Wildly fluctuating T levels, what to believe and do I need TRT?

[zillapod]

As the title says, I've had 4 testosterone tests since August:

372 - 8am, fasting (traditional Dr's office lab) range is: 280-800
282 - 9am, not fasting (TRT clinic) range is: 201-993
220 - 9am, not fasting (TRT clinic) range is: 201-993
542 - 7am, fasting (different Dr's office lab from first test) range is: 240-870

After the first 3 results of 372, 282, 220 I was definitely leaning toward starting TRT with the clinic, but then just yesterday I got the 542 result after meeting with an Endocrinologist and doing one more round of labs. At age 40, 542 sounds WAY better to me than the 220 did. I know testosterone fluctuates but to go from 220 as a low end to 542 on the high end, I'm not sure what to believe. Other lab panels, FSH, LH, TSH, etc. were all well within the normal ranges and I only had SHBG (40, range 17-56) and Free T (61, range 47-244) tested once.

I think I'm even more confused now! Any help or experience navigating these results as part of the decision would be greatly helpful. Fatigue/brainfog/no motivation is my major complaint, some libido issues but not too bad. The Endo just said to get my Vitamin D level up (it was 33) and that should help.

 

[lowtdunce]

Put more stock in the Free T than the total, if thats consistently borderline low then treatment may be for you.

 

[Sean Mosher]

FreeT of 61 with the range being 47-244 is pretty low.
Would like to see some dramatic improvements there.
I would post all your labs if you can.
Normal/In Range does not mean optimized.

 

[trt reznor]

What was your estradiol (E2)?

 

[Systemlord]

The Endo just said to get my Vitamin D level up (it was 33) and that should help.

Low vitamin D can cause IBS which could then lower testosterone because you're unable to process foods properly. Your FT levels are low, TT is not the active hormone, only FT matters and yours is low and therefore need TRT. Your somewhat high SHBG is deactivating your bioavailable testosterone.

Your endo cannot prescribe TRT unless FT or TT are below range even if you are experiencing a testosterone deficiency. This is how insurance companies keep ahold of the profits, by denying medical coverage to those in need to grow the company.

Your fluctuations in SHBG (made in liver) is why your TT and FT levels are fluctuating all the time. You may be in the normal range, but this is guarantee that you will not experience a testosterone deficiency. Some guys (me for instance) can be in the 300 ranges and not be symptomatic, others can experience the effects of low testosterone at 500 ranges, usually high SHBG is the reason.

I have low SHBG (14) and so these levels would be optimal for me, when my TT is 450, my FT is almost at the top of the ranges.

 

[zillapod]

Got the Free T result, this time it was 92 (scale 47-244), so up a decent amount from the previous 61, but not sure if that would still be considered borderline low? No SHGB result on this round of tests and they did not test Estradiol.

Sean Mosher suggested posting the other results, which are:

FSH: 10.9 (scale 1.4-18.1)
LH: 2.6 (no range given)
TSH: 1.73 (range 0.27-4.20)

I'm guessing this is as far as I'll get with either my primary care Dr. or the Endo, so from here it is up to me I think on whether to try TRT. This latest round of labs was literally 15 minutes after awaking at 7am, and I'd been laying around and resting the last 10 days due to a hamstring strain, sleeping way more than usual, and abstained from ejaculating for 7 days so I'd imagine that would make these results the absolute highest they could be?

 

[M.J]

Maybe u didn’t sleep well the first three test?
Testosterone fluctuate like this can go down by 40% or 50% from what I have seen.

I have test showing 11 and sometime 6.
People who have 20 can see fluctuation that goes down to 11 nmol/L range ( 8-27 )

also if you workout it can go that high I have went through this 8 years ago unfortunately now even workout can’t take it high anymore.

 

[Vince Carter]

The flaw in your testing is different labs being used and different tests being applied...of the 4 tests youve taken it's been 3 different tests, see the 3 different lab ranges = different tests.
The only two that you can compare side-by-side are the 282/220 which in the scheme of things is a rather miniscule difference.
You'd like to believe that a test is a test but they're not all the same.

 

[Vince]

As the title says, I've had 4 testosterone tests since August:

372 - 8am, fasting (traditional Dr's office lab) range is: 280-800
282 - 9am, not fasting (TRT clinic) range is: 201-993
220 - 9am, not fasting (TRT clinic) range is: 201-993
542 - 7am, fasting (different Dr's office lab from first test) range is: 240-870

After the first 3 results of 372, 282, 220 I was definitely leaning toward starting TRT with the clinic, but then just yesterday I got the 542 result after meeting with an Endocrinologist and doing one more round of labs. At age 40, 542 sounds WAY better to me than the 220 did. I know testosterone fluctuates but to go from 220 as a low end to 542 on the high end, I'm not sure what to believe. Other lab panels, FSH, LH, TSH, etc. were all well within the normal ranges and I only had SHBG (40, range 17-56) and Free T (61, range 47-244) tested once.

I think I'm even more confused now! Any help or experience navigating these results as part of the decision would be greatly helpful. Fatigue/brainfog/no motivation is my major complaint, some libido issues but not too bad. The Endo just said to get my Vitamin D level up (it was 33) and that should help.

Why don't you consider having a complete set of labs, along with thyroid labs. Through defy Medical or discount labs. Make sure you do it first thing in the morning and I would fast for 12 hours before labs.