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Thread: Relationship betwen Total testosterone and Free

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  1. #1
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    Quote Originally Posted by Enfuego129 View Post
    Depression isn't too bad but I don't think my head is in as good a place as it was when I was on the gel. I plan on calling the Endo's office to see if he will order the SHBG bloodwork. FYI, about three years ago I went to the doctor for treatment for depression. We tried five different meds over two years none of which did anything. Sometimes the side effects were worse than the depression symptoms. Hindsight, the depression may have been caused by low T since the Androgel made my head feel better than I could remember.
    Mate you need a good dr..

    Look up Dr John crisler if you are in the states www.allthingsmale.com

    He will help you! Dont mess aorund with amateurs.

  2. #2
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    Quote Originally Posted by n00bs View Post
    Mate you need a good dr..

    Look up Dr John crisler if you are in the states www.allthingsmale.com

    He will help you! Dont mess aorund with amateurs.
    i've heard only good things about him

  3. #3
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    Quote Originally Posted by jpkman View Post
    i've heard only good things about him
    Yes he is not a quack i have not dealt with him but have simply read alot of his infomation studied it myself.. And met alot of helpful people on the forums there who are all going through the same thing...

    He is light years ahead of other dr's and endos... I see people rpeorting that endos dont get tests (that even i know) are needed for a diagnosis and its jsut ridiculous.

    When a forum full of random people get together and know more then dr's something is totally wrong!

  4. #4
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    Enfuego, I'm a little late to the party on this one, been traveling today. Not much I can say that hasn't been said on the causes. The SHBG and albumin factors were hit spot on, and the amount of information provided on this thread pretty much makes it a "must see" for anyone studying up on HRT.

    Even though the information provided was priceless, I was still kind of scratching my head (it itched anyway) about your spreadsheet. Then rmacgurn hit it on post #19! (I think you deserve a reputation point for that BTW). I was basically going to say the same thing. Normal free "T" should and can be around 2%. In fact I've seen ranges from 1% to 2.7% ... So great if you're hitting 2.3 or 2.4.

    So, as others have also stressed, your attention and emphasis needs to be on that "Total T" number and getting that score in the satisfactory zone. Plus the E2, IGF and other pertinent tests need to be addressed. Have you really taken the time to investigate what it would cost to do this out of pocket with a place that can treat you properly? You might be surprised. I've been through the same thing my friend. It was truly frustrating because I'd rather just do a 1 stop shopping program with my primary and pocket the extra $$. However, that was just one big happy illusion. After my doc crashed me (like yours is doing) I knew hard choices needed to be made. However, I discovered those hard choices were actually easy choices when it comes to my health and I crossed over.

  5. #5
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    Quote Originally Posted by vetteman08 View Post
    Enfuego, I'm a little late to the party on this one, been traveling today. Not much I can say that hasn't been said on the causes. The SHBG and albumin factors were hit spot on, and the amount of information provided on this thread pretty much makes it a "must see" for anyone studying up on HRT.

    Even though the information provided was priceless, I was still kind of scratching my head (it itched anyway) about your spreadsheet. Then rmacgurn hit it on post #19! (I think you deserve a reputation point for that BTW). I was basically going to say the same thing. Normal free "T" should and can be around 2%. In fact I've seen ranges from 1% to 2.7% ... So great if you're hitting 2.3 or 2.4.

    So, as others have also stressed, your attention and emphasis needs to be on that "Total T" number and getting that score in the satisfactory zone. Plus the E2, IGF and other pertinent tests need to be addressed. Have you really taken the time to investigate what it would cost to do this out of pocket with a place that can treat you properly? You might be surprised. I've been through the same thing my friend. It was truly frustrating because I'd rather just do a 1 stop shopping program with my primary and pocket the extra $$. However, that was just one big happy illusion. After my doc crashed me (like yours is doing) I knew hard choices needed to be made. However, I discovered those hard choices were actually easy choices when it comes to my health and I crossed over.
    Vetteman thanks for weighing in on this subject. My inexperience with HRT is really holding this thread back. What is obvious to most of you is confusing to me. I will continue to research all replies here to better understand what is being taught here. Regarding your reply, hitting the 2.3 to 2.4 % normal / free testosterone is a good thing. What will happen to that number if my total T is increased with supplemental T? Also, if the normal / free % is above range wont my Endo say you are fine even with low total T? Which provides ammunition to withhold supplemental T?

  6. #6
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    Quote Originally Posted by Enfuego129 View Post
    Vetteman thanks for weighing in on this subject. My inexperience with HRT is really holding this thread back. What is obvious to most of you is confusing to me. I will continue to research all replies here to better understand what is being taught here. Regarding your reply, hitting the 2.3 to 2.4 % normal / free testosterone is a good thing. What will happen to that number if my total T is increased with supplemental T? Also, if the normal / free % is above range wont my Endo say you are fine even with low total T? Which provides ammunition to withhold supplemental T?
    Most endos will go off total t (god knows why)..

    And even if he refuses you treatment because you are 10 points off the barminimum of a ridiculous scale then he is not the sort of uneducated person you want treating your problems...

    SHBG binds to sex hormones

    Total test is all testosterone even that bound to shbg albumin and other peptides.

    Free test is unbound and bioavailable..

    The higher your SHBG the more test you will need, however shbg usually is increased by oestrogen..

    Oestrogen is made from testosterone in fat cells from an enzyme called aromatase..

    Im not sure if you guys can get FAI tests done (free androgen index) it measures the percentage of well.. free androgens like the name states...

    Supplemental transdermal T will increase t levels unless you have a major thyroid issue.

    But it will be best to get adrenals and thyroid sorted and checked to make sure it is not them mimicking hypogonadism..

    Hope some of that makese more sense to you then it did before.



    EDIT:

    Thats alot of "cardio" work.. Now doubt cortisol will be all over the shop and not helping because of it cortisol.. If you have adrenal issues this will worsen the problem.
    Last edited by n00bs; 06-30-2010 at 08:12 AM. Reason: EDIT

  7. #7
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    Quote Originally Posted by n00bs View Post
    Most endos will go off total t (god knows why)..

    And even if he refuses you treatment because you are 10 points off the barminimum of a ridiculous scale then he is not the sort of uneducated person you want treating your problems...

    SHBG binds to sex hormones

    Total test is all testosterone even that bound to shbg albumin and other peptides.

    Free test is unbound and bioavailable..

    The higher your SHBG the more test you will need, however shbg usually is increased by oestrogen..

    Oestrogen is made from testosterone in fat cells from an enzyme called aromatase..

    Im not sure if you guys can get FAI tests done (free androgen index) it measures the percentage of well.. free androgens like the name states...

    Supplemental transdermal T will increase t levels unless you have a major thyroid issue.

    But it will be best to get adrenals and thyroid sorted and checked to make sure it is not them mimicking hypogonadism..

    Hope some of that makese more sense to you then it did before.



    EDIT:

    Thats alot of "cardio" work.. Now doubt cortisol will be all over the shop and not helping because of it cortisol.. If you have adrenal issues this will worsen the problem.
    n00bs, good post and thanks for putting it in layman's terms for me.

  8. #8
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    Quote Originally Posted by n00bs View Post
    Most endos will go off total t (god knows why)..

    And even if he refuses you treatment because you are 10 points off the barminimum of a ridiculous scale then he is not the sort of uneducated person you want treating your problems...

    SHBG binds to sex hormones

    Total test is all testosterone even that bound to shbg albumin and other peptides.

    Free test is unbound and bioavailable..

    The higher your SHBG the more test you will need, however shbg usually is increased by oestrogen..

    Oestrogen is made from testosterone in fat cells from an enzyme called aromatase..

    Im not sure if you guys can get FAI tests done (free androgen index) it measures the percentage of well.. free androgens like the name states...

    Supplemental transdermal T will increase t levels unless you have a major thyroid issue.

    But it will be best to get adrenals and thyroid sorted and checked to make sure it is not them mimicking hypogonadism..

    Hope some of that makese more sense to you then it did before.



    EDIT:

    Thats alot of "cardio" work.. Now doubt cortisol will be all over the shop and not helping because of it cortisol.. If you have adrenal issues this will worsen the problem.
    yes,
    it is an available test...and i had it done...by an endo's order (at his office) and was told mine was way too high (all on 10mg ed of androgel)....i said..."but i feel great" and he says "yes, cuz your doing too much"....

    thats when i moved on

  9. #9
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    Quote Originally Posted by n00bs View Post
    Most endos will go off total t (god knows why)..

    And even if he refuses you treatment because you are 10 points off the barminimum of a ridiculous scale then he is not the sort of uneducated person you want treating your problems...

    SHBG binds to sex hormones

    Total test is all testosterone even that bound to shbg albumin and other peptides.

    Free test is unbound and bioavailable..

    The higher your SHBG the more test you will need, however shbg usually is increased by oestrogen..

    Oestrogen is made from testosterone in fat cells from an enzyme called aromatase..

    Im not sure if you guys can get FAI tests done (free androgen index) it measures the percentage of well.. free androgens like the name states...

    Supplemental transdermal T will increase t levels unless you have a major thyroid issue.

    But it will be best to get adrenals and thyroid sorted and checked to make sure it is not them mimicking hypogonadism..

    Hope some of that makese more sense to you then it did before.



    EDIT:

    Thats alot of "cardio" work.. Now doubt cortisol will be all over the shop and not helping because of it cortisol.. If you have adrenal issues this will worsen the problem.
    Just one minor correction or clarification to this post, free test and bioavailable are not the same. Free is unbound and bioavail includes what is called losely bound. As such it is a bit more sensitive measure. Not all labs offer it so you can use free if they do not. No a biggy but trying to be factual here. best suggestion here is continue your education and find a good doctor...

  10. #10
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    Quote Originally Posted by Enfuego129 View Post
    Vetteman thanks for weighing in on this subject. My inexperience with HRT is really holding this thread back. What is obvious to most of you is confusing to me. I will continue to research all replies here to better understand what is being taught here. Regarding your reply, hitting the 2.3 to 2.4 % normal / free testosterone is a good thing. What will happen to that number if my total T is increased with supplemental T? Also, if the normal / free % is above range wont my Endo say you are fine even with low total T? Which provides ammunition to withhold supplemental T?
    You will find the percentage of free will remain relevant to the total as seen from previous tests, even at higher levels. Might fluctuate a little back and forth, as you've seen already.

    To ease your concern, take a look at your spreadsheet. You will see that the biggest deviation on your free % was when your Total "T" hit 319 (2.48 highest) and when your Total "T" was 290 (1.8 lowest). Think about it, 290 was your 2nd highest score for Total, but was your lowest on free %. Your free % was higher than that when your Total "T" was at 179 (1.98).

    Again, as others have stressed ... Your real issues are with your medical team. Having to feel like you need ammunition to get treated properly means you're on the defense with these guys, and that usually ends in failure at your expense. They probably won't change ... The question is, will you?

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