Total Teststerone Low But Free T in Normal Range?

[callebs]

My first test results from LabCorp showed my total T very low (156), but free T was actually within the reference range, though on the low end (9.8 with ref range of 7.2 - 24.0). Is this unusual? Any thoughts as to why? It almost makes me question the accuracy of the lab test. And regardless of the numbers, I am very symptomatic, with brain fog, fatigue, muscle weakness, sleepy after dinner, etc.

 

[Vince]

You probably have low shbg which gives you High free T. Low shbg can really make trt of struggle, members usually do more frequent injections with low shbg.

 

[callebs]

You probably have low shbg which gives you High free T. Low shbg can really make trt of struggle, members usually do more frequent injections with low shbg.

SHBG is 30.6 with a reference range of 19.3 - 76.4. I was thinking of trying a compounded cream first, does that seem advisable since I would be applying it daily as opposed to less frequent injections? LH is also low (1.4), not sure how that would play into the TRT.

 

[Gman86]

SHBG is 30.6 with a reference range of 19.3 - 76.4. I was thinking of trying a compounded cream first, does that seem advisable since I would be applying it daily as opposed to less frequent injections? LH is also low (1.4), not sure how that would play into the TRT.

So even though 30.6 isn't going to seem very low to most members, it actually is very low. We have to factor in the reference range here. 19.3-76.4. Not sure if most of us go by this range, but me personally I use Quest which has a range of 10-50. So for Quest 30.6 would be mid range, but for Labcorp, your SHBG is very low, which is why your free T is actually pretty good considering how low your total T is. So anyone looking at this thread, make sure you consider the reference ranges when looking at his SHBG of 30.6.

Not sure about the compounded cream, as I have no experience or knowledge about it. But once you're on TRT, whether it be injections, cream or any other form, your LH and FSH go to basically zero. So while on TRT, LH and FSH have absolutely zero significance. There's no point of even testing them. They will just show either 0, or very close to 0.

 

[Vince]

When I started trt I refused to testosterone cream or gels, I was afraid of contaminating my lover or my grandkids. For me injections are much faster and simpler than gels.

 

[Gman86]

When I started trt I refused to testosterone cream or gels, I was afraid of contaminating my flowers for my grandkids. For me injections are much faster and simpler than gels.

I agree. Injections are what 9/10 guys use for a reason. Plus we all pretty much use tiny insulin needles to inject our testosterone now, so you barely even feel it. Quick, painless and effective.

 

[Vince]

I agree. Injections are what 9/10 guys use for a reason. Plus we all pretty much use tiny insulin needles to inject our testosterone now, so you barely even feel it. Quick, painless and effective.

I agree I use the Easy Touch 29g 1/2 inch syringe for both by testosterone and HCG injections, simple and virtually painless.

 

[callebs]

I've been trying to decide between cream vs. injection, as both Dr. Crisler and Nelson Vergel have said that transdermals get an unfairly bad rap among TRT patients, and I know there are some people on this forum who are doing great on creams. Honestly everything I've been reading about the different treatment types, taking HCG (or not), Anastrozole, DHEA, etc. is really overwhelming, and I'm afraid of making the wrong choice and wind up feeling worse than I do now (which I don't even want to imagine). My urologist recommended starting injections but I have a telemed appointment with a Dr. at Defy on June 20th so maybe I'll hold off until I talk to him.

 

[Vince]

I've been back and forth on cream vs. injection, as both Dr. Crisler and Nelson Vergel have said that transdermals get an unfairly bad rap among TRT patients, and I know there are some people on this forum who are doing great on creams. Honestly everything I've been reading about the different treatment types, taking HCG (or not), Anastrozole, DHEA, etc. is really overwhelming, and I'm afraid of making the wrong choice and wind up feeling worse than I do now (which I don't even want to imagine). My urologist recommended starting injections but I have telemed appointment with a Dr. at Defy on June 20th so maybe I'll hold off until I talk to him.

You are in good hands with Dr. Says, write down all your questions and be well prepared. For me as you know injections are number one, but you're right so men do prefer gels. I think at times we complicate trt too much, for me is pretty simple testosterone, HCG and DHEA.

Vince's testosterone panel from 6/12/2018

https://www.excelmale.com/forum/showthread.php?15162-Vince-s-testosterone-panel-from-6-12-2018

 

[Systemlord]

This is enough to sway the decision for most men. --> https://www.ncbi.nlm.nih.gov/pubmed/29542875

[h=4]CONCLUSIONS:[/b]

Intramuscular TRT is more effective than transdermal formulations at increasing LBM and improving muscle strength in middle-aged and older men, particularly in the lower extremities.

 

[callebs]

So even though 30.6 isn't going to seem very low to most members, it actually is very low. We have to factor in the reference range here. 19.3-76.4. Not sure if most of us go by this range, but me personally I use Quest which has a range of 10-50. So for Quest 30.6 would be mid range, but for Labcorp, your SHBG is very low, which is why your free T is actually pretty good considering how low your total T is. So anyone looking at this thread, make sure you consider the reference ranges when looking at his SHBG of 30.6.

I guess what I don't understand is, if the free/bioavailable T is within normal range, why am I having so many bad symptoms? I thought the free T was the main decider of whether a person experiences symptoms, but obviously my low total T is causing problems. Whenever someone reports on their test results while on TRT, that total number is always the one they focus on...

 

[callebs]

You are in good hands with Dr. Says, write down all your questions and be well prepared. For me as you know injections are number one, but you're right so men do prefer gels. I think at times we complicate trt too much, for me is pretty simple testosterone, HCG and DHEA.

Vince's testosterone panel from 6/12/2018

https://www.excelmale.com/forum/showthread.php?15162-Vince-s-testosterone-panel-from-6-12-2018

Unfortunately I didn't get an appt. with Dr. Saya, he was booked well into August and I really need to do something asap so they booked me with another doctor (can't remember the name she said but I think it started with C, though not Crisler).

The DHEA is another concern, I know some men take this in conjunction with TRT but my DHEA-Sulfate level is off the chart at 616.7, so I can't imagine I would need to take additional amounts of that, if it's the same thing.

Congratulations on your success! I've been attentive to all of your replies on everyone's pots since it's obvious you've done your research and appear to have your protocol pretty much dialed in.