recent Lab Results

[Mike.M]

So my total testosterone was 159.4 ng/dl and free testosterone 21.2 pg/ml. Both of these are below the lower normal limit. The doctor said if I don't have any symptoms we should leave my dosage alone. Is is good to be at lower limit? Should I request dosage increase to get me to normal blood levels? How do I know if I'm having symptoms. Thank you for opinions.

 

[Systemlord]

Free T matters most as it's the free hormone that's circulating in the blood.

Wow you must have very low SHBG in the single digits to have Free T that low given your Total T level. I have to get Total T beyond 500 ng/dL to have Free T over 21 pg/mL and my SHBG is on the lower end.

Low thyroid function and genetics can explain low SHBG.

 

[Vince]

So my total testosterone was 159.4 ng/dl and free testosterone 21.2 pg/ml. Both of these are below the lower normal limit. The doctor said if I don't have any symptoms we should leave my dosage alone. Is is good to be at lower limit? Should I request dosage increase to get me to normal blood levels? How do I know if I'm having symptoms. Thank you for opinions.

What was your pre trt levels? Do you feel better now than before you started trt.

 

[Vince Carter]

So my total testosterone was 159.4 ng/dl and free testosterone 21.2 pg/ml. Both of these are below the lower normal limit. The doctor said if I don't have any symptoms we should leave my dosage alone. Is is good to be at lower limit? Should I request dosage increase to get me to normal blood levels? How do I know if I'm having symptoms. Thank you for opinions.

Post your labs...post your dosages...and frequency...you're really not giving anyone any thing to work with besides just stabbing in the dark, your devoid of any meaningful details.

 

[Mike.M]

OK, so more of the story is I've been prescribed, by an endocrinologist, trt for the past ten years. My free and total numbers at the time of my diagnosis were well below the lower limit of normal, don't remember that far back. I'm 61 years old. I am hypothyroid, daily taking 0.2mg levothyroxine and 5mcg liothyronine. With my current health insurance Testim is covered and my daily dosage is one 5 g tube of gel containing 50mg 1% testosterone.
So again I ask, does anyone know if there is a medical reason for maintaining the dosage as low as possible to keep me below the lower limits of normal? Is there a detrimental side-effect to maintaining higher, middle of normal range, blood levels of total and free testosterone?
As I've aged I've lost a lot of muscle mass. My erection certainly isn't what it once was and has failed me on occasion. My mood has been fairly even with some negative thoughts as normal.
Here are my labs from 3 weeks ago:

total testosterone was 159.4 ng/dl (normal range is 193 to 950)

and free testosterone 21.2 pg/ml (normal range is 46 to 224)

What other lab work is good to know for regulating trt dosage?

Thank you

 

[Systemlord]

The endocrine society defines low testosterone below 300 ng/dL and even this is considered too low my most experts, a lot of doctors confuse labs ranges with healthy ranges. Labcorps ranges for testosterone is 264-916 ng/dL, yet low testosterone is defined below 300 ng/dL.

Life expectancy is higher with testosterone in the high normal ranges, men below 300 have a higher mortality rate, your doctor is just incompetent and likely knows very little about sex hormones.

Endocrinologist typically are ignorant with anything related to sex hormones, they specialize in diabetes and hypothyroidism and most doctors in managed healthcare have no clue how to do TRT.

Tropical testosterone generally is absorbed poorly by the majority of men and injections is the most effective way to raise testosterone. SHBG is important and dictates the type of TRT protocol, testosterone and estrogen binds to SHBG. SHBG also affects your Total T and Free T levels.

An E2 sensitive test is also critical, estrogen to high or too low can affect erections and libido in men. Total T, Free T, SHBG and Sensitive Estrogen (LC/MS/MS method) should be used to periodically check your levels to see where you are.

I would like to see your thyroid labs including Free T3 and Reverse T3 as these are needed to balance out your thyroid when on thyroid medications.

Testosterone Threshold for Increased Cardiovascular Risk in Middle-Aged and Elderly Men:

These data showed that a testosterone threshold of 440 ng/dL was associated with increased Framingham 10-year CVD risk in middle-aged and elderly men. Poor sexual performance, decreased morning erection, and loss of libido had an impact on the testosterone threshold for CVD risk. The threshold level was higher in men with sexual dysfunction. Further study is required to evaluate the validity of these testosterone thresholds for CVD risk.

 

[Mike.M]

Thank you, guys for the good information.

 

[Tommy Wall]

Obviously your Testim treatment is not working you might need to apply more or you have problem with the it absorvation (which is not rare).
You could try to apply it on your scrotum instead and to checked up with labs (DHT might become high) or try injections that will surely put you on the right level.