T Nation

Mid-Range Total Test and off the charts Free Test


#1

4 days after my weekly 200 mg test cypionate injection (Dr. administered), my total test was 678 ng/dl. This is normal for me on this protocol. What surprised me is the Free Test value that came back of greater than 49 pg/ml (reference range 6.8 to 21.5 pg/ml). This was the first time I had pulled the LabCorp Testosterone, Free plus Total LC/MS test. To this point, my doctor has used the calculated free test value that uses SHBG, Albumin, and Total Testosterone. Using this formula, I would have expected something between 15 and 18 pg/ml (within the reference range).

Anybody have an thoughts on why the measured free test might be so high for a middle-of-the-range total test?

I don't know that this is relevant, but I recently crashed my e2 and have since gotten off the adex entirely. Also, my SHBG is generally at the very low end of the range and total test prior to treatment was 167. I am 42 years old.


#2

There’s no way to know unless you had SHBG and albumin labs. Since high E2 tends to elevate SHBG you could hypothesize that the SHBG was driven lower than normal due to your crash. If you haven’t been on any crash diets or have liver problems then getting E2 back in check should correct the FreeT. If you don’t have recent labs you should get albumin, SHBG, ALT, AST, bilirubin and possibly GGT.


#3

When you inject once a week there are waves of TT, FT and E2 levels and any one test is quite useless and SHBG is a lingering effect of these things that are unsteady. Inject twice a week or EOD so your body is in balance and labs will then represent reality instead of a single frame in a movie of an accident scene.

You have high peal values and no one should be surprised.


#4

Totally agree with the frequency of injections. I spoke to the doc last week and he has moved me to 2 x week injections. Hope that helps smooth things out.


#5

Lower estrogens lead to lower SHBG. However, more FT also lowers SHBG, which increase FT. So there can be some non-linear self-reinforcing effects.

Your higher FT is having some effects on SHBG.