What are all possible reasons for a higher total Testosterone number but significantly lower Free T number

[akizal]

Like for example your bloodwork always comes back as around 20% above mid range Total T , but 20% below mid range Free T ?? anything you can do , or just genetics ?

 

[Rhino 2.0]

Like for example your bloodwork always comes back as around 20% above mid range Total T , but 20% below mid range Free T ?? anything you can do , or just genetics ?

Usually do to high SHBG which is genetic most of the time

 

[Vince Carter]

need to pull SHBG but this would be a fair indicator of an elevated number deserving of being tested to verify.

 

[CoastWatcher]

Are you on a TRT protocol? If so, what are details, and where did your SHBG sit prior to the initiation of therapy?

 

[stevep]

I'm in the same boat as you Akilal. When I've tested at trough over the past few years my averages are; SHGB ~55, TT ~880, FT % ~1.60 (calc ~145), Estradol Sensitive ~32.

M/Thr:
Test Cyp 60mg
HCG 400IU

Daily:
CoQ10
Fish Oil
Zinc
Magnesium
Statin
Asprin
DHEA


My libido is OK, (can't complain), sleep disruption maybe 2 or 3 nights per week, and feel good overall.

I exercise regularly, almost eat right and get a good night sleep (most nights). I've decided that I'm going to try a couple supplements to see if I can bring down my SHGB. I"d like a higher FT calculation.

I've read on here about Boron (3mg) and the mixed results from individuals on here. I'm going to try that, and Jill at Defy mentioned that I might want to try 500mg of Stinging Nettle Root.

I just received these two supplements yesterday and will start them today. I don't think they will mess with anything else, but I'll see soon enough.

 

[Straightnasty34]

I'm in the same boat as you Akilal. When I've tested at trough over the past few years my averages are; SHGB ~55, TT ~880, FT % ~1.60 (calc ~145), Estradol Sensitive ~32.

M/Thr:
Test Cyp 60mg
HCG 400IU

Daily:
CoQ10
Fish Oil
Zinc
Magnesium
Statin
Asprin
DHEA


My libido is OK, (can't complain), sleep disruption maybe 2 or 3 nights per week, and feel good overall.

I exercise regularly, almost eat right and get a good night sleep (most nights). I've decided that I'm going to try a couple supplements to see if I can bring down my SHGB. I"d like a higher FT calculation.

I've read on here about Boron (3mg) and the mixed results from individuals on here. I'm going to try that, and Jill at Defy mentioned that I might want to try 500mg of Stinging Nettle Root.

I just received these two supplements yesterday and will start them today. I don't think they will mess with anything else, but I'll see soon enough.

Look into proviron , 50 mgs a day 25 am / 25 pm

 

[Systemlord]

Pretty much all you can do to increase Free T and lower SHBG is TRT, SHBG will increase as you get older and testosterone will decline. This only ends one way, lower and lower testosterone.

 

[akizal]

new 27.5 mg EOD protocol, started 23 days before bloodwork, too soon I know still probably raise slightly , I will retest, but Total T was 693.7 ng/dl (264-916), free T 13.6 pg/mL(9.3-26.5), E2 sensitive 17.0 pg/mL(8-35) , all LC/MS.

 

[akizal]

I am at a loss of where to go from here, I need to change something up , or possibly come off restart with HCG, main symptoms, are brain fog, anxiety, fatigue , maybe I just need more time to settle out idk

 

[akizal]

Are you on a TRT protocol? If so, what are details, and where did your SHBG sit prior to the initiation of therapy?

I think SHBG was always mid normal range, maybe slightly more than mid range, but that was when I first went on therapy, and before therapy, 6.5 years ago who knows now, but does it really matter? cant really change SHBG ?

 

[captain]

Are you on Thyroid meds?

 

[akizal]

no , i will be getting the thyroid tested though

 

[madman]

I'm in the same boat as you Akilal. When I've tested at trough over the past few years my averages are; SHGB ~55, TT ~880, FT % ~1.60 (calc ~145), Estradol Sensitive ~32.

M/Thr:
Test Cyp 60mg
HCG 400IU

Daily:
CoQ10
Fish Oil
Zinc
Magnesium
Statin
Asprin
DHEA


My libido is OK, (can't complain), sleep disruption maybe 2 or 3 nights per week, and feel good overall.

I exercise regularly, almost eat right and get a good night sleep (most nights). I've decided that I'm going to try a couple supplements to see if I can bring down my SHGB. I"d like a higher FT calculation.

I've read on here about Boron (3mg) and the mixed results from individuals on here. I'm going to try that, and Jill at Defy mentioned that I might want to try 500mg of Stinging Nettle Root.

I just received these two supplements yesterday and will start them today. I don't think they will mess with anything else, but I'll see soon enough.

Using the newer calculated method TruT Free Testosterone Calculator if one had a TT level 600 ng/dL or less along with an SHBG of 55 nmoL/L than they would definitely have sub-par FT levels 18.01 ng/dL reference range 16-31 ng/dL

In your case with a TT of 880 ng/dL and an SHBG of 55 nmoL/L than using the newer calculated method (TruT™ provides the most accurate estimates for free testosterone)
TruT Free Testosterone Calculator by FPT than your FT level is near the top end of the range 28.94 ng/dL reference range 16-31 ng/dL

People need start understanding that all of these other equations whether linear law-of-mass action models or empiric equations are flawed!






Current problems with accurate free testosterone determination
Current methods for measuring free testosterone (fT) are technically challenging and not accurate. The widely used direct immunoassay and tracer analog techniques for measuring fT have been shown to be inaccurate. Equilibrium dialysis, the reference method against which other methods are compared, is labor-intensive and cumbersome, and therefore has had limited clinical adoption. As an alternative, free testosterone can be computed from the total testosterone, SHBG, and albumin concentrations. Recently, Endocrine Society’s Expert Panel acknowledged the experimental problems in fT measurements and concluded that "...the calculation of free testosterone is the most useful estimate of free testosterone in plasma..." However, we have demonstrated that even the calculated fT values derived from the prevailing equations, based on linear law-of-mass action models or empiric equations, differ systematically from free testosterone measured by equilibrium dialysis by as much as 40%.



Why TruT™?
The only FDA-registered free testosterone calculator

• Improved biophysical characterizations have suggested the importance of models that consider allosteric coupling of testosterone with dimeric SHBG. This model, as implemented by TruT™ provides the most accurate estimates for free testosterone.
• Commonly available free testosterone calculators (issam.ch, nebido.com, pctag.uk) use models of testosterone:SHBG binding (proposed by Vermeulen et al. and Sodergard et. al) which were developed before the crystal structure for SHBG:T complexes were available. These models assume that the two SHBG monomers behave identically in binding testosterone. Detailed experimental data show that the "simplified linear model is erroneous." References.
• The Endocrine Society has issued position statements which highlights the laboratory- and operator-dependent variability inherent in direct free testosterone measurements. For this reason they advocate for indirect "calculator" based methods References.
• The TruT™ calculator provides the ideal solution by using measurements of total testosterone, SHBG, and albumin to calculate free testosterone while taking into account the complex, non-linear allostery in SHBG's association with testosterone. TruT™ is the only calculator available that uses this more complex formulation. References

Forget relying on the older calculated methods let alone direct immunoassay and tracer analog techniques.....either pay to have the gold standard equilibrium dialysis or ultrafiltration or better yet do not spend the money and simply use the newer calculated method TruT Free Testosterone Calculator by FPT


People tend to go on and on and on about high SHBG resulting in low FT.....sure when TT levels are sub-par or low but when TT levels are high enough even with a higher SHBG one can still have healthy FT levels.

Even with an SHBG of 70,80.90 as long as TT is high enough one can have a healthy FT.

In your case although most would consider an SHBG of 55 nmol/L high seeing as your TT (trough) is fairly high 880 ng/dL than your FT of 28.49 ng/dL is right near the top end of the reference range of 16-31 ng/dL and keep in mind this is using the newer calculated method TruT™ which provides the most accurate estimates for free testosterone.

 

[stevep]

Using the newer calculated method TruT Free Testosterone Calculator if one had a TT level 600 ng/dL or less along with an SHBG of 55 nmoL/L than they would definitely have sub-par FT levels 18.01 ng/dL reference range 16-31 ng/dL
View attachment 7565









In your case with a TT of 880 ng/dL and an SHBG of 55 nmoL/L than using the newer calculated method (TruT™ provides the most accurate estimates for free testosterone)
TruT Free Testosterone Calculator by FPT than your FT level is near the top end of the range 28.94 ng/dL reference range 16-31 ng/dL
View attachment 7566




People need start understanding that all of these other equations whether linear law-of-mass action models or empiric equations are flawed!






Current problems with accurate free testosterone determination
Current methods for measuring free testosterone (fT) are technically challenging and not accurate. The widely used direct immunoassay and tracer analog techniques for measuring fT have been shown to be inaccurate. Equilibrium dialysis, the reference method against which other methods are compared, is labor-intensive and cumbersome, and therefore has had limited clinical adoption. As an alternative, free testosterone can be computed from the total testosterone, SHBG, and albumin concentrations. Recently, Endocrine Society’s Expert Panel acknowledged the experimental problems in fT measurements and concluded that "...the calculation of free testosterone is the most useful estimate of free testosterone in plasma..." However, we have demonstrated that even the calculated fT values derived from the prevailing equations, based on linear law-of-mass action models or empiric equations, differ systematically from free testosterone measured by equilibrium dialysis by as much as 40%.



Why TruT™?
The only FDA-registered free testosterone calculator

• Improved biophysical characterizations have suggested the importance of models that consider allosteric coupling of testosterone with dimeric SHBG. This model, as implemented by TruT™ provides the most accurate estimates for free testosterone.
• Commonly available free testosterone calculators (issam.ch, nebido.com, pctag.uk) use models of testosterone:SHBG binding (proposed by Vermeulen et al. and Sodergard et. al) which were developed before the crystal structure for SHBG:T complexes were available. These models assume that the two SHBG monomers behave identically in binding testosterone. Detailed experimental data show that the "simplified linear model is erroneous." References.
• The Endocrine Society has issued position statements which highlights the laboratory- and operator-dependent variability inherent in direct free testosterone measurements. For this reason they advocate for indirect "calculator" based methods References.
• The TruT™ calculator provides the ideal solution by using measurements of total testosterone, SHBG, and albumin to calculate free testosterone while taking into account the complex, non-linear allostery in SHBG's association with testosterone. TruT™ is the only calculator available that uses this more complex formulation. References

Forget relying on the older calculated methods let alone direct immunoassay and tracer analog techniques.....either pay to have the gold standard equilibrium dialysis or ultrafiltration or better yet do not spend the money and simply use the newer calculated method TruT Free Testosterone Calculator by FPT


People tend to go on and on and on about high SHBG resulting in low FT.....sure when TT levels are sub-par or low but when TT levels are high enough even with a higher SHBG one can still have healthy FT levels.

Even with an SHBG of 70,80.90 as long as TT is high enough one can have a healthy FT.

In your case although most would consider an SHBG of 55 nmol/L high seeing as your TT (trough) is fairly high 880 ng/dL than your FT of 28.49 ng/dL is right near the top end of the reference range of 16-31 ng/dL and keep in mind this is using the newer calculated method TruT™ which provides the most accurate estimates for free testosterone.

Thanks Madman. Obviously I had no idea this existed, nor do I think Jill at Defy is aware of this either since we discussed low FT in my last consult. Like I mentioned I feel fine and don't have any issues to speak of.

It was my intent to see IF I could raise my FT could I feel better? But, with this new calculator it looks like I'm chasing my tail and trying these supplements I could possibly mess up where I'm at.

Thanks again.

 

[fifty]

Nettle extract snd fenugreek extract make me feel better when i took them pre trt...can’t say they’ve altered my shbg or labs at all though.

 

[madman]

Thanks Madman. Obviously I had no idea this existed, nor do I think Jill at Defy is aware of this either since we discussed low FT in my last consult. Like I mentioned I feel fine and don't have any issues to speak of.

It was my intent to see IF I could raise my FT could I feel better? But, with this new calculator it looks like I'm chasing my tail and trying these supplements I could possibly mess up where I'm at.

Thanks again.

Also keep in mind that your FT (trough) levels are close to the top end of the reference range using the newer calculated method.

Can you venture into upping your FT levels into the 30-50 ng/dL range.....sure but if you choose to make the move be prepared for 2 outcomes.....either you will possibly feel better overall than you do now or you will simply feel worse.

Remember to that increasing FT levels will result in an increase in e2, hemoglobin/hematocrit levels and there is also the possibility that if T levels are too high it can have a negative effect on lipids (lowering of HDL).

As you stated "Like I mentioned I feel fine and don't have any issues to speak of..... so it would seem sensible to stay the course although there would be no harm in trying to run slightly higher FT (trough) levels seeing as you also stated "It was my intent to see IF I could raise my FT could I feel better?"

Do what you feel is best for you!

 

[Vvs1]

I'm in the same boat as you Akilal. When I've tested at trough over the past few years my averages are; SHGB ~55, TT ~880, FT % ~1.60 (calc ~145), Estradol Sensitive ~32.

M/Thr:
Test Cyp 60mg
HCG 400IU

Daily:
CoQ10
Fish Oil
Zinc
Magnesium
Statin
Asprin
DHEA


My libido is OK, (can't complain), sleep disruption maybe 2 or 3 nights per week, and feel good overall.

I exercise regularly, almost eat right and get a good night sleep (most nights). I've decided that I'm going to try a couple supplements to see if I can bring down my SHGB. I"d like a higher FT calculation.

I've read on here about Boron (3mg) and the mixed results from individuals on here. I'm going to try that, and Jill at Defy mentioned that I might want to try 500mg of Stinging Nettle Root.

I just received these two supplements yesterday and will start them today. I don't think they will mess with anything else, but I'll see soon enough.

10mg of Boron to decrease shbg.

Also, stinging nettle binds to shbg 'in vitro' which is just observed in a Petri dish, not in the body. Its also a DHT inhibitor, and DHT is what lowers shbg.

 

[stevep]

10mg of Boron to decrease shbg.

Also, stinging nettle binds to shbg 'in vitro' which is just observed in a Petri dish, not in the body. Its also a DHT inhibitor, and DHT is what lowers shbg.

I started the Boron. Right now I'm trying 3mg in the AM and 3mg in the PM. Been a week. The only thing noticeable is my urine is yellow. Brightest after taking Boron and the color tapers off during the day. I drink a gallon or so of water a day so I know I'm not dehydrated.

 

[fifty]

10mg of Boron to decrease shbg.

Also, stinging nettle binds to shbg 'in vitro' which is just observed in a Petri dish, not in the body. Its also a DHT inhibitor, and DHT is what lowers shbg.

DHT is what lowers SHBG?