Total or free testosterone?

[johann]

Hi
Im wondering if I should go after Total or Free Testosterone.
If I have total in the high range like this blood test shows.
Total 988. reference 221-716ng/dl
Free 12.5 reference 7.0-36.7 ng/dl
SHB 80 reference 11-78 nmol/L

Then if I increase the T dose to go after the free T
it will look like this.
Total 1345. reference 221-716ng/dl
Free 24.1 reference 7.0-36.7 ng/dl
SHB 59 reference 11-78 nmol/L

My T dose for the later one is 40mg 2x a week so its not much.
My SHB and free looks better on the later one but my Dr is not happy when it goes over 1000.
Thanks in advance
Johann

 

[Cataceous]

Free testosterone is more important, but it must be measured by an accurate method. If yours wasn't measured by equilibrium dialysis or ultrafiltration then the numbers should be disregarded. Free testosterone calculators may be the next best thing. Assuming default albumin, the Vermeulen calculation has free T increasing from 12.6 to 24.5 ng/dL. The former figure is within the normal range, while the latter is above it. If these are trough measurements then peaks could be considerably higher. Chances are good that a lower dose would be more natural for you, and less likely to cause side effects.

 

[Systemlord]

Total 988. reference 221-716ng/dl
Free 12.5 reference 7.0-36.7 ng/dl
SHB 80 reference 11-78 nmol/L

Your Free T is a tad low here, you need a higher Total T because of high SHBG.

Total 1345. reference 221-716ng/dl
Free 24.1 reference 7.0-36.7 ng/dl
SHB 59 reference 11-78 nmol/L

These are healthy Free T levels and if your doctor can't comprehend this, find another doctor.

 

[johann]

Your Free T is a tad low here, you need a higher Total T because of high SHBG.



These are healthy Free T levels and if your doctor can't comprehend this, find another doctor.

I probably have over 20 blood test on record and the only time when I ran the total T up to 1345 that is when the SHBG got in to range and the free T got in a good range. And Im just using 80mg a week to get it up to that.

 

[bixt]

You haven’t told us, most importantly, how do you feel?

 

[johann]

You haven’t told us, most importantly, how do you feel?

I feel ok, I did bring my dose down from 80mg to 75mg a week and I will have a blood test next Friday, will see where my free t and SHBG at that dose, if the free t drops and SHBG goes out of range I will raise it again and compare better how I feel, did not compare it before..

 

[johann]

After lowering my test to 75mg spilt to twice a week it came in at

TESTOSTERONE, TOTAL

1,008 ng/dL

221 - 716 ng/dL

TESTOSTERONE, FREE, CALCULATED

13.9 ng/dL

7.0 - 36.7 ng/dL

SEX HORMONE BINDING GLOBULIN

73 nmol/L

11 - 78 nmol/L

I don't thing I feel any better there, might go back up to my previous number where my free t is at 24

 

[Belekas]

Whats the timeframe between your last change in variables?

 

[TLawyer]

After lowering my test to 75mg spilt to twice a week it came in at

TESTOSTERONE, TOTAL

1,008 ng/dL

221 - 716 ng/dL

TESTOSTERONE, FREE, CALCULATED

13.9 ng/dL

7.0 - 36.7 ng/dL

SEX HORMONE BINDING GLOBULIN

73 nmol/L

11 - 78 nmol/L

I don't thing I feel any better there, might go back up to my previous number where my free t is at 24

Probably need to give it a few weeks to see how you'd really feel at these numbers.

 

[johann]

Whats the timeframe between your last change in variables?

10/14/21	3/17/22	7/22/22

75mg a week. 80mg a week. 75mg a week
I went up to 80mg a week 2 months before the blood-test on the 3/17 and back down to 75mg 4 weeks before the last draw.

 

[madman]

After lowering my test to 75mg spilt to twice a week it came in at

TESTOSTERONE, TOTAL

1,008 ng/dL

221 - 716 ng/dL

TESTOSTERONE, FREE, CALCULATED

13.9 ng/dL

7.0 - 36.7 ng/dL

SEX HORMONE BINDING GLOBULIN

73 nmol/L

11 - 78 nmol/L

I don't thing I feel any better there, might go back up to my previous number where my free t is at 24

You need to have your FT tested using an accurate assay (Equilibrium Dialysis or Ultrafiltration), especially in cases of altered SHBG!

What's Coming? Accurate measurement of total and free testosterone levels for the diagnosis of androgen disorders - Excel Male TRT Forum

Accurate measurement of total and free testosterone levels for the diagnosis of androgen disorders (7/2022) Ezgi Caliskan Guzelce, MD, Clinical/ Research Fellow, Francesca Galbiati, MD, Fellow, Anna L. Goldman, MD, Assistant Professor of Medicine, Arijeet K. Gattu, MD, Fellow, Shehzad Basaria...

www.excelmale.com

When Binding Proteins Interfere With Immunoassays - Excel Male Men's Health Forum

https://www.aacc.org/cln/articles/2022/june/when-binding-proteins-interfere-with-immunoassays WHY ARE ABNORMAL BINDING PROTEIN CONCENTRATIONS AN ISSUE FOR IMMUNOASSAYS? Immunoassay detection relies on noncovalent binding interactions between the receptor and the target analyte. These...

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[johann]

You need to have your FT tested using an accurate assay (Equilibrium Dialysis or Ultrafiltration), especially in cases of altered SHBG!

What's Coming? Accurate measurement of total and free testosterone levels for the diagnosis of androgen disorders - Excel Male TRT Forum

Accurate measurement of total and free testosterone levels for the diagnosis of androgen disorders (7/2022) Ezgi Caliskan Guzelce, MD, Clinical/ Research Fellow, Francesca Galbiati, MD, Fellow, Anna L. Goldman, MD, Assistant Professor of Medicine, Arijeet K. Gattu, MD, Fellow, Shehzad Basaria...

www.excelmale.com

When Binding Proteins Interfere With Immunoassays - Excel Male Men's Health Forum

https://www.aacc.org/cln/articles/2022/june/when-binding-proteins-interfere-with-immunoassays WHY ARE ABNORMAL BINDING PROTEIN CONCENTRATIONS AN ISSUE FOR IMMUNOASSAYS? Immunoassay detection relies on noncovalent binding interactions between the receptor and the target analyte. These...

www.excelmale.com

I will ask my dr for that for the next test.
Thanks

 

[madman]

I will ask my dr for that for the next test.
Thanks

Would not start tinkering with your protocol (dose T/injection frequency) until you have a better idea of where your FT truly sits.

Need to have it tested using an accurate assay, especially in cases of altered SHBG!

 

[johann]

Would not start tinkering with your protocol (dose T/injection frequency) until you have a better idea of where your FT truly sits.

Need to have it tested using an accurate assay, especially in cases of altered SHBG!

Yes, I have been really consistent with my protocol for a long time, only change I went from 75mg to 80mg that's all, just to see if I would feel better or have more energy.