High total T, low free T... no TRT... WTF

[Blazerod]

Trying to figure out my labs... not on any exogenous hormones. (I do take metformin for anti-aging/cancer)

46 yo... BMI 23... weightlifting 5-6 times/week... hard to gain muscle mass... kind of down in the evenings.

Total T: 874 ng/dL
Free T: 60 pg/ml
FSH: 4.3 mIU/mL
LH: 2.8 mIU/mL

Seems like my SHBG must be in the 150's??? but that's insane. Talked to my urologist, but he said AUA only looks at Total T and mine is above normal range high; he said they don't even look at free T unless the total T is low or low normal. But I definitely don't feel like my T is 874... feels more like 60.

 

[tareload]

Trying to figure out my labs... not on any exogenous hormones. (I do take metformin for anti-aging/cancer)

46 yo... BMI 23... weightlifting 5-6 times/week... hard to gain muscle mass... kind of down in the evenings.

Total T: 874 ng/dL
Free T: 60 pg/ml
FSH: 4.3 mIU/mL
LH: 2.8 mIU/mL

Seems like my SHBG must be in the 150's??? but that's insane. Talked to my urologist, but he said AUA only looks at Total T and mine is above normal range high; he said they don't even look at free T unless the total T is low or low normal. But I definitely don't feel like my T is 874... feels more like 60.

What is your SHBG? Simple test.

Report ref ranges and assay type for TT and FT.

DiscountedLabs has very cheap and great offer to measure TT/SHBG accurately.

Using Vermeulen fT calculator and taking your TT and FT as gospel that would imply 150 SHBG as you stated.

 

[sammmy]

Unreliable free T test and you cannot tell your T levels by how you feel.

Next time measure total T, SHBG, Comprehensive Metabolic Panel (contains Albumin) and calculate free T.

 

[Blazerod]

Interesting....
Albumin was 4.3

Lab was quest.
Upper limit of total testosterone was 827 (My value was 874)
Range of free T was 46-224 (My value was 60... pretty low, but still "normal")

So quest is not measuring the SHBG in the background to calculate the free T?

 

[Blazerod]

Just looked on the lab report and it says "Free T is derived from a mathematical model using Total T by LCMSMS, SHBG and albumin"... So I think quest is measuring the SHBG in the background.

 

[tareload]

Just looked on the lab report and it says "Free T is derived from a mathematical model using Total T by LCMSMS, SHBG and albumin"... So I thing quest is measuring the SHBG in the background.

Yep. Really high about 150 as you stated. FT by equilibrium dialysis typically 10 to 20% lower than calculated cFTV so you are pretty low.

 

[Systemlord]

Talked to my urologist, but he said AUA only looks at Total T and mine is above normal range high; he said they don't even look at free T unless the total T is low or low normal.

That’s unfortunate, because testosterone deficiency isn’t defined by Total T. The Kaiser guidelines pertaining to TRT are a little different, both the Total T and Free T must be low the normal range for TRT to be prescribed even though no consensus can be reached defining testosterone deficiency.

Sadly most guidelines are out dated and are inadequate and don’t take into account individual variation in gene CAG keg repeats, sensitivity at the androgen receptor or individual variation in the binding affinity for SHBG.

That’s why these private TRT clinics are so popular, starting treatment now instead of waiting around for the medical societies to get their act together, while you’re suffering.

 

[AdamHalley]

Why not just add 3-20 mg of boron to your daily supplementation regimen and see of you feel the difference in a few day? In most men it lowers SHBG and frees up testosterone fairy quickly...

 

[sammmy]

Just don't expect miracles. Boron is not going to double your free T, but does act a bit like a stimulant, at least for me.

I would be interesting to test SHBG to see if it's really 150 or something is messing with the test.

 

[AdamHalley]

My blood work disagrees. Boron has been proven to lower shbg in studies too. Especially in men who are deficient

 

[sammmy]

After 1 month of 9 mg/day Boron (as Calcium Borogluconate), not exactly ground breaking results:

Testosterone 590 -> 653 ng/dL,
SHBG 64 -> 60 nmol/L,

Free Testosterone (Quest Diagnostics, not dialysis) 45.1 -> 53.2 pg/mL [range 46 - 224]
Free Testosterone calculated: 80 -> 95.8 pg/mL (8.0 ng/dL -> 9.58 ng/dL)

* 1 pg/mL = 0.1 ng/dL

 

[AdamHalley]

After 1 month of 9 mg/day Boron (as Calcium Borogluconate), not exactly ground breaking results:

Testosterone 590 -> 653 ng/dL,
SHBG 64 -> 60 nmol/L,

Free Testosterone (Quest Diagnostics, not dialysis) 45.1 -> 53.2 pg/mL [range 46 - 224]
Free Testosterone calculated: 80 -> 95.8 pg/mL (8.0 ng/dL -> 9.58 ng/dL)

* 1 pg/mL = 0.1 ng/dL

I tried several different doses, types and brands of boron until I found what worked. Up To 20 mg is what I have found listed in studies. My go to is Now Brand Boranic Glycine (albion) at 12 mg daily.

Apparently not all borons are the same

 

[sammmy]

Post your lab tests. While boron gave me more energy and decreased inflammatory reactions, it impaired my sleep - something like a stimulant. This indicates it was absorbed but I stopped taking it because it was not a miracle and I value my sleep more.

Also note that half of the Free T increase is related to increase of my Total T and half to decrease of SHBG. All changes in my case were within typical daily fluctuations of T, SHBG, and free T, so I can't even claim that it was an effect of Boron.

 

[AdamHalley]

Post your lab tests. While boron has given me more energy and decreased inflammatory reactions, it impaired my sleep - something like a stimulant. That's why I stopped taking it.

Post your lab tests. While boron has given me more energy and decreased inflammatory reactions, it impaired my sleep - something like a stimulant. That's why I stopped taking it.

Also note that half of the Free T increase is related to increase of my Total T and half to decrease of SHBG. All changes are withing typical daily fluctuations of T, SHBG, and free T, so I can't even claim that it was an effect of Boron.

The sleep interference is exactly how I know I'm taking too much boron. Since boron itself is not a stimulant and I know for a fact that when my total testosterone is too high it also bothers my sleep, it is how I can tell almost immediately when my shbg has reduced and my free testosterone has risen. My lab work is from 5 years ago when I started the boron journey, and I have no idea where the files are. But once I saw the difference, and obviously felt the difference, I knew it was working. I'm also very careful not to change more than one parameter at a time so I know what is and isn't working, and I typically wait at least a month if not 6 weeks before I change anything else so my body has a chance to get used to the new regimen.

Obviously it doesn't work for everyone, nothing does. But I generally recommend it as an inexpensive and very quick starting point. If it works, it usually works fairly quickly for most men I have seen on the ******** group.

 

[sammmy]

Whether the stimulating effect of Boron is mediated through increase of free testosterone or is a direct effect on the nervous system is not known.

In my case, the Boron supplementation did NOT improve delayed ejaculation/orgasm so it did not have the typical sexuality boost of more potent free testosterone boosters (Arimidex, or the honeymoon period of TRT). It is also unlikely to improve physique like TRT can do in very hypogonadal men.

So I recommend Boron for energy/stamina but not sexuality or physique.