Men's Health Forum: This is a discussion on Low Free Testosterone within the Anabolic Steroids forums, part of the extensive steroid information at MESO-Rx; Originally Posted by marianco
Free Testosterone will be determined by how much albumin is present to bind to testosterone (weakly ...
Free Testosterone will be determined by how much albumin is present to bind to testosterone (weakly bound testosterone), and how much SHBG is present to bind to testosterone (strongly bound testosterone). Albumin production is fairly stable and difficult to change without severe illness present. The albumin concentration is primarily determined by hydration - with dehydration increasing its level. SHBG is modified by multiple hormones: increased by thyroid, estrogens, progesterone; lowered by testosterone, DHT, DHEA, growth hormone, insulin; and is modified up or down by some medications, etc.
Is Free Testosterone a good measure of testosterone activity to determine whether nor not to adjust the testosterone dose? Not really.
First, Free Testosterone not a reliable test.
Secondly, and more importantly, it is also determined by multiple factors. It is more a measure of the sum of these factors than of testosterone activity itself.
Would it be better to use Bioavailable Testosterone, since this is calculated taking Albumin and SHBG into account, or does it also serve no purpose?
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Re: Free Testosterone as a measure
Quote:
Originally Posted by 1cc
Would it be better to use Bioavailable Testosterone, since this is calculated taking Albumin and SHBG into account, or does it also serve no purpose?
Bioavailable Testosterone (Free plus Albumin bound testosterone) is useful to obtain to help interpret what is happening.
Free testosterone is useful to obtain (particularly if it is accurate) to help interpret what is happening.
They do have a purpose - in interpretation of what balances or imbalances of other factors are occurring.
When it comes to the determining the dose of testosterone, I still think total testosterone is the single best and simplest measure.
For example,
Suppose a person has a total testosterone of 800 ng/dl. This is a level at the high end of the reference range (300-1000 ng/dl), and is high even for young adult men. Suppose this person has the symptoms associated with hypogonadism - low libido, lack of energy, concentration and memory problems, anxiety or depression, etc.
Should this person receive testosterone supplementation?
I would say clearly "no". The total testosterone is already good. Most probably other factors are contributing to the symptoms.
I would look for other neurotransmitter/hormone/cytokine imbalances that are causing his problem. These are far more likely to be the problem than having a low testosterone level. The common suspects would be hypothyroidism, suboptimal adrenal function, and depressive/anxiety conditions. These and other problems that can cause similar symptoms to hypogonadism.
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I just hope JanSz reads this he has been doging my posts telling me about Free T and BAT. I have been saying Total T is best for dosing for yrs.
It is really the same horse, it just depends at what part of the horse one is looking.
CALCULATED FreeT is looking for an interaction between three hormones and checking how they balance. It is additional important information. Looking just at T and closing eyes at SHBG and Albumin is throwing away available information.
Issue is somewhat clouded by useless assays of FreeT, they bring confusion.
Looks like Dr Shippen is interested in FreeT level. (I am sure he does many other investigations.)
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In this post, Dr Marianco have nothing against FreeT and Bio-available T, but he underlines "the accurate ones".
Quote
"Bioavailable Testosterone (Free plus Albumin bound testosterone) is useful to obtain to help interpret what is happening.
Free testosterone is useful to obtain (particularly if it is accurate) to help interpret what is happening.
They do have a purpose - in interpretation of what balances or imbalances of other factors are occurring."
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Each doctor may have a somewhat different path when planning treatment.
You keep missing my point your always posting to us, that are on TRT and know we have low testostereone about these tests. My point is we don't need all of this tested and it does not help when one is on TRT all one needs to know is there Total T for dosing. The tests you are talking about having done are good when one is first tested to find out why and what is going on.
Other testes that are good is Estradiol, SHBG and DHT. I just don't see how anyone can change there dose of TRT by looking at BAT or Free T. Your going to find that Dr. Shippen does a lot of things different then what is in his dated book. We will find all of this out when his new book comes out.
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I just hope JanSz reads this he has been doging my posts telling me about Free T and BAT. I have been saying Total T is best for dosing for yrs.
Second answer, and I hope that is what you were looking for.
When you reach T=650 , stop increasing it and look for other problems.
Right here: Quote:
"How can one decide that the testosterone dose is too high or too low?
Using total testosterone, the TRT decisions become very simple:
1. The goal of TRT is getting the average total testosterone to at least 650 ng/dl (midrange on a reference scale from 300-1000 ng/dl).
2. If any problems remain, then it is due to other neurotransmitter/hormone/cytokine imbalances or excessive testosterone dose (i.e. supraphysiologic total testosterone)." http://forum.mesomorphosis.com/500180-post6.html
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Observing my own responses.
On 10mg of Androgel I had TT=932ng/dL(241-827)
Not really happy sexually, good endurace to excercise.
I lowered to 7.5mg Androgel, no testing.
Better sexually, noted some degradation in endurance while working out.
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Just came from a doctor, got 7 prescription papers, I am on a way to pharmacy.
Armour Thyroid, Corteff, Novarel, Tcream (thanks 1cc), syringes, whole bit.
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About endurance and time to recovery after exercises,
what govern it?
Adrenals????
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Your going to find that Dr. Shippen does a lot of things different then what is in his dated book. We will find all of this out when his new book comes out.
He wast doing the FreeT check just couple weeks ago.
Any idea when his book is going to be out?
Is there a way to get his material from any of conferences, when he teaches there?
Re: Free Testosterone as a measure 
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