This is one of the great TRT mysteries to me. Especially the interplay between libido, TT, FT. Vince has optimal TT but seemingly low FT. In contrast, I ran my stuff last month and got: TT=531, FT (dialysis)=70.6, DHT(LC/MS)=35, DHEA=101
What to think?
The most noticeable benefit to TRT though is the increase in strength. But is it worth that to decrease sex drive? I don't think Vince has that problem though. Wish I didn't. It's become an unreconciled trade off.
FT 5-10 ng/would be considered low.
FT 16-31 ng/dL (top-end) is healthy.
Most men will do well with FT 20-30 ng/dL.
He is hitting a high FT 33 ng/dL running a TT 1000 ng/dL and that is with highish SHBG.
His FT was tested through Labcorp using one of the most accurate assays Equilibrium Ultrafiltration reference range 5.00-21.00 ng/dL.
His FT is far from being low or so-called seemingly low as you stated!
You most likely had your FT tested through Quest also using what would be considered one of the most accurate assays Equilibrium Dialysis reference range 35-155 pg/mL.
As you can see you are hitting a lower-end FT of 70.6 pg/mL.
You both used the most accurate assays but tested through different labs using different assays (UF/ED) which also have different reference ranges.
As you should very well know when it comes to libido let alone erectile function much more going on than just TT, FT, estradiol, DHT, and prolactin.
Too many get caught up on just the hormones.
I have stated numerous times on the forum:
Unfortunately, when it comes to libido let alone ED they are multifactorial and there is much more involved than just having healthy hormones (TT, FT, estradiol, DHT, prolactin).
*Thyroid/adrenals, neurotransmitters, stress (mental/physical), quality of sleep, diet/insulin sensitivity let alone underlying vascular health can all have a big impact on one's libido/erectile function.
My reply from a previous thread regarding ED/libido:
ED has multiple etiologies including vascular, neurologic, and endocrine disorders.
Underlying vascular health is critical!
Even when using PDE5is although effective for many most men have some degree of vascular/endothelial dysfunction.
Some men are poor responders and will end up needing to use intracavernosal injections to achieve/maintain an erection.
Having healthy testosterone levels is beneficial to one's libido/erectile function but it is far from the only thing that is required to achieve such.
Thyroid/adrenals, neurotransmitters, stress (mental/physical), quality of sleep, diet/insulin sensitivity let alone
underlying vascular health can all have a big impact on one's libido/erectile function.
Unfortunately, libido/ED is much more complex than simply having healthy testosterone levels.