On TRT Endo worried about "Skyhigh Bioavailable Testosterone)

beav1875

New Member
So everything in my blood panels look great, I'm on 100 mg a week of test cypionate split into two doses .50 each a week. E2 lc/ms is 23, Total T he also ran as Lc/ms and its 589, Free T was 27 shbg was 24. He told me today he wants to cut my dose to .75 a week because my bioavailable testosterone was in the 200's. I understand Total, and free. I also know I feel great where I am right now. Can anyone explain what the big deal is if my "Bioavailable Testosterone" is high?
 
So everything in my blood panels look great, I'm on 100 mg a week of test cypionate split into two doses .50 each a week. E2 lc/ms is 23, Total T he also ran as Lc/ms and its 589, Free T was 27 shbg was 24. He told me today he wants to cut my dose to .75 a week because my bioavailable testosterone was in the 200's. I understand Total, and free. I also know I feel great where I am right now. Can anyone explain what the big deal is if my "Bioavailable Testosterone" is high?


100 mg/week is by no means a high dose and is actually a common starting dose for trt.

Forget worrying about TT as FT is what truly matters as it is the unbound active fraction of testosterone responsible for the positive benefits.

Most men do well having FT 2-3% of TT.

Seeing as your TT is 589 and your SHBG is 24 when using the Free & Bioavailable Testosterone calculator (Vermeulen method) your FT is 2.56% and your BT is 60.1%.....by no means high. Free & Bioavailable Testosterone calculator

Your doctor is senseless as you stated "I also know I feel great where I am right now"

So why would he want to lower your dose as not only did you state "So everything in my blood panels look great" but you feel great and are experiencing no negative effects.....this one is a no brainer here......find a new doctor!

When was your blood work done at trough?

When did you start trt?

Also post ranges for your labs.

Blood work is important and critical to know but treating ones symptoms is what truly matters.
 
Last edited:
100 mg/week is by no means a high dose and is actually a common starting dose for trt.

Forget worrying about TT as FT is what truly matters as it is the unbound active fraction of testosterone responsible for the positive benefits.

Most men do well having FT 2-3% of TT.

Seeing as your TT is 589 and your SHBG is 24 when using the Free & Bioavailable Testosterone calculator (Vermeulen method) your FT is 2.56% and your BT is 60.1%.....by no means high. Free & Bioavailable Testosterone calculator

Your doctor is senseless as you stated "I also know I feel great where I am right now"

So why would he want to lower your dose as not only did you state "So everything in my blood panels look great" but you feel great and are experiencing no negative effects.....this one is a no brainer here......find a new doctor!

When was your blood work done at trough?

When did you start trt?

Also post ranges for your labs.

Blood work is important and critical to know but treating ones symptoms is what truly matters.
Blood work was done on Friday, last shot was Wednesday so that’s peak. I have been on TRT for nearly a year now. I tried on my own to go down to .90 about 4 months ago and on week three I felt like I wasn’t on trt at all. I told him this and he stated there are other reasons I could have felt that way besides lower testosterone. I guess he’s right but on 100mg a week since I haven’t felt that. I will get the ranges and post them when I get home
 
Blood work was done on Friday, last shot was Wednesday so that’s peak. I have been on TRT for nearly a year now. I tried on my own to go down to .90 about 4 months ago and on week three I felt like I wasn’t on trt at all. I told him this and he stated there are other reasons I could have felt that way besides lower testosterone. I guess he’s right but on 100mg a week since I haven’t felt that. I will get the ranges and post them when I get home


Your endo doesn't care about how you feel, he cares about getting in trouble for allowing your Free T to be very high. Endo is like a dirty word in the TRT world because they would rather chase a number on paper and ignore the patient telling him that he feels amazing.

This is how managed health operates, treating the reference ranges and ignore the symptoms or lack thereof. I believe for this reason managed healthcare can't do TRT effectively as they are handcuffed by insurance companies.

If you went to a private doctor you wouldn't have to worry about running very high Free T as long as your other labs looked healthy.
 

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⚠️ Medical Disclaimer

This tool provides predictions based on statistical models and should NOT replace professional medical advice. Always consult with your healthcare provider before making any changes to your TRT protocol.

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Understanding Your Hormones

Estradiol (E2)

A form of estrogen produced from testosterone. Important for bone health, mood, and libido. Too high can cause side effects; too low can affect well-being.

DHT

Dihydrotestosterone is a potent androgen derived from testosterone. Affects hair growth, prostate health, and masculinization effects.

Free Testosterone

The biologically active form of testosterone not bound to proteins. Directly available for cellular uptake and biological effects.

Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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