Low total testosterone but normal free testosterone

[Montana18745]

My total testosterone is 232 ng/dl and my free testosterone is 62.4 pg/dl. How can I have low total testosterone but normal free testosterone ? I feel I have symptoms of low t. Last year I seen an endo and he basically said I'm fine and my total t was due to a low/normal shbg. All other bloodwork came back normal. No one has answers can someone help?

 

[sespress]

Subbed for info - the free vs total discussion is something I'd like to be in from the get go. Always wondered.

 

[fweed]

Do you have any clue of why your normal testosterone is so low?
How do you feel, any signs of low testosterone - sexual problems, fatigue, weakness.
If you feel alright, perhaps the doctor is right, and your testosterone is just being used.

 

[Montana18745]

I have low total but normal free testosterone. If I knew why it was like this I wouldn't have made the thread. I feel there might be something someone is missing. Yes I have symptoms

 

[bad rad]

I would start looking at insulin resistance issues since high circulating insulin drives down SHBG. Metabolic Syndrome and low T tend to go hand in hand.

 

[Montana18745]

How do I get tested for insulin resistance? My glucose has always come back normal

 

[bad rad]

How do I get tested for insulin resistance? My glucose has always come back normal

That's good but if its borderline in the high range I'd investigate further. I'm no Doc but insulin resistance is usually what happens before type II diabetes. There are blood glucose clearance protocols to test for it but you'd be better off discussing this with a Doc.

Low SHBG is seen with type II diabetics due to the high insulin levels associated with insulin resistance. Type I diabetics have very high SHBG since they have no/low insulin levels produced in the body.

 

[fweed]

Ask an endocrinologist about which test to take.
They gave me a diabetes test, I don't know the name exactly but it was to check sugar absorption. First they took some blood, having fasted overnight. Then I had to drink a high glucose solution, wait 1 hour, another blood extraction, wait a second hour, then another blood extraction. It is more accurate than just one test.
Searching for info usually brings up something as a guideline.

Have you had your testicles checked. Also your thyroid?

If you have symptoms then something is not right, and you might want to see another urologist, andrologist or endocrinologist for a second or third opinion.
Don't listen to them if they say "the results seem fine" and they ignore your symptoms. If the patient doesn't feel right, something needs doing.

 

[Montana18745]

Just seen my regular doctor today and all my other bloodwork is perfect! They are referring me to a different endo. I'll mention the insulin resistance to him we will see if this one wants to listen. I did have my testicles checked and my thyroid is perfect also

 

[Montana18745]

I did see a urologist last idea he tested everything and also had no clue

 

[bad rad]

I'd try a Clomid restart if low LH/FSH.

 

[Montana18745]

Have you heard of Clomid restarts being successful?

 

[bad rad]

Have you heard of Clomid restarts being successful?

Yes, but the results aren't always permanent and require consistent dosing to maintain the higher testosterone levels.

 

[The Matrix]

Just seen my regular doctor today and all my other bloodwork is perfect! They are referring me to a different endo. I'll mention the insulin resistance to him we will see if this one wants to listen. I did have my testicles checked and my thyroid is perfect also

Perfect means nothing when the ranges are based off a sick and diseased population from 18-90 years old

Ex Results
Testosterone 301- range 300-1100 - Dr response " ITS PERFECT" - my response "complete BS and pure example of medical ignorance"

Insulin resistance
HA1C should be <5.3 IMO no 5.6 -

Any endo with common sense with low T and normal Free level should be looking at SHBG (most likely <20 in your case) , e2 and prolactin, as well as TSH around 1.5 with ft3 around 2.9-3.1 with negative antibodies.