Do i need more testosterone? Testosterone non responder?

[tj]

@madman, thanks for you're response! Really apreciate it.
But just like fifty mentions, if all those measurements are incorrect or not accurate, what else to do. A lot of the specific labwork isn't available here.

I gues just going by how i feel....(keeping hct and other parameters in range offcourse)

 

[DragonBits]

@madman, thanks for you're response! Really apreciate it.
But just like fifty mentions, if all those measurements are incorrect or not accurate, what else to do. A lot of the specific labwork isn't available here.

I gues just going by how i feel....(keeping hct and other parameters in range offcourse)

First, labs are not often wrong even if they can occasionally be wrong. No one ever looks at how often they are wrong (People seem to obsess over the occasional lab error) or the causes for them being wrong. Like maybe someone has very high c-reactive protein which will throw off the ECLIA. Ok, not good to cause a false high E2, BUT, you have a more serious problem than E2, your C-reacive protein indicates inflammation in your body which you should address.

Second, I don't see where you posted what TT level you started at. Why were you taking testosterone in the first place, was it labs or was it something else?

If your TT was already normal, I wouldn't expect you to feel a lot different making it higher.

For some of use, our TT was below or near the bottom of the range, raising it makes a more obvious difference.

Third, there is more to health than just TT, E2 and thyroid levels. neurotransmitters, cortisol, IGF-1, HGH, sleep problems just to name a few that can throw you off, and various diseases and mental problems.

 

[fifty]

Huge Difference Between Labs

 

[DragonBits]

Huge Difference Between Labs

I have seen similar things by Cataceous before, it is interesting.

One expects absolute differences between labs, if you note quest's Estradiol, Sensitive (LC/MS/MS) range, high is over 29, Labcorp's high for the same test is over 35, so something is different, maybe just the ranges are different? Even factoring that into account by adjusting the numbers for the range, it's still a big difference.

I never even tested E2 for 5 years on Nebido.

Now I test E2 because Defy wants me to. My results (FT, E2) are about what I would expect given the level of TT, and TT is about what I would expect given my protocol.

One swing factor has been supplements that changed my SHBG, without testing that I wouldn't have known what was causing a change in FT/E2 for the same TT. So if I got an unexpected result for either Ft or E2, I would also test SHBG and testing c-reactive is a good thing to keep track of. My shbg has doubled and it started at 36. After stopping the supplement I would expect SHBG to come down, but how soon I have no idea, and maybe it won't come down, who knows. Things that affect SHBG seem more of a mystery.

 

[fifty]

My test has recently been 1500+ total and 25-27 free using the cheap total t and direct free t...meaning 2 draws in the past 6months it was this. Tru T calculates me to be at 50 free T. I recently got the expensive t test (ultrafiltration) and it said test 972 and free t 30.

I trust this stuff about as far as I can throw a pint of blood.

 

[madman]

Huge Difference Between Labs

Pointless in comparing the estradiol sensitive LC/MS/MS tests between Labcorp and Quest as
Labcorp has been certified with the CDC HoSt Program.....Quest has not!







New Analytical Method for Measuring Serum Estradiol Is Sensitive, Calibrated to CDC Standard

New Analytical Method for Measuring Serum Estradiol Is Sensitive, Calibrated to CDC Standards - Oncology Nurse Advisor





There are two tables. Table 1 is the list of assays that are currently certified with the CDC HoSt Program. Table 2 is the list of assays that have been certified previously but are not currently certified. Participants are listed in alphabetical order.


CDC Hormone Standardization Program (CDC HoSt) Certified Estradiol Procedures (UPDATED 03/2019)

-BioReference Laboratories, an OPKO Health Company Elmwood Park, NJ

-Brigham Research Assay Core (BRAC) Laboratory at Harvard Medical School Boston, MA

-Clinical Chemistry Branch CDC Atlanta, GA

-Craft Technologies, Inc. Wilson, NC

-Fujirebio Malvern, PA

-LabCorp Calabasas Hills, CA

-Mayo Clinic Rochester, MN



You remember this thread.....Why All Men Should be Tested with the Sensitive Estradiol Test

 

[madman]

My test has recently been 1500+ total and 25-27 free using the cheap total t and direct free t...meaning 2 draws in the past 6months it was this. Tru T calculates me to be at 50 free T. I recently got the expensive t test (ultrafiltration) and it said test 972 and free t 30.

I trust this stuff about as far as I can throw a pint of blood.

You stated...."My test has recently been 1500+ total and 25-27 free using the cheap total t and direct free t...meaning 2 draws in the past 6months it was this. Tru T calculates me to be at 50 free T"





If this is the cheap test you are refering to "1500+ total and 25-27 free using the cheap total t and direct free t"




140103: Testosterone, Free, Direct With Total Testosterone | LabCorp


Testosterone, Free, Direct With Total Testosterone
TEST:140103
Test number copied

CPT: 84402; 84403
Test Details
Synonyms

• Free Testosterone, Direct and Total

Methodology
Free T: Direct analog enzyme immunoassay (EIA)
Total T: electrochemiluminescence immunoassay (ECLIA)


Total T: electrochemiluminescence immunoassay (ECLIA) - 1500+ ng/dL

Free T: direct analog/radioimmunoassay (RIA)- 25-27 ng/dL






TruT Free Testosterone Calculator by FPT

TT 1500 ng/dL, SHBG 45.9 nmol/L, Albumin 4.5 g/dL would give you a FT of 51.33 ng/dL.....roughly what you stated "Tru T calculates me to be at 50 free T"

Now you can see the difference using the direct analog-based free testosterone immunoassays which are known to be inaccurate your FT is 25-27 ng/dL compared to the when using the new calculated method TruT Free Testosterone Calculator by FPT your FT is 51.33 ng/dL














I recently got the expensive t test (ultrafiltration) and it said test 972 and free t 30.


070038: Testosterone, Free, Equilibrium Ultrafiltration... | LabCorp




Testosterone, Free, Equilibrium Ultrafiltration With Total Testosterone, LC/MS-MS
TEST: 070038
Test number copied

CPT: 84402; 84403
Test Details



Methodology
Free: Equilibrium Ultrafiltration
Total: liquid chromatography/tandem mass spectrometry (LC/MS-MS)


Total T: LC/MS-MS - 972 ng/dL

Free T: Equilibrium Ultrafiltration - 30 ng/dL






TruT Free Testosterone Calculator by FPT

TT 972 ng/dL, SHBG 45.9 nmol/L, Albumin 4.5 g/dL would give you a FT of 31.75 ng/dL.....which is very close to the results you had from Equilibrium Ultrafiltration which has your FT at 30 ng/dL......roughly what you stated "I recently got the expensive t test (ultrafiltration) and it said test 972 and free t 30"

Now you can see the difference using the Equilibrium Ultrafiltration your FT is 30ng/dL compared to when using the new calculated method TruT Free Testosterone Calculator by FPT your FT is 31.75 ng/dL.....very close.

When testing FT Equilibrium Ultrafiltration is considered the next best method when compared to the gold standard Equilibrium Dialysis.




In the 1st set of labs for TT you used the:Total T: electrochemiluminescence immunoassay (ECLIA) - 1500+ ng/dL

For FT you used the:Free T: direct analog/radioimmunoassay (RIA)- 25-27 ng/dL





In the second set of labs for TT you used the: Total T: LC/MS-MS - 972 ng/dL

For FT you used the:Free T: Equilibrium Ultrafiltration - 30 ng/dL



So we have no idea if your protocol T dose/injection frequency/hCG dose (or if it was used)
have been kept the same between the 2 sets of lab work you had done and whether labs were done a trough (most likely were as you would know this)?


Lets just say if protocol was consistent between both sets of labs than in the 1st set of labs the accuracy of the assays would not be comparable to the 2nd set of labs.


Total T: LC/MS-MS would be the more accurate assay when compared to the electrochemiluminescence immunoassay (ECLIA) which are known for (Reduced accuracy at low/high T levels and Significant inter-assay variability)


Free T: Equilibrium Ultrafiltration would be the more accurate assay when compared to the direct analog/radioimmunoassay (RIA) which it has been stated that the widely used direct immunoassay and tracer analog techniques for measuring fT have been shown to be inaccurate.

















I would be basing your results of the 2nd set of labs which also compare well to the new calculated method TruT Free Testosterone Calculator by FPT

 

[fifty]

So we’re all worried about inaccurate eclia for e2 while 99% of patients are using eclia for total testosterone... and direct free t is also inaccurate.

 

[madman]

So we’re all worried about inaccurate eclia for e2 while 99% of patients are using eclia for total testosterone... and direct free t is also inaccurate.

electrochemiluminescence immunoassay (ECLIA) which are known for (Reduced accuracy at low/high T levels and Significant inter-assay variability)

* reduced accuracy at low/high T levels.....meaning extremes .....in patients with (very low or very high) testosterone levels.

 

[fifty]

Extreme being 100 and 1600 or extreme being 5 and 5000?

 

[tj]

First, labs are not often wrong even if they can occasionally be wrong. No one ever looks at how often they are wrong (People seem to obsess over the occasional lab error) or the causes for them being wrong. Like maybe someone has very high c-reactive protein which will throw off the ECLIA. Ok, not good to cause a false high E2, BUT, you have a more serious problem than E2, your C-reacive protein indicates inflammation in your body which you should address.

Second, I don't see where you posted what TT level you started at. Why were you taking testosterone in the first place, was it labs or was it something else?

If your TT was already normal, I wouldn't expect you to feel a lot different making it higher.

For some of use, our TT was below or near the bottom of the range, raising it makes a more obvious difference.

Third, there is more to health than just TT, E2 and thyroid levels. neurotransmitters, cortisol, IGF-1, HGH, sleep problems just to name a few that can throw you off, and various diseases and mental problems.

Total T before trt was 274 ng/dl. I started taking testosterone to get optimized.

 

[S1W]

tj,

Are you able to simply try a higher dosage and find out? Although my SHBG is not as low as yours (mine is at 23) I have found that at least so far I don't do well on lower dose more frequent injections and also don't seem to get much benefit from TRT until my levels are at or slightly above the lab ranges.

The line you walk when you run higher levels isn't so much E2 in my experience, but rather high HCT, etc. If HCT is not an issue, why not just try and see how you feel?

 

[madman]

Extreme being 100 and 1600 or extreme being 5 and 5000?

<100 on the lower end greater than 1500+ on the higher end depending on the immunoassay

 

[DragonBits]

Total T before trt was 274 ng/dl. I started taking testosterone to get optimized.

That is certainly low enough to need TRT, at least in my experience.

I would look at supplements that tend to raise SHBG.

My shbg doubled in a short period of time, PSA went down from 4.2>3.2.

I thought it was due to taking life extension ultra prostate formula, but I don't see any reason for that being the factor increasing SHBG even though it seemed to follow taking it.

Metformin increases SHBG, thyroid meds like triidothyronine (T3) can raise SHBG. Since at one time I was taking all three, hard to isolate what caused my SHBG to double.

Now I am not taking metformin, not taking the prostate formula, I retested SHBG 1.5 months ago, shgb still increased a little to 73.

It's not causing a problem, but I would like SHBG to be where it was, around 35-45.

 

[tj]

tj,

Are you able to simply try a higher dosage and find out? Although my SHBG is not as low as yours (mine is at 23) I have found that at least so far I don't do well on lower dose more frequent injections and also don't seem to get much benefit from TRT until my levels are at or slightly above the lab ranges.

The line you walk when you run higher levels isn't so much E2 in my experience, but rather high HCT, etc. If HCT is not an issue, why not just try and see how you feel?

S1w, 250 mg a week is the highest HG dose i can take. My presciption doesn't go higher.
I already tried 100 mg twice a week. Trough was 23 nmol/l(663 ng/dl) range 12-32nmol (346-923ngdl) felt the same as on 65 eod.

 

[Abuser200]

tj,

Are you able to simply try a higher dosage and find out? Although my SHBG is not as low as yours (mine is at 23) I have found that at least so far I don't do well on lower dose more frequent injections and also don't seem to get much benefit from TRT until my levels are at or slightly above the lab ranges.

The line you walk when you run higher levels isn't so much E2 in my experience, but rather high HCT, etc. If HCT is not an issue, why not just try and see how you feel?

Are you injecting once or twice a week with that shbg of 23?

 

[tj]

Sw1, what are your dosages and frequencys?

 

[S1W]

Are you injecting once or twice a week with that shbg of 23?

Sw1, what are your dosages and frequencys?

I started at 1x/week and did not like that, then went to 2x/week, then to 3x/week, then to EOD, now back to 2x/week. I would say that I liked them all really, the 1x/week was the only one that absolutely did not work for me.

3x/week almost doesn't make any sense to me - might as well just go to 2x/week or EOD. Though some guys do just fine on it.

2x/week just seems to work for me. My E2 is higher on the 2x/week protocol than on say EOD, but for whatever reason I feel best on this protocol.

Currently, I inject 60 mg Test Cyp E3.5D. This puts my TT and FT at or just above the top of the lab ranges at trough. I have played around with labs and know that there is a significant difference in my levels between peak and trough.

My E2 on this protocol is also high out of lab range at trough. I have more acne on this protocol too. But as far as side effects go, I'm most concerned with HCT, which for me ranges from upper 40s to low 50s. Though I do live at a moderately high elevation. I did not test but suspect HCT was a bit lower on EOD protocol.