Please Advise Needed on high T low Free T
- 06-13-2009, 05:18 PM
Please Advise Needed on high T low Free T
I am a 54 year old male with the symptoms of low T, most importantly, low libido and lack of “hardness” in erections. In addition, I have been taking variety of antidepressants (currently cymbalta 60 mg, buspar 15 mg for the past 18 months) since the spring of 06. I am fully aware of the sexual side effects of these meds but feel what I have been experiencing is out of the ordinary.
At a recent appointment with my doctor I convinced her to order a blood test. Even though I printed out the recommended tests from an article written by Dr Crisler, she would not order them all. The following is a partial list of what I was able to gather:
Cortisol 15.9 UG/DL
Estradiol 21.4 PG/ML
Testosterone 754.7 (250-950) NG/DL
TSH 2.04 (0.38-7.0) UIU/ML
Free Testosterone 10.7 PG/ML
ALK Phosphatase 63 (26-126) U/L
Bilirubin Total 0.4 (0.2-1.2) MG/DL
Direct Bilirubin 0.1 (0-0.3) MG/DL
AST (SGOT) 29 (0-46) U/L
ALT (SGPT) 30 (6-40) U/L
From what I have researched, it appears my Free Testosterone could be low. I asked my doctor and her answer was “yes, it is on the low side but still normal”. I would like opinions on if I should pursue raising my free T numbers or accept them as being in the “normal” range?
I have received a second opinion from an urologist; he is not concerned about my free testosterone because my total T number is so high. He blames my symptoms entirely on the anti-depressants.
Should I accept the AD meds as the cause or look into a third opinion on my testosterone levels? Any help would be greatly appreciated.
- 06-13-2009, 05:24 PM
- 06-13-2009, 05:50 PM
Thanks. I have tried to educate myself on this subject and it seems the logical answer could be high SHBG levels. It concerned me that both docs think since my Total T is so high, that no further information is needed. I saw a new doctor this week (Matt Rosenberg) and inquired about my testosterone numbers. Matt is in primary care and I have linked a panel discussion on hypergonadism he took part in on MedScape. (no permission)
Rosenberg attributes all of my issues to the AD med cymbalta, and suggests I approach my shrink about lowering the dosage. He says my total T number is high enough and does not warrant further concern.
I live about 30 miles from Doctor John Crisler. The problem is Dr Crisler charges $500.00 for a consultation. Now this would be a small price to pay for my well being, but I am unsure if I am chasing a ghost. If my total testosterone is above average and I think it is, should I be concerned about free T and high SHBG? Or is the likely hood of a problem so small I would be wasting $500.00 to have Crisler tell me what Rosenberg already has?
I am just real confused and appreciate the advise.
06-13-2009, 08:21 PM
1. Rule out adrenals, Thyroid and SHBG with proper testing
2. If shbg is too high then danazol at 50 mgs everyday will lower it by half which needs to be subscribed by a physcian
3. Free T is not as important as bio T which you want to go for. If your shbg you can try danazol or need more test to compensate for the test bound up by shbg.
Damn he went up 100 bucks !! Mental note made..
inflation is a real killer
Hypergonadism? You are not clinical no where near that.
The Anti depressant may have cause damage to liver because they have to be metabolised by the liver throughh the P450 pathways. If these pathways are over loaded it could affect shbg production because shbg is released from the liver . High SHBG can indicate liver malfunctoin or stagnation
Inflation sucks !!
06-13-2009, 08:28 PM
Thank you just the kind of advise I was looking for.
06-13-2009, 08:54 PM
06-14-2009, 10:37 PM
correct me if im wrong........ but IIRC, total t is the androgenic signal.... free t is the anabolic side of t........
If your taking ssri's, i bet its from that. I have NO sex drive on ssri's. They throw off the balance of serotonin & dopamine.
06-16-2009, 02:30 PM
06-16-2009, 03:16 PM
06-16-2009, 10:23 PM
I'm sure it works for some people. It is worth a shot if you have exhausted other options.
06-16-2009, 11:32 PM
Correcting other things had a major impact.
17 year old extremely health TT 560 shbg 45.
Dr want to put on T.
Person was anorexic for 2 years and this caused major hormonal issues.
Further investigation should several nutrient defieincy, low thyroid, vitamin D
Corrected deficency TT went to 1000 shbg droped down 30
Correcting the other issues resulted in desire results
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