T Nation

Blood Tests vs Urine Testing

I am a complete noob to low t and I am 43 yrs old.
I have read all the stickies and you guys have provided a great deal of info and I appreciate it.
I have noticed the debate between the urine testing vs blood. My question is:
Has anyone done both and done any sort of a comparison ? I know these tests are not cheap, but I may be
Willing to do both tests during the first year, just for the sake of our collective knowledge.

For a little background, I have been on the slow motion train wreck of low t symptoms for the past 10 years.
I have worked shift work for 22 years as well as tons of overtime, so I am sure that doesn’t help.
Kind of being in denial, I blamed all my symptoms on my job, stress, not eating right, long hours (12 hour shift),
Etc. a little over a year ago, I approached my primary doc about low t, after hearing commercials, etc.
My doc basically blew me off and said lose weight, exercise, and everything will be fine.
So after getting diet in check, going back to the gym, weights and cardio, I dropped from 240 to 212. My body
fat started at 33% and is down to 24%.
Everything is NOT fine. I feel worse now, a year later.
I did blood work in early December and demanded that my doc check my testosterone level, and he reluctantly
agreed. At that time I knew nothing about free t or estrogen, and the doc did not order it.
When total t came back 418 on scale of 347 - 1147 (Labcorp) .
I had an appt. scheduled with my doc specifically to discuss my symptoms (you guys know them) but the day
before the appt. the doctor calls and tells me I am normal and I don’t need to come in, basically cancels my appt.
Being totally pissed and frustrated, I went through the process online with one of the big name clinics.
I don’t know if we are supposed to name them or not so I won’t. This clinic accepted my blood work, I had to send
In physical results, and get follow up psa test and igf-1 test. They did not request free t or estrogen, but said
they would test during follow up labs to " dial everything in."
They approved me for test cyp (200 mg/week) hcg, b-12. As an option, I was approved for GH (out of my
Price range) or semorelin/GRHP-6 (still fairly expensive).
I was ready to pull the trigger, even though like the rest of them, they dont take insurance, but my wife was more
apprehensive about how easy it was to do online without talking to a doctor face to face. She also wanted me to do whatever
I could to get this covered by insurance. (united health care).
So I agreed to a second opinion, to talk to a local urologist who is currently working with " multiple male patients on injectable
test." I have printed all the important info to take into this appt. Friday jan. the 6th. Of course I could have been a month into
treatment by now, and hopefully feeling better.
Anyhow, I have not really had anyone to discuss this with, as I don’t know anyone who is on trt, or nobody is talking about it.
I am open to any further advice on what to ask this urologist lady next Friday, and I apologize for this post being so long.
I am gonna ask her if she has any experience with the urine testing, and I have a lab corp very close.
Thanks for being here.

Welcome man…to answer your first question, I have had both serum and urine T tests done on the same day before I started TRT…Serum came back in the 400’s, while the urine test came back ABOVE RANGE…the serum test correlated more strongly with my symptoms, so I consider the urine tests bunk

Hopefully you will have luck with your urologist next week…you are doing things the right way by not hopping onto the anti-aging bandwagon, but just be prepared for possible frustrations and outright dismissals…you need to emphasize your symptoms first and foremost instead of pushing your doctor towards a protocol he probably is not familiar or comfortable with…good luck!

Thanks for the reply. It sounds like you guys that have been dealing with this for a while are comfortable working with the blood work numbers.
I appreciate the help.