Bioavailable vs free testosterone

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    Bioavailable vs free testosterone


    I got blood work results

    total T 15 nmol/l range 8.4 -28.7
    free 39 pmol/l range 31 pmol/l -94 pmol/l
    bioavailable T 12.6 nmol/l range 2.5 nmol/l - 15 nmol/l
    TSH 1.61 miu/l 0.35 - 5
    FSH 6 iu/l 2-8
    LH 4iu/l 2-6
    prolactin 6 ug/l 2-18

    So based on the results I have low normal free testosterone and quite high normal bioavailable. How is it possible? I thought they are related. If one is lower than another one should be the same. BTW Age 37. Have symptoms low T but doctor says nothing wrong in this area. Any comments. Thanks.

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    Quote Originally Posted by MikeM72 View Post
    I got blood work results

    total T 15 nmol/l range 8.4 -28.7
    free 39 pmol/l range 31 pmol/l -94 pmol/l
    bioavailable T 12.6 nmol/l range 2.5 nmol/l - 15 nmol/l
    TSH 1.61 miu/l 0.35 - 5
    FSH 6 iu/l 2-8
    LH 4iu/l 2-6
    prolactin 6 ug/l 2-18

    So based on the results I have low normal free testosterone and quite high bioavailable. How is it possible? I thought they are related. If one is lower than another one should be the same. BTW Age 37. Have symptoms low T but doctor says nothing wrong in this area. Any comments. Thanks.
    What is your SHBG?

    total T 15 nmol/l =~420ng/dL

    you are low,
    something is not right with your bioavailable T
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    Quote Originally Posted by JanSz View Post
    What is your SHBG?

    total T 15 nmol/l =~420ng/dL

    you are low,
    something is not right with your bioavailable T
    Unfortunately I don't have SHBG

    but earlier I did free testosterone and it was 39 again.
    Another urologist asked to do bioavailable and that time was 8.7 I believe which is fine based on his words.
    All tests were from 8 to 9 a.m.


    When you say something is not right what do you mean exactly? It can't be that high having free low normal?
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    Quote Originally Posted by MikeM72 View Post
    Unfortunately I don't have SHBG

    but earlier I did free testosterone and it was 39 again.
    Another urologist asked to do bioavailable and that time was 8.7 I believe which is fine based on his words.
    All tests were from 8 to 9 a.m.


    When you say something is not right what do you mean exactly? It can't be that high having free low normal?
    Urologists and endos will tell you that you are ok if you are laying on dying bed.

    Make a copy of the whole page where you have that test, attach to your post.
    Sometimes the test spans 2 pages.
    .
    For now, believe me, you are low.
    ============================== =========================
    In the future, if you are going to LabCorp, make sure that you have TotalTest and SHBG done at the same time.
    Then you are able to double check using chart on my post #41
    Jan's BloodTest April13/2007

    Better, do tests at Quest Diagnostics, ask for this tests:
    47 ----------- Testosterone, Free, Bio/Total (LC/MS/MS)

    This test is a part of longer list that I do for my self, post #44
    Consider doing the whole list at some point in time.
    If you have a time, peruse the whole thread, 5 pages.
    ============================== ==========================
    On some tests, you do not want to be just within range, you want to be high up, close to the top range.
    On some tests the range given is wrong. Range is given for ones age. We always want to work from range apropriate for (20-30) yo men.

    BioavailableTestosterone is one of those tests.

    Some tests are giving wrong answers (often enough) and should not be used at all.
    Laboratories know about, but keep doing those tests.
    Sometimes they get new tests but keep the old available ($$ for the lab).
    Sometimes, good test is good only for women but not for men.
    Stay around, read boards, learn.

    The tests I am talking about are:

    DHEAs
    FreeT3
    FreeT4
    BioAvailableTestosterone (BAT)
    FreeTestosterone
    Estrodial
    IGF-1
    IGFBP3

    May be more.
    ============================== ========================
    When blood is drawn at doctor's office, good chance of getting screwed.
    Always ask for script and do the blood draw at the lab.

    Depending on test and your protocol you may want to get ready for it.

    If one is on testosterone shots, and going to check BAT, glucose, cortisol
    Make appointment to lab for 7AM (48 hrs after T-shot)(be there at least 1/2 hr earlier to calm down (cortisol)
    fast previus 9-12 hours (glucose)
    do not eat high carbs prior 3 days (glucose)
    drink 12oz of plain water around 5:30AM (Albumin)
    ============================== ========================
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    Thanks for the reply

    I just got referral from urologist to endo who is supposed to be very knowledgeable.
    Before he sees me he asked to do estradiol,T3,T4,PSA,Calcium

    But what should I ask endo beside explaining my concerns ? I'm not sure if I want to do TRT even if he offers it Is there such a thing as TRT trial that I could easily stop without shutting down own production.How long this trial can last? I really don't want to end up to be on TRT for life especially it won't help my sexual problems. Is there a way to boost own T production without any harm for health? May be herbal supplements or even FDA approved drugs if there are any? I just want to see if low T is actual cause of my problems.

    Thanks,
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    Doctors are taught to believe that anything above ~250 or so total T is completely fine, and textbooks tell them that is the level where symptoms occur (they need a new textbook). I think it's the same with adrenals, most don't recognize it until you have adrenal failure (Addison's).
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    Can you go to Quest labs on your own to get a blood lab done or does doctor have to order it? How much does it cost? Do you go through insurance?
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    Quote Originally Posted by male25 View Post
    Can you go to Quest labs on your own to get a blood lab done or does doctor have to order it? How much does it cost? Do you go through insurance?
    There are two places that I know where you can get blood test without doctor's script.

    One is LEF.org
    One of important tests, (E2), is of questionable quality.

    the other place, look at my post #101 here:

    Jan's BloodTest April13/2007

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    Bioavailable test should be about half of total test and is equal to the free test plus the portion bound to albumin. Since your free is toward the low end, your total test is in the normal range and your bioavailable is toward the high end then you must have a lot of albumin and SHBG bound testosterone - or the test is wrong.
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    I use this lab without a script:

    http://www.privatemdlabs.com/

    Prices are good... you can order online and results are returned online, usually within 2-3 days!

    They have a men's (sensitive) estradiol test for $68
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    Quote Originally Posted by Gutterpump View Post
    Doctors are taught to believe that anything above ~250 or so total T is completely fine, and textbooks tell them that is the level where symptoms occur (they need a new textbook). I think it's the same with adrenals, most don't recognize it until you have adrenal failure (Addison's).

    exact reason why I left the medical profession!

    MDs cant think outta the dam Merck Manuals and lab #s when we all know (and we aint even MDS) that everyone is a unique body and things affect us all differently at different levels..
    I may die (have an arrythmia) with a K (potassium of 2.2) but someone else wont---ETC--

    Same with my dog lol------her thyroids shot-----she functions great with Synthroid but at a T-4 level of 3-- but at 1.5 (which is normal as per "the textbooks"-- she sleeps all day and isnt active)

    reps for you gutterpump
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    Quote Originally Posted by MikeM72 View Post
    I got blood work results

    total T 15 nmol/l range 8.4 -28.7
    free 39 pmol/l range 31 pmol/l -94 pmol/l
    bioavailable T 12.6 nmol/l range 2.5 nmol/l - 15 nmol/l
    TSH 1.61 miu/l 0.35 - 5
    FSH 6 iu/l 2-8
    LH 4iu/l 2-6
    prolactin 6 ug/l 2-18

    So based on the results I have low normal free testosterone and quite high normal bioavailable. How is it possible? I thought they are related. If one is lower than another one should be the same. BTW Age 37. Have symptoms low T but doctor says nothing wrong in this area. Any comments. Thanks.

    Finally I had endo appoitment. My estradiol level is good hence low. Having bioavailabe T 12.6 there is no way he'll put me on T. I mentioned that other day BAT was 8.7 he said it's still pretty good. The doc professor of endocrinology. He said free T is BS. They should even remove this test and leave BAT instead. He said my problem with ED and lack of libido is not T related. It's possible he is right.

    The question about Tribestan. Is it a good idea to try to see if there is any difference? Does it actually boost T?
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    Quote Originally Posted by MikeM72 View Post
    Finally I had endo appoitment. My estradiol level is good hence low. Having bioavailabe T 12.6 there is no way he'll put me on T. I mentioned that other day BAT was 8.7 he said it's still pretty good. The doc professor of endocrinology. He said free T is BS. They should even remove this test and leave BAT instead. He said my problem with ED and lack of libido is not T related. It's possible he is right.

    The question about Tribestan. Is it a good idea to try to see if there is any difference? Does it actually boost T?
    I've been researching free testosterone vs. bioT measurements and according to the Mayo Clinic, your doctor is correct, bioT is the preferred test. This is from the Mayo Clinic's website:

    "However, these tests may be insufficient for diagnosis of mild abnormalities of testosterone homeostasis, particularly if abnormalities in SHBG (#9285 "Sex
    Hormone Binding Globulin [SHBG], Serum") function or levels are
    present. Additional measurements of free testosterone or bioavailable
    testosterone are recommended in this situation; bioavailable
    testosterone (see #80065 "Testosterone, Total and Bioavailable,
    Serum") is the preferred assay."


    I would really like another source to confirm this though. If you could PM me (or just post it in this thread if you're not concerned with being discreet) the professor's name who told you about free T being worthless, I would really appreciate it. I'm dealing with a similar issue (except reversed) and could use some info.

    Congrats on finding a decent endo. Make sure you keep an eye out for medical conditions that are known to cause fatigue (which could lead to ED and low libido). Something as small as a vitamin D deficiency and can cause chronic fatigue. In regards to tribestan, it will most likely not increase your testosterone, but it might improve your sexual problems. Check out this thread on anabolicmind:

    /forum/supplements/87001-best-test-booster.html (note, since I don't have enough posts, I can't post the full link)
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    Quote Originally Posted by phyviti View Post
    I
    I would really like another source to confirm this though. If you could PM me (or just post it in this thread if you're not concerned with being discreet) the professor's name who told you about free T being worthless, I would really appreciate it. I'm dealing with a similar issue (except reversed) and could use some info.
    An Extraordinarily Inaccurate Assay for Free
    Testosterone Is Still with Us


    http://jcem.endojournals.org/cgi/reprint/86/6/2903.pdf

    /////////////////////
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    Your lab results look screwy. How could your BAT be in a good range if your Free T is low?

    For next tests, get SHBG directly tested (not calculated), Total T, and Albumin (this is included in the metabolic comp). With these three tests it is possible to calculate Free and Bioavailable T.

    You mentioned symptoms of low T. Besides low libido, what are the others? Also, what's your height/weight/body comp/fitness level?

    You can get the male hormone panel for about $150 at privatemdlabs (this will include the metabolic comp), then add SHBG for about $50. Labcorp will draw the blood, and you can see the results online in 2 or 3 days. They don't send anything to your doc or insurance co. Post the results here if you like.
  

  
 

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