Targeting Total or Free Testosterone?

[VacationMan]

Apologize if this has been asked before...but...

I'm one of those with relatively low SHBG. That said, my free T is somewhat elevated even when total T is in the low end of normal.

So question (and this stems from dealing with thyroid issues and finally getting that normalized): Should we target getting free testosterone or total testosterone in range? Reason I ask: I'm on a 2x per week shot protocol (t.cyp). Taking right at .2 CC each time (roughly 40mg), on a Tue morning/Fri evening schedule (once every 3.5 days). I typically have blood work done on Monday mornings or Friday afternoons - before I take my next shot. Doc only tests for total T and total estrogen (I'm on my way to kick him to the curb and let Defy handle this). Current doc is more or less a prescription writer than anything else. Total testosterone is generally betwen 750 and 900, and total estrogen is in range as well. I have had E2 tested and it's typically between 18 and 30, so good there too. Even so, my free T is consistently elevated above "normal". Example: Total testosterone at 782 ng/dL (scale of 264 - 916) with free testosterone measuring 27.2 pg/mL (scale of 7.2 - 24.0).

Being low SHBG (26 nmol/L, scale of 19.3 - 76.4), I tend to plow through testosterone faster than most. What I've noticed is that my morning "good news" (morning wood) happens most frequently the morning before I take my shot. The rest of the time, not so much. Could it be that I need to pay more attention to free T rather than total T?

Anyone else encounter this?

 

[Cataceous]

You have the right idea, but if you're using the standard direct free T test then know that it is not accurate. Alternatives are to use an accurate, but more expensive test, such as equilibrium dialysis or ultrafiltration, or use the Tru-T calculator after measuring total testosterone and SHBG.

Your SHBG of 26 nMol/L is not low. I'd say it's within the optimal range of 25-35. Using your TT value of 782 ng/dL we find Tru-T FT is 28 ng/dL (with default albumin). This is within the healthy normal range of 16-31. However, it's at the higher end, so it is quite possible that you would do better overall with a somewhat lower dose. I would experiment with a 10-25% dose decrease and give it some months to fairly evaluate. Keep in mind that dose decreases are difficult because initially you may feel bad and be tempted to abandon the experiment. But try to see it through, as many guys do feel better with less.

Also, you might consider injecting more often. Your peak testosterone on twice-weekly injections may be as much as 50% higher than what you're seeing at the troughs.

 

[Vince]

I agree with cataceous, your not a low shbg guy. You could increase your injection schedule. More frequent injections could eliminate your picks and valleys.