T Nation

Normal T and High Free T


#1

T dose: 160 mg weekly, Arimidex: 0.25 EOD

Quest Diagnostics (7 am):
Total T: 551 ng/dL [250-1100]
Free T: 172 pg/mL [35-155]
PSA, Total: 0.6 [< OR=4.0 ng/mL] (refrained from sexual activity for 48 hrs)
When I didn't refrain from sexual activity, I have seen PSA upto 0.9 ng/mL.

Labcorp (8 am):
Total T: 653 ng/dL [348-1197]
Free T: 17.9 pg/mL [6.8-21.5]
SHBG: 9.9 nmol/L [16.5-55.9]

All the above results are for 160 mg weekly T dose.

When I was at 150 mg weekly testosterone, my results were:
Quest:
E2: 23 [Labcorp:
Total T: 608 ng/dL [348-1197]

I have currently dropped my T dose to 150 mg weekly with 0.25 arimidex every third day.

8/2/14
Fasting glucose (Lab Corp): 108 (last week).
Total cholesterol: 167 mg/dL [<200]
HDL cholesterol: 30 mg/dL [>40]
LDL: 100 mg/dL [<100]
Triglycerides: 187 mg/dL [<150]

June 2014
TSH: 1.85 [0.4-4.5 mIU/L]
Vitamin B12: 688 [200-1100 pg/mL]

Blood work from May 2014.
A1C = 6.1
Fasting glucose = 103
Urea Nitrogen = 11 [7-25]
Creatinine = 0.98 [0.6-1.35]
eGFR Non-Afr American = 97 [>OR = 60 ml/min]
eGFR African American = 112
Bun/Creatinine ration = not applicable
Sodium = 142 [135-146]
Potassium = 4.2 [3.5-5.3]
Chloride = 105 [98-110]
Carbon dioxide = 27 [19-30]
Calcium = 9.7 [8.6-10.3]
Protein, total = 6.7 [6.1-8.1]
Albumin = 4.3 [3.6-5.1]
Bilirubin = 0.4 [0.2-1.2]
Alkaline phosphate = 55 [40-115]
AST = 26 [10-40]
ALT = 34 [9-46]

CBC
WBC count = 6.4 [3.8-10.8]
RBC count = 5.32 [4.2-5.8]
Hemoglobin = 15.8 [13.2-17.1]
Hematocrit = 46.8 [38.5-50]
MCV = 88 [80-100]
MCHC = 33.7 [32-36]
RDW = 14.1 [11-15]
Platellet count = 195 [140-400]
Absolute neutrophils = 2925 [1500-7800]
Absolute Lymphocytes = 2854 [850-3900]
Absolute monocytes = 429 [200-950]
Absolute eosinophils = 166 [15-500]
absolute basophils = 26 [0-200]
neutrophils = 45.7 %
lymphocytes = 44.6 %
Monocytes = 6.7 %
Eosinophils = 2.6 %
Basophils = 0.4 %

Since this last blood work, I have donated blood once.

Thyroid in March 2014
TSH: 1.69 [0.4-4.50]
T4, total = 4.9 [4.5-12]
T3 free = 3.4 [2.3-4.2]
T3, total = 85 [76-181]

Ferritin (Feb 2014): 16 [20-345] ng/mL
I also donated blood in July. So I suspect it dropped a little more.

Age: 40
Height: 5' 7"
Weight: 230 lbs
waist: I wear 38" pant at maximum circumference

Meds:
Losartan: 25 mg daily
Taurine: 1000 mg daily
Chromium picolinate: 200 mcg daily
GNC mega men sport multivitamin daily

  1. Which lab to trust (quest or labcorp)?
  2. Sex life is good but very difficult to lose weight.

Any help would be appreciated. Thanks. My goal is to reduce weight. Thank you for your reply KSman. Can you please provide any suggestion?


#2

Both labs are good T levels change and the FT ranges are very different and you can edit the ranges into the post above, see the |Edit in the corner above.

You need followup labs to determine average glucose, can’t recall what it is called. Some concern with diabetes.

Please read the advice for new guys sticky and note all of the causes, your low T is a symptom.

We need more info and more labs if you have them.

You really need E2 lab work, and TSH, as well as that diabetes followup. Maybe more suggestions when we get age, weight, waist etc.

SHBG looks good! Expect lower E2. So next suspect for fat gain is thyroid or eating and lifestyle.


#3

KSman, thanks for your reply. I have posted more information. Can you provide some feedback. Thanks.
Age: 40
Height: 5’ 7"
Weight: 230 lbs
Waist: 38"


#4

Is this really working well for you?

With those low ferritin levels, does it really make sense to be donating blood? Ferritin suggests a problem, but other CBC items don’t tell that story.

You do have a serious weight loss challenge.

For high blood pressure, I recommend:

  • fish oil[good concentrated product], nuts, flax seed oil/meal for essential fatty acids
  • 100mg Ubiquinol form of CoQ10, a bit pricey
  • vitamin C
  • DHEA to achieve youthful DHEA-S levels, at your age, take 25mg then test later to see how that is going
  • lower E2 levels - looks good so far
  • high normal TT, FT
  • optimal thyroid levels
  • mini aspirin
  • high potency B-complex multi vit with trace elements and iodine [your vitamin looks good!]
  • 5000iu vit-D3, find tiny 5000iu oil based caps
  • might be something else in the advice for new guys sticky

All of this addresses endothelial dysfunction. The endothelium is a one cell thick lining of the arteries. When that goes bad, you have arterial disease. Estrogens make things worse as well as increased blood sugar and increase insulin. There is a lab test, homocysteine that reflects inflammatory processes in the arteries.

Your thyroid levels seem odd. T4 is low. T3, T4, fT4, fT3 should all be near mid range and TSH near 1.0
Please read the thyroid basics stick and see what your waking and mid-afternoon body temperatures are like. Also not that one needs years of iodine intake from using iodized salt. Your vitamins contain iodine, but that cannot make up for a situation where one has been using sea salt or avoiding salt, perhaps from a misguided doctors reactions to elevated BP.

I think that you are injecting weekly. Please see the protocol for injections sticky for advice. You need steady T and E2 levels. So not knowing that your T levels really are… if tested 7 days after injecting, I don’t really know what to suggest other than that I would like to see your T levels higher and there all of the time.

If you improve your TRT and improve thyroid status if temperatures are low, then your metabolism would be more able to support weight loss. And also note that you do not want E2 levels too low.

If your energy/metabolism is low, could be thyroid, CoQ01 or low cortisol. Do “AM cortisol”, at 8AM. Thyroid regulates body temperatures by modulating mitochondrial function, which can also be compromised by low C0Q10, which can be low for older people not taking a statin drug. Perhaps you can improve your metabolism and loose some weight.

So there are three stickies to read which will keep you busy for a few days:

  • advice for new guys, lots of technical stuff
  • protocol for injections
  • thyroid basics

Great to hear that your libido is good. Can you describe other aspects of your health and how you feel? Stress levels? Diet?


#5

Thanks brother.

  1. I decreased my dose from 160 mg weekly to 150 mg weekly because my free T was past the normal range. Do I need to go back to 160 mg weekly? Is there a concern if free T is that high?

  2. Currently I am doing once a week shot. If I inject twice a week, will my T level increase or decrease midway between shots?

  3. With twice a week shot, will my arimidex dose increase or decrease?

  4. Do I need to test my DHEA levels before supplementing with it?

  5. Do I need to test my CoQ10 levels before supplementing with it?

  6. You stated that my GNC Mega Men Sport vitamin is good. I have been taking this vitamin from the last 6 years. It has 300 mg of vitamin C. I can add a little more. All B vitamins are 50 mg each in this multivitamin.

  7. My multi has 1600 IU of Vitamin D. I can add more.

I have a sedentary job (desk job). I workout 3-4 days a week. Back issues as well.

Diet
Breakfast: egg whites, sausage, hash potatoes (occasionally), fruit
Snack 1: almonds, nutrigrain bar, fruit
Lunch: mostly salad
Snack 2: almonds, fruit
Snack 3: milk, protein bar
Dinner: nothing special on menu
glass of milk before bed.
I do snack randomly when I feel hungry.

I can check on my body temp upon awakening. A couple of weeks ago my body temp in doctors office (in afternoon) was 98.1 deg.


#6

Quest Diagnostics (7 am):
Total T: 551 ng/dL [250-1100]
Free T: 172 pg/mL [35-155]
I didn’t refrain from sexual activity, I have seen PSA up to 0.9 ng/mL.

Labcorp (8 am):
Total T: 653 ng/dL [348-1197]
Free T: 17.9 pg/mL [6.8-21.5]

According to Labcorp, your FT was mid range. Were both labs done the same day?
Were both labs done at the same time after injecting?

When you inject once a week, levels will exceed normal ranges at the peak.

Inject twice a week, then always do labs 1/2 between injections. There is no reason to do labs at 8AM with your HPTA shudown.

Anastrozole: Until you get E2 labs done later injecting twice a week, you don’t know what to do. Your prior E2 labs were sort of meaningless.

Take DHEA now, test DHEA-S later to see if you need more of less. DHEA levels start to drop after age mid 30’s

With your condition, I suggest Ubiquinol in any case.

Body temps in doctors office can be low after walking, talking etc.


#7

Thanks for the reply.

The labs at Quest and Labcorp were done on the same day. They were only 1 hr apart. So, what do you think? Which one is more reliable?

On weekly injections, my level on 7th day (before shot) is 650 (per Labcorp). If I inject half dose twice a week and check midway, will my level be lower or higher than 650?

Will 7 Keto DHEA help in my case? Any reason for taking DHEA-S vs DHEA or 7 Keto DHEA?

I have started taking 50 mg of Ubiquinol and experience bloating? Is this transient? Can I do something to minimize the effect?