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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Side Effect Management
Should We Be Managing Estradiol and Hematocrit in Men on Testosterone Replacement?
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<blockquote data-quote="J. Keith Nichols MD" data-source="post: 71097" data-attributes="member: 15691"><p>The first thing to look for is symptom improvement after starting TRT. The problem recently with labCorp is that they changed the reagent so now when you order a free T you will get a response of "too high to measure". The same thing just happened with the testing of a women's progesterone. I find that my patients are most optimal at a free T level of 30-50 and some even higher (it's just a number and I am treating symptoms ). With the current test it won't give you those numbers so we have to order a equilibrium ultra filtration test which is a more specialized test and will give me the actual free T level no matter what the value. Believe me, we have no complaints when a free T is maintained at a optimal level 24/7. So in summary, the total T is insignificant really. It is the free T you are looking to optimize. If your free T Is in a optimal range don't worry about total. The most simple test that I tell my patients is if they are having consistent morning erections. If you are then you are optimal. This will also start another thread but don't look to lower your SHBG. The higher the better. I can send you all the studies. You don't want to lower SHBG to raise T, you just increase the T dosage. When you increase your T you also increase your E2 which also increases SHBG and all three are beneficial. Just follow your free T and get that 30-50 and I assure you you will not worry about your E2 or SHBG</p></blockquote><p></p>
[QUOTE="J. Keith Nichols MD, post: 71097, member: 15691"] The first thing to look for is symptom improvement after starting TRT. The problem recently with labCorp is that they changed the reagent so now when you order a free T you will get a response of "too high to measure". The same thing just happened with the testing of a women's progesterone. I find that my patients are most optimal at a free T level of 30-50 and some even higher (it's just a number and I am treating symptoms ). With the current test it won't give you those numbers so we have to order a equilibrium ultra filtration test which is a more specialized test and will give me the actual free T level no matter what the value. Believe me, we have no complaints when a free T is maintained at a optimal level 24/7. So in summary, the total T is insignificant really. It is the free T you are looking to optimize. If your free T Is in a optimal range don't worry about total. The most simple test that I tell my patients is if they are having consistent morning erections. If you are then you are optimal. This will also start another thread but don't look to lower your SHBG. The higher the better. I can send you all the studies. You don't want to lower SHBG to raise T, you just increase the T dosage. When you increase your T you also increase your E2 which also increases SHBG and all three are beneficial. Just follow your free T and get that 30-50 and I assure you you will not worry about your E2 or SHBG [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Side Effect Management
Should We Be Managing Estradiol and Hematocrit in Men on Testosterone Replacement?
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