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Thread: What level do physicians aim for, and which, free or total T?

  1. #1
    sacredbiovitality is offline New Member
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    What level do physicians aim for, and which, free or total T?

    I may receive TRT based on my total T, not my free T or bio T, since my doc says they are within normal range, but I have symptoms. So in this case:

    Which would a physician aim for in my situation, a total T level or free/bioavailable T level?

    And what levels do physicians aim for? I'd like to have an idea of what are high levels for physicians to aim for, and low levels. A typical physician is probably more hesitant, while TRT specialists would probably aim for higher levels, is this right?

    If the T level my physician aims for is too low, would it be a good idea to switch to a different physician that will aim for a higher level?

    I am 23 if that helps, my physician said TRT is rarely prescribed for someone my age, so reactions may vary as compared with someone who is 50 or whatever. I take my T level pretty seriously, so I want to get the best deal. I have testicular issues, for those who say it's not a good idea for a 23 year old to go on TRT.

  2. #2
    Beethoven's Avatar
    Beethoven is offline Productive Member
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    At your age I would be weary of starting trt. It should be your last resort, then and only then your physician should aim for the appropriate level for your age.

  3. #3
    sacredbiovitality is offline New Member
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    Well it is a last resort, just read the last sentence of my post.

    And funny. My physician said they must compare T level to the average for all ages, and it doesn't matter what my T level is like FOR MY AGE. I guess you're not a reliable source of information.

  4. #4
    sacredbiovitality is offline New Member
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    Or actually, sorry, my physician said they don't have anything to compare my T level to, as a 23 year old. I think they only have official lab ranges on men 26+ from what I've read on the internet.
    Last edited by sacredbiovitality; 07-12-2014 at 02:48 PM.

  5. #5
    Beethoven's Avatar
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    I think you need to find a Dr. knowledgeable in trt. most Drs. shoot for just that, middle of the road. In reality someone your age would be in the upper level range rather than middle of the road.

  6. #6
    2Sox's Avatar
    2Sox is offline Knowledgeable Member
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    Quote Originally Posted by sacredbiovitality View Post
    Well it is a last resort, just read the last sentence of my post.

    And funny. My physician said they must compare T level to the average for all ages, and it doesn't matter what my T level is like FOR MY AGE. I guess you're not a reliable source of information.
    The only "reliable" source of information you will ever find is from well researched scientific findings and the conclusions you've drawn from your own experience and hard learned lessons. However, there are many well respected, solid and reliable sources of information - which have been drawn from a good deal of experience and dedicated self education and very often from pain and hard lessons - which you will find here on this forum. Beethoven's contributions on this forum have been valued by many here. I'm certain after spending some time on this forum, you will see why. So I'd suggest you slow down and listen when those more knowledgeable than you offer to be useful. Humility never hurt anyone.

    Something else you'll soon learn here is that most doctors know less about TRT than most of the long time members of this forum. Just a fact. If your doctor is fixated on Total T, he is one of those that is sorely lacking in knowledge. I'd advise that you get your education here, so that you can go back and educate him.

    To try to answer your question: IMO, at your age, you should be at peak testosterone levels - both Total and Free. You'll soon learn that Total Test numbers mean nothing. At best they are merely a guide. Free T is what you should be looking at. So if you are interested in a guide, I'd say you ought to be between 800 and 1100 Total testosterone . Free T should be in the 300-500 range. Again, my opinion. And this was a no brainer. I just looked at the ranges for Quest and gave you my best guess. You could have done the same.

    If you'd like the members of this forum to REALLY be useful to you, it would be best if you said something about your medical history - including the cause of your low T - and post your most recent blood work. The members here are exceedingly generous and well intentioned, and sincerely want to help. We've all been where you are now.
    Beethoven likes this.

  7. #7
    OingoBoingo's Avatar
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    Quote Originally Posted by sacredbiovitality View Post
    Well it is a last resort, just read the last sentence of my post.
    Who made this determination? You or your physician?

    What therapies did you try previously?

    Can you post your blood work? There are some guys on the forum that might be able to help you.


    Quote Originally Posted by sacredbiovitality View Post
    And funny. My physician said they must compare T level to the average for all ages, and it doesn't matter what my T level is like FOR MY AGE. I guess you're not a reliable source of information.
    I believe you've come to the right place if you're looking for some help, but you've got to be willing to listen. There's a good chance someone on the forum might have already dealt with the same problem you are now facing.

    Although I am only at the beginning of my journey, I am very grateful for the help I've received from this forum. My guess is a condescending attitude won't help you much. You should want people to contribute to your thread, not sit on their hands for fear of being ridiculed.

    I inject myself with Testosterone daily. I know it sounds like fun, but really it isn't. My best advice is that at your age I would do everything I could to avoid TRT.

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    Every doctor is different. It depends on a combination of things such as their background and type of physician they are. I.E. a GP, vs. and Endo vs. anti aging specialist, etc. as well as individual personality. I have a GREAT GP who is focused on getting me up to the high end of norm. So I'm very fortunate. Most GPs play it safe and as long as you're "in range" they don't care how you actually feel. Even if you're still miserable, they play it safe because this area of treatment tends to be a bit taboo, what with all the negative press over the years from sports abuse. Etc. You just have to find a doctor who possesses your same ideals and stick to your guns until you do. Though in many cases, TRT at your age may not actually be the best approach. You may still have options that can restart your natural production, which is ideal at best.
    Last edited by forrest_and_trees; 07-13-2014 at 09:42 PM.

  9. #9
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    my trt guy goes by "at what point are your symptoms relieved"... theres a huge range..forget what it is for normal but its like 300 to 900 i think.... having the highest number possible isnt necessarily what you want.. variables such as what is your actual free t level etc. are highly important. I have seen posters here claiming very high numbers at ages nearly 60 and you have to wonder how the dr isnt doing malpractice as you shouldnt be on trt if your starting point is 500 and such....

  10. #10
    Chicagotarsier is offline Senior Member
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    1. The RANGE for TT is based on all ages. There is only one approved range via the FDA and organization that standardizes the ranges. If he pulls some age ranges out ask where they come from...because your research shows there is only one approved range in the USA.
    2. The RANGE was based on all ages and all types of people with issues also....some were diabetic and patients under treatment for other serious illnesses.
    3. Most important....your first question to your doctor should be...what are we shooting for and what is your process to determine if I am at the right level. Hearing it from the guys mouth will mean more than anything.

  11. #11
    kelkel's Avatar
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    Expand on your testicular issues if you would please. Are you referring to a varicocele?
    -*- NO SOURCE CHECKS -*-

  12. #12
    Low Testosterone is offline ~ HRT Specialist ~
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    Quote Originally Posted by sacredbiovitality View Post
    I may receive TRT based on my total T, not my free T or bio T, since my doc says they are within normal range, but I have symptoms. So in this case:

    Which would a physician aim for in my situation, a total T level or free/bioavailable T level?

    And what levels do physicians aim for? I'd like to have an idea of what are high levels for physicians to aim for, and low levels. A typical physician is probably more hesitant, while TRT specialists would probably aim for higher levels, is this right?

    If the T level my physician aims for is too low, would it be a good idea to switch to a different physician that will aim for a higher level?

    I am 23 if that helps, my physician said TRT is rarely prescribed for someone my age, so reactions may vary as compared with someone who is 50 or whatever. I take my T level pretty seriously, so I want to get the best deal. I have testicular issues, for those who say it's not a good idea for a 23 year old to go on TRT.
    Low testosterone isn't common in young men, although it most certainly occurs. However, it is increasingly becoming more common largely due to the way we live. Terrible diets full of crappy foods plays a role, but that's not the biggest one IMO. So many young kids are heavily exposed to antidepressants, ADD and other hyper active medications that all damage testosterone production. That, along with environmental chemicals, it's no wonder we're seeing an increase in low test in young men as well as men as a whole.

    As far as what matters, Free Testosterone is all that matters. As for what level to aim for, you and your doctor should be aiming for symptomatic relief without complications or side effects. Numbers can be a guide but they're still just numbers. For example, most all men will have symptoms of low test when their free levels are below 15 pg/ml regardless of their Total Testosterone. And then most men will feel their best in the 20-30 range but plenty of men will feel great 15-20 pg/ml, which tells us numbers aren't as important as symptomatic relief.

    Go by how you feel.

  13. #13
    Ryanmcd is offline Associate Member
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    Funny you say the ADD meds because they gave me that when I started having issues with focus, it was mostly bad diet, then when I stopped the meds I really needed them, after that I did a full bloodwork and I had a test lvl of 200, I knew it had to be something because I was always on the high side as a kid and in my 20's.

    They would hand out ADD meds but when I asked about test they told me that's not a good idea and maybe we can check that in 6 months The more I deal with the medical field the more I see this really is modern day drug dealing and kick backs etc.

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