T Nation

How Do These Basic Testosterone Results Look?

Total Testosterone: 302 ng/dL

Free Testosterone: 40.0 pg/mL

Bioavailable Testosterone: 91.0 ng/dL

This was my first ever test a week ago… and the doctor said he didn’t understand how the bioavailable testosterone could be so low.

How do I feel health wise? I feel like absolute sh#$. I wake up from sleeping 10-11 hours. I’m good for about 3-4 hours… and I get brain fog after that. I want to go to bed early.

I hope this isn’t what life is like after 40.

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The reason why your doctor doesn’t understand why Free T is so low is because he is not very knowledgeable in this area of medicine. SHBG binds sex hormones and when elevated handcuffs Free T, SHBG from low to high normal can affect Free T by as much as 50 percent.

These levels are associated with cardiovascular disease and shorter lives.

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Your free t is awful. 40 pg/mL is equivalent to 4 ng/dL. I felt like shit at 10 ng/dL. My symptoms were: insomnia, low libido, no nocturnal or morning erections, fatigue, etc.

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Interesting that you just mentioned this. My blood pressure keeps getting higher. Currently it’s at 150/95. I’ve always had a blood pressure 135 and under. I eat extremely healthy and no fast food. I hardly use any oils in my diet. I eat a lot of chicken breast and tuna. For carbs I’m always eating a small serving of oatmeal plain. I always thought my entire life I was eating for the better? But no one can explain the high blood pressure. I was never diagnosed with any disease or any other issue.

I’m also starting to get creases in my earlobe. I believe they call it Frank’s Sign? You can google it. Has something associated with early cardiovascular disease.

I passed 2 heart tests. Both of them passed extremely well according to the doctor. I’m supposed to go for a 2nd blood test tomorrow. I should have the results in 3-4 business days.

Doctor claims according to the blood work… my kidney’s are in his words are “under performing”. What test do you examine for that? Is that the BUN TEST? Numbers were 23 mg/dL

I do have an TRT doctor lined up right now… but I’m waiting to see what my PCP doctor does first. Was hoping to get TRT covered by my insurance first.

I would only assume my Testosterone has been around 302 for about 1 full year now. Don’t know how much longer I should wait?

I had 35. I felt like I was dying. Get yourself on Trt and start on a larger dose to get over this hump ASAP. 170-200mg should work for you … try twice weekly and wait 6-8 weeks.

If you want to use my doc you would have to fly to him in Chattanooga once and after that he can prescribe and treat you for life.

The other option is defy medical a telemedicine clinic.

Or any clinic that is good. Share the doc or clinic you intend to use and we will help you make a good choice.

Hang in there I feel your pain.

You need to fall below the total serum range for the insurance to cover. That’s going to be below 300 or 350 and they will make you prove it’s that low twice. They wooo also ask you to do it at a time where the Most amount of t is created. Essentially making it harder for you to fail.

Thank you for the post. I appreciate your input.

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My doctor requested a 2nd test. I took the test last week… results came in this past Friday.

Total Testosterone: 413 ng/dL

Free Testosterone: 45.4 pg/mL

Bioavailable Testosterone: 99.3 ng/dL

Again, doctor requested these tests first thing in the morning. The results are above. What is causing the Total Testosterone to be in the “normal” range but Free Testosterone and Bioavailable Testosterone in the “very poor” range? I don’t understand this… I’m a newbie. Trying to learn. Would my doctor prescribe TRT on these numbers? Also, my blood pressure is 150/95 I believe my low testosterone is causing havoc on my cardiovascular system. Blood pressure has never been this high and I’m afraid to workout anymore. I’m 5’11’’ 195 lbs. I’ve been in the gym for 20+ years always trying to stay fit and enjoying life. But, I’m at crossroads… and somewhat confused.

I also have this odd feeling dead center of my chest. It feels like liquid… or some form of pressure. It feels like a slight weight. It comes and goes. I told my doctor about it and did 2 heart tests this month… he said I passed normal. This weird feeling comes and goes. I believe low testosterone is causing issues throughout my entire body. Definitely going to make changes this week… and find a doctor to get on TRT. I see my PCP this Tuesday. We’ll see what he decides to do.

Low testosterone equals high blood pressure. Testosterone effects the cardiovascular system, when low veins narrow and the heart must beat harder to get the blood moving.
One of the things I noticed about after going on TRT is my veins started to show again, more so than before which suggests I wasn’t optimal for a long time.

Typically doctors who take insurance, to get through their days and be able to see 20-30 patients in an 8 hour shift, they must fixate on labs ranges, this mentality sets the odds of finding a good TRT doctor against you greatly.

The endocrine society set the cut off point for low testosterone <300, so if you come in at 302, you’re +2 and therefore normal. There’s no critical thinking because the doctor realizes the insurance would refuse TRT, that’s the end of that and the doctor is on to the next patient!

To set the standard even lower, you require two separate tests <300.

Ranges are needed

I don’t understand what you mean about ranges?

The doctor emailed me and confirmed that I was low on testosterone. Apparently, he had time to see the blood tests early this morning. He said would you like to do TRT? I said sure!

He wrote the prescription for CYP 200mg

Dosage: 0.25ml Every 7 Days

So basically is that 50mg of Cyp a week?

Will this make me better?

He said… pick up your prescription today and see me tomorrow for your appointment. I will show you the do’s and don’ts of injecting.

Lab companies all have different labs ranges and units of measurements, Labcorps Free T reference ranges for a guy in his mid 40’s is 6.8-21.5 pg/mL, ranges are higher for a 20 year old (9.8-26 pg/mL), other lab companies have completely different ranges and use other units of (pmol/L, ng/dL) measurement.

Sorry dude, that won’t be enough testosterone! You more likely need 100-160mg weekly split up once or twice weekly. I would just slam on the brakes and talk to your doctor and request an increase in dosage or not bother with TRT until you find a competent doctor or you will end up lower than your pre-TRT levels.

As it stands now your doctor has probably never prescribed TRT and can only lead to more problems down the road if he is unwilling to learn. If none of your doctors will listen to reason, you may need to seek a competent doctor privately that specializes in this area of medicine.

You will not find anyone injecting 50mg weekly! I’m injecting 96mg weekly split up every 2 days which gets my Total T to 500 ng/dL and more importantly Free T levels are at the top of the reference ranges.

I would also request you test SHBG preferably before you start TRT or at least on your next set of lab work which needs to include Total, Free T and estrogen. These are the four labs needed to check or make changes to your TRT protocol.

No you need at least 100 a week. 150 is a better start. 200 works but usually is to much for most folks.

50 is worse and will only cause you to stay low.

Find a trt doc. We always tell men to do this but they don’t listen and spend weeks and months spinning wheels.

Right now you have realized your docs scared to dose. That should be a warning sign to find a new one.

Similar to how when you find you have low t and need to do something different.

Dont even bother going to the appointment. Send a respectful email back just saying that you have investigated this and have even spoken to other Drs and that 50mg a week is far too low and that you would rather wait until you find a Dr willing to start at a realistic dose. Just say that you do not want to waste his time going to the appointment anfld arguing with him about raising the dose if he is uncomfortable with TRT or just dont have alot of experience with it but you appreciate the thought. He will most likely ask you to come in and raise the dose.

Thanks for the posts fellas.

The reference numbers from the labs…

Total Testosterone - (Range 250 - 1100 ng/dL) My Value: 413 ng/dL

Free Testosterone - (Range 46.0 - 224.0 pg/mL) My Value: 45.4 pg/mL

Bioavailable Testosterone - (Range 110.0 - 575.0 ng/dL) My Value: 99.3 ng/dL

Sex Hormone Binding Globulin - (Range 10-50 nmol/L) My Value: 40 nmol/L

Serum Albumin - (Range 3.6 - 5.1 g/dL) My Value: 4.8 g/dL

Sorry about the ranges guys… I thought the range was just a standard universal amount that every lab used? Didn’t know they were different.

I do have another TRT doctor lined up… but I was trying to let my insurance handle it. The NEW TRT doctor wants to be paid out of pocket. Which isn’t a big deal… I’m learning on the fly right now. Trying to keep costs as low as possible. I still want to see my doctor tomorrow because my blood pressure is higher than normal… and I want to question him on a few other things.

Even if I questioned him on dosage… I don’t want to get into an argument with him. I don’t want him to think I’m challenging him with knowledge etc. Doctor’s have their reasons… and yes… some doctors may not want to write higher prescriptions… maybe they want to keep the liability low?

I just want to feel somewhat normal… and I’m far from normal right now. I seem to be just clinging on from a mental standpoint at the moment. Don’t know how many more days I can last? I think I’ve been dangerously low now since November 2018. Just a guess.

Your Free T is below ranges and so you’ll need probably more than 100mg weekly to get Free T from low normal to high normal. SHBG is right where I thought it would be, on the higher end, it may drop to around 30 while on TRT and is optimal.

You’ll likely need levels above ranges in order to increase Free T high enough, you’re already at 400 and Free T is very low. Your SHBG is binding androgens strongly.

I appreciate your time and knowledge (systemlord). Thank you. My doctor doesn’t seem like a hot shot. He does listen… and is very understanding. He’s only been my doctor for a few months… but I know an a$$hole when I see one. Perhaps, there’s an angle or approach he wants to take? I agree with you… the dose is very low. If you look at the size of this vial… Mighty Mouse would even laugh. I got robbed on the amount. There’s only 8 dosages in one vial. It’s ridiculously small.

I don’t have time to wait around to see if the doctor bumps up the dosage… but perhaps that’s what he wanted to do??? See blood results in a month??? Again, perhaps milking the insurance?

I hope to be able to read lab results as good as you. lol Wish I could be my own doctor. So SHBG is binding androgens strongly??? Is that a good thing?