First Total and Free T Results: Help Me Understand

[Dr Justin Saya MD]

But within my range it's probably not giving me falsely higher numbers or anything like that, right? I will do the LC/MS next time though if that's the better route.



I live at sea level, have never smoked cigarettes (I did grow up in a smoking house hold and was exposed to second hand smoke for years though), and do not have COPD, no idea on iron yet, have never had it tested, should I do ferritin or TIBC, I havent seen a solid answer on which is more useful for me yet.

I have been curious about sleep apnea for awhile, I get up to urinate 3-5 times a night on average, and I always feel super sluggish upon waking up, it takes me forever to get going, and it's gotten worse and worse. I bought a new memory foam mattress last year, still having trouble, less body aches but I still do not sleep well at all.

For iron assessment test: serum iron, % saturation, TIBC, ferritin.

Given your sleep symptoms, general symptoms, and our previous discussion regarding baseline H/H - a sleep study to evaluate for possible sleep apnea wouldn't be a bad idea for you at this point.

 

[AlwaysCold]

Going to call around locally Monday and see what the damage is on a sleep study, I have always heard they are thousands of dollars, Im hoping that's not sure. I will order up the iron tests, thank you for your recommendations and replies!

 

[AlwaysCold]

Alright, getting ready to order more blood tests. Should I do test levels again? Since testing last time I have went to the gym a couple times (easing back into it), and have started taking B6. Do I need to nail all of these in one shot, or should I do a few at a time and do more testing as necessary depending on results?

I know as of now I want to do PSA, Prolactin (my refractory time is insanely long, and the medicine Im on is known to raise prolactin substantially), Estradiol, Thyroid, Vitamin D, Iron/TIBC/Ferritin. Should I focus on LH & FSH and SHBG or should I only go after them if I pull another low T result?

 

[CoastWatcher]

Alright, getting ready to order more blood tests. Should I do test levels again? Since testing last time I have went to the gym a couple times (easing back into it), and have started taking B6. Do I need to nail all of these in one shot, or should I do a few at a time and do more testing as necessary depending on results?

I know as of now I want to do PSA, Prolactin (my refractory time is insanely long, and the medicine Im on is known to raise prolactin substantially), Estradiol, Thyroid, Vitamin D, Iron/TIBC/Ferritin. Should I focus on LH & FSH and SHBG or should I only go after them if I pull another low T result?

If you can afford it I'd order everything in one shot. Why keep returning to the lab, week in and week out? Be sure you have the appropriate estradiol test (Sensitive, LC, MS/MS).

 

[seaexplorer]

Vince, I was put on Paxil for OCD in 1999, I was on a much higher dose but have been slowly weaning down over the years. It's one of the hardest things to get off of once you have been on it for a long period of time. I think the side effects of being on it, as well as the withdrawal side effects of missing a dose are worse than anything I was ever put on it for.

Your mention of Paxil brings back bad memories. You're so right, that is a horrible drug and very difficult to stop.

A couple couple years after being on daily 5g of Androgel, I started feeling very lethargic and had all the classic low T symptoms reappear. My Dr "diagnosed" me with depression and promptly put me on 40mg of Paxil. That stuff was hell and really screwed things up. I went back and insisted on getting my hormones retested and sure enough they were low, as in off the scale low. The Dr doubled my Androgel dose but now I was stuck on that Paxil junk and could not stop taking it and my Dr was worthless by saying to "stay on it for a couple years, it might do you some good". F that. This was horrible. I can feel my body cry every time I took it, but when I skipped a dose or tried to stop, I just wanted to die.

I finally did manage to get off of Paxil and I did it through a very long taper. I first worked my way down to 10mg, then from that point I dropped the dose by small slivers per week until I was down to virtually nothing. My method was to cut the pill as precise I could then later as the pieces needed to be smaller, I'd smash the pill to dust, then using a razor blade, I'd take small slivers away. It took a few months doing this, and there wasn't anything real precise I was doing, but I was so desperate to get off of it and my dipsh-t Dr who put me on it was no help, so anyway I was desperate and had to try something, anything. It was tough, but the long taper made it much more manageable dealing with the symptoms. When I got real low with the doses, I started supplementing with 5- HTP and Melatonin at night. It worked for me and I got off the stuff. It was definitely a scary experience. That stuff gets prescribed so frequently, and reading the paperwork that comes direct from the maker, it says it's not fully understood how the medicine work. Yeah, that was real reassuring reading that.

Be real careful if you decide you had enough and want to stop it. If you feel horrible when skipping a dose, a real long and slow taper might work.

 

[AlwaysCold]

If you can afford it I'd order everything in one shot. Why keep returning to the lab, week in and week out? Be sure you have the appropriate estradiol test (Sensitive, LC, MS/MS).

Im going to split tests up between where it's the cheapest to order, Im going to use the discountedlabs.com estradiol test for sure, since it seems to be the correct one at a good price. I guess Im worried Im going to do labs for everything, then end up doing them again shortly if I go through a Dr if I cant get a handle on this low T thing. I just dont know the pecking order of importance among them, I know I want to check prolactin, D and thyroid at a minimum because Im highly suspect of them. I guess I dont know enough about the importance of LH & FSH if I already know my T is low. I might just do it all. I figured I might have to split days if I order through a few different places (Life Extension, WalkInLabs, and DiscountedLabs).

Your mention of Paxil brings back bad memories. You're so right, that is a horrible drug and very difficult to stop.

A couple couple years after being on daily 5g of Androgel, I started feeling very lethargic and had all the classic low T symptoms reappear. My Dr "diagnosed" me with depression and promptly put me on 40mg of Paxil. That stuff was hell and really screwed things up. I went back and insisted on getting my hormones retested and sure enough they were low, as in off the scale low. The Dr doubled my Androgel dose but now I was stuck on that Paxil junk and could not stop taking it and my Dr was worthless by saying to "stay on it for a couple years, it might do you some good". F that. This was horrible. I can feel my body cry every time I took it, but when I skipped a dose or tried to stop, I just wanted to die.

I finally did manage to get off of Paxil and I did it through a very long taper. I first worked my way down to 10mg, then from that point I dropped the dose by small slivers per week until I was down to virtually nothing. My method was to cut the pill as precise I could then later as the pieces needed to be smaller, I'd smash the pill to dust, then using a razor blade, I'd take small slivers away. It took a few months doing this, and there wasn't anything real precise I was doing, but I was so desperate to get off of it and my dipsh-t Dr who put me on it was no help, so anyway I was desperate and had to try something, anything. It was tough, but the long taper made it much more manageable dealing with the symptoms. When I got real low with the doses, I started supplementing with 5- HTP and Melatonin at night. It worked for me and I got off the stuff. It was definitely a scary experience. That stuff gets prescribed so frequently, and reading the paperwork that comes direct from the maker, it says it's not fully understood how the medicine work. Yeah, that was real reassuring reading that.

Be real careful if you decide you had enough and want to stop it. If you feel horrible when skipping a dose, a real long and slow taper might work.

It's annoying isnt, Dr's throw this garbage at people at will but have NO and I mean NO clue about the withdrawal symptoms, or how to get off of it. It's enraging, it really is. I still have Dr's and pharmacists say stupid stuff like "just take it every other day until you are off", yeah, that doesnt work, that's a 20 year old protocol that has never worked for anybody. I have missed it for two days before on a few different occasions, have missed a single day a handful of times, it's awful. The electrical zaps through the brain, the feeling like you are floating above yourself, slurred speech, RAGE, feeling like you have the flu times 10000 with no energy except for when the rage boils over, driving in the oncoming traffic lane and constant suicidal thoughts.

How long were you on for? I have pretty much tapered from 40mg to 5mg, but it has taken me 17 years lol. I started trying a lot harder in the last few years to get the dose lowered, it's been misery every time. 5htp and melatonin mess me up when I take them, seems like an interaction. I might have to start crushing it like you, they are already hard to cut in half even with a splitter, they try to explode. It's now illegal in the UK for Dr to prescribe it for people under 18, and in the US while not illegal, it's frowned upon. Where was this ruling when I was getting put on this garbage a week before I turned 17.

 

[seaexplorer]

How long were you on for? I have pretty much tapered from 40mg to 5mg, but it has taken me 17 years lol. I started trying a lot harder in the last few years to get the dose lowered, it's been misery every time. 5htp and melatonin mess me up when I take them, seems like an interaction. I might have to start crushing it like you, they are already hard to cut in half even with a splitter, they try to explode. It's now illegal in the UK for Dr to prescribe it for people under 18, and in the US while not illegal, it's frowned upon. Where was this ruling when I was getting put on this garbage a week before I turned 17.

Good job getting yourself down to 5 mg. It's tough. I wasn't on it that long. I was taking for several months and it was horrible and during this time, my low testosterone remain undiagnosed. I complained repeatedly to my Dr that I was not feeling great and what does he do? He said he thinks I have severe depression and he refers me to a psychiatrist. I trusted him at that time and went to see the psych Dr and that new Dr wanted to immediately prescribe an additional anti depressant to take which he said would work great with the Paxil and so writes a script for Wellbutrin. The visit lasted 10 minutes. That whole experience just didn't feel right so I trusted my instincts and decided to stay the hell away from the psych Dr and take matters into my own hands and get off the Paxil. You're so right, there's zero help in getting off of it, just the usual ignorant blanket statements of "just skip doses and taper over a few days". I convinced myself it had to be done super slow. I don't remember the exact time but I spent many months tapering off the paxil.

I didn't start taking HTP and Melatonin until I was well under 1 mg and I introduced those very slowly. It's officially not understood how the class of paxil-like drugs work, but the theory is it makes more efficient use of serotonin, so yes you have to be super careful introducing supplements that can increase generation of seratonin while on antidepressants otherwise the risk for seratonin syndrome increases and that can be dangerous.

I'm sure there are some people who can benefit by taking an antidepressant, but they are definitely way over prescribed. Shortly after starting my taper, I insisted on a testosterone recheck and the total came in at under 200!

It took a long time to get off the Paxil and even then, it took a few months to start feeling somewhat normal. For me, it was definitely worth it. If I followed my Drs advice, I'm sure I'd be a total mess by now on even more prescriptions and living with super low testosterone. Life would suck if that happened. It pays to be your own advocate for your health and well being.

 

[AlwaysCold]

Dr's and the pill racket piss me off, badly. They push antidepressants like a crack dealer. I love how they want to push MORE anti depressants while you are already on them, it's the biggest scam in the medical world. The long term effects of most of these drugs are horrendous, never mind the side effects while being on them, anything that murders your libido and causes weird sexual side effects cannot in anyway be good for your overall health, let alone causing electrical zaps through the brain.

Interesting on waiting until super low dose to start taking other things to help, that may be a good idea. What was your test level before you started tapering off?

 

[seaexplorer]

What was your test level before you started tapering off?

For some reason, my dipsh-t Dr didn't want to test my hormones because he said it "wasn't time" .... He said they only needed to be checked once a year during my annual physical and that my insurance wouldn't cover until it was time. It was about 3 months into my taper that I finally got him to cave in and test them and he only tested the total testosterone, nothing else, and that came back at under 200. I'm a mellow type-B person, but I seriously wanted to kick his a-- right there! I asked him how come my level is so low while I'm taking Androgel and his answer was "I don't know". He then prescribed an increase in the Androgel. No additional testing, no follow ups, and it just wasn't an option to even have a discussion with him on this. Anyway, getting off the Paxil was tough but very worth it. I was obviously prescribed it via a misdiagnosis. That drug did not agree with me from the first day I took it and it took months to get off of it and my brain chemistry to rebalance itself. If you decide to get off of it, I recommend doing very slow even if it takes a whole year or more.

 

[AlwaysCold]

I love know it all Dr's that dont even LISTEN to what people are saying, I think most are super jaded and just want to get paid at the end of the week. There are more bad Dr's than good out there imo, and it gets worse when you get into anti depressants and hormones.

I have been slowly lowering it but have hit a major wall, each time I lowered doses my whole body felt like it was being crushed in a vice for 2-3 days, nerves felt like they were on fire, it was basically extreme withdrawal. I have gotten down from 15mg to 5mg in the last few years, but it has not been easy. I dont know how Im going to get to zero. It would certainly help in the downstairs department, that's for sure.