last fridays blood work

[zillagod]

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[bass]

I have no clue what to make of this! so you did two tests at the same time? I think that free T maybe a mistake, I could be wrong but you can't have high free T with low LH, FSH and total T! its either a typo or botched test.

[100%]

Well the good news is you are not primary hypogonadism. You boys are doing a pretty good job for what little simulation they have. There is no point in trying to compare result from two different labs the mythology is completely different ranges testing. The problem is most likely pituitary related. I also notice your prolactin is a little high. Did doctor send you for a mri yet? Do you have any past drug use?

[zillagod]

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[zillagod]

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[100%]

You may be a prime candidate for Clomid Treatment ask your endo about it. Also if you had any head injuries from playing
extreme sports can cause this.

[zillagod]

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[zillagod]

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[100%]

Your nuts are fine. I really don't see a need or benefit to adding hcg . It would most likely cloud the results of treatment. Stimulating the pituitary is the key here. Attempting this on your own would be very difficult even for doctors that know what they are doing. It is a very delicate process a lot of monitoring and analyzing results.

[zillagod]

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[100%]

Prolactin is not that high just something to look at. Pituitary tumor usually raises prolactin to extremely high levels. Pituitary adenomas are much more common if this is the case they would treat it with a d2 antagonist in most case this is very effective. Your free test is high because you shgb is low. You could also have high total testosterone and high shgb free could still be low.

[zillagod]

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[100%]

The concentration
of testosterone in the various free and bound
forms is essentially a function of total testosterone
concentration and the relative concentrations
of SHBG and albumin. It can be predicted that
increased SHBG will decrease the concentration of
both free and bioavailable testosterone for a given
total testosterone concentration. Many clinicians
use a calculated free androgen index to estimate
physiologically active testosterone.5,6 This index is
typically calculated as the ratio of total testosterone
divided by SHBG and multiplied by 100 to yield
numerical results comparable in free testosterone

[100%]

So basically it is based off a ratio if you have low shgb and mid to low total it will make free test appear normal. That is why most dont go by free. Bio available test is said to be more accurate.

[100%]

Bioavailable Testosterone . Bioavailable testosterone
is a term applied to the sum of circulating free
testosterone and albumin-bound (weakly bound)
testosterone.5,6,10,22,31 A commonly used method for
determining bioavailable testosterone involves the
selective precipitation of SHBG with ammonium
sulfate. As in the free testosterone methods described
above, tritiated testosterone is added to serum that
is then allowed to come to equilibrium at physiologic
temperature. Testosterone bound to SHBG is then
selectively precipitated with 50% ammonium sulfate,
leaving free and albumin-bound testosterone in
solution. The percentage of tritiated label not bound
to SHBG is multiplied by the total testosterone to
produce the bioavailable testosterone.

[zillagod]

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[100%]

From Dr.Crisler
We've given up monitoring serum free testosterone as a biomarker of a male's testosterone metabolism, and we've switched to monitoring bioavailable testosterone.

This is because since the 1980's when the free testosterone tests became available, we've discovered that serum free testosterone too rarely correlated to a male's symptoms of testosterone metabolism - eg: damage tolerance.

On the other hand, since the early 1990's, monitoring of bioavailable testosterone has yielded highly reliable correlation with our testosterone metabolism.

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Total testosterone = testosterone-bound-to-SHBG + testosterone-bound-to-albumin + free testosterone

Bioavailable testosterone = [ testosterone-bound-to-albumin + free testosterone ]

Total testosterone = testosterone-bound-to-SHBG + Bioavailable testosterone

####

There are three bioavailable T tests which I recommend to forum members, and they all have different reference ranges:

1) Quest have a calculated BioT test (14966X).



2) Labcorp have a pure measurement BioT test, ie: "Testosterone, Free and Weakly Bound (143255)", and this test does use precipitation to remove the SHBG-bound-to-testosterone component, but it uses RIA (radio-immunoassay) instead of LC/MS/MS to measure the residual BioT component.

Insert 143255 into the "test number" field at the following page:


Labcorp now have a more sensitive Total Testosterone test, ie: "Testosterone, Total, Women, Children, and Hypogonadal Males, LC/MS-MS (070001)".
This test uses LC/MS/MS to measure the total T.

Insert 070001 into the "test number" field at the following page:

....and two tests will be listed not one (not sure why), then click on the number 070001


3) Mayo Labs have a BioT test "Testosterone, Total, Bioavailable, and Free, Serum (83686)", and this test uses precipitation to remove the SHBG-bound-to-testosterone component, but they measure the remaining fraction of BioT using reference samples, radioactive labeling, and a percentage calculation.

[100%]

Thanks for the further explanation 100% !!

Anytime

[100%]

Did they check your glucose?

[zillagod]

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[100%]

Have it checked there is a strong link between low Sex Hormone Bind GLB and insulin resistances.

[zillagod]

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[zillagod]

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[100%]

thats the thing though, since i have to go through clinics, i cant just have them test me for anything, they do the very bare minimum when it comes to everything, most of them are still students/not even finished their residencies

No doctor should have any problem checking that especially with a family history. Im really surprised they didn't already.

[zillagod]

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[100%]

If you did not eat or drink 8-12hr before test and you shouldn't have you are prediabetic. Need to address this first could be the root of your problems.

[zillagod]

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[zillagod]

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[100%]

Think of hcg as exogenous LH it will not stimulate pituitary. If anything it would suppress natural LH production. Even starting on trt with exogenous would take a least three months to get dialed in. It is best to get to the root of problem. Guys with low shgb for med reason do not do well by adding exogenous testosterone .