Super High Total T and Low Free T: Albunim binding? Or DHT?

[RonMexico]

I have been on TRT 6 years. Switched 2 years ago to a hybrid protocol of Daily Sub Q shots and daily testosterone cream. My protocol is weekly 140 mg testosterone from Wells Pharmacy. It is a blend of 80% cypionate and 20% Propionate . My doctors preferred pharmacy and choice, not mine. I am also doing 1 click 50 mg of a 200 mg cream applied to my scrotum daily. This is to raise DHT and give me a sex drive which is zero without the cream.

My challenge is my labs are always very strange. They have been for 2 years on this protocol.

My total T will be mega high (1300-2200) and my free t will be super low (2 - 19).

I went for a 2nd opinion with Defy Medical. A doctor at Defy said he felt my Free T wasn't showing correctly on the labs. He felt the albumin might be binding the Free T or I was a high excretionor of testosterone.

He used a calculation to determine my free t:

Total T (>1500) / Albumin (4.6) and SHBG (16.2) and he said my Free T was 48.

He told me to not worry about the Free T level on the labs and to trust this calculation.

I found other calculators online that agreed with his math.

Note: My DHT was 240. Lab range is 30-85.


Question for the Board: Any one had this before where the numbers did not add up? Any reason why?

 

[Systemlord]

Question for the Board: Any one had this before where the numbers did not add up? Any reason why?

I have never seen this before. Maybe check the bioavailable next time along with the Free T.

You’re not taking biotin supplements are you?

 

[Cataceous]

This is demonstrating that the direct free testosterone test is useless and should be ignored. Clearly the calculated values are closer to reality, and in line with the very high doses of testosterone. If you want to verify further then you must test free testosterone with an accurate method, such as equilibrium dialysis or ultrafiltration.

The Labcorp tests are:

500726: Testosterone, Free, Mass Spectrometry/Equilibrium Dialysis (Endocrine Sciences) | Labcorp

Labcorp test details for Testosterone, Free, Mass Spectrometry/Equilibrium Dialysis (Endocrine Sciences)

www.labcorp.com

070038: Testosterone, Free, Equilibrium Ultrafiltration With Total Testosterone, LC/MS-MS | Labcorp

Labcorp test details for Testosterone, Free, Equilibrium Ultrafiltration With Total Testosterone, LC/MS-MS

www.labcorp.com

For Quest you can use Nelson's panel:

Testosterone, Free (Dialysis) and Total, LS/MS/MS

Get an affordable and accurate testosterone test results with our Total and Free (Equilibrium Dialysis) LC/MS test. Visit DiscountedLabs.com for more information.

www.discountedlabs.com