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Old 08-09-2008, 10:03 PM   #1
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Question Testosterone Free & Total Questions

Hello Everyone,

I just recently had my testosterone checked out and I have a few question to ask that my doctor could not explain to me.
I am 32yo with low energy & mood, no libido whats so every and its been this way for a few years. I am not super overweight, just 10 or 15lbs over and I had several blood test checked out which came back normal.
Can someone please explain these results and shine some light my way??

Here are my results..
- Total Test = 502 (Normal Range - 250 to 1100) NORMAL
- % Free Testosterone = 1.47 (Normal Range - 1.5 to 2.2) LOW
- Free Testosterone = 74.0 (Normal Range - 35.0 to 155.0) NORMAL

Thanks in advance,

 
Old 08-10-2008, 06:56 AM   #2
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Re: Testosterone Free & Total Questions

Your T is a bit low for your age. It should be in the upper 1/4 of the range.

Get your Estradiol E2 tested. It may be high.

If you are not on anti-depressants or hair restore meds the hormones can be corrected.

 
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Old 08-10-2008, 12:28 PM   #3
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Re: Testosterone Free & Total Questions

Actually I have been taking Anti-Depressants but only 10mg of Lexapro. Even when I stopped taking the anti-depressants and was hitting the gym focusing more on the cardio side my engergy, libido was still low.
I have been taking Androgel past these few days and I have to admit my mood has been better. I also have been taking B-12 shots daily for the first five days then once a week.

What is the Estradiol E2 test? Does it have something to do with Estrogen?

The doctors feel as long as I am in the ideal "Normal Range", low or high I am good so this is why they are not taking this seriously. I know there are lots of people who have way lower test then I do so I am not trying to complain.

I just wonder if this is the reason why I easily become depressed because of my testosterone?

Thanks again...

 
Old 08-10-2008, 02:15 PM   #4
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Re: Testosterone Free & Total Questions

Your percent of total testosterone that is free is below norm. It
could be held down by estradiol (E2) which constitutes the largest
percentage of estrogen, or your SHBG could be tying up too much.
But without tests its all speculation and guesswork. Free testosterone
is what contributes most to feeling good so if its low so are you.

 
Old 08-11-2008, 07:31 AM   #5
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Re: Testosterone Free & Total Questions

Maybe this explains the baldness going up there lol.
So if my Free Test is low this could be the reason why I get depressed, have mood issues, anxiety, sleeping disorder and a very, very low sex drive?
Can you explain to me why I have 2 test results for the Free Testosterone? One shows low and the other shows normal which is kind of confusing.
Also my Total Testosterone test shows normal but don't you think at the age 32yo I should be in the 700 - 900 range?

 
Old 08-11-2008, 04:46 PM   #6
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Re: Testosterone Free & Total Questions

Yes, brando, all those unpleasant symptoms can readily be attributed
to insufficient free T. And/or insufficient DHT as well.
The two results are not both for just free T. The low 1.47 is for
percent of the total that is free and the 74 is for actual free T.
At your age none of these test results should be labeled 'normal'.
You are considered normal if you fall within a range that spans what
has been tested in healthy individuals ages 15 to 95 or something
like that.
At 77 my total T was 521 and my free was 65. My doctor at that
time believed my free T should be at least 100. Androgel 5mg daily
brought me up to 98 in short order and I felt more like 57 than 77.
Yep, if I were your age I wouldn't settle for less than 800 or 900.
But be sure to get all the basic tests that can help you establish the
root cause of your low T before you begin TRT. If you wait it will be
too late and a real problem. Lotsa luck

 
Old 08-11-2008, 07:20 PM   #7
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Red face Re: Testosterone Free & Total Questions

Your the Best LALOV for helping me out with this!

I will admit since I started taking the androgel and b-12 shots I have been feeling great. Only if you knew how I felt before I started taking the androgel and how long I have been taking medications, seeking counselors and being told I suffer from "Manic Depression", "ADD", "Bipolar", "Borderline Personality Disorder", "GAD" and the list goes on as well the medications that were prescribed.

Since I have HMO I am not as cared for as I would like to be by my many doctors. So going forward what kind of advice would you have for me such as blood work needed and how to aproach my doctor by letting him/her know I do have an issue depending on blood work?
Remember the doctors only see their ideal "Normal Range" and thats that for them. I hate having to change doctors because I feel like I am not being taking seriously.
Also just an FYI if it helps I had a virus called Guillain-Barré when I was 16yo which put me in the hospital for a month..
Thanks again..

 
Old 08-11-2008, 09:15 PM   #8
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Re: Testosterone Free & Total Questions

Really glad to hear, brando, that A-gel and B-12 shots are making
you feel better. A very good sign. All too many guys get diagnosed
as mental due to hormones out of whack. So much easier and more
economical to slap on a convenient label and a bottle of pills to mask
symptoms than to spend time and effort to unravel a rather more
complex reality. And it's not easy to find a doctor skilled in up to
date hormonal knowledge. And of course hormone imbalance can
produce symptoms that appear like mental problems.
So, blood tests: estradiol (E2) since if high effectively lowers your
testosterone. SHBG since if high binds to testosterone and makes it
unavailable...can also be used to calculate your free T from total T
number. TSH, T4, T3 to rule out hypothyroidism which can also
detract from testosterone effectiveness. Prolactin to help clear
your pituitary of blame for not doing it's job signaling your testes
to produce more T and finally ACTH and cortisol to clear your adrenals
as they can complicate your symptoms and also depend upon your
pituitary doing it's job. So those are the tests and reasons for them.
It's too late to get accurate FSH and LH unfortunately.
I just don't know if you will be able to convince an HMO doctor that
you really need them all, even if they know you do. It's likely just
not cost effective by their standards, which don't place a patients
needs as uppermost. Again, much luck and let us know how it goes, okay??

 
Old 08-11-2008, 09:18 PM   #9
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Re: Testosterone Free & Total Questions

Brando,
You probably feel bad because your free T is very low for your age. Total T is also low for your age but not too terribly low. Anyway, free T is the important T. Most T is bound to proteins in the blood, the primary protein being SHBG (sex hormone binding globulin). What is not bound is called free T and that is the T that gives you many of the benefits of T.

The most common reason for low free T is either low total T or high SHBG. We don't know your SHBG level so you should have it tested but we do know total T at 500 is low for your age. At 32 you should be aware that any type of T supplement like androgel will make your body stop making T. Your testicles will shut down and you will become relatively infertile. Your testicles are also likely to shrink. If you take HCG (human chorionic gonadotropin) along with or instead of T replacement this can be avoided. HCG stimulates the testiles just like the LH your pituitary should be making does. In your case LH is probably low since your total T is low.

You need a full workup from an expert in this area. You are not likely to get it from an HMO but you might if you are persistent. Testing should be done when NOT on androgel or any other T replacement or the results will all be skewed.

Estradiol could be the reason your total T is low but there is no way to know since it has not been tested. You should go off androgel for a week and test total T, LH, FSH, TSH, prolactin, estradiol, total estrogen. This is a good set of tests to start out with to try to find the root cause of your low T.

 
Old 08-18-2008, 10:10 PM   #10
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Re: Testosterone Free & Total Questions

I actually have an appointment with an Urologist next month so these are things I will ask to have tested. I noticed since I started taking the Androgel my testicles seem to be shrinking. From what I read I thought Testosterone was suppose to help produce sperm so not sure why the shrinkage. I am only taking two packets and sometimes I feel a little spike in my libido but nothing major. I am wondering if I take 4 packets if there would be a difference?

 
Old 08-19-2008, 07:54 AM   #11
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mail04 HB User
Re: Testosterone Free & Total Questions

Quote:
Originally Posted by brando76 View Post
I actually have an appointment with an Urologist next month so these are things I will ask to have tested. I noticed since I started taking the Androgel my testicles seem to be shrinking. From what I read I thought Testosterone was suppose to help produce sperm so not sure why the shrinkage. I am only taking two packets and sometimes I feel a little spike in my libido but nothing major. I am wondering if I take 4 packets if there would be a difference?
You should start a new thread about your situation, but taking testosterone will most likely shut down your testicles hence the shrinking.

 
Old 08-19-2008, 05:59 PM   #12
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Re: Testosterone Free & Total Questions

I'm wondering where you got the idea that testosterone was
supposed to help produce sperm. FSH from your pituitary
signals your testes to produce sperm just as LH from your
pituitary signals your testes to produce testosterone. Adding
testosterone to your system from outside actually results in
lessening sperm production, sorry to say.

 
Old 08-19-2008, 10:11 PM   #13
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brando76 HB User
Re: Testosterone Free & Total Questions

Quote:
Originally Posted by LALOV929 View Post
I'm wondering where you got the idea that testosterone was
supposed to help produce sperm. FSH from your pituitary
signals your testes to produce sperm just as LH from your
pituitary signals your testes to produce testosterone. Adding
testosterone to your system from outside actually results in
lessening sperm production, sorry to say.
Actually the instructions / package notice from the Androgel said it helps with all of that. Maybe I read it wrong or something
Even before taking the Androgel I noticed shrinkage, I just thought it was from cold weather despite it's 103 here.
Does anyone know if its possible to take 3-4 packets at once? I can only rub it in three places according to the instructions but wondering if I could rub it on my glute or thighs?
Thanks again...

 
Old 08-20-2008, 10:20 AM   #14
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Re: Testosterone Free & Total Questions

brando, it is likely your estrogen level has gone up from the
androgel and increasing to 4 packets would likely cause it
to spike even higher. Until you get test results to guide you
accurately as to what to do next I think you better not make
radical dosage changes with your androgel. It could very well
make you feel much worse. Remember, estrogen is much more
effective at occupying your testosterone receptors and thereby
blocking them than testosterone. It really needs to be taken
care of as a priority. You can't just double up on androgel
and thereby feel better, it just doesn't work that way.

 
Old 08-20-2008, 08:43 PM   #15
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brando76 HB User
Re: Testosterone Free & Total Questions

I just upped the dosage becase my mood started to change again but I do hear what you are saying. The doctor said I can use three packages a day but I was wondering if it would be wise to use on packet at nite before bed since I wake up tired and grumpy and two in the morning after a shower?
Anyhow I know this is a diff subject so I dont want to keep going on about Androgel. I will look for your reply and keep you posted on my results from the Urologist.
Once again, I really want to thank you for your help LALOV929.
Last question...When I see the Urologist what test should I request to be done? I know the Estrogen is one but...
Thanks...

 
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