Were is the T going????

[Mr Bill]

My last blood work October

Total 753 348-1197
Free t 20.8 6.8-21.5
E2 11 3 - 70

This blood work

Total 591 348-1197
Free t 11.2 6.8-21.5
E2 18.9 7.6-42.6

This is on 160mg Test cyp per week
2x 250 units HCG per week
1/4 mg Anatrazole 3x per week

Blood was drawn on day 7 before test injection. What could cause my numbers to drop? I thought it was taking longer to recover from work outs. I did go to test depot from the test made at a compound pharmacy. Should I seek an increase in my dose or could it be something else?

[steroid.com 1]

SHBG assay says???

What is "test depot" a legit pharmacy???

[bass]

yes SHBG. it could be under dosed compound!

[HRTstudent]

Your T didn't fall that much. It's still in a very good range, and definitely high. Remember that that number you see is your trough... so most of the time you are high and you are no doubt supraphysiological at times, likely half the time.

Not only that, but your e2 test is different. You seem to be aromatizing more, but the tests are different so it's always tricky. I like and advise to pick a test and use it repeatedly.

What your e2 tests do show is that on the first bloodwork you are very low-normal e2. However, on the second test you are closer to mid-normal. I would wager that this extra conversion to e2 could easily explain that small drop in testosterone.

[ecdysone]

The average of the two is 672 which is not much more than ±10% - well within assay precision.

I would get another set of BW done if you are concerned.

[Vettester]

SHBG assay says???

What is "test depot" a legit pharmacy???

Actually, I think he Bill meant to say "Depo Testosterone", which is manufactured by Pfizer.

The average of the two is 672 which is not much more than ±10% - well within assay precision.

I would get another set of BW done if you are concerned.

Agree completely!!

[Mr Bill]

SHBG assay says???

What is "test depot" a legit pharmacy???

Sorry!I had a brain fart depo testosterone LOL

I don't have the SHBG assay test. What does that test tell you?

[Bonaparte]

Well, your estrogen rose, and your test fell. This tells me that your aromatase activity has increased, which is the main issue here.
Do you have more bodyfat now than in October?
Are you stressed out or drinking/using drugs? Still sleeping as well?
Also, your body will eventually adapt to the effects of AIs by producing more aromatase enzymes to compensate (if you keep E2 too low).

And have you gained weight since October? More body mass = more blood volume = lower hormone concentrations.

[Vettester]

Based on an average albumin score of 4.4 (this could be higher or lower), the SHBG score for OP has almost doubled, going from approx. 21nmol/L -to- 40nmol/L. Again, the score is based on albumin being at 4.4, which is just speculation on my part. Either way, his SHBG has seen a significant increase.

Bonaparte is hitting on some definite possibilities. SHBG is synthesized in the liver. The suggestion of drinking and/or drug usage might be complicating part of this. You might consider running a ALT/AST panel if you haven't done so yet.

I would be curious about the body mass increase as well ... Also, very important, how do things look with your thyroid?? Hyperthyroidism is something that needs to looked at and ruled in/out.

Anyways, if you can run a SHBG lab, or pull the albumin score out of a metabolic panel we can get the exact on it.

Also, I noticed a variance in the reference ranges of the two (2) E2 scores. If Ecdysone is reading, he will probably know if the two scores with that amount of variance on the ref. range are apples-to-apples. Either way, IMO, it's on the low side. I would personally cut out the AI for a little bit and see if you can increase it a little bit (again, JMO, go by what your doctor suggests).

[ecdysone]

Also, I noticed a variance in the reference ranges of the two (2) E2 scores. If Ecdysone is reading, he will probably know if the two scores with that amount of variance on the ref. range are apples-to-apples. Either way, IMO, it's on the low side. I would personally cut out the AI for a little bit and see if you can increase it a little bit (again, JMO, go by what your doctor suggests).

Good catch - probably apples to oranges, IMO.

The guys here might be right and there has indeed been real drop in your test levels, but honestly, I wouldn't base any change in therapy without a third assay. And, would be nice to see what your SHBG looks like.

So much can affect test levels, and not just the obvious: exact dose injected, timing, etc - but recent studies have shown that fasting levels are significantly higher.

[steroid.com 1]

^^^^Agree with ecd & Vette.

Even if the OP is injecting once a week his serum levels should be pretty consistent; to see such a suppression would lead one to look at possible cause and SHBG is one culprit for sure.

Like stated, don't change anything till your next BW and look at the sticky on what hormone panels that are recommended.

[kelkel]

Ecd do you have any studies handy on that topic? I'd be interested in reading them.

Op, once your go through your next testing and IF your shbg is high, consider (do your research) adding avenocosides or stinging nettle root as supplements. Also add vitamin D. They can help to reduce shbg levels. Most all of us are deficient in vit D levels unless supplementing.

[ecdysone]

Ecd do you have any studies handy on that topic? I'd be interested in reading them.

Yes, but I got it from elsewhere: http://onlinelibrary.wiley.com/doi/1...296.x/abstract

We found a decline of S[erum]-T of 30% from 60 to 120 min after food intake compared to samples taken in the fasting state. This decline may give false low T values and overestimate the number of men with suspected hypogonadism. Until the mechanism behind this effect has been explored, we suggest that assessment of T for diagnostic purposes should be collected in the morning after an overnight fasting.

[kelkel]

Thanks E. Interesting as I will look through some past BW of my own and see if I can find a correlation. I've had tests done in that scenario that did not involve lipids or anything else that fasting was needed for. I wonder what effect on Estrogen, if any? I will email this to my doc.
Great find!

[HRTstudent]

It is interesting, but we must keep in mind this study was done on males not on exogenous testosterone. Quite frankly, if you're on T cypionate you can forget about your T circadian rhythm.

This would definitely be useful for someone who is in the diagnostic phase, however, before starting any HRT.

[ecdysone]

Excellent point. However, the mechanism as to why test levels are lower after eating is still is hard to rationalize, which is mainly why I even referred to the study. For those of us contributing to this forum, the "morning" portion can certainly be dismissed.

[Mr Bill]

Sorry it took so long, but here is the info.


I have been doing fasting cardio 6x a week and lifting 4x a week since January.
I now have more muscle and less fat.
I am at 225 lb. 6'1"
I have 2-3 drinks over the weekend
No drugs
I am on thyroid meds and my TSH is 2.0


The estradiol test in October was sensitve and the test in April says Roche ECLIA Methodolgy (whatever that means)

The labs from April did include ALT/AST ALT 31 0-55
AST 43 0-40 HIGH

Albumin, serum 4.3 3.5-5.5

I have an appointment with the doc on Tuesday.

I was not tested for SHGB and I went through my labs for last year and was never tested for it.


What does the SHGB test tell you???

[kelkel]

SHBG binds your free T. So does albumin to some extent. So, the lower the shbg level, the more free or unbound T is available for use. Read the following excerpt:

"The test for sex hormone binding globulin (SHBG) is primarily ordered in conjunction with other tests to evaluate the status of a person's androgen levels - the male hormones. With men, the issue of concern is testosterone deficiency, while with women the concern is excess testosterone production. A total testosterone may be ordered prior to or along with a SHBG test.

SHBG and testosterone levels may be ordered on an adult male to help determine the cause of infertility, a decreased sex drive, and erectile dysfunction, especially when total testosterone results are inconsistent with clinical signs.

In women, small amounts of testosterone are produced by the ovaries and adrenal glands. Even slight increases in testosterone production can disrupt the balance of hormones and cause symptoms such as lack of menstruation (amenorrhea), infertility, acne, and male pattern hair growth (hirsutism). These symptoms and others are often seen with polycystic ovarian syndrome, a condition characterized by an excess production of androgens. SHBG and testosterone testing may be useful in helping to detect and evaluate excess testosterone production and/or decreased SHBG concentrations.

Testing for free testosterone, albumin level, and one or more other sex hormones, such as prolactin, estradiol, and LH (lutenizing hormone), may also be performed to evaluate a person's existing balance of hormones.

Sometimes, a total testosterone and SHBG are ordered to evaluate free androgens by calculating the Free Androgen Index (FAI). This equation gives doctors an idea of the quantity of testosterone that is not bound (bioavailable testosterone) to SHBG and is calculated as follows: FAI = Total Testosterone / SHBG. In males, a fall in testosterone causes a rise in SHBG, so an FAI or another measure (bioavailable testosterone) is often ordered to detect low levels of free testosterone, which may cause decreased sex drive, loss of muscle mass, decreased bone mass, or occasionally problems with having erections (erectile dysfunction). An elevated FAI may be useful in the evaluation of androgenic alopecia (balding), hirsutism, and severe acne where testosterone levels may be normal.

When is it ordered?
Currently, the SHBG test is not performed frequently or routinely. In many cases, doctors feel that the total testosterone, and perhaps free testosterone, provides sufficient information. SHBG is ordered primarily when the total testosterone results do not seem to be consistent with clinical signs, such as decreased sex drive in men or hirsutism in women.

What does the test result mean?


When the SHBG level is increased beyond what is expected, there is likely to be less free testosterone available to the tissues than is indicated by the total testosterone. If the SHBG concentration is decreased, more of the total testosterone is "bioavailable" - not bound to SHBG. This information may be important in the overall evaluation of an individual with signs and symptoms of a condition related to excess or deficient sex hormone production."

[Mr Bill]

I will ask to be tested for SHBG. What can I do to reduce high SHBG if that is the problem?

[kelkel]

Bill re-read post #12.

[Mr Bill]

Bill re-read post #12.

Thanks Kel, I will get my levels and go from there.

[Mr Bill]

My SHBG came back at 27.2 16.5 - 55.9 nmol/L

[kelkel]

My last test was 40. Before that 34. They will fluctuate a bit. I'll be checking mine soon also to see if there's a difference since adding the nettle and D.

[Squirrel88]

I know the feeling. When I first learned my body had almost quit producing testosterone, I was happy I started to get shots. My levels went up from 113 to around 850 by getting a shot once a week for around 4-5 months. My doctor's decided to put me on one shot every 2 weeks. BAD IDEA! My levels dropped from 850 to 200. I guess I am going to be getting shots every week for a long time to come.

[jamotech]

Lots of good info already, first thing I noticed was that the test drop was very low, along with a slight rise of E2. My answer would be that your never gonna test the same, there will always be small fluctuations, and yours are that small, I dont see anything to fix. You just happen to convert a little more t to e this time, and at day 7, numbers are ok. Go to 2x a week for more stable levels.