There is something funny about these numbers - can anyone help me interpret them?

[jobshopper]

Back story: I am 68 years old and have been on my current protocol since April of 2020. I inject 100mg of Test C E3-1/2D. My PCP who has been overseeing my protocol for the past 4 years decided to retire leaving me without a PCP or anyone to manage my TRT.

I now have a new PCP. That means I have new challenges and he uses a different lab than the one I have been using for many years (Quest). He uses a lab called Laboratories Northwest.

Now to my issue. I had labs done in September of 2020. I have attached two pictures. The first one is my Quest Lab from last year and the second one is the one done on 5-11-21 by Laboratories Northwest.

I was shocked to see my Test T/Bioavailable Testosterone total numbers off of the chart. I asked a nurse at the PCP office (via telephone) about why there seemed to be two different numbers for my "Total T". She did not know and suggested I talk to the lab.

I asked the lab about this and they said that it was two different tests and that is why I have two different "Total T" values (1080 and 1630). Of course this makes no sense to me and I am hoping that someone can explain it to me?

 

[madman]

Back story: I am 68 years old and have been on my current protocol since April of 2020. I inject 100mg of Test C E3-1/2D. My PCP who has been overseeing my protocol for the past 4 years decided to retire leaving me without a PCP or anyone to manage my TRT.

I now have a new PCP. That means I have new challenges and he uses a different lab than the one I have been using for many years (Quest). He uses a lab called Laboratories Northwest.

Now to my issue. I had labs done in September of 2020. I have attached two pictures. The first one is my Quest Lab from last year and the second one is the one done on 5-11-21 by Laboratories Northwest.

I was shocked to see my Test T/Bioavailable Testosterone total numbers off of the chart. I asked a nurse at the PCP office (via telephone) about why there seemed to be two different numbers for my "Total T". She did not know and suggested I talk to the lab.

I asked the lab about this and they said that it was two different tests and that is why I have two different "Total T" values (1080 and 1630). Of course this makes no sense to me and I am hoping that someone can explain it to me?

View attachment 14276View attachment 14277

I know it was out of your hands but this is why we should always have blood work done using the same lab, same assays (most accurate) let alone when comparing.

You are on a whopping dose of T 200 mg/week (100 mg every 3.5 days) and as you can see in the 1st set of labs although your trough TT is not absurdly high it is in the upper end almost 900s but more importantly, your trough FT would be high as your SHBG is only 23 nmol/L.

Although TT is important to know FT is what truly matters as it is the active unbound fraction of testosterone responsible for the positive effects.

The only way to know where your FT level truly sits is to have it tested using the most accurate assays such as the gold standard Equilibrium Dialysis or Ultrafiltration.

Unfortunately, you did not have your FT tested using the most accurate assays (both sets of labs)!

Your trough FT is most likely much higher than you think.

Also, you never posted one of the most critical markers RBCs/hemoglobin/hematocrit (both sets of labs)?

Quest Diagnostics: Test Directory

testdirectory.questdiagnostics.com

The second set of labs:


TT 1080 ng/dL reference range (200-600 ng/dL).....seems odd?

TT 1630 ng/dL refernce range (240-950 ng/dL)


The bottom of the page states TT (LC/MS-MS).

Regardless of whether your trough TT truly sits at an absurd 1630 ng/dL or a very high 1080 ng/dL your trough FT would be very high--->absurdly high as your SHBG is only 31 nmol/L.

Again your FT was not tested using the most accurate assays (ED or UF) which is critical if you want to know where it truly sits.

My advice would be to take matters into your own hands and use Nelson's discounted labs which uses Quest and retest your TT and FT using the most accurate assays (ED or UF).

Then you can see whether your trough TT is closer to 1000 ng/dL or an absurd 1630 ng/dL.....let alone know where your FT level truly sits!

Many men would hit an absurdly high TT/FT level when injecting a whopping dose of T (200mg/week) let alone split twice-weekly (100 mg every 3.5 days).


Total Testosterone (LC/MS- No Upper Limit) and Free Testosterone (Equilibrium Dialysis)

Total and Free Testosterone Test Panel plus Hematocrit

Lowest Cost Hematocrit, Total and Free Testosterone Test Panel for Men on TRT

www.discountedlabs.com

Testosterone,Total, LC/MS and Free (Equilibrium Ultrafiltration)

Testosterone, Free (Dialysis) and Total, MS

Get an affordable and accurate testosterone test results with our Total Testosterone, M and Free (Equilibrium Dialysis) test. Visit DiscountedLabs.com for more information.

www.discountedlabs.com

 

[jobshopper]

I know it was out of your hands but this is why we should always have blood work done using the same lab, same assays (most accurate) let alone when comparing.

You are on a whopping dose of T 200 mg/week (100 mg every 3.5 days) and as you can see in the 1st set of labs although your trough TT is not absurdly high it is in the upper end almost 900s but more importantly, your trough FT would be high as your SHBG is only 23 nmol/L.

Although TT is important to know FT is what truly matters as it is the active unbound fraction of testosterone responsible for the positive effects.

The only way to know where your FT level truly sits is to have it tested using the most accurate assays such as the gold standard Equilibrium Dialysis or Ultrafiltration.

Unfortunately, you did not have your FT tested using the most accurate assays (both sets of labs)!

Your trough FT is most likely much higher than you think.

Also, you never posted one of the most critical markers RBCs/hemoglobin/hematocrit (both sets of labs)?

Quest Diagnostics: Test Directory

testdirectory.questdiagnostics.com

View attachment 14280




The second set of labs:


TT 1080 ng/dL reference range (200-600 ng/dL).....seems odd?

TT 1630 ng/dL refernce range (240-950 ng/dL)


The bottom of the page states TT (LC/MS-MS).

Regardless of whether your trough TT truly sits at an absurd 1630 ng/dL or a very high 1080 ng/dL your trough FT would be very high--->absurdly high as your SHBG is only 31 nmol/L.

Again your FT was not tested using the most accurate assays (ED or UF) which is critical if you want to know where it truly sits.

My advice would be to take matters into your own hands and use Nelson's discounted labs which uses Quest and retest your TT and FT using the most accurate assays (ED or UF).

Then you can see whether your trough TT is closer to 1000 ng/dL or an absurd 1630 ng/dL.....let alone know where your FT level truly sits!

Many men would hit an absurdly high TT/FT level when injecting a whopping dose of T (200mg/week) let alone split twice-weekly (100 mg every 3.5 days).


Total Testosterone (LC/MS- No Upper Limit) and Free Testosterone (Equilibrium Dialysis)

Total and Free Testosterone Test Panel plus Hematocrit

Lowest Cost Hematocrit, Total and Free Testosterone Test Panel for Men on TRT

www.discountedlabs.com

Testosterone,Total, LC/MS and Free (Equilibrium Ultrafiltration)

Testosterone, Free (Dialysis) and Total, MS

Get an affordable and accurate testosterone test results with our Total Testosterone, M and Free (Equilibrium Dialysis) test. Visit DiscountedLabs.com for more information.

www.discountedlabs.com

Thank you for the quick reply. I did not post the "... RBCs/hemoglobin/hematocrit (both sets of labs)" because they are good and in range. I can post them if you would like to see them. My question is which number (the 1080 or the 1630) is the correct number. I have to see my PCP next week and I don't want him making adjustments off of the wrong TT number. The lab person I talked to today said it was the 1080.

What is your best guess on which of the two numbers is correct?
And, why would there be two different values?
And, why would they be so different?
And, if the 1630 number is the correct TT then how did it go from 861 in September to where it is now on the same protocol?