Thoughts on latest labs

[Pringle]

Just got my 6 weeks labs back after switching to Defy for HCG.
Initial labs at consult were:
Total T 1117 ng/dl range 264-916
Free T 29.7 pg/ml range 7.2-24.0
Estradiol sens 45.3pg/ml range 8.0-35
Shbg 46.2 nmol/l range 19.3-76.4
DHEA-s 116 ug/dl range 71.6-375.4
Progesterone .4g/dL range 0-.5

After adding DHEA 25mg daily, HCG 500 iu E3.5d, anastrozole .125 E3.5d, lowering my T dose to 40mg E3.5d from 50mg my results now are:
Total T 863
Free T 33.7
Estradiol 24.4
DHEA 468.2
Shbg 38.0
Progesterone .4

The obvious I need to lower the daily dose of DHEA. Larger question is Total testosterone to Free ratio. If you go by labcorp standards I am 33pg/ml. If I evaluate based on SHBG and Albumin through the calculator it is closer to 19pg/ml. What are your thoughts on proper method to evaluate free T? My doc that manages my Hemotology covers my T prescription to allow insurance reimbursement. He gets a little cautious when I am over top of range, but I feel better closer to 1000 total T. Thoughts?

 

[CoastWatcher]

Is your doctor aware that it was just last summer that LabCorp adjusted their ranges? That means that an awful lot of men woke up one morning and were posting out-of-range total testosterone values. The only change? LabCorp arbitrarily fiddling with their internal ranges. I raise this to point out that it makes little sense for him to react so negatively to something that has no clinical implications. Numbers/lab values in this game are certainly important, but to lock-step every patient into a range (without understanding the politics behind the range) is foolish. Feel good closer to 1000? I'd argue to stay there.

 

[Pringle]

Thanks for the input. I may just take my whole regimen thru Defy. Will Cost a little more out of pocket, but don’t have to be the one continuously trying to educate the doc!

 

[CoastWatcher]

Thanks for the input. I may just take my whole regimen thru Defy. Will Cost a little more out of pocket, but don't have to be the one continuously trying to educate the doc!

How much is peace of mind worth? Not being snide, I fully understand that costs have to be managed, but don't complicate your life if you can avoid it. It may be reasonable to have that discussion with your doctor once...but again and again...you start to dread the whole interaction.