unusually high free testosterone - 5 months in to t-cyp + hCG

[Re-Ride]

Comments requested on this very high free T from last weeks labs. SBGH was not done. Refer to Jan 01 labs below. No AI used.

Testosterone Total 250 - 1100 ng/dL 1133 (H)
Testosterone Free 35.0 - 155.0 pg/mL 325.4 (H)

(1) The calculator requires SBGH to calculate %. I forget if I need to convert pg/ml to ng/dL. Is this really 35% of total?
(2) Based upon normal trigs, normal lipids and reasonable hematocrit am I correct to not be concerned?

C Peptide 0.8 - 3.1 ng/mL 2.2
DHEA Sulfate 25 - 95 ug/dL 215 (H)
Estradiol (E2) <56 pg/mL 88 (H)
Progesterone 0.3 - 0.9 ng/mL 0.4
DIHYDROTESTOSTERONE 16 - 79 ng/dL 36
Pregnenolone 18-58 YEARS: 13 ng/dL 29
Vitamin D, 25-HYDROXY 30 - 100 ng/mL 53
Albumin 3.2 - 4.7 g/dL 3.8

Blood counts, chemistry, Lipids all resulted within normal range. I deleted numbers for a cleaner post:

WBC
Hemoglobin 13.5 - 18.0 g/dL 16.2
Hematocrit 40.0 - 52.0 % 48.3
MCV
MCH
MCHC
RDW
Platelet Count 150 - 400 K/uL 165

Sodium 136 - 145 mmol/L 143
Potassium 3.5 - 5.1 mmol/L 3.7
Chloride 98 - 110 mmol/L 106
CO2 (Bicarbonate) 21 - 32 mmol/L 28
Glucose 70 - 99 mg/dL 76
Urea Nitrogen (BUN) 6 - 25 mg/dL 28 (H)
Creatinine 0.50 - 1.30 mg/dL 1.20
GFR Est-Other
GFR Est-African American
Calcium 8.2 - 10.2 mg/dL 8.8
Total Protein 6.4 - 8.2 g/dL 7.1
Albumin 3.2 - 4.7 g/dL 3.8
Bilirubin Total <1.1 mg/dL 0.7
Alkaline Phosphatase 26 - 137 U/L 44
AST 0 - 37 U/L 20
ALT 0 - 60 U/L 31

Cholesterol <200 mg/dL 159
Triglycerides <150 mg/dL 120
HDL Cholesterol >40 mg/dL 41
LDL Cholesterol <130 mg/dL 94
Cholesterol/HDL Ratio <5.0 3.9
VLDL Cholesterol (Calculated) 5.0 - 40.0 mg/dL 24

Hemoglobin A1c 4.8 - 5.6 % 5.1
Average Glucose mg/dL 100
Testosterone Total 250 - 1100 ng/dL 1133 (H)
Testosterone Free 35.0 - 155.0 pg/mL 325.4 (H)
C Peptide 0.8 - 3.1 ng/mL 2.2
DHEA Sulfate 25 - 95 ug/dL 215 (H)
Estradiol (E2) <56 pg/mL 88 (H)
Progesterone 0.3 - 0.9 ng/mL 0.4
DIHYDROTESTOSTERONE 16 - 79 ng/dL 36
Pregnenolone 18-58 YEARS: 13 ng/dL 29
Vitamin D, 25-HYDROXY 30 - 100 ng/mL 53
--------

Jan 01 2016 - before t-cyp, hCG Mono only
Testosterone,Free 82.9 pg/mL 46.0 - 224.0 pg/mL
Testosterone,Bioavailable 188.5 ng/dL 110.0 - 575.0 ng/dL
SHBG 21 nmol/L 22 - 77 nmol/L L
Albumin,Serum 5.0 g/dL 3.6 - 5.1 g/dL
Total Testosterone 459 ng/dL 250 - 1100 ng/dL

 

[Vince Carter]

Youre Free T is 3.49%, over 3% is typically regarded as good to very good. Clear indicator of your SHBG is likely less than 21 as previously tested

 

[CoastWatcher]

Free testosterone is such a devil to capture in the lab. A study, here in Canada, at Queen's University, was urging doctors to rely more and more on the calculated value. You're feeling well?

 

[Cyp250]

Re-Ride,
How are you feeling with your levels where they are now? Also what is your dosage for T-Cyp?

 

[johndoesmith]

I'm curious why your DHT is so low. It's generally about 10% of total test. Are you taking any 5AR inhibitors?

 

[Re-Ride]

Youre Free T is 3.49%, over 3% is typically regarded as good to very good. Clear indicator of your SHBG is likely less than 21 as previously tested

Thanks Vince. Note the lab range though. They mark it high by over twice their "upper normal". My doc texted me with concern: "Must cut back on the hCG" Grateful for citations and the calculation you used to put him at ease.

I'm curious why your DHT is so low. It's generally about 10% of total test. Are you taking any 5AR inhibitors?

John, I take nothing but the supplements and aminos posted elsewhere on these pages. I've had awful scalp zits treated with keto shampoo, nice oily skin which suggests it may be higher than reported at least on average.

Free testosterone is such a devil to capture in the lab. A study, here in Canada, at Queen's University, was urging doctors to rely more and more on the calculated value. You're feeling well?

Yes I am CW ad Cyp250! Better than ever notwithstanding underlying conditions. I haven't determined yet if the free direct test I requested was performed.

Factors this last month beyond my control have forced me to skip doses. I started low with poor results then went over 200mg/week in split doses.

Noobs prohibited from reading the following:
Testing at the trough is the goal but where is the trough if you do EOD one week and every five the next?
__

Blood draw here takes four hours. The in-network lab prints out the orders entered by my doc. "Sir, we're going to require new lab orders direct to our fax"
They think I hacked their computer?
The only constant in TRT is insanity.

 

[johndoesmith]

Testing at the trough is the goal but where is the trough if you do EOD one week and every five the next?
.

I don't understand the question. Why are you changing protocols weekly?

 

[Re-Ride]

Divide 32.54 by 1133= .0287 x 100= 2.87%
(1) Would someone explain why Vince thinks free T is 3.49% of total?
(2) Why is the lab reporting the result as 200% of upper normal?

I don't understand the question. Why are you changing protocols weekly?

Without question, everyone who can afford protocols is encouraged buy as many as possible before the price jumps again.

 

[johndoesmith]

Without question, everyone who can afford protocols is encouraged buy as many as possible before the price jumps again.

That sentence is absolutely unintelligible. You're screwing with me, right?

I still don't see why you'd do EOD then E5D. What on earth is the purpose for that?

 

[Re-Ride]

John, I'd rather keep this thread on topic. I suspect that the region where you live allows you luxuries which you take for granted. Is the phrase "factors beyond my control" intelligible enough?

I've posed questions about free testosterone. Vince Carter thinks 325pg/ml is "generally regarded as good to very good" I don't get his calculation of %free to total though.

As for absolute assay the lab says "not over 155" . Life Extension says 15-25.

I read here that 65-100 pg/ml are sufficient for a diagnosis of deficiency.
https://www.excelmale.com/forum/showthread.php?4858-Testosterone-Therapeutic-Options-and-Best-Practices-in-Management&highlight=ideal+free+testosterone

What is too high?
Nelson begins with a set of healthy parameters sidestepping the numbers game. Serum goals from Discount Labs are posted which state 2% free as a desirable goal.
[url]https://www.excelmale.com/forum/showthread.php?6354-What-is-the-highest-testosterone-level-for-long-term-health


[/URL]

 

[Re-Ride]

Here's a recent thread by Rawx. He's concerned about 33 pg/ml ( 2.6-9.8 ) and calls it "through the roof"
https://www.excelmale.com/forum/sho...Testosterone&highlight=free+testosteron+total

Vince Carter: "Your free T being that high is indicative of low SHBG"
O.K. Vince you said "that high" not "too high".

Nelson: You again refer us to maintenance of specific healthy parameters as listed on the Discount Labs "Targets" pdf which does not set an alarm for any specific free T number except insufficiency <2

The discussion then turns to high E2 which would have been a more appropriate focus of my endo's review. Fortunately I know what to do about E2.
__

Well folks, tell me if I'm wrong: No reason whatsoever to pull free T and likely not total T either once you get beyond the noob FB learning phase and start listening to your body.

Lab "normal" free T ranges are all over the map even at the same lab. Today they are 35-155pg/mL, June? 46-224. No trend can be followed. Lipids liver chemistry and blood counts are all essential.

I already knew my E2 was too high. All the classic signs were there including darkening under the eyes. It's much harder to dial E2 in to 21-30 by feel.

Aside from feeling pretty darn good, underlying conditions excepted, I've regained quite a bit of muscle mass, I have decent libido, less daytime somulance, and reduced skeletal pain. My cognition is greatly improved as evidenced by the fact that it took me 3 seconds to burn my ballot when it arrived in the mail.

 

[Vince]

Re-ride, it sounds like you're feeling pretty good, "congratulations" on your progress. I wouldn't mess with your protocol too much. For my skin I really like the sulfur soap.

 

[Nelson Vergel]

Re-Ride: Are you also using HCG?

 

[johndoesmith]

John, I'd rather keep this thread on topic. I suspect that the region where you live allows you luxuries which you take for granted. Is the phrase "factors beyond my control" intelligible enough?

No. I'm not intending to argue. It's relevant to the discussion, because constantly changing protocols will invalidate your lab tests.

No need to be upset, and you're coming across a bit rude, I just can't understand how living in an area with restrictions on TRT would force you to do EOD then E5D. It would help to understand why.

I've posed questions about free testosterone. Vince Carter thinks 325pg/ml is "generally regarded as good to very good" I don't get his calculation of %free to total though.

As for absolute assay the lab says "not over 155" . Life Extension says 15-25.

This is a confusing one for most, I was confused by it too for a while. The error I made(and you probably are too) is in trying to compare different assay methods. There is calculated free test, which is the gold standard IMO, and there are direct assay methods.

The results simply aren't comparable. Free testosterone can be measured directly, and the actual measurement of it isn't all that important. You CANNOT compare a 9-26 pg/ml range test to calculated free testosterone.

They each need to have their ranges taken into consideration when evaluating the results. Think of it like this, what is considered fast? Usain bolt is pretty fast, but when comparing his 27mph speed to a car, it's a joke. This metaphor may not be perfectly accurate but I think it gets the point across.

Well folks, tell me if I'm wrong: No reason whatsoever to pull free T and likely not total T either once you get beyond the noob FB learning phase and start listening to your body.

Barring extreme circumstances, the way you feel should trump a lab test being slightly out of range. Of course, when something is REALLY out of range, you should attempt to fix it. I don't believe free testosterone is one of those things, I had my free test at 33 on a 9-26 range, and dr saya said it was fine. Although yours is significantly higher than mine.

I already knew my E2 was too high

but then you say

Aside from feeling pretty darn good

So it doesn't seem like you're very symptomatic, in fact it seems like you're feeling good! I'd consider lowering dose if you're concerned about free test and E2. Of course, without knowing exactly how long you were on a consistent dose, and exactly when you had these labs done relative to injection, it may not be your true steady state level and trough.

My cognition is greatly improved as evidenced by the fact that it took me 3 seconds to burn my ballot when it arrived in the mail.

This genuinely cracked me up. I imagine you live in the USA?

 

[Re-Ride]

Still looking to resolve the calculation in post #8

Thank you everyone for your replies and insight!

Nelson: yeah, I've been up-taking 500 IU hCG in a 3ml syringe, then top load cyp followed by a 19-nor. My plan calls for me to pin cyp EOD. I ran out of B-D vanishing point tuberculin syringes though. Ideally I'd do hCG daily or EOD at most. As it has to be refrigerated looks like that will be history soon.

John: My apologies for being short with you last night. The cause for my non-compliance is a sensitive subject. I sure would like your further thoughts on the low DHT. I think it was May that I abandoned hCG mono.
1/19/16 6/1/16 11/7/16
DIHYDROTESTOSTERONE
16 - 79 ng/dL
43 79 36

I didn't realize how symptomatic I'd gotten from high E2, off AI until I restarted a few days ago. I'll bet it was MUCH higher over summer. At least a tad of missed cyp dosing was because it made me feel better. Water retention, bloating, puffiness, and insomnia were all issues. Some of these are high T. The other drastic improvements made up for it.

Free T: It's always been very high, before hCG mono , on it and now but never more than twice the labs upper normal range.
---

I should have been on this therapy twenty five years ago. That's a long time to have lived an impaired life as a duped law abiding citizen for no reason other than the greed of big pharma, "health" care and politics.

The message of Excelmale is informed managed HRT under the care of a qualified physician. I agree with that wholeheartedly. My message to you noobs out there is go for it. If you don't find it or if you do and b.s. starts piling up, consuming your time, your life, screw the "health" care system and do what you need to do to take care of yourself. You'll likely do a better job.

 

[johndoesmith]

Still looking to resolve the calculation in post #8

Thank you everyone for your replies and insight!

If you read my previous post, I somewhat explain that. You're basically trying to compare different assays and it's just not possible to do.

John: My apologies for being short with you last night. The cause for my non-compliance is a sensitive subject. I sure would like your further thoughts on the low DHT. I think it was May that I abandoned hCG mono.
1/19/16 6/1/16 11/7/16
DIHYDROTESTOSTERONE
16 - 79 ng/dL
43 79 36

I do think it'd help to understand why you change protocols so often, because it makes your tests invalid. Without consistency for many weeks before testing, the numbers aren't consistent and that could change things significantly. So it's like trying to hit a moving target.

With just your DHT levels in isolation, it's hard to say anything. Usually DHT is about 10% of total test, without knowing what your total test was on these dates, it's impossible to say anything unfortunately.

 

[Re-Ride]

John, I don't understand Vince Carter's calculation in post #2. If every time pp calculate %free of total it is invalid than why is it mentioned so much? hy did Vince mention it? I do not know if my free T was a direct assay or calculated. I'll likely never know. Even though HHS requires that pt are to have access to labs, "Here, It doesn't work like that" I'm told.

I understand that you believe there needs to be "consistency for many weeks prior to draw". LOL!

Life doesn't work like that anymore.

I've deleted "consistency" from my vocabulary. $3,000 per month suddenly can't put a tarp (literally) over your head. It was 30 last night. 40 inside. I paid $2500 rent this month. PGE disconnected most of the outlets and lights last month for safety reasons.

It use to be that LLs were required to provide things folks take for granted like heat and sanitary facilities.

"It doesn't work like that anymore"

America is for sale to the highest bidder, the retired and disabled need not apply. My brief HRT experience will likely come to an end well before March. There's no point in providing health care and medicine to the homeless. The republicans have been complaining for decades that there "needs to be something done about entitlements" .They've finally found a way. They mean Medicare Medicaid and SS of course not the the more expensive entitlements for the elite like subsidized solar , subsidized mortgages for slumlords, cash for clunkers ( my 1976 p.u. was too old to be a clunker) and countless other handouts.

Wake up folks. The housing, debt/credit/hyperinflation crisis that's hitting hard in Cali will soon be in your own back yard.

 

[Vince Carter]

John, I don't understand Vince Carter's calculation in post #2. If every time pp calculate %free of total it is invalid than why is it mentioned so much? hy did Vince mention it? I do not know if my free T was a direct assay or calculated. I'll likely never know. Even though HHS requires that pt are to have access to labs, "Here, It doesn't work like that" I'm told.

I understand that you believe there needs to be "consistency for many weeks prior to draw". LOL!

Life doesn't work like that anymore.

I've deleted "consistency" from my vocabulary. $3,000 per month suddenly can't put a tarp (literally) over your head. It was 30 last night. 40 inside. I paid $2500 rent this month. PGE disconnected most of the outlets and lights last month for safety reasons.

It use to be that LLs were required to provide things folks take for granted like heat and sanitary facilities.

"It doesn't work like that anymore"

America is for sale to the highest bidder, the retired and disabled need not apply. My brief HRT experience will likely come to an end well before March. There's no point in providing health care and medicine to the homeless. The republicans have been complaining for decades that there "needs to be something done about entitlements" .They've finally found a way. They mean Medicare Medicaid and SS of course not the the more expensive entitlements for the elite like subsidized solar , subsidized mortgages for slumlords, cash for clunkers ( my 1976 p.u. was too old to be a clunker) and countless other handouts.

Wake up folks. The housing, debt/credit/hyperinflation crisis that's hitting hard in Cali will soon be in your own back yard.

Just about nothing you're posting in this thread makes any sense or has anything to do with anything else and it's a barrier to helping you. 564 posts and you should be much farther along that what you're presenting.

 

[johndoesmith]

Just about nothing you're posting in this thread makes any sense or has anything to do with anything else and it's a barrier to helping you. 564 posts and you should be much farther along that what you're presenting.

I thought it was just me, but if you're seeing it, and I am too, then he's not making any sense.

If every time pp calculate %free of total it is invalid than why is it mentioned so much?

He did not calculate it from SHBG because you do not have a recent SHBG test. Calculating free test from total and SHBG is far superior IMO to any direct assay.

Even though HHS requires that pt are to have access to labs, "Here, It doesn't work like that" I'm told

These look like quest labs. Go to quest and sign up on their website. Get them directly.

Or tell your doc you want a second opinion and need your labs.

Or lay down the law.

I don't know what else to say. The law is very clear.

I understand that you believe there needs to be "consistency for many weeks prior to draw". LOL!

Life doesn't work like that anymore.

It's not just me, but every leading TRT physician, PA, and anyone who even prescribes TRT. Even the schmucks who prescribe E14D 100mg protocols believe in consistency.

Your belief of how things work do not change how things work. There's no need to mock me for giving you the truth. You can choose to accept it, or choose to accept the consequences of not accepting the truth.

 

[Re-Ride]

Just about nothing you're posting in this thread makes any sense or has anything to do with anything else and it's a barrier to helping you. 564 posts and you should be much farther along that what you're presenting.

How can one be more clear? "Explain your calculation"
Why respond just to berate me? 18 posts and still no formula posted?

In post #6 I stated "factors beyond my control" "please keep the thread on topic" Why can't pp accept that instead of pushing? When you get the answer you complain you don't want to hear it.

As for "helping me" just answer the questions. Accept the fact that I'll be off HRT soon any way and back where I started. "Compliance" makes no difference at all. I just want to get the most out of the few days I have left on HRT.