T Nation

Is Increasing Bioavailable T The Goal?


#1

My question for my fellow TRT patients, is increasing bioavailable testosterone the most important goal. I understand that keeping E2 levels in check and many other factors are important but what is the one I should focus on.

Is it better to have a total T. of 500 with a bioavailable T of 100 or total T. of 1000 and a bioavailability of 50?


#2

Before trt, my total testosterone was 750, my free was at the bottom of the normal range. To most people, 750 would be a pretty good number, but since my free was so low, I had all the symptoms of low t.


#3

The consensus is that Free T gets the job done so that is the more important one. You could have TT 2000 but if 100% of that is bound up and not Free it is pretty much useless.

So yes, having more % free testosterone is more important than the Total Testosterone number.


#4

Both are important, at least from a diagnostics perspective.


#5

both.

and it depends. how do you feel at 500/100 vs 1000/50? if you feel great with one and terrible with the other, you have your answer. this is more art than science, and each person is different.


#6

I see you point Pure Chance. I think for me I am to stoic. I have high blood pressure and there has been times when my systolic pressure has been as high as 190. The nurse will ask me who I feel and I will say fine. My first blood test showed me at a total testosterone of 39 L (250 ? 1100 ng/dl).

When the doctor ask me how I felt I said "fine." I had a list of symptoms but over all I could not judge how I felt. It wasn't till I raised my T levels that I was able to judge the difference in the two states. I like to have a optimal parameter to aim for. I am just awful at self evaluation.


#7

No. The idea is not to score high on some numbers test, but just to feel normal.

Many of us are not aware that natural hormone production is pulsatile, and varies throughout the day. Measurement during the morning can be quite different from a measurement at night. I think we lose a lot by making just this one T component in a highly complex mix of hormones steady throughout a 24-hour day. But I guess it's the best we can do at this time.