12 Weeks Blood Test Results

Just got results of my first labs after being on TRT for about 12 weeks. I wanted your guys inputs on the numbers and see what you think. This is from daily 14mg SubQ injections. The only side effects that I have noticed on the daily SubQ is the boys downstairs are slowly starting to retract. No acne, no gyno, no mood swings or anything so far. Haven’t noticed much change in the gym/weight dept. I didn’t have much problem with libido prior to TRT and after 12 weeks haven’t noticed any changes in that either. Still very hard for me to go more than 1 round per night in bedroom.

  1. Since the reference ranges are different than my normal Kaiser ranges that I’m used to, how much impact does that have? I’m sitting at around middle of the range for Ulta Labs on Total T. Does that mean if I had taken Kaiser test I would sort of come in the middle? I ask this because my physician at Kaiser doesn’t want me to go above ~400ng/dL he wants me to stay in the middle so I went outside and paid for my own labs to see where I was before taking the Kaiser Lab test.

  2. I am above the rage on Free T with Ulta Labs. But it is 178.3 pg/mL. When I convert that into ng/dL it’s 17.83ng/dL. If i take this number it’s right in the middle of Kaiser range but for some reason its above the range with Ulta Labs. Is having too much Free T a bad thing? Is there an ideal Total T/Free T ratio one should try and achieve? Basic logic says having extra Free T is good since it’s the unbound T left over after SHBG and Albumin take their cut out that is used for other functions. after the conversion 17.83ng/dL doesn’t seem all that high.

  3. My SHBG still showed up pretty much at the bottom on the two different ranges. Seems like that is one thing that TRT hasn’t improved. Any idea on how to increase this as I feel like this seems very bad to be on the borderline low levels of SHBG.

  4. Per below new lab results, do you think there needs any adjustment on the dosage? Is 100mg/wk (14mg/daily SubQ) too high and possibly drop it down to see if my SHBG comes up? There is absolutely 0 chance of increasing my dosage if my doc saw me sitting at nearly 600ng/dL on Total T lol. Only way I can convince him to increase that is if there was some solid research proving increased Test dosage helps with increasing SHBG. Other than that I’m stuck with my current dosage.

New Labs: 12/13/19 Ulta Labs Ranges

  • Total T: 592 ng/dl Range 250-1100

  • Free T: 178.3 pg/mL Range 35.0-155.0

  • SHBG: 10 nmol/L Range 10-50

Old Labs: All Kaiser Permanent Ranges

10/4/19 (prior to TRT) no glucose tabs. Unaltered results

  • Total T: 302 ng/dl Range 240-871

  • Free T: 9.5 ng/dL Range 7.0-36.7 ng/dL

  • SHBG: 11 nmol/L Range 11-78

8/23/19 Test Taken ~40mins after 40gm of glucose tabs

  • Total T: 174 ng/dl Range 240-871

  • Free T: 5.7 ng/dL Range 7.0-36.7 ng/dL

  • SHBG: 9 nmol/L Range 11-78

7/17/19 Test Taken ~40mins after 80gm of glucose tabs

  • Total T: 158 ng/dl Range 240-871

  • Free T: 5.3 ng/dL Range 7.0-36.7 ng/dL

  • SHBG: 7 nmol/L Range 11-78

Glucose Tabs: for those that are wondering why labs on 7/17 and 8/23 are super low is because Kaiser Physicians refused to help me because I was on the borderline of low T. I did a ton of research on how to lower natural test and found the easiest way for me was to eat 10-20 glucose tabs (4gm of carbs/tab) prior to getting my blood drawn.

Can’t really compare hormone tests across different labs. Probably best to stick with one.

Not especially, depends on how high. Yours is not crazy high.

Free test level between 2 to 3% of total is thought to be ideal.

It won’t improve it, usually decreases it.

How are you feeling? Maybe a little early to expect full benefits from TRT.

I’m a once weekly 200mg guy and even though I know a lot of guys on TRT, I know zero that inject daily. I’ll let the daily champions jump in here since they have more (any would be more) experience with daily than I. @systemlord

Nice.

I have Kaiser and the endos aren’t well educated or good at prescribing TRT. All my endos are uneducated in sex hormones and don’t test for critical hormones. I see lots of guys seeking TRT at these levels.

I’m a rare case where 400 ng/dL is optimal for me, otherwise I would have to seek TRT from a local or anti-aging clinic which unless you have very low SHBG is exactly what you should do. Dr. Daniel Demoss (Kaiser endo) knows I inject 7mg daily (49mg weekly) and he didn’t seem bothered by it because my hematocrit is lower, but he would never suggest it to a patient!

I feel very bad on SQ injections, testosterone is lower and estrogen damn high, but I can flip it around the other way injecting IM.

Testosterone threshold for cardiovascular risk in middle aged and elderly men:

The locally weighted regression showed that total testosterone levels of 440 and 480 ng/dL were associated with increased Framingham CVD risk and an increased probability of increased hsCRP, respectively. Men with sexual dysfunction (poor sexual performance, decreased morning erection, and loss of libido) had significantly greater CVD risk.

So by keeping your levels in the low 400’s Kaiser is not only keeping you in an unhealthy range but also putting you at risk for cardiovascular disease. Generally sick care docs are very bad at TRT and the directives put in place for doctors to follow prevent men from truly feeling good and reliving all symptoms of low testosterone.

Total T isn’t the active portion of testosterone, Free T is the active portion of testosterone. If your SHBG is higher, you’ll need a bigger dose of T to have sufficient FT levels, something Kaiser docs don’t understand. Kaiser doesn’t test FT directly, they use TT and SHBG to calculate your FT.

Do you get SHBG tested?

Yup every time I get the test I have the receptionist click off on the SHBG test as well. for past 4 tests all showed SHBG sitting at the bottom of scale. Even with different lab and different ranges it’s still at the bottom of the barrel. I’m just glad it hasn’t hit 0 yet with TRT since TRT in theory decreases it. For some off reason TRT impacts all of my labs except SHBG, that doesn’t seem to fluctuate more than 1-3 points. Weird.

Bottom of the scale is vague, 10 versus 20 is a big difference, you’ll probably need around 450-650 to achieve good FT and might need to make other aramgements. My recent SHBG was 13, but TRT increases my SHBG (mid 20’s) which isn’t common, usually TRT decreases SHBG, but my weight and insulin resistance is suppressing SHBG, TRT reverses insulin resistance which then increases SHBG.

My Labcorp testing I pay for were within 5 ng/dL of the Kaiser labs, the Labcorp showed TT at 495 ng/dL and Kaiser labs at 490 ng/dL a day apart. Back then I was on an 20mg EOD protocol. The funny thing is 7mg (49mg weekly) daily gets my very close to these numbers.

Aren’t we - for very good reasons - saying that total T is worthless and SHBG needs to be taken into account?

You are constantly bashing the medical community and yet you go along with them whenever it provides the opportunity to call another physician an idiot.

His free T is perfect and the high level is to be expected due to the very low SHBG. No reason to believe that the current T levels put him on any risks whatsoever due to being undertreated.

It seems more interesting to find out what causes these low SHBG levels in the first place. If its hypothyroidism than this would actually open the door to thyroid hormone replacement which could alleviate the need for TRT altogether.

Before today we only knew his SHBG was on the lower end, but my estimation was correct, he needs between 450-650 to have optimal FT and his doctor wanted him confined to a range <400 which would have his FT suboptimal when you look at his other labs scoring in the 300’s and trough levels at 9.5 ng/dL (range 7.0-36.7 ng/dL) is unacceptable.

I will stop bashing the medical community when they stop treating everyone like clones as if we all have the same SHBG levels and treat everyone as an individual. If this guy had high SHBG, 400 would be no good and he would have needed possibly levels above the reference ranges which isn’t allowed in Kaiser because they are behind in knowledge.