Quick Question on Free testosterone score and lab range

[Notpretty]

I'm a Kaiser member so I don't know who there lab is...

My Free testosterone score was 208 and the range is 35-155 pg/ml. I've seen various pg/ml ranges for free testosterone on this forum and don't really understand what pg/ml beyond "Picograms per milliliter.

My question is....is my score of 208 really that high? My total was 689 ng/dl with a range of 220 -1100. And I guess to be more specific I'd like to know what other's Free test scores are relative to mine are. And, those who are seeing these doctors who really know this field what do you think is a high score? And, how much are you injecting weekly?

The endo wants me to be lower and is very concerned that it is so high. I don't see it that way because as we've reduce I feel worse...much worse. When she lowered my dose from 300mg every other week to 200mg every other week I am finding myself losing sex drive, depressed and pissy all the time. I was getting this same pissy feeling at the 300mg EOW, but only after the first 8 days past. I had 8 good days and did have a sex drive. Now at the lower dose, I'm more pissy...nearly all the time...well until I take more then I'm supposed to. Then I feel better for a while. Then I try to go back to the recommended dose and into hell I go again.

Still at 200 EOW...Then we went to weekly injections to try to reduce the roller coaster. That just made more dips. Then, I went to Thursday/Sunday injections with tiny injections of .25 cc or 50 mg's per injection. I'm still dipping into hell and I can't make it through four injections at such a small dose. After the third at that dose...I have zero sex drive...none none none...feel like crap all the time and barely notice the injections at all. I have to take more to get out of hell and have because I get a bit scared with my thinking. Seriously, bad thoughts etc. I'm tired of living this roller coaster and just want some stability. How do I get that? I only take testosterone cypionate ...no HCG or AI's or anything else. I know you'll want labs and I have some, but very few. One Estradil was 8 with range of 2-15. LH is low like it should be taking testosterone. No other revelant tests have been done nor do they seem to be needed by my Endo view of things. How do I get the Dr. to understand this is not me trying to juice...its just a matter of how I feel and that I need more than her acceptable range of 35-155 allows?

Thoughts?

[keep fightin]

just curious at what point in your 300eow did you get bw done? looks like you were at the top of that roller-coaster,thought the e3d might have helped, I would post whatever bw you have and see if any knowledgeable members can weigh in

[bass]

something doesn't sound right, was is e2 sensitive test? your doctor is right being concerned with your high free T, you really need to bring that within range, preferably high end or normal. your total is not important as long as your free is in a healthy range. you need to do e2 sensitive test to make sure your e2 is not too high. like KF said post your blood work with ranges so we can see what else is going on.

[zaggahamma]

here i been thinking free test can and usually is high out of range for optimal health/benefits....

subscribed

[bullshark99]

I have the same concerns as my free tes was even higher than that. My clinic told me dont worry its fine, good to be high but we all know here that we need to do or own due diligence, since a clinic could care less about of health instead they want to sell product. Dont have my numbe rin front of me but I know it was higher than that. Total was a tad bit out of range but I think the free is more important. Curious to what others have to say regarding a high number and possible long term ramifications??

[steroid.com 1]

I would like to see your complete hormonal panels including SHBG and Albumin as well as E2.

Total is normal range but Free over the reference range.

Immediate thoughts are low levels of Albumin and more importantly SHBG; you're not binding.

Or, E2 is in the tank and your not converting Test into E2 visa vi your high Free levels.

If E2 was high we wouldn't see high Free Test as it would be converting to Estradiol via aromatization.

bass is correct, Total Test is less important then Free Test as this point.

Final thought; hCG has been known to eliminate much of the symptoms you are describing. Read the post here I did on hCG and in the stickies as well. You could very well need to add in hCG to kick start your testicular function and increase sense of well being. I have a suspicion that this could very well be the issue...but still need BW with ranges.

Read this and the sticky as well: http://forums.steroid.com/showthread...e-While-on-TRT

[zaggahamma]

g
Just confirm that one fact please...does crisler, etc. want all numbers IN RANGE including free test?

[zaggahamma]

..........

[Notpretty]

I wish I had more BW data to show, but all I get tested for is Free Test and Total test. I begged for the one Estrodil and finally got it and as I posted earlier... it came back 8. Range was 2-15. So normal dead center.

I did have LH test done before therapy and one after about a year of therapy. The latter came back very low as it should be when on therapy. The early LH test came back 4.5 with range of 2.5 - 15. So I was low before therapy and am curious how just HCG would have affected me. I was tested pre-therapy for prolactin. My score was normal...right in the middle of the range. I can't post that score and range because its not available on the KP website. But I know it was dead center of normal.

But guys, this is all I have. I have not been tested for anything else. I can list my scores for Free and total during my 2 years of TRT if that helps. I'm usually a bit too high for Free T and in range for total, but on the high end. I have been complaining about severe symptoms since the start of therapy and am sick of living this way. I just want stability. Sanity. Off the roller coaster.

What should I be tested for and why...what does each test hope to tell me?

I only know a bit about estrogen build up. I don't see that as my core issue, but I really don't know why I think that. I don't have sore tits but I'm sure there's more than that to it. I've read this forum for about 6 months now and see my story over and over....People who are struggling with there therapy because their doctors are not up to speed or in the dark ages. I've changed Endo's three times now. This one seems to be better...open minded and willing to discuss things...but still very conservative. The others wouldn't even discuss things I've read here...like HCG. I was told HCG is not FDA approved.


I think I'm secondary, but still wounder if I have always have had LH production issue in my pituitary. I did have an MRI of my head to check for tumors before therapy, and it came back clear. I went through puberty but saw no genital grow spurt that usually occurs. I'd say I only changed about 10% of what a "normal" person does/did...based on locker room views while that age. I thought I was wierd and something was wrong but didn't know what to do. I did develop in all the other puberty area's: muscles, hair, beard, etc. I just don't know what happened at the crittical time. Both penis and testical are very small. Testicals are glaringly small. The diameter on a good day (Before Therapy) is a bit over a 1/2"..say 5/8". I couldn't or wouldn't wear a speedo...I'd look like a girl. What sucked is I was an outstanding swimmer. I swam with Summer Sanders in AAU at age 7/8, but when everyone changed after age 9/10 and I didn't, I just quit. People were shocked I quit...I was that good, but I just said some excuse and moved on. Maybe some sort of environmental factor interrupted things or something at that key period of time happened. I don't know and just don't get it.

My story and my untrained guess at what is happening is this. I am good when my overall testosterone level is high, but I do feel dips after day 7-8 from the injection...back when I was 300mg and 1 injection every two weeks. The dips ranged from mild to moderate but rarely did they ever get severe. But, when I got test scores back, they'd say...too high. But, they just monitored it to see if it settle on its own. Recently starting in November I was reduced to 200mg e2w and switch to an injection each week. That made things worse and I became convinced that my dips always happed after the level in my system peaked and I began to fall. And, now at a lower dose, my overall level has come down and the severity of the dips is worse during this slide down from 300MG to 200MG E2W. It was hell during that entire slide and I was only up for a couple days after an injection, then back to hell.

I stayed in hell staying at this dose but we went to injections twice a week Sunday/Thursday hoping I might level me out. Nope. I got really bad the second week in De***ber ...scary bad. I finally said f'it and I increased the dose of my Dec 8th injection from 50mg to 85mg. In two days I came out of hell...but still felt crappy in general, but noticabley better.

On the 11th I took that same amount of 85mg again and I felt better yet and even notice a tiny bit of sex drive. But then I knew I was not following Dr orders and went back to 50mgs knowing a test is coming on Jan 10th. I felt pretty good until Dec 21 when I absolutely fell apart again. It started on the 20th and by mid day the 21st I was in hell. Racing negative thoughts, paranoid thinking, mean to others, angry, bitter, anti-social. It got scary again and I said F'it again and decided I was not going to ruin xmas for my family and live in hell like this. So late in the day on the 21st which was a day before my scheduled injection, I took three Dr. prescribed doses which was 150mg. I figured that would get me through the holiday. And it did. As I type I have not yet taken another injection...I suspect I'll be dropping into hell any moment, but so far I'm doing good. I'm good now I think in part because the larger recent injections pushed my overall level up and I do better when its higher. If I do the right thing, I should not take an injection until Jan 1. That's when three doses would have ended had I stuck to the schedule. I know I should go back to 50 mgs, but if I do...here comes hell and I'm just not going to do that. Its too scary. I'm going to last as long as I can and when hell comes, I'll take an amount that is enough to kick me out of hell, but no more then I need to do that...bit of a quessing game. Then I'll take the test and we'll see where I'm at.

So I think I get goofy when I've peaked after an injection and slide back down. But, I don't do that as bad if my over all level is higher. I do it very bad when its lower. And each time I've tried to go to 200mg and stay there as directed it gets scary bad. What the hell is happening to me.

[steroid.com 1]

IMO he says that so the Feds leave him alone LOL!

But he's mostly right of course...

TRT Specialists need to be very careful.

My Doc has a lawyer on staff...kid you not!

g
Just confirm that one fact please...does crisler, etc. want all numbers IN RANGE including free test?

[HRTstudent]

Your total T looks ok, your free T is high according to that. However, your personal well being seems to be very poor. So, it could be either you have something else making you feel poor or your T "sweet spot" is simply a little higher. The main thing, I think, is that you feel better from the T therapy. I would really stress that to the doctor that you are feeling a lot worse.

If you simply tell a doctor "I want higher numbers" they won't give that much credence. However, in your mind you may be thinking "I felt much better at a higher number" but if you don't communicate that then a doc MAY NOT get that.

Quite frankly, I think you might be changing things around too much, too quickly to get a good grasp of what is best for you. I say that because it seems like you are only trying some protocols for 1-2 weeks. Hormones can tend to be a little slower acting and I would not think something like 10 days is a good period of time to accurately gauge things.

[steroid.com 1]

Your total T looks ok, your free T is high according to that. However, your personal well being seems to be very poor. So, it could be either you have something else making you feel poor or your T "sweet spot" is simply a little higher. The main thing, I think, is that you feel better from the T therapy. I would really stress that to the doctor that you are feeling a lot worse.

If you simply tell a doctor "I want higher numbers" they won't give that much credence. However, in your mind you may be thinking "I felt much better at a higher number" but if you don't communicate that then a doc MAY NOT get that.

Quite frankly, I think you might be changing things around too much, too quickly to get a good grasp of what is best for you. I say that because it seems like you are only trying some protocols for 1-2 weeks. Hormones can tend to be a little slower acting and I would not think something like 10 days is a good period of time to accurately gauge things.

hrt - Please read the sticky at the top of the forum on how long it takes for "things to change" when a man starts a TRT protocol...10 days is nothing!

Six weeks at a minimum to see any chages in serum levels.

His Doc is slow to react and he can't even get the right blood work done.

It could be anything causing this to happen and he's a bit desperate and frustrated right now...and rightly so.

In absence of proper blood work, E2 and consideration of HPTA suppression in absence of hCG MAY be something to consider BUT without proper BW its pure speculation.

[HRTstudent]

I agree with what you're saying.

[kelkel]

Proper bw is in the stickies or Crisler's web site. Better yet, and since your having issues, cut to the chase and go see Dr. Crisler or Shippen. It will be worth the time and effort to get straightened out.

[Notpretty]

I get that it takes time for any change to take affect. Its a huge ship in the ocean and takes time to move it to another path. But what I don't get is how in 24-48 hours I can go from insane to not only sane, but feeling downright great. And the only change is an injection of testosterone .

I know to understand and treat me Doctors want one small change done over a couple months or more to make an assessment. But, when I'm dipping and its bad I simply cannot stay in that frame of mind knowing all I have to do is take an injection. I know that sounds like addiction, but if you were in my frame of mind you would do the same thing. I have not read of anyone having a similar experience as mine. I know others have written about being in bad moods, and grumpy...and it is related to the downside of an injection. That is what happens to me, but the severity is extreme.

I like to think I have strong mental control over myself. That I can deal with stress as well as anyone. And, when I'm in this mental meat grinder I can say to myself its just the testosterone...take a deep breath and relax...focus and don't let it control your mind. And that will work...for about 10 minutes. I'll do something...see something...think of something and bam I'm racing negative thoughts. I end up in bed with the TV on trying to distract my mind. I keep everyone away from me and just try to get through it. So far I've kept from really losing it....meaning lost all control and black out or something worse, but I fear that is possible at some point. I fear, if the right thing triggers me at the wrong time, I could do something really bad. So that is the scary part. I fear for myself an others. That is when I decide to take more.

I'm not a juicer...never have been and am not an addict of anything. I'm typically a B type personality which all this manic thinking is more type A and OCD like. Its wierd. Hormones can really affect the very foundation of who and what we believe we are...think we are...and alter us in every moment of our lives. I am getting afraid that I have a tumor or cancer or something else that the T fills a void temporarily and make me feel normal, but when it starts to fade it triggers something else. Sometimes I think I should stop entirely and see if I can get through the insanity (If that is possible) and see if my system will kick back in even a little bit. But my T was so low before therapy...I had total T scores of 35, 85, 68...they didn't do free tests then.

I can't go to that doctor because I can't afford it...really quite poor...on disability etc. I have to hope this Kaiser Dr will become educated or let me educate her and will try doing more. But even she is limited by "Kaiser protocol" and if she steps too far from it she has to justify it first before Kaiser will allow it. I will try and get the BW...but say I do, what can it tell us. I'll still need testosterone...

I'm sure my doctor will ask me to go to gel next..."It will be pattern the natural level of testosterone the male body normally has." First is that true? Second, do you guys think it will help my mental stability?

IS THERE ANYONE OUT THERE THAT HAS A SIMILAR EXPERIENCE????

[Vettester]

Agree with GD, we need the other labs. The free test can be verified with the SHBG and Albumin labs that are taken. Run the gamut on the hormone panels, then work with the facts.

[zaggahamma]

IMO he says that so the Feds leave him alone LOL!

But he's mostly right of course...

TRT Specialists need to be very careful.

My Doc has a lawyer on staff...kid you not!

cant remember in YOUR recent bw if your free test was in range or not?

[Notpretty]

cant remember in YOUR recent bw if your free test was in range or not?

Huh?? My most recent free score was 181 11/3. Before that it was 216 8/28, and 209 on 7/14. Not sure where your confusion is.

[zaggahamma]

Huh?? My most recent free score was 181 11/3. Before that it was 168. Not sure where your confusion is.

wasnt confused..you are...as i was directly asking that question to gdevine...look above my post that you are questioning you will see gdevines post that i quoted in the box above my post

[steroid.com 1]

cant remember in YOUR recent bw if your free test was in range or not?

Here is my Endocrine Panel as of a few weeks ago on a peak day J:

Endocrine Evaluation
Progesterone 0.92 Range: ng/ml 0.2 - 1.4
Estradiol 21.3 Range: pg/ml 7.6 - 42.6 (Sensitive)
DHEA-S 228.5 Range: ug/dl 44.3 - 331.0
DHT 47.72 Range: ng/dl 11.2 - 95.5
Test , Total 1133 Range: ng/dl 280 - 1100
Test , Free 30.50 Range: ng/dl 1.6 - 22
Test, % Free 26.2 Range: ng/dL = 2.53 %
Test, Bioavailble 681 Range: ng/dL = 66 %
SHBG 26 Range: nmol/L 10 - 80
IGF -1 195 Range: ng/ml 87 - 238
Cortisol 16.1 Range: ug/dl 4.3 - 22.4

Total Test and Free Test at the top of the reference ranges. These two are less important to me and my Doctor (a TRT Specialist) as are the Test % Free and Bio Available...which are ideal.

Every thing else here is pretty spot on.

I feel fantastic...we're leaving every thing alone.

[zaggahamma]

not at the top of the range...out of range..like i suspected and stated in the 4th post in this thread

^^^^also in response to gdevine...for some reason i forgot to quote him this time

[flatscat]

Hey g, what do u mean it takes six weeks for serum levels to rise when you start trt? Thanks

[steroid.com 1]

Hey g, what do u mean it takes six weeks for serum levels to rise when you start trt? Thanks

Generally accepted practice is:

Gels/Cream: Labs in 2 weeks.

Injections: Labs in 6 weeks.

Crisler and other practice the same.

Must have to do with daily use versus once a week injections and getting serum levels to a point that are somewhat statistically sound.

[steroid.com 1]

not at the top of the range...out of range..like i suspected and stated in the 4th post in this thread

^^^^also in response to gdevine...for some reason i forgot to quote him this time

J - My Doc and I feel that Total Testosterone and Test Free are less a marker for optimization as opposed to Bio Available and % Free assays especially in consideration of E2 and Cortisol and Progesterone values.

If a man feels good at these levels, presents no neg sides and ranges are not pushing supraphysiological levels optimal health can be achieved.

I feel fantastic and never looked this good in my entire life.

For me, it's damn near ideal in my case.

[Notpretty]

Wow! That panel is way beyond my knowledge level. I wonder what my Dr would say if I asked for that testing? I doubt she even knows why they are important. Given my situation, any advice? Assuming I cannot change dr, and have to make the best of this one.

[Notpretty]

Also, what the heck is Kaiser's lab doing for my free test when it's range is 35-155 when your range is 1.6 - 22. My test range indicates ng/dl too. ? WAIT....I just double checked and mine is pg/ml... ?

[flatscat]

Generally accepted practice is:

Gels/Cream: Labs in 2 weeks.

Injections: Labs in 6 weeks.


Crisler and other practice the same.

Must have to do with daily use versus once a week injections and getting serum levels to a point that are somewhat statistically sound.

Okay cool then it was a typo - it is not 6 weeks to see a change in levels, but six weeks for levels to stabilize enough to get a good indicator of how the protocol is working - got it and agree with that.

[steroid.com 1]

Wow! That panel is way beyond my knowledge level. I wonder what my Dr would say if I asked for that testing? I doubt she even knows why they are important. Given my situation, any advice? Assuming I cannot change dr, and have to make the best of this one.

Read the stickies and see blood work required for pre and post follow-up. Print it out and take it to her.

Google each panel and learn!