Total test vs. bioavailable

[pcproffy]

Does total test mean anything? Would it be better if person A has lower total test, but more available test than person B?

 

[JanSz]

Does total test mean anything? Would it be better if person A has lower total test, but more available test than person B?

When starting discussion on testosterone, discussion quickly broadens into interconnected hormones and proteins.


Input Data:
T_tot (ng/dL)
DHT_tot (ng/dL)
E2_tot (pg/mL)
E1_tot (pg/mL)
Cortisol (ug/dL)
Alb_tot (g/dL)
SHBG_tot (nmol/L)
CBG (mg/dL)

Output:Free hormones

cFT (pg/mL)
cFDHT (pg/mL)
cFE2 (pg/mL)
cFE1(pg/mL)
cFC (ng/mL)

Output:BioAvailable hormones
cBT (ng/dL)
cBDHT (ng/dL)
cBE2 (pg/mL)
cBE1 (pg/mL)


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Some of the items above we can influence more than others.

What influences most how we feel is status of BioAvailable hormones.

Speaking of Testosterone
usually the biggest obstacle preventing proper level of BioAvailableTestosterone (BAT)
is not only TotalTestosterone but also SHBG level.

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[pcproffy]

Since our bodies are always trying to maintain its set point, when we add test will the body just create more SHBG to tie it up?

 

[JanSz]

Since our bodies are always trying to maintain its set point, when we add test will the body just create more SHBG to tie it up?

Not really.
SHBG is hard to influence.
There is two (three) type situations where if corrected I have seen improvement in SHBG.

Ideal SHBG(15-25)
Improvement means that SHBG would either get lower or higher, so it would fit into ideal range.

They are
metabolic ballance, mostly glucose/insulin
and
Thyroid hormones ballance, mostly getting TT3 & FT3 high and RT3 low
often involves using Cytomel-T3 only (pure-T3) and abstaining from anything that contains T4.

Many people have very high SHBG,
they may benefit by
slight overload on testosterone and keeping E2 little lower.
Overload of testosterone mean that instead of aiming at
ideal BAT~575
one would aim at say BAT~650 (no more)
use this test at Quest:

Testosterone, Free, Bio/Total (LC/MS/MS) Code: 14966X

Testing blood at Quest becomes handy, specially testing BAT
unfortunately all E2 tests there are rather unreliable or have some significant problems, so it is better to use LabCorp when testing, this test:

Estradiol, sensitive 140244 (3-70)

This test at Quest is adequate for E2 (but lab have a habit of changing to different tests even if script is clearly written)

Estradiol [4021X](13- 54 pg/mL)


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Other labs are coming with BAT tests.
They are useless, at least at this time.

..

 

[The Matrix]

Does total test mean anything? Would it be better if person A has lower total test, but more available test than person B?

Depends if it is unbounded or not by estrodial, shbg, or albumin as well as numerous other factors that can affect it at the tissue level such as nutrients, cell membrane integrity, ect.
bioavailavble is the amount avaliable to the body to use ..