Testosterone Blood Work "Calculated Method"

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Hello,

Got my blood test done using the calculated method to see what that test looked liked for me. Here are the results:
Total Testosterone: 752 ( 250-1100 )
Free Testosterone: 86 ( 45-200 )
Bioavailable: 172 ( 110-275 )

I do not think they tested for SHBG but its probably high like always and looks like it with these numbers. Once again I'm 27 years old and not on TRT but still have low t symptoms most of the time. Just want to make sure its low free t before I go the TRT route. I heard the calculated method is pretty reliable other than the equilibrium method.
 
Defy Medical TRT clinic doctor
They would have needed SHBG to do the calculation, and ideally albumin too. These days we need to consider which method is used for the calculation. In the past the Vermeulen method was the most common. But we should be switching over to the TruT method, as it is better aligned with equilibrium dialysis results. A tip of the hat to @madman for publicizing this.

I suspect your free T result is 8.6 ng/dL by the Vermeulen method. It's not super low, but we would start to see guys reporting low T symptoms when these numbers get below 10 or so.
 
They would have needed SHBG to do the calculation, and ideally albumin too. These days we need to consider which method is used for the calculation. In the past the Vermeulen method was the most common. But we should be switching over to the TruT method, as it is better aligned with equilibrium dialysis results. A tip of the hat to @madman for publicizing this.

I suspect your free T result is 8.6 ng/dL by the Vermeulen method. It's not super low, but we would start to see guys reporting low T symptoms when these numbers get below 10 or so.
Is the Vermeulen method the same as the free t direct test? I heard that test is very unreliable.
 
Is the Vermeulen method the same as the free t direct test? I heard that test is very unreliable.
No, the Vermeulen method is a way to calculate free testosterone using total T, SHBG and albumin. The direct free T test is an inexpensive and inaccurate way to measure free testosterone.
 
They would have needed SHBG to do the calculation, and ideally albumin too. These days we need to consider which method is used for the calculation. In the past the Vermeulen method was the most common. But we should be switching over to the TruT method, as it is better aligned with equilibrium dialysis results. A tip of the hat to @madman for publicizing this.

I suspect your free T result is 8.6 ng/dL by the Vermeulen method. It's not super low, but we would start to see guys reporting low T symptoms when these numbers get below 10 or so.


I see you are still doing reruns on this?

You have been given solid advice on here from numerous members on the board regarding this!



OCT.13/2017

I am a 25 year old male with no medical issues. I am completely natural and not on any TRT or anything. For a couple years now I have been experiencing symptoms of low testosterone. The blood work I have is not anywhere saved on my computer so Im just going to type in my results.

Total Testosterone-687ng/dl (250-1100)
Free Testosterone-73.5pg/ml (46-224)
SHBG-40nmol/L (10-50)
Estradiol-36pg/ml (<or =39)
LH-2.9 (1.6-9.3)
FSH-4.3 (1.6-8.0)
TSH-1.39 (0.40-4.50)
T4 free-1.3 (0.8-1.8)
T3 total-72 (76-181) LOW
DHEA-484 (61-1636)
Vitamin D-32(30-100)

So my symptoms I have been having are partial ED, No morning wood, impossible to build muscle and strength even though I work out 5 days a week hard, can't burn any fat, no pumps in gym, libido is ok, no motivation. So by going by these labs does any thing seem off?? The doctors Ive been to keep telling me I'm normal but I keep on having symptoms. Any advice would be great.
*important note, when I take a natural test booster like D aspartic acid, I can really feel an improvement in the gym with strength and pump for a couple weeks then it wears off.

OCT.17/2017

My first test which was in Jan of 2017:
Total Testosterone:623ng/dl (250-1100)
Free Testosterone:73.5pg/ml (46-224)
Testosterone,Bioavailable:154.3 (110-575)
SHBG:40 (10-50)
Estradiol:36 (<or=39) Also had my estradiol measured at 30 before.
T3 total: 72 (76-181)

My test in August of 2017:
Total Testosterone: 730ng/dl (250-1100)
Free Testosterone: 77pg/ml (46-224)
SHBG: 47 (10-50)

Also I am not on any TRT and I'm 25 years old. Just trying to figure out why my free Testosterone seems a little low because I have a feeling that is what is causing my symptoms.

DEC19./2017

Defy Medical Blood Work-SHOCKED AT RESULTS!






JAN.15/2018

Free test and SHBG



You stated....."872 total test and 22.6 free test. Range I think was from 242-917 for total and 9.6-26.5 for free. SHBG was 71 with range from 10 -50ish I think"



AUG.10/2018

High SHBG

You stated......"Is rare for a younger guy to have high SHBG? My total testosterone is usually anywhere from 600-800 but my SHBG is always top of reference range or more . I’ve also tried everything possible to raise my free testosterone naturally but to no avail. Is testosterone therapy the only thing that fix high SHBG to free up more test? Also does anybody know if SARMS can lower SHBG?"


OCT.13/2018


Latest labs 10/13
Latest labs 10/13





You stated.....

Total testosterone-657 (264-916)
Free Testosterone (direct)-23.4 (9.3-26.5)
LH-5.8 (1.7-8.6)
FSH-3.6 (1.5-12.4)
Estradiol sensative-17.2 (8.0-35.0)
SHBG-53.5 (16-55.9)

It looks like I'm neither primary or secondary and I just have high SHBG. In my next consult I am going to ask to go on TRT. My total testosterone is good but with my SHBG being so high it is really lowering my free testosterone even though my free is at the top of range. Is direct free testosterone a reliable test? I have all the symptoms of low t but with those numbers would you consider TRT?


OCT.21/2018

HCG WHILE ON TRT

You stated.....

Oct 21, 2018
Thread starter #1
I'm going to be starting TRT soon but I have a question about HCG. Is it needed right away? I am looking to preserve my fertility since I'm 26 years old while on TRT but I am not going to try have any kids any time soon. Is it possible I could start HCG when the times comes when I want to try to have a kid or do you need to use it all the time while on TRT? I also heard mixed stories about HCG making TRT better and worse. So I'm kind of cautious about trying HCG. Is there also still a slight chance that given my age I can somehow remain fertile while on TRT without taking HCG?





OCT.30/2018

TRT protocol

Finally you decided to take the plunge and Defy prescribed you a trt protocol.....which you ended up bailing out on!


You stated....."How many mg is 200mg/ml of Test Cyp 0.38ml twice weekly? Sorry I never injected before and have no idea about the dosages. Does this protocol seem like it will work for a high shbg guy like me?"






NOV.7/2018


Low t clinics





You remember this thread clearly.....NO?

This is the explanation you gave as to why you decided to bail out on the Defy protocol.

You stated "Long story short. I live with my parents and they freaked out when they seen the needles and testosterone mailed to me. I actually do not feel comfortable injecting myself like that and would rather have a doctor do it in person for me. I also do not feel comfortable injecting testosterone in my body that’s been shipped. I guess I will just sell to some gym rat that’s at my gym"


Not only did you bail out on Defy treating you which is top of the line.....you than eventually decide to ask/get treated by a Low-T clinic!


DEC.22/2018

New blood work

You stated.....

Hi guys,

I just got some recent bloods taken for total t, free t, bio t, and shbg. Any comments our advice is appreciated. Not on TRT BTW.

Total testosterone- 517ng/dl (250-1100)
Free testosterone- 52.3pg/ml (46.0-224.0)
Bioavailable testosterone- 154.3ng/dl (110.0-575.0)
SHBG- 42 (10-50)


I finally was able to see that my free testosterone is much lower on this test with Quest Diagnostics then it is on the direct free testosterone test with Lab corp. I might be looking into starting TRT with a low t clinic around my area that accepts my insurance.



JAN.12/2019

Starting TRT soon with low t clinic

You stated.....yet when you were with Defy one of the best you still persist to ask.....Looking for opinions on what to start with?"

"I will be starting TRT with a men's clinic here soon in the next week or so. I don't know my protocol yet but I heard it is smart to just start with testosterone only. I want start with testosterone and hcg right away to preserve fertility since I'm 27 years old though. Looking for opinions on what to start with?"



FEB.1/2019

150mg testosterone enathate a week



Still persisting to ask as you stated.....

"Would a once weekly injection of 150mg testosterone enathate be enough for a High SHBG(50-70's) guy like me since it has a long half life of 8-9 days? or would twice a week at 75mg be better?"
 
Last edited:
MAR.6/2019


This is where I want to nip this all in the bud.

You finally had your free testosterone levels testing using Equilibrium Dialysis considered the gold standard.....unfortunately this thread is missing (need to look into).

3/2 blood work-testosterone equilibrium

You very well know that your FT levels came back in a descent range and to top it off @Cataceous replied giving his solid opinion.
 
APR.14/2019

1st 2 first shots of T cyp



You finally take the plunge.....only to bail out again?


After my first 2 shots of T cyp at 70mg each I feel fatigued and weaker. Maybe a little worse then I first started. Is this normal since my levels are fluctuating or should I be feeling great since I'm basically adding to my natural production right now?
 
Now we are back to square one again as you persist to ask the same questions over and over when in fact you know where testing stands on getting an accurate measurement of ones FT levels.




Hello,

Got my blood test done using the calculated method to see what that test looked liked for me. Here are the results:
Total Testosterone: 752 ( 250-1100 )
Free Testosterone: 86 ( 45-200 )
Bioavailable: 172 ( 110-275 )


I do not think they tested for SHBG but its probably high like always and looks like it with these numbers. Once again I'm 27 years old and not on TRT but still have low t symptoms most of the time. Just want to make sure its low free t before I go the TRT route. I heard the calculated method is pretty reliable other than the equilibrium method.



-------------------------------------------------------------------------------------------------------
Did you miss this by any chance.....highly doubtful!




Unfortunately regarding testing ones FT (free testosterone) most are using the direct analog-based free testosterone immunoassays which are inaccurate.

If anything you should be getting the equilibrium dialysis or better yet save yourself the money and use the Calculate free testosterone with TruT by FPT - Try the public free testosterone calculator at tru-t.org

Do you truly know your FT levels?




500726: Testosterone, Free, Mass Spectrometry... | LabCorp

Testosterone, Free, Mass Spectrometry/Equilibrium Dialysis (Endocrine Sciences)

TEST:500726
Test number copied

CPT: 84402; 84403






Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline (2018)


Testosterone Therapy in Men With Hypogonadism: An Endocrine Society * Clinical Practice Guideline



In men who have conditions that alter sex hormone–binding globulin (SHBG) (Table 2), or whoseinitial total testosterone concentrations are at or near the lower limit of the normal range (Fig. 1), clinicians should determine free testosterone concentrations either directly from equilibrium dialysis assays or by calculations that use total testosterone, SHBG, and albumin concentrations. Clinicians should not use direct analog-based free testosterone immunoassays, as they are inaccurate.
 
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