T Nation

HRT/Blood Work Question

I’m 39 years old and I’ve been on Testim 5g for four months now and just got the results back from the blood work done last week. I must say that I am surprised. Before HRT my total test was 137. I don’t know what my free numbers were. Here is what my printout from Quest Diagnostics says:

(The numbers in parenthesis are the ranges from Quest Diagnostics on what they say it should be.)

Test Total - 547 ng/dL (250-1100)
% Free Test - 3.18 (1.0-3.1)
Test, Free - 174.6 pg/mL (35.0-155.0)

Quest says that my free testosterone levels on the two parts listed above are “out of range”. I’ve been reading and cannot validate that.

Is my free testosterone being too high a bad thing? What do these free test numbers mean?

I still can’t believe that I went from 137 to 549 in total test on just 5g of Testim. I guess all the tips and tricks I’ve learned on this forum has really helped me get the most “bang for my buck” on this low dose. Unbelievable!

Thanks in advance to anyone that can help me interpret these free test numbers and explain whether it’s a bad or good thing. I think it’s good but I’m not sure.

How close was your prior application of T to the blood draw? The FT might not be very representative if it is a post application spike.

Good news over all. How are you feeling? Mood/energy/libido etc.

Some will argue that your total should be higher.

[quote]KSman wrote:
How close was your prior application of T to the blood draw? The FT might not be very representative if it is a post application spike.

Good news over all. How are you feeling? Mood/energy/libido etc.

Some will argue that your total should be higher. [/quote]

Thanks for the reply. I would say that the blood draw was at least 4" away from the area where there was an application from the day before. I had the blood test done in the morning and hadn’t put any gel on since the day before.

I’m feeling pretty good overall. I don’t really know how to judge the way I feel on the T-level or not because I had my thyroid removed three weeks ago. I just started thyroid replacement for that just yesterday.

I tried to ask my doctor on Monday about estradiol and aromatization. He just looked at me like I was crazy and wondered where I got that from. He told me to quit worrying about it and come back in a month. I guess I’m going to have to go to the LFE and do my own blood test.

I thought going from 137 to 549 was pretty good for only a 5g dose. I had read so many posts from other men on here that had little or no results at all even after moving up to 10g.

If the free T wasn’t from a post-application spike, is the number being on the high out of range a good thing?

Thanks for your input. My doctor wouldn’t tell me a thing. I’ve been reading for hours today.

Tell your doc that you want HCG, E tests and AI as needed to treat symptoms, not just E levels above lab ranges. And that you want to have a collaborative relationship. Then ask if he has any recommendations for another doctor.

You will need the HCG to keep your testes healthy. Some get pain/ache in their testes as they loose LH levels.

Maybe you should just find another doc for your your TRT + thyroid hormone replacement.

PM me if you have any things that you would like to discuss.

[quote]KSman wrote:
Tell your doc that you want HCG, E tests and AI as needed to treat symptoms, not just E levels above lab ranges.[/quote]

What exactly does this mean. I am on 5 g Androgel and i dont know exactly what all my T levels are, but I want to make sure I am getting the most benefit I can out of it.

E is ESTRADIOL? AI is Aromatase Inhibitor? I need an AI class of drug to decrease my absolute E level?

Reading this forum has prompted me to find out exactly what the levels are. If they are in the smaller range of “normal”, will injections likely boost my level?

[quote]fugative wrote:
KSman wrote:
Tell your doc that you want HCG, E tests and AI as needed to treat symptoms, not just E levels above lab ranges.

What exactly does this mean. I am on 5 g Androgel and i dont know exactly what all my T levels are, but I want to make sure I am getting the most benefit I can out of it.

E is ESTRADIOL? AI is Aromatase Inhibitor? I need an AI class of drug to decrease my absolute E level?

----- yes

Reading this forum has prompted me to find out exactly what the levels are. If they are in the smaller range of “normal”, will injections likely boost my level?[/quote]

Injections are 100% delivery. TransDermals, when they work well, are 10% delivery. Some are TD non-responders. But you need blood work to know. Some need to increase the amount of TD… based on BW results/

Test for total T, free T and E2 aka estradiol.

If TD works, the HPTA will be shut down, testicles will shrink and the scrotum will tighten up. If you see that, you know that the delivered dose is greater than or equal to the amount of T that you used to produce. But in some cases, the T levels are no higher. For a few, shrinking testes are a 24x7 ache. Shrinking testes are a QOL and self image thing as well as fertility issue. Injections of HCG will stimulate the LH receptors and maintain baseline testicular function. If TRT was required because the system could not produce enough LH, and the testes are viable, then HCG can increase testicular function above your baseline. That can increase T amounts as well and will be additive to your dose. In some such cases [few] HCG alone could/might provide significant benefits.

[quote]fugative wrote:
KSman wrote:
Tell your doc that you want HCG, E tests and AI as needed to treat symptoms, not just E levels above lab ranges.

What exactly does this mean. I am on 5 g Androgel and i dont know exactly what all my T levels are, but I want to make sure I am getting the most benefit I can out of it.

E is ESTRADIOL? AI is Aromatase Inhibitor? I need an AI class of drug to decrease my absolute E level?

Reading this forum has prompted me to find out exactly what the levels are. If they are in the smaller range of “normal”, will injections likely boost my level?[/quote]

It means go by how you “feel” not what the lab reports say.

You need to get a copy of your labs and post them up.

There is good and bad estrogen that need to be in certain parameters. Estradoil(e2) is a particularily nasty estrogen that needs to be closely monitored. Most of estrogens nasty side effects occur when E2 is out of control.

AI means aromitase inhibitor. You might need one depending upon your E2 level. E2 might go down naturally with better treatment and weight loss. If you can get away without using an AI, that is ideal.

Injects and TD’s will take your T level to whatever you want it to. The sky is the limit, but remember due to health reasons its always better to stay within safe ranges.

Yes.

Yes.

Often, when using exogenous testosterone, it also causes an elevation in E due to the action of aromatase. Using an AI counteracts this trend.

It isn’t that simple and you won’t know until you have the blood work done. You may not be responding to the gel or you may simply need to add an AI to the equation. The human body is incredibly complex and this is especially true when working with hormones. Be patient and educate yourself as much as you can. The information is available on the Internet and there is no reason why you can’t be even more knowledgeable than your doctor. It’s your life and your body and your health. You’re doing the right thing by taking responsibility for it. Don’t give up.