High Free T. but Regular T levels?

[jmjmjm]

Quick question.

I just restarted TRT after an approximate 5 month break for fertility reason.

Im on HCG (250 twice per week,) and 120ml weekly shots of test E (divided in two subq weekly shots.)

I just received my blood work and my resultare as follows:

Testosterone 20nmolL

Testosterone 576 ngdlL

Free testosterone 769pmolL

Testosterone 576 ngdlL

Shgb 11nmol

Estradiol and estrogen are twice what they used to be (non sensitive estradiol test since I’m in Canada, sorry)


I was wondering why is my free T higher than my total t?

Any side effects for this type of result?

I have been feeling great under the new protocol, except that it feels that my high estrogen and estradiol level are catching up to me, so will see what the dr recommends in my next appointment (my sex drive and boners have decreased quite a bit this last month substantially.) I know that there is a bit of a honey moon phase when you first start, but my sex drive is for sure lower than “normal”.

Thanks for the support. And any information would be appreciated.

 

[Systemlord]

SHBG levels affect the balance between Total T and Free T. Also testing methods may be different and If not using accurate testing methods, you can't really trust the results.

We're you on HCG the first time on TRT? If no this would explain the higher Free T and estrogen.

 

[jmjmjm]

SHBG levels affect the balance between Total T and Free T. Also testing methods may be different and If not using accurate testing methods, you can't really trust the results.

We're you on HCG the first time on TRT? If no this would explain the higher Free T and estrogen.

Thanks for the feedback. Yeah, this was the first time using HCG, and also DHEA

 

[Systemlord]

Yeah, this was the first time using HCG, and also DHEA

HCG will allow your testis to produce some testosterone and estrogen in addition to the injected testosterone which is then covered to estrogen via aromatase.

The DHEA can also increase estrogen. If you want what you had before you would need to be on Test only.

 

[madman]

Quick question.

I just restarted TRT after an approximate 5 month break for fertility reason.

Im on HCG (250 twice per week,) and 120ml weekly shots of test E (divided in two subq weekly shots.)

I just received my blood work and my resultare as follows:

Testosterone 20nmolL

Testosterone 576 ngdlL

Free testosterone 769pmolL

Testosterone 576 ngdlL

Shgb 11nmol

Estradiol and estrogen are twice what they used to be (non sensitive estradiol test since I’m in Canada, sorry)


I was wondering why is my free T higher than my total t?

Any side effects for this type of result?

I have been feeling great under the new protocol, except that it feels that my high estrogen and estradiol level are catching up to me, so will see what the dr recommends in my next appointment (my sex drive and boners have decreased quite a bit this last month substantially.) I know that there is a bit of a honey moon phase when you first start, but my sex drive is for sure lower than “normal”.

Thanks for the support. And any information would be appreciated.

The most accurate assays for TT/estradiol/DHT would be (LC/MS-MS) and Free Testosterone would be the gold standard Equilibrium Dialysis or Ultrafiltration (next best).

When posting labs always include reference ranges and testing methods/assays if possible.

I am a fellow canuck and looking over what you posted then your labs were most likely done at Dynacare or Lifelabs.

What province do you reside in?

Canadian reference range units are in (nmol/L).

US reference range units are in (ng/dL).

Regarding estradiol, I have used the standard immunoassay in the past and fortunately, the estradiol sensitive (LC/MS-MS) has been available in my province (Ontario) through Dynacare for the past few years.

Yours was tested using the standard immunoassay which can overestimate especially in cases of high CRP which can skew results.

Unfortunately the estradiol sensitive (LC/MS-MS) is only available through Dynacare in Ontario.

Seeing as you are injecting 120mg T/week (60 mg every 3.5 days) when were labs drawn?

We always want to test at the true trough (the lowest point) just before the next injection).

Being nitpicky when injecting every 3.5 days (84 hrs between injections)

Keep in mind that although TT is important to know FT is what truly matters as it is the active unbound fraction of testosterone responsible for the positive effects.

Again the only way to know where your FT truly sits is to have it tested using the most accurate assays such as ED or UF otherwise you would need to rely on calculated methods.

Yours was most likely done using the linear law-of-mass action cFTV as the piss poor direct immunoassay is no longer used and access to the gold standard Equilibrium Dialysis or Ultrafiltration is not readily available to everyone.

Although your TT 20 nmol/L (576 ng/dL) is far from high your FT would most likely be descent and if these are trough levels then the peak will be much higher.

We always need to keep peak/trough in mind when following a protocol (dose of T used/injection frequency) as this will have a significant impact on the outcome!

SHBG is critical to know as it will have a significant impact on TT/FT let alone can dictate what injection frequency may suit you best.

Men with low/lowish SHBG do not need to run very high let alone absurdly high TT in order to achieve a healthy FT.

Men with low/lowish SHBG tend to do better injecting lower doses of T more frequently (daily or EOD).....it comes down to the individual.

With an absurdly low SHBG 11 nmol/L, you would most likely fair better injecting lower doses of T daily or EOD.

Most men on trt are injecting (once weekly, twice weekly (every 3.5 days), M/W/F, EOD, or daily) using 100-200 mg/week T and many can easily achieve a healthy let alone high or in many cases absurdly high FT injecting 100-150 mg/week.

Believe it or not, some men achieve great FT levels by injecting <100 mg/week.

Sure some men may need the higher end dose (200 mg/week) but it is far from common.




*Running too high an FT can cause a majority of the issues one can run into when using exogenous testosterone!

 

[jmjmjm]

Thanks for the thorough response!

I’m in Alberta.

Even though I am going through a private Clinique, my labs were done through our provincial lab (precision lab.)

I know this is not he best for TRT purposes, but it probably helps with keeping the therapy cost down (I checked private cliniques around 6 years ago, and their prices, including testing, were pretty high.)

I am currently doing subq injections twice a week.
This lab was done the same day that my second weekly injection was due, so I guess closer to the trough levels.



My dr. just started me on anastrozole, .25 twice per week. Hoping this will bring my estrogen/estradiol within range and see if my Sex drive and moods get a bit closer to what they were before (just “normal” would be nice.)


I hope this anastrozole dose is not too high, because my next consult/bloodwork is not for a while lol.
Thanks again for the information

 

[Match]

Pergunta rápida.

Acabei de reiniciar o TRT após um intervalo de aproximadamente 5 meses por motivos de fertilidade.

Im no HCG (250 vezes por semana) e injeções semanais de 120ml do teste E (dividido em duas injeções semanais subq.)

Acabei de receber meu exame de sangue e meus resultados são os seguintes:

Testosterona 20nmolL

Testosterona 576 ngdlL

Testosterona grátis 769pmolL

Testosterona 576 ngdlL

Shgb 11nmol

Estradiol e estrogênio são o dobro do que costumavam ser (teste de estradiol não sensível desde que estou no Canadá, desculpe)


Eu estava me perguntando por que meu T livre é maior do que meu t total?

Algum efeito colateral para este tipo de resultado?

Tenho me sentido muito bem com o protocolo novo, exceto que parece que meu alto nível de estrogênio e estradiol estão me alcançando, então verei o que o médico recomenda em minha próxima consulta (meu desejo sexual e ereções diminuídas um pouco isso no mês passado, Eu sei que há um pouco de fase de lua de mel quando você começa, mas meu desejo sexual é com certeza mais baixo do que o “normal”.

Obrigado pelo apoio. E qualquer informação seria apreciada.

T Livre 769pmol / l = 16 ng / dl. E pela fórmula Tru-t.org seria 21 ng / dl.
ASSIM, Claro Que Não E Maior Que TTotal. Lembra qual o seu Estradiol?