T Nation

Question About Salivary vs Blood Testing


#1

So here is my issue.

I've had serum and salivary testing for Testosterone in the past. While my Salivary testosterone which is (bio-available I think) comes out over the HIGH range on the tests, my serum levels of Free and Total are right on the low range.

This makes no sense to me. Is it possible my Albumin, SHBG and Red blood is holding so much testosterone (and loosely) that when it reaches the tissue level I'm above the high range? Anyone heard of this?

Secondly, my "symptoms" mostly lead to LOW testosterone, not high. Although a couple indicators lead toward High T like Libido, and Body hair.

The doc's and the lab seemed to think Androgen resistance is to blame, although I've never touched AAS, or any pro-hormone etc. Can natural levels of Testosterone cause Androgen resistance?

Estradiol is consistent with Salivary and serum about midpoint in the Range.

Confused.


#2

Salivary testing for sex hormones is bunk, and even salivary cortisol testing is likely worthless at most labs unless screening for disease states characterized by very high levels of cortisol. Urinary testing for cortisol is legitimate. Urinary testing for testosterone can be helpful in certain situations, but serum testing should paint the picture in most cases.

So you have high libido and a lot of body hair? What are your serum T levels?

Androgen resistance would point to some type of genetic receptor malfunction. This is highly unlikely if you had a normal puberty and have never manipulated your testosterone levels in any way.


#3

Serum T levels:

Total test 10.1nmol/L (8-29) - this was one of my first test just over 2 years ago. Just about to turn 26 years old.

My most recent blood testing they "forgot" to do total testosterone. Anyway they got free test Came back at 33.3 pmol/L [30-130].

Couple others for comparison:

Estradiol 90pmol/L (<200) - Last year it was 87pmol/L, converts to around 24 in your units.
FSH 4.1 U/L (<7.0) - Last year was 3.0U/L
LH 3.8 U/L(<12.0) - Last year was 4.7U/L

Any like I said My salivary was off the charts, both times.


#4

LH AND FT vary a lot during the day making lab values of limited value. TT and FSH are steadier and those numbers are more useful in this context.

While E2=24 would seem to be good, it is high relative to your T levels, creating some degree of estrogen dominance. The E2:FT ratio is really what matters as SHBG bound T [SHBG-T] in TT is functionally inert and not in the game.