Guest guest Posted January 27, 2011 Report Share Posted January 27, 2011 I don't agree with him you need Total Testosterone because of all your Bio and Free T it's only 1 to 2 % of your Total. So you have no Idea whats going out without your Total if your Total is very low 1 to 2 % of nothing is nothing. Yes a low grade infection can lower your Testosterone levels I say keep testing over time after jumping on TRT is for life. I had a guy posting he had low T and did not want to go on TRT because he wanted kids. I told him to run every kind of test that he could get. To look for infections low story short he had a root canel done they did not get all the nerver out and when they pulled the tooth his Testosterone levels came back up. Co-Moderator Phil > From: dbourgeo@... <dbourgeo@...> > Subject: FSH question. > > Date: Thursday, January 27, 2011, 2:55 PM > I have had for many years > non-specific symptoms that could be caused by many things. > One of them was hypogonadism, that I recently began looking > at. I do pass the Adam questionnaire, but that was always > attributed to depression. I do have moderate sleep apnea (15 > events per hour) and during my first two tests, some kind of > inflammation was going on with my prostate, causing high PSA > (15) and ALT and AST liver enzymes were elevated. The AST is > back in the normal range 31 of 0-37 (was highest at 61), and > the ALT is a little high at 44 of 0-37 (highest was 186). My > culture for infection came back negative, and various other > infections were ruled out. Could any of this caused my low > readings and then the seeming rebound below? > > My first test for total T was 8.3 (5.5-25.2) in SI units, a > month later I was tested (and I could feel it trying to go > up the 2 flights to the blood clinic) at 4.4. My Prolactin, > FSH, and LH were normal. > > I travelled to see an endocrinologist (and get the sleep > apnea properly diagnosed) as the waiting here is about a > year. > > He is a by the numbers guy. No total T was measured. Tfree > is 22.4 of 25-80 pmol/L. FSH is 11 of 2-8 IU/L, LH is 4 of > 2-6 IU/L, Total Prolactin is 3 of 2-18 ug/L, and > Bioavailable T is 9.9 of 2-15.4 nmol/L. > > He was considering Androgel until the bioavailable result > arrived literally at the last minute. We will repeat the > bioavailable in one month. > > Does this seem right to rely on bioavailable? I wonder > about the slight rise in FSH and why my Total T seems to > bounce around, but in the pretty low range. > > Also, my Thyroid is OK. Subclinical just means no symptoms > to him, though the numbers were always very low. > > > > ------------------------------------ > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 27, 2011 Report Share Posted January 27, 2011 Hi, what are your thyroid results, with ranges? On 27 January 2011 13:55, <dbourgeo@...> wrote: > > > I have had for many years non-specific symptoms that could be caused by > many things. One of them was hypogonadism, that I recently began looking at. > I do pass the Adam questionnaire, but that was always attributed to > depression. I do have moderate sleep apnea (15 events per hour) and during > my first two tests, some kind of inflammation was going on with my prostate, > causing high PSA (15) and ALT and AST liver enzymes were elevated. The AST > is back in the normal range 31 of 0-37 (was highest at 61), and the ALT is a > little high at 44 of 0-37 (highest was 186). My culture for infection came > back negative, and various other infections were ruled out. Could any of > this caused my low readings and then the seeming rebound below? > > My first test for total T was 8.3 (5.5-25.2) in SI units, a month later I > was tested (and I could feel it trying to go up the 2 flights to the blood > clinic) at 4.4. My Prolactin, FSH, and LH were normal. > > I travelled to see an endocrinologist (and get the sleep apnea properly > diagnosed) as the waiting here is about a year. > > He is a by the numbers guy. No total T was measured. Tfree is 22.4 of 25-80 > pmol/L. FSH is 11 of 2-8 IU/L, LH is 4 of 2-6 IU/L, Total Prolactin is 3 of > 2-18 ug/L, and Bioavailable T is 9.9 of 2-15.4 nmol/L. > > He was considering Androgel until the bioavailable result arrived literally > at the last minute. We will repeat the bioavailable in one month. > > Does this seem right to rely on bioavailable? I wonder about the slight > rise in FSH and why my Total T seems to bounce around, but in the pretty low > range. > > Also, my Thyroid is OK. Subclinical just means no symptoms to him, though > the numbers were always very low. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 27, 2011 Report Share Posted January 27, 2011 I would agree 1 to 2% of nothing is nothing, but the Free T and Bioavailable T tests came with their own reference ranges, I was a bit low outside the Free T range, but the Bioavailable was right in the middle. He calls the Bioavailable the Gold Standard and once that arrived said he would ignore the low Free T in favour of the Gold Standard. The Gold Standard ruled out considering any treatment, though he would like for me to have it tested again with my GP. My GP is a bit puzzled by this reliance on Bioavailable, actually, but he'll wait for the official results with comments to be sent in. T Free is 22.4 of 25-80 pmol/L Bioavailable T is 9.9 of 2-15.4 nmol/L I'm guessing my FSH can be a little high and mean nothing, as long as the LH is within range. That is the bit I find confusing. I do agree you need to rule out the infections, plus I'm back on CPAP (that's a long story) and hopefully a month on that would also sort out anything sleep apnea has done to my T. I've looked for my thyroid stuff but that was back in the days when I was trusting doctors, all I can find in my records is TSH was 0.75 and the T3/T4 was normal (my own notes). That is pretty much where it has been in the last few years since I wanted some extra testing done. > > > From: dbourgeo@... <dbourgeo@...> > > Subject: FSH question. > > > > Date: Thursday, January 27, 2011, 2:55 PM > > I have had for many years > > non-specific symptoms that could be caused by many things. > > One of them was hypogonadism, that I recently began looking > > at. I do pass the Adam questionnaire, but that was always > > attributed to depression. I do have moderate sleep apnea (15 > > events per hour) and during my first two tests, some kind of > > inflammation was going on with my prostate, causing high PSA > > (15) and ALT and AST liver enzymes were elevated. The AST is > > back in the normal range 31 of 0-37 (was highest at 61), and > > the ALT is a little high at 44 of 0-37 (highest was 186). My > > culture for infection came back negative, and various other > > infections were ruled out. Could any of this caused my low > > readings and then the seeming rebound below? > > > > My first test for total T was 8.3 (5.5-25.2) in SI units, a > > month later I was tested (and I could feel it trying to go > > up the 2 flights to the blood clinic) at 4.4. My Prolactin, > > FSH, and LH were normal. > > > > I travelled to see an endocrinologist (and get the sleep > > apnea properly diagnosed) as the waiting here is about a > > year. > > > > He is a by the numbers guy. No total T was measured. Tfree > > is 22.4 of 25-80 pmol/L. FSH is 11 of 2-8 IU/L, LH is 4 of > > 2-6 IU/L, Total Prolactin is 3 of 2-18 ug/L, and > > Bioavailable T is 9.9 of 2-15.4 nmol/L. > > > > He was considering Androgel until the bioavailable result > > arrived literally at the last minute. We will repeat the > > bioavailable in one month. > > > > Does this seem right to rely on bioavailable? I wonder > > about the slight rise in FSH and why my Total T seems to > > bounce around, but in the pretty low range. > > > > Also, my Thyroid is OK. Subclinical just means no symptoms > > to him, though the numbers were always very low. > > > > > > > > ------------------------------------ > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 28, 2011 Report Share Posted January 28, 2011 For one thing your Bio is just at mid range for your low Total T again I don't agree with your Dr. Free T and Bio T are calc from Total Testosterone. It's just common sense if your Total is low how can you have good Free T or Bio T that is working in your body. I can't help but think your seeing a Dr. that dose not listen to you and how your feeling he is one of them Dr.'s that thinks if your in a labs range your fine and your not. I am not a Dr. but I have been at this 30 yrs seeing Dr.'s like yours, it took me 23 yrs. to figure out why my T levels were low. My story is in this link. http://www.stopthethyroidmadness.com/stories-of-others/phils-story/ Here is a cut and paste from Dr. 's TRT: A Recipe for Success. He says " Total T is important for titration of dosing " you know why with lower Total T levels good levels of Free T and Bio T are calc using Total T. Labcorp is said to uses direct measurement, ie: ammonium sulfate precipitation, and radioassay. For Bio T but it's up in the air as to how good it is some men have very high SHBG levels and there testing does not address this. Quests current test for bioavailable testosterone, number 14966X, uses calcs, from total testosterone, albumin, SHBG, and some sort of empirical adjustment which is the function of the algorithm itself. Quest claimed they compared their calcs for bioavailable testosterone against ammonium sulfate precipitation, and the results were " adequately " accurate when total testosterone is in the higher ranges. That means that Quest's test isn't optimum when total testosterone is in the lower ranges. I have always assumed Quest used calcs because the ammonium sulfate precipitation test must have been more expensive to perform reliably. Of course we still don't know how accurately Labcorp are measuring the ammonium sulfate precipitates. So Labcorp's test may still be less accurate than Quest's calcs. ================================ TOTAL TESTOSTERONE This is the assay your patients will most focus on, as will clinicians unpracticed in the art. Physicians who do not understand sex hormones will deny patients the testosterone supplementation they want--and need!--when Total T is at low-normal levels. Total T is important for titration of dosing, but its relevance is reduced in older men, by virtue of their increased serum concentrations of SHBG (and therefore lowered Bioavailable Testosterone), in favor of: BIOAVAILABLE TESTOSTERONE Where we get the “bang†for the hormonal buck, so to speak. This is the actual amount the body has available for use, as the concentration of hormone available within the capillary beds before the androgen receptor approximates the sum of the Free Testosterone plus that which is loosely bound to other carrier proteins in the blood, primarily albumin. If Bio T is not readily available, Free T may be a second choice substitute, as Bio T and Free T serum concentrations are usually well correlated. Bioavailable Testosterone is the gold standard for serum androgen evaluation. Co-Moderator Phil > From: dbourgeo@... <dbourgeo@...> > Subject: Re: FSH question. > > Date: Thursday, January 27, 2011, 11:42 PM > I would agree 1 to 2% of nothing is > nothing, but the Free T and Bioavailable T tests came with > their own reference ranges, I was a bit low outside the Free > T range, but the Bioavailable was right in the middle. He > calls the Bioavailable the Gold Standard and once that > arrived said he would ignore the low Free T in favour of the > Gold Standard. The Gold Standard ruled out considering any > treatment, though he would like for me to have it tested > again with my GP. My GP is a bit puzzled by this reliance on > Bioavailable, actually, but he'll wait for the official > results with comments to be sent in. > > T Free is 22.4 of 25-80 pmol/L > Bioavailable T is 9.9 of 2-15.4 nmol/L > > I'm guessing my FSH can be a little high and mean nothing, > as long as the LH is within range. That is the bit I find > confusing. > > I do agree you need to rule out the infections, plus I'm > back on CPAP (that's a long story) and hopefully a month on > that would also sort out anything sleep apnea has done to my > T. > > I've looked for my thyroid stuff but that was back in the > days when I was trusting doctors, all I can find in my > records is TSH was 0.75 and the T3/T4 was normal (my own > notes). That is pretty much where it has been in the last > few years since I wanted some extra testing done. > > > > > > > From: dbourgeo@... <dbourgeo@...> > > > Subject: FSH question. > > > > > > Date: Thursday, January 27, 2011, 2:55 PM > > > I have had for many years > > > non-specific symptoms that could be caused by > many things. > > > One of them was hypogonadism, that I recently > began looking > > > at. I do pass the Adam questionnaire, but that > was always > > > attributed to depression. I do have moderate > sleep apnea (15 > > > events per hour) and during my first two tests, > some kind of > > > inflammation was going on with my prostate, > causing high PSA > > > (15) and ALT and AST liver enzymes were elevated. > The AST is > > > back in the normal range 31 of 0-37 (was highest > at 61), and > > > the ALT is a little high at 44 of 0-37 (highest > was 186). My > > > culture for infection came back negative, and > various other > > > infections were ruled out. Could any of this > caused my low > > > readings and then the seeming rebound below? > > > > > > My first test for total T was 8.3 (5.5-25.2) in > SI units, a > > > month later I was tested (and I could feel it > trying to go > > > up the 2 flights to the blood clinic) at 4.4. My > Prolactin, > > > FSH, and LH were normal. > > > > > > I travelled to see an endocrinologist (and get > the sleep > > > apnea properly diagnosed) as the waiting here is > about a > > > year. > > > > > > He is a by the numbers guy. No total T was > measured. Tfree > > > is 22.4 of 25-80 pmol/L. FSH is 11 of 2-8 IU/L, > LH is 4 of > > > 2-6 IU/L, Total Prolactin is 3 of 2-18 ug/L, and > > > Bioavailable T is 9.9 of 2-15.4 nmol/L. > > > > > > He was considering Androgel until the > bioavailable result > > > arrived literally at the last minute. We will > repeat the > > > bioavailable in one month. > > > > > > Does this seem right to rely on bioavailable? I > wonder > > > about the slight rise in FSH and why my Total T > seems to > > > bounce around, but in the pretty low range. > > > > > > Also, my Thyroid is OK. Subclinical just means no > symptoms > > > to him, though the numbers were always very low. > > > > > > > > > > > > ------------------------------------ > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 28, 2011 Report Share Posted January 28, 2011 I believe Bioavailable T was supposed to be measured and not calculated. I hope I didn't pay $70 for a calculation. As you say below, if Free T and Bioavailable T are supposed to be correlated so well, why are mine off so much? I guess I must have too much SHBG floating around, then, but that wasn't measured. I kind of get the picture I probably have low Total T (though that wasn't measured the third time around with the endocrinologist) and low Free T, but there must be a contribution from Albumin that is enough to raise my bioavailable into the normal range. Why this should be, and my FSH is a bit elevated, leaves me puzzled. Phil, do most doctors rely on bioavailable or the other tests? I was told most people don't get bioavailable done because of the expense, but it is the better test (endocrinologist says). I'm in Canada, so its LifeLabs who did my tests. Again, my GP is a bit puzzled by relying totally on the Bioavailable, but he's not an endocrinologist and probably won't go against what he says. I'll try to get all these things measured the next time around in a few weeks time. > > > > > > > From: dbourgeo@ <dbourgeo@> > > > > Subject: FSH question. > > > > > > > > Date: Thursday, January 27, 2011, 2:55 PM > > > > I have had for many years > > > > non-specific symptoms that could be caused by > > many things. > > > > One of them was hypogonadism, that I recently > > began looking > > > > at. I do pass the Adam questionnaire, but that > > was always > > > > attributed to depression. I do have moderate > > sleep apnea (15 > > > > events per hour) and during my first two tests, > > some kind of > > > > inflammation was going on with my prostate, > > causing high PSA > > > > (15) and ALT and AST liver enzymes were elevated. > > The AST is > > > > back in the normal range 31 of 0-37 (was highest > > at 61), and > > > > the ALT is a little high at 44 of 0-37 (highest > > was 186). My > > > > culture for infection came back negative, and > > various other > > > > infections were ruled out. Could any of this > > caused my low > > > > readings and then the seeming rebound below? > > > > > > > > My first test for total T was 8.3 (5.5-25.2) in > > SI units, a > > > > month later I was tested (and I could feel it > > trying to go > > > > up the 2 flights to the blood clinic) at 4.4. My > > Prolactin, > > > > FSH, and LH were normal. > > > > > > > > I travelled to see an endocrinologist (and get > > the sleep > > > > apnea properly diagnosed) as the waiting here is > > about a > > > > year. > > > > > > > > He is a by the numbers guy. No total T was > > measured. Tfree > > > > is 22.4 of 25-80 pmol/L. FSH is 11 of 2-8 IU/L, > > LH is 4 of > > > > 2-6 IU/L, Total Prolactin is 3 of 2-18 ug/L, and > > > > Bioavailable T is 9.9 of 2-15.4 nmol/L. > > > > > > > > He was considering Androgel until the > > bioavailable result > > > > arrived literally at the last minute. We will > > repeat the > > > > bioavailable in one month. > > > > > > > > Does this seem right to rely on bioavailable? I > > wonder > > > > about the slight rise in FSH and why my Total T > > seems to > > > > bounce around, but in the pretty low range. > > > > > > > > Also, my Thyroid is OK. Subclinical just means no > > symptoms > > > > to him, though the numbers were always very low. > > > > > > > > > > > > > > > > ------------------------------------ > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 29, 2011 Report Share Posted January 29, 2011 I wish you guys would say were you live in Canada and other Countries Endo's are much better on low T. Still you need to see your Total T and for the labs to come up with your Bio T they had to do your Total T to clac. it. But still Bio T is Clac. in Canada doing a search only one lab has a Bio T test that is not Clac. And Dr.'s are not sure it's any good. Here is a link on how it's done. http://www.issam.ch/freetesto.htm You will see what I am saying when your read this link. Plus some of the best Dr.'s on low T like to see BIO T up into the upper end of the range my BIO is dam good but I am on TRT and having good levels like this are driving up my Estradiol levels big time so we are now lowering my dose of Test C shots. Testosterone, Total 917 range 250 – 1100 ng/dL. Testosterone, Free 201.0 range 46.0 – 224.0 pg/mL. Testosterone, Bioavailable 395.9 range 110.0 to 575.0 ng/dL. SHBG 22 range 17 – 54 nmol/L. Albumin, Serum 4.3 range 3.6 – 5.1 g/dL. Co-Moderator Phil > From: dbourgeo@... <dbourgeo@...> > Subject: Re: FSH question. > > Date: Friday, January 28, 2011, 4:40 PM > > > I believe Bioavailable T was supposed to be measured and > not calculated. I hope I didn't pay $70 for a calculation. > > As you say below, if Free T and Bioavailable T are supposed > to be correlated so well, why are mine off so much? I guess > I must have > too much SHBG floating around, then, but that wasn't > measured. > > I kind of get the picture I probably have low Total T > (though that wasn't measured the third time around with the > endocrinologist) and low Free T, but there must be a > contribution from Albumin that is enough to raise my > bioavailable into the normal range. Why this should be, and > my FSH is a bit elevated, leaves me puzzled. > > Phil, do most doctors rely on bioavailable or the other > tests? I was told most people don't get bioavailable done > because of the expense, but it is the better test > (endocrinologist says). I'm in Canada, so its LifeLabs who > did my tests. Again, my GP is a bit puzzled by relying > totally on the Bioavailable, but he's not an endocrinologist > and probably won't go against what he says. > > I'll try to get all these things measured the next time > around in a few weeks time. > > > > > > > > > > > From: dbourgeo@ <dbourgeo@> > > > > > Subject: FSH question. > > > > > > > > > > Date: Thursday, January 27, 2011, 2:55 > PM > > > > > I have had for many years > > > > > non-specific symptoms that could be > caused by > > > many things. > > > > > One of them was hypogonadism, that I > recently > > > began looking > > > > > at. I do pass the Adam questionnaire, > but that > > > was always > > > > > attributed to depression. I do have > moderate > > > sleep apnea (15 > > > > > events per hour) and during my first > two tests, > > > some kind of > > > > > inflammation was going on with my > prostate, > > > causing high PSA > > > > > (15) and ALT and AST liver enzymes were > elevated. > > > The AST is > > > > > back in the normal range 31 of 0-37 > (was highest > > > at 61), and > > > > > the ALT is a little high at 44 of 0-37 > (highest > > > was 186). My > > > > > culture for infection came back > negative, and > > > various other > > > > > infections were ruled out. Could any of > this > > > caused my low > > > > > readings and then the seeming rebound > below? > > > > > > > > > > My first test for total T was 8.3 > (5.5-25.2) in > > > SI units, a > > > > > month later I was tested (and I could > feel it > > > trying to go > > > > > up the 2 flights to the blood clinic) > at 4.4. My > > > Prolactin, > > > > > FSH, and LH were normal. > > > > > > > > > > I travelled to see an endocrinologist > (and get > > > the sleep > > > > > apnea properly diagnosed) as the > waiting here is > > > about a > > > > > year. > > > > > > > > > > He is a by the numbers guy. No total T > was > > > measured. Tfree > > > > > is 22.4 of 25-80 pmol/L. FSH is 11 of > 2-8 IU/L, > > > LH is 4 of > > > > > 2-6 IU/L, Total Prolactin is 3 of 2-18 > ug/L, and > > > > > Bioavailable T is 9.9 of 2-15.4 > nmol/L. > > > > > > > > > > He was considering Androgel until the > > > bioavailable result > > > > > arrived literally at the last minute. > We will > > > repeat the > > > > > bioavailable in one month. > > > > > > > > > > Does this seem right to rely on > bioavailable? I > > > wonder > > > > > about the slight rise in FSH and why my > Total T > > > seems to > > > > > bounce around, but in the pretty low > range. > > > > > > > > > > Also, my Thyroid is OK. Subclinical > just means no > > > symptoms > > > > > to him, though the numbers were always > very low. > > > > > > > > > > > > > > > > > > > > ------------------------------------ > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 29, 2011 Report Share Posted January 29, 2011 Well, I live in Newfoundland, but the wait to see an endo here is one year, so I travelled to Ontario to get my sleep apnea looked at again, and also saw an endo while there (a few days wait). I looked at the fine print on my results and the bioavailable T was referred to Warnex Medical Labs in Laval, QC. My other results were done by LifeLabs. I'm hoping Warnex just didn't measure my SHBG and Albumin and run a calculation. Do you have the search terms you used still in mind, or any other way I can find out about this? I was aware of the online calculator, but since my SHBG wasn't measured (at least not by Lifelabs) and I paid $70 just for the bioavailable test (the others like Free T were no cost, paid by healthcare), I assumed that it must be the proper test and not a calculation. If bioavailable is unreliable, where does the endo get the idea its some kind of Gold Standard? > > > > > > > > > > > From: dbourgeo@ <dbourgeo@> > > > > > > Subject: FSH question. > > > > > > > > > > > > Date: Thursday, January 27, 2011, 2:55 > > PM > > > > > > I have had for many years > > > > > > non-specific symptoms that could be > > caused by > > > > many things. > > > > > > One of them was hypogonadism, that I > > recently > > > > began looking > > > > > > at. I do pass the Adam questionnaire, > > but that > > > > was always > > > > > > attributed to depression. I do have > > moderate > > > > sleep apnea (15 > > > > > > events per hour) and during my first > > two tests, > > > > some kind of > > > > > > inflammation was going on with my > > prostate, > > > > causing high PSA > > > > > > (15) and ALT and AST liver enzymes were > > elevated. > > > > The AST is > > > > > > back in the normal range 31 of 0-37 > > (was highest > > > > at 61), and > > > > > > the ALT is a little high at 44 of 0-37 > > (highest > > > > was 186). My > > > > > > culture for infection came back > > negative, and > > > > various other > > > > > > infections were ruled out. Could any of > > this > > > > caused my low > > > > > > readings and then the seeming rebound > > below? > > > > > > > > > > > > My first test for total T was 8.3 > > (5.5-25.2) in > > > > SI units, a > > > > > > month later I was tested (and I could > > feel it > > > > trying to go > > > > > > up the 2 flights to the blood clinic) > > at 4.4. My > > > > Prolactin, > > > > > > FSH, and LH were normal. > > > > > > > > > > > > I travelled to see an endocrinologist > > (and get > > > > the sleep > > > > > > apnea properly diagnosed) as the > > waiting here is > > > > about a > > > > > > year. > > > > > > > > > > > > He is a by the numbers guy. No total T > > was > > > > measured. Tfree > > > > > > is 22.4 of 25-80 pmol/L. FSH is 11 of > > 2-8 IU/L, > > > > LH is 4 of > > > > > > 2-6 IU/L, Total Prolactin is 3 of 2-18 > > ug/L, and > > > > > > Bioavailable T is 9.9 of 2-15.4 > > nmol/L. > > > > > > > > > > > > He was considering Androgel until the > > > > bioavailable result > > > > > > arrived literally at the last minute. > > We will > > > > repeat the > > > > > > bioavailable in one month. > > > > > > > > > > > > Does this seem right to rely on > > bioavailable? I > > > > wonder > > > > > > about the slight rise in FSH and why my > > Total T > > > > seems to > > > > > > bounce around, but in the pretty low > > range. > > > > > > > > > > > > Also, my Thyroid is OK. Subclinical > > just means no > > > > symptoms > > > > > > to him, though the numbers were always > > very low. > > > > > > > > > > > > > > > > > > > > > > > > ------------------------------------ > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 30, 2011 Report Share Posted January 30, 2011 I did not say Bio T was unreliable it is the best test over Free T but your missing my point. Without your Dr. testing your Total T and looking at it if your Total T is low it is a waste of time talking about Free T or Bio T. I don't care how you read this Free T and Bio T are only 1 to 2% of all the Testosterone your testis make. Even if the labs test it derect if your Total T is low your sick and it needs to be looked into. Here is a link about this most of the time it does not open so here is a link and a cut and paste. If after you read this you still don't under stand about it I don't know what more I can tell you. http://tinyurl.com/49utas2 The bottom line here is your Testis make T this is all the T in your body called Total and Free T and Bio T are a mesure off Total so if Total is low what good is Free and Bio. ================================================== The Big T How your lifestyle influences your Testosterone levels — Part 1 by M. Berardi Like it or not (and I'm sure T-mag readers really like it), Testosterone is the hormone of the decade. The granddaddy of the male hormones has gotten more media attention over the last few years than any other hormone around. Heck, I even heard a rumor that some crazy bodybuilding media guys were thinking of naming a magazine after it. Can you imagine that? While Testosterone (the hormone, of course) has been the target of much bad press, I think that if you asked this big dog of hormones what he thought of all of this, he would bark out something to the effect of " What of it? I must be doing something right if they keep talking about me! Now can't you see I'm trying to work this shaved little poodle over here? " Although the popular media has made Testosterone out to be a destructive bad guy, researchers have been slowly but surely embracing its use. Clinical trials have been conducted in diverse groups of individuals from HIV wasting patients and burn victims to people with compromised immunity, along with older men whose " Testosterone " hasn't been up in years. There have even been a number of recent trials investigating the use of Testosterone in healthy weight trained men. So where do I sign up? The results of these investigations have shown that Testosterone is not the demon the medical community once thought it to be and that it actually can be of great benefit to certain individuals and, in certain patients, possesses very few risks. I'm pretty positive though, that the use of Testosterone will never be condoned for use in healthy weight trained males. To this end, us law abiding citizens have to do the best we can with what we've got to work with. So let's talk about how our own body provides us with the big T and what we can do, both naturally and with dietary supplements, to maximize our T levels. When most people think of steroids, they tend only to think of Testosterone. This, my friends, is yet another fact which tends to make me believe that T is the hormone of the decade. Testosterone, however, is only one member of the steroid family. Some of the other steroids in this family include cholesterol, progesterone, the estrogens, cortisol, and aldosterone. Although these molecules are part of the same family and have strikingly similar structures, their functions differ like night and day. This is important to recognize because although the steroids tend to act very differently, they are subject to similar rules with respect to biochemistry and metabolism. For a simplified view of steroid metabolism in the body, you can assume that all steroid hormones begin with cholesterol. From cholesterol, steroid metabolites are formed in various tissues of the body. For example, enzymes in the adrenal glands are responsible for converting cholesterol into cortisol, while enzymes in the gonads are responsible for converting cholesterol to Testosterone. With this simplified view, it's easy to make the mistake of thinking that by simply providing the body with more cholesterol (make that two large fries, please), we can make more Testosterone. This is a mistake because the body has regulatory mechanisms that control hormone production. These regulatory mechanisms, not your bedtime prayers to the iron gods, are what determine which steroid metabolites will ultimately be formed. So the next important questions are, what magic does it take to make Testosterone out of cholesterol (now don't get too excited, you can't do this in your bath tub), what regulates this conversion, and ultimately, what regulates Testosterone production? In order to get the gonads to produce T, the body has a chain of command that must be dealt with just like any smooth running business. In business, the action plan comes down from the CEO to upper management, the plan is solidified and delegated to the production team, and the production team gets the job done. Well, in the body, a portion of the brain called the hypothalamus is the CEO, the pituitary gland is the upper management, and the testes are the production team members. As in business, the buck stops with the CEO/hypothalamus, which is known as a " pulse generator, " because during the day it sends out pulses of hormones that are designed to stimulate other organs. With respect to T, the hypothalamus sends out numerous daily pulses of GNRH (gonadotropin releasing hormone) through the blood stream. These pulses are designed to stimulate the pituitary gland to get to work. The pituitary gland then senses the pulses of GNRH and sends out a work order of its own, consisting of LH (leutinizing hormone) pulses. The LH message travels down to the leydig cells of the testis to stimulate the enzymatic conversion of cholesterol to Testosterone. Cholesterol conversion to T is no easy process and I'm not going to go into all of the details (partly because no one really knows them all). One fact that you should understand, though, is that there's a high level of complexity to this pathway and that there are many enzymes and intermediates that cholesterol has to encounter before forming T. Some of these intermediates include pregnenolone, DHEA, androstenedione, and other well-known androgens. So, although the hypothalamus might be functioning well, the pituitary might be doing the right thing, and the testis are getting the " ball " in motion, ultimately the enzymes in the leydig cells determine whether you're pumping out loads of muscle building T or simply forming other intermediates at the expense of the top dog. As a result of the process I mentioned above, T levels fluctuate wildly. If you were to measure your Testosterone levels throughout the day, you'd likely be amazed. One minute you have the hormonal profile of a hyper-muscular bull ready to " fertilize " an entire herd of cattle? and the next minute your blood profile is that of a fully menstruating Martha intent on color coordinating your powder room. These odd fluctuations occur as a result of the pulsatile nature of hormone secretion. Again, this begins with the hypothalamic pulse generator's release of GNRH. Incidentally, researchers now believe that it is this physiologic pulsatility of Testosterone that makes it anabolic. So if you can mimic this pattern of hormone release, you can stimulate muscle growth. With this hormonal cascade in mind, it's important to realize that each step in the pathway has a regulation point designed to either stimulate or inhibit pulse release. In this respect, the body is a bit of a control freak as it tends to like many control points rather than just one. In this particular case there are three main control points; the hypothalamus, the pituitary, and the testis. With this type of control, the body can maintain the Testosterone homeostasis (a sort of hormonal status quo) and prevent us from any abnormal changes in muscle development and strength. For example, if our Testosterone levels go way up, the body senses this and the hypothalamus and the pituitary produce less GNRH and LH in order to slow down T production. This, of course, is the famous negative feedback. Damn that homeostasis! Now that I'm certain you're all experts in Testosterone production (and there will be a test at the end — I'm serious!), I'd like to address one more important issue that will come up later in the article with regard to Testosterone in the body. When Testosterone is converted from cholesterol in the leydig cells of the testis, it's released into the blood stream where it embarks on an anabolic adventure. However, when in the blood, 60% of the big T released from the boys down below is bound up by a protein known as SHBG, or sex-hormone binding globulin. SHBG is produced and released by the liver. The important point is that the Testosterone bound to SHBG is biologically inactive and this is why there's an important distinction between total T and bioavailable T. Total T represents all the Testosterone in the blood, while bioavailable T represents the non SHBG bound Testosterone. There are other proteins in the blood that bind Testosterone, too, but their binding is rather weak, so this T is bioavailable and these proteins can still enter the cells to produce and effect all the things we're interested in. As I said, bioavailable T represents the Testosterone that is not SHBG bound, while free T represents the Testosterone that's not bound to any blood proteins at all. It's tricky, I know, but I hope that it's now evident that although only about 2% of the T in blood is technically considered free T, there is a larger percentage of T (about 40% or so) that is bioavailable because it's only weakly bound to non SHBG blood proteins. I'm taking you through this complex path for good reason. When trying to increase T levels in the body, one must attempt to not only increase total T. More importantly, one must attempt to increase bioavailable T. If you increase total T, but you increase SHBG to a larger extent, they you will actually have less bioavailable T for muscle building purposes! A great example of this is the use of both thyroid drugs and tamoxifen (nolvadex). Both may increase total T levels in the body, but both also increase SHBG to a large extent. Although you may get a bit of a T surge with each (hurray!), the increase in SHBG may bind up any extra, and actually decrease your bioavailable T (boo!). Well, now that the class is up to speed with our physiology and endocrinology (will someone please wake up Mr. Luoma! — he's always falling asleep during my physiology lectures), we can dive, full force, into how lifestyle factors including things like diet, training, recreational drugs, over the counter medications, altitude, and how psychological mood states influence T levels. There's an abundance of Testosterone literature out there and some of it is applicable for us while some is not, but to a science geek like me who both likes facts and likes being big and lean, it's all interesting nevertheless. Oh wait, I almost forgot! Before we go on, I promised a test didn't I? Settle down! Although there are no actual grades on this test, I hope that you take away a few fundamental things from this article. If you can answer these questions, you're ready to take on next week's article in which I'll review a number of environmental and lifestyle factors that can influence your levels of free T, total T, and bioavailable T. Rest easy, next week's article ties in all that you learned this week and makes some recommendations about how to up the T levels. And next week there won't be a test! Co-Moderator Phil > From: dbourgeo@... <dbourgeo@...> > Subject: Re: FSH question. > > Date: Saturday, January 29, 2011, 6:17 PM > Well, I live in Newfoundland, but the > wait to see an endo here is one year, so I travelled to > Ontario to get my sleep apnea looked at again, and also saw > an endo while there (a few days wait). > > I looked at the fine print on my results and the > bioavailable T was referred to Warnex Medical Labs in Laval, > QC. My other results were done by LifeLabs. I'm hoping > Warnex just didn't measure my SHBG and Albumin and run a > calculation. > > Do you have the search terms you used still in mind, or any > other way I can find out about this? I was aware of the > online calculator, but since my SHBG wasn't measured (at > least not by Lifelabs) and I paid $70 just for the > bioavailable test (the others like Free T were no cost, paid > by healthcare), I assumed that it must be the proper test > and not a calculation. > > If bioavailable is unreliable, where does the endo get the > idea its some kind of Gold Standard? > > > > > > > > > > > > > > > > From: dbourgeo@ > <dbourgeo@> > > > > > > > Subject: FSH > question. > > > > > > > > > > > > > > Date: Thursday, January 27, > 2011, 2:55 > > > PM > > > > > > > I have had for many years > > > > > > > non-specific symptoms that > could be > > > caused by > > > > > many things. > > > > > > > One of them was hypogonadism, > that I > > > recently > > > > > began looking > > > > > > > at. I do pass the Adam > questionnaire, > > > but that > > > > > was always > > > > > > > attributed to depression. I > do have > > > moderate > > > > > sleep apnea (15 > > > > > > > events per hour) and during > my first > > > two tests, > > > > > some kind of > > > > > > > inflammation was going on > with my > > > prostate, > > > > > causing high PSA > > > > > > > (15) and ALT and AST liver > enzymes were > > > elevated. > > > > > The AST is > > > > > > > back in the normal range 31 > of 0-37 > > > (was highest > > > > > at 61), and > > > > > > > the ALT is a little high at > 44 of 0-37 > > > (highest > > > > > was 186). My > > > > > > > culture for infection came > back > > > negative, and > > > > > various other > > > > > > > infections were ruled out. > Could any of > > > this > > > > > caused my low > > > > > > > readings and then the seeming > rebound > > > below? > > > > > > > > > > > > > > My first test for total T was > 8.3 > > > (5.5-25.2) in > > > > > SI units, a > > > > > > > month later I was tested (and > I could > > > feel it > > > > > trying to go > > > > > > > up the 2 flights to the blood > clinic) > > > at 4.4. My > > > > > Prolactin, > > > > > > > FSH, and LH were normal. > > > > > > > > > > > > > > I travelled to see an > endocrinologist > > > (and get > > > > > the sleep > > > > > > > apnea properly diagnosed) as > the > > > waiting here is > > > > > about a > > > > > > > year. > > > > > > > > > > > > > > He is a by the numbers guy. > No total T > > > was > > > > > measured. Tfree > > > > > > > is 22.4 of 25-80 pmol/L. FSH > is 11 of > > > 2-8 IU/L, > > > > > LH is 4 of > > > > > > > 2-6 IU/L, Total Prolactin is > 3 of 2-18 > > > ug/L, and > > > > > > > Bioavailable T is 9.9 of > 2-15.4 > > > nmol/L. > > > > > > > > > > > > > > He was considering Androgel > until the > > > > > bioavailable result > > > > > > > arrived literally at the last > minute. > > > We will > > > > > repeat the > > > > > > > bioavailable in one month. > > > > > > > > > > > > > > Does this seem right to rely > on > > > bioavailable? I > > > > > wonder > > > > > > > about the slight rise in FSH > and why my > > > Total T > > > > > seems to > > > > > > > bounce around, but in the > pretty low > > > range. > > > > > > > > > > > > > > Also, my Thyroid is OK. > Subclinical > > > just means no > > > > > symptoms > > > > > > > to him, though the numbers > were always > > > very low. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > ------------------------------------ > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 30, 2011 Report Share Posted January 30, 2011 I appreciate your reply, and it makes sense to me, but I'm trying to understand why the endo would think a low Total T is fine, provided Bioavailable is in range. I guess I must have a low amount of SHBG floating around in order to have low Total T and still have Bioavailable in range. However, if that is something that can change a fair bit (I suspect), then yes, low Total T would matter a lot. The more you have to work with, probably the better. I would agree that low Total T makes me sick, but I can't argue against this endo guy who calls Bioavailable a Gold Standard without something more to go on. I would also be reluctant to start up on TRT just to see what might happen without more to go on. From what you've said elsewhere, its not very easy to come off. But what if my GP agreed to one or two months, would that mess me up entirely? > > > > > > > > > > > > > > > From: dbourgeo@ > > <dbourgeo@> > > > > > > > > Subject: FSH > > question. > > > > > > > > > > > > > > > > Date: Thursday, January 27, > > 2011, 2:55 > > > > PM > > > > > > > > I have had for many years > > > > > > > > non-specific symptoms that > > could be > > > > caused by > > > > > > many things. > > > > > > > > One of them was hypogonadism, > > that I > > > > recently > > > > > > began looking > > > > > > > > at. I do pass the Adam > > questionnaire, > > > > but that > > > > > > was always > > > > > > > > attributed to depression. I > > do have > > > > moderate > > > > > > sleep apnea (15 > > > > > > > > events per hour) and during > > my first > > > > two tests, > > > > > > some kind of > > > > > > > > inflammation was going on > > with my > > > > prostate, > > > > > > causing high PSA > > > > > > > > (15) and ALT and AST liver > > enzymes were > > > > elevated. > > > > > > The AST is > > > > > > > > back in the normal range 31 > > of 0-37 > > > > (was highest > > > > > > at 61), and > > > > > > > > the ALT is a little high at > > 44 of 0-37 > > > > (highest > > > > > > was 186). My > > > > > > > > culture for infection came > > back > > > > negative, and > > > > > > various other > > > > > > > > infections were ruled out. > > Could any of > > > > this > > > > > > caused my low > > > > > > > > readings and then the seeming > > rebound > > > > below? > > > > > > > > > > > > > > > > My first test for total T was > > 8.3 > > > > (5.5-25.2) in > > > > > > SI units, a > > > > > > > > month later I was tested (and > > I could > > > > feel it > > > > > > trying to go > > > > > > > > up the 2 flights to the blood > > clinic) > > > > at 4.4. My > > > > > > Prolactin, > > > > > > > > FSH, and LH were normal. > > > > > > > > > > > > > > > > I travelled to see an > > endocrinologist > > > > (and get > > > > > > the sleep > > > > > > > > apnea properly diagnosed) as > > the > > > > waiting here is > > > > > > about a > > > > > > > > year. > > > > > > > > > > > > > > > > He is a by the numbers guy. > > No total T > > > > was > > > > > > measured. Tfree > > > > > > > > is 22.4 of 25-80 pmol/L. FSH > > is 11 of > > > > 2-8 IU/L, > > > > > > LH is 4 of > > > > > > > > 2-6 IU/L, Total Prolactin is > > 3 of 2-18 > > > > ug/L, and > > > > > > > > Bioavailable T is 9.9 of > > 2-15.4 > > > > nmol/L. > > > > > > > > > > > > > > > > He was considering Androgel > > until the > > > > > > bioavailable result > > > > > > > > arrived literally at the last > > minute. > > > > We will > > > > > > repeat the > > > > > > > > bioavailable in one month. > > > > > > > > > > > > > > > > Does this seem right to rely > > on > > > > bioavailable? I > > > > > > wonder > > > > > > > > about the slight rise in FSH > > and why my > > > > Total T > > > > > > seems to > > > > > > > > bounce around, but in the > > pretty low > > > > range. > > > > > > > > > > > > > > > > Also, my Thyroid is OK. > > Subclinical > > > > just means no > > > > > > symptoms > > > > > > > > to him, though the numbers > > were always > > > > very low. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > ------------------------------------ > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 30, 2011 Report Share Posted January 30, 2011 No I am the last guy to tell you to start on TRT with out knowing why your low. If you can figure out why your Total is low and fix it it will go back up. All I am trying to tell you is this and most Endo's don't know anything about low Testosterone in men. Yes Bioavailable a Gold Standard but for men on TRT taking meds they shoot for a upper 1/3 of the top of the range for Bioavailable dosing there meds. I can't tell you how many times I seen an Endo and found out they are not up on low T in men. I seen 7 in the last 30 yrs not one helped me they made me sicker and never figured out why I have low T. You see Dr.'s GP or Family Dr.'s think Endo's are specialists for Hormones so when they are treating a men and he is not doing well the send him to see an Endo or Uro. But all Endo's are good at is treating Diabetes they even suck at Thyroid. I have seen men posting they did labs were low were sent to see an Endo had a Total T of 270 bottom of range is say 250 and were told they are fine they are in the range WTF men over 100 yrs of age have higher levels then 400. When a Dr. tests you this way and tells you your fine he is not up on this and did not do the right testing. I read labs all day been reading them for yrs. I am not a Dr. but I know enough to tell men when they are seeing the wrong Dr. You can be tested and Treated by the best Dr. there is for this just get your family Dr. to work with Dr. over the phone www.allthingsmale.com he will learn about this and be able to treat you on your dime. Here is the up to date link to the AACE Guildelines read this I am betting your Endo never seen this. http://www.endo-society.org/guidelines/final/upload/FINAL-Androgens-in-Men-Stand\ alone.pdf If you can't get the link to work cut and paste it in. Men are sent to see Endo's by GP's and Family Dr.'s on TRT when they see them the Endo tells them he needs them to come off TRT so he can do a Base Line set of labs. I now know today there is no way a Dr. can do this. The poor guys crash and burn I had this happen to me 6 x's each time I ended up off work in bed on sick leave. Try to feed you family feeling like this. And each time I needed up finding a new Dr. and it took me a very long time to get my levels back up. Here is a link to my story. http://www.stopthethyroidmadness.com/stories-of-others/phils-story/ I do what I do so men like your self don't end up going down that long road I had go down. Co-Moderator Phil > From: dbourgeo@... <dbourgeo@...> > Subject: Re: FSH question. > > Date: Sunday, January 30, 2011, 1:20 PM > I appreciate your reply, and it makes > sense to me, but I'm trying to understand why the endo would > think a low Total T is fine, provided Bioavailable is in > range. I guess I must have a low amount of SHBG floating > around in order to have low Total T and still have > Bioavailable in range. However, if that is something that > can change a fair bit (I suspect), then yes, low Total T > would matter a lot. The more you have to work with, probably > the better. > > I would agree that low Total T makes me sick, but I can't > argue against this endo guy who calls Bioavailable a Gold > Standard without something more to go on. > > I would also be reluctant to start up on TRT just to see > what might happen without more to go on. From what you've > said elsewhere, its not very easy to come off. But what if > my GP agreed to one or two months, would that mess me up > entirely? > > > > > > > > > > > > > > > > > > > From: dbourgeo@ > > > <dbourgeo@> > > > > > > > > > Subject: > FSH > > > question. > > > > > > > > > > > > > > > > > > Date: Thursday, > January 27, > > > 2011, 2:55 > > > > > PM > > > > > > > > > I have had for many > years > > > > > > > > > non-specific > symptoms that > > > could be > > > > > caused by > > > > > > > many things. > > > > > > > > > One of them was > hypogonadism, > > > that I > > > > > recently > > > > > > > began looking > > > > > > > > > at. I do pass the > Adam > > > questionnaire, > > > > > but that > > > > > > > was always > > > > > > > > > attributed to > depression. I > > > do have > > > > > moderate > > > > > > > sleep apnea (15 > > > > > > > > > events per hour) > and during > > > my first > > > > > two tests, > > > > > > > some kind of > > > > > > > > > inflammation was > going on > > > with my > > > > > prostate, > > > > > > > causing high PSA > > > > > > > > > (15) and ALT and > AST liver > > > enzymes were > > > > > elevated. > > > > > > > The AST is > > > > > > > > > back in the normal > range 31 > > > of 0-37 > > > > > (was highest > > > > > > > at 61), and > > > > > > > > > the ALT is a little > high at > > > 44 of 0-37 > > > > > (highest > > > > > > > was 186). My > > > > > > > > > culture for > infection came > > > back > > > > > negative, and > > > > > > > various other > > > > > > > > > infections were > ruled out. > > > Could any of > > > > > this > > > > > > > caused my low > > > > > > > > > readings and then > the seeming > > > rebound > > > > > below? > > > > > > > > > > > > > > > > > > My first test for > total T was > > > 8.3 > > > > > (5.5-25.2) in > > > > > > > SI units, a > > > > > > > > > month later I was > tested (and > > > I could > > > > > feel it > > > > > > > trying to go > > > > > > > > > up the 2 flights to > the blood > > > clinic) > > > > > at 4.4. My > > > > > > > Prolactin, > > > > > > > > > FSH, and LH were > normal. > > > > > > > > > > > > > > > > > > I travelled to see > an > > > endocrinologist > > > > > (and get > > > > > > > the sleep > > > > > > > > > apnea properly > diagnosed) as > > > the > > > > > waiting here is > > > > > > > about a > > > > > > > > > year. > > > > > > > > > > > > > > > > > > He is a by the > numbers guy. > > > No total T > > > > > was > > > > > > > measured. Tfree > > > > > > > > > is 22.4 of 25-80 > pmol/L. FSH > > > is 11 of > > > > > 2-8 IU/L, > > > > > > > LH is 4 of > > > > > > > > > 2-6 IU/L, Total > Prolactin is > > > 3 of 2-18 > > > > > ug/L, and > > > > > > > > > Bioavailable T is > 9.9 of > > > 2-15.4 > > > > > nmol/L. > > > > > > > > > > > > > > > > > > He was considering > Androgel > > > until the > > > > > > > bioavailable result > > > > > > > > > arrived literally > at the last > > > minute. > > > > > We will > > > > > > > repeat the > > > > > > > > > bioavailable in one > month. > > > > > > > > > > > > > > > > > > Does this seem > right to rely > > > on > > > > > bioavailable? I > > > > > > > wonder > > > > > > > > > about the slight > rise in FSH > > > and why my > > > > > Total T > > > > > > > seems to > > > > > > > > > bounce around, but > in the > > > pretty low > > > > > range. > > > > > > > > > > > > > > > > > > Also, my Thyroid is > OK. > > > Subclinical > > > > > just means no > > > > > > > symptoms > > > > > > > > > to him, though the > numbers > > > were always > > > > > very low. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > ------------------------------------ > > > > > > > > > > > > > > > > > > > Links > > > > > > > > > > > > > > > > > > > > > > > > > > >   > -fullfeatured > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > ------------------------------------ > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 30, 2011 Report Share Posted January 30, 2011 I know you've got other things going on, but you deserve a good thyroid work up to see how that's standing. TSH, Free T4, free T3 and thyroid antibodies (TPO and anti-thyroglobulin). The other tests here are good too: http://www.stopthethyroidmadness.com/recommended-labwork/ -Nigel On 27 January 2011 22:42, <dbourgeo@...> wrote: > > I've looked for my thyroid stuff but that was back in the days when I was > trusting doctors, all I can find in my records is TSH was 0.75 and the T3/T4 > was normal (my own notes). That is pretty much where it has been in the last > few years since I wanted some extra testing done. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 21, 2011 Report Share Posted February 21, 2011 Hi Your liver functions are altering your SHBG which is giving a false indication of free T this happened to me and the endo took me off the T thinking I didn't need it and I crashed bad. I would ask for a shbg level next time you have blood work done. if this is low it can give you this result. Being overweight and hypothyroid can cause this to go down as well as liver function abnormalities. Rule out blood sugars as well. hope this helps. > > I have had for many years non-specific symptoms that could be caused by many things. One of them was hypogonadism, that I recently began looking at. I do pass the Adam questionnaire, but that was always attributed to depression. I do have moderate sleep apnea (15 events per hour) and during my first two tests, some kind of inflammation was going on with my prostate, causing high PSA (15) and ALT and AST liver enzymes were elevated. The AST is back in the normal range 31 of 0-37 (was highest at 61), and the ALT is a little high at 44 of 0-37 (highest was 186). My culture for infection came back negative, and various other infections were ruled out. Could any of this caused my low readings and then the seeming rebound below? > > My first test for total T was 8.3 (5.5-25.2) in SI units, a month later I was tested (and I could feel it trying to go up the 2 flights to the blood clinic) at 4.4. My Prolactin, FSH, and LH were normal. > > I travelled to see an endocrinologist (and get the sleep apnea properly diagnosed) as the waiting here is about a year. > > He is a by the numbers guy. No total T was measured. Tfree is 22.4 of 25-80 pmol/L. FSH is 11 of 2-8 IU/L, LH is 4 of 2-6 IU/L, Total Prolactin is 3 of 2-18 ug/L, and Bioavailable T is 9.9 of 2-15.4 nmol/L. > > He was considering Androgel until the bioavailable result arrived literally at the last minute. We will repeat the bioavailable in one month. > > Does this seem right to rely on bioavailable? I wonder about the slight rise in FSH and why my Total T seems to bounce around, but in the pretty low range. > > Also, my Thyroid is OK. Subclinical just means no symptoms to him, though the numbers were always very low. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 23, 2011 Report Share Posted February 23, 2011 Thanks! I was definitely going to have my SHBG looked at. I'm confused as to how this would work. If my SHBG is low, then would more Testosterone bind to the albumin in my blood, causing that to look good (my bioavailable=bound to albumin was good)? Or do you mean more Testosterone is around floating free, not bound at all, although your total level is low? > > > > I have had for many years non-specific symptoms that could be caused by many things. One of them was hypogonadism, that I recently began looking at. I do pass the Adam questionnaire, but that was always attributed to depression. I do have moderate sleep apnea (15 events per hour) and during my first two tests, some kind of inflammation was going on with my prostate, causing high PSA (15) and ALT and AST liver enzymes were elevated. The AST is back in the normal range 31 of 0-37 (was highest at 61), and the ALT is a little high at 44 of 0-37 (highest was 186). My culture for infection came back negative, and various other infections were ruled out. Could any of this caused my low readings and then the seeming rebound below? > > > > My first test for total T was 8.3 (5.5-25.2) in SI units, a month later I was tested (and I could feel it trying to go up the 2 flights to the blood clinic) at 4.4. My Prolactin, FSH, and LH were normal. > > > > I travelled to see an endocrinologist (and get the sleep apnea properly diagnosed) as the waiting here is about a year. > > > > He is a by the numbers guy. No total T was measured. Tfree is 22.4 of 25-80 pmol/L. FSH is 11 of 2-8 IU/L, LH is 4 of 2-6 IU/L, Total Prolactin is 3 of 2-18 ug/L, and Bioavailable T is 9.9 of 2-15.4 nmol/L. > > > > He was considering Androgel until the bioavailable result arrived literally at the last minute. We will repeat the bioavailable in one month. > > > > Does this seem right to rely on bioavailable? I wonder about the slight rise in FSH and why my Total T seems to bounce around, but in the pretty low range. > > > > Also, my Thyroid is OK. Subclinical just means no symptoms to him, though the numbers were always very low. > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 27, 2011 Report Share Posted February 27, 2011 I think I can partly answer my own question regarding Bioavailable and SHBG that I asked Manraj, although the answer I found wasn't totally clear (I'd like a mechanism). If your levels of SHBG might vary, these people recommend relying on Free T instead of BAT. Anyone with any thoughts? Go to http://www.griffinmedical.com/labs.htm and look for the answer to the following question: What are free and bioavailable testosterone? Here it is: Testosterone is present in the blood as " free " testosterone (2-3%) or bound testosterone. The latter may be bound to either albumin (a serum protein) or to a specific binding protein called Sex Steroid Binding Globulin (SSBG) or Sex Hormone Binding Globulin (SHBG). The binding of testosterone to albumin is not very tight and is easily reversed; so the term bioavailable testosterone (BAT) refers to the sum of free testosterone plus albumin-bound testosterone. Alternatively, it is the fraction of circulating testosterone that is not bound to SSBG. It is suggested that BAT represents the fraction of circulating testosterone that readily enters cells and better reflects the bioactivity of testosterone than does the simple measurement of serum total testosterone. Also, varying levels of SSBG can result in inaccurate measurements of BAT. Decreased SSBG levels can be seen in obesity, hypothyroidism, androgen use, and nephritic syndrome. Increased levels are seen in cirrhosis, hyperthyroidism, and estrogen use. In these situations, measurement of free testosterone may be more useful. However, technically, free testosterone is difficult to measure. > > > > > > I have had for many years non-specific symptoms that could be caused by many things. One of them was hypogonadism, that I recently began looking at. I do pass the Adam questionnaire, but that was always attributed to depression. I do have moderate sleep apnea (15 events per hour) and during my first two tests, some kind of inflammation was going on with my prostate, causing high PSA (15) and ALT and AST liver enzymes were elevated. The AST is back in the normal range 31 of 0-37 (was highest at 61), and the ALT is a little high at 44 of 0-37 (highest was 186). My culture for infection came back negative, and various other infections were ruled out. Could any of this caused my low readings and then the seeming rebound below? > > > > > > My first test for total T was 8.3 (5.5-25.2) in SI units, a month later I was tested (and I could feel it trying to go up the 2 flights to the blood clinic) at 4.4. My Prolactin, FSH, and LH were normal. > > > > > > I travelled to see an endocrinologist (and get the sleep apnea properly diagnosed) as the waiting here is about a year. > > > > > > He is a by the numbers guy. No total T was measured. Tfree is 22.4 of 25-80 pmol/L. FSH is 11 of 2-8 IU/L, LH is 4 of 2-6 IU/L, Total Prolactin is 3 of 2-18 ug/L, and Bioavailable T is 9.9 of 2-15.4 nmol/L. > > > > > > He was considering Androgel until the bioavailable result arrived literally at the last minute. We will repeat the bioavailable in one month. > > > > > > Does this seem right to rely on bioavailable? I wonder about the slight rise in FSH and why my Total T seems to bounce around, but in the pretty low range. > > > > > > Also, my Thyroid is OK. Subclinical just means no symptoms to him, though the numbers were always very low. > > > > > > Quote Link to comment Share on other sites More sharing options...
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