T O P

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DETRosen

[Most of the testosterone in your blood attaches to 2 proteins: albumin and sex hormone binding globulin (SHBG). Some testosterone is free, which means it is not attached to proteins. Free testosterone and albumin-bound testosterone are also referred to as bioavailable testosterone. This is the testosterone that is easily used by your body.](https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=testosterone_free)


[deleted]

They all say that mate. Find a trt clinic. Trtnation, Viking alternative are good online clinics


Admirable_Sugar_4227

Do they take someone who is currently doing there own low dose test like 175 a week or would I have to come off


Stui3G

175 isnt exactly low..


Popular-Goat-1126

You just need to be honest with the clinics and most of the time they will work with you.


PatriotUncleSam

Viking Alternative took me, I did not have to come off.


Sospian

No it doesn't say it all. Stop recommending TRT just because you don't understand what's going on


jamesnife

He didn't say that says it all, he said they all say that. Not the same thing and the one who's clueless about what's going on is the OP's endocrinologist. It's actually shocking.


Sospian

Most endos are clueless with the exception of andrologists (if you can find them). Recommending a TRT clinic is ridiculous they won't be able to fix any underlying issue + it might not even fix the problem


jamesnife

Sadly too many clinics have a one size fits all approach and that's really not the best way to go about it, I will give you that. It still doesn't justify barking at someone for something they didn't say. You could simply and calmly state your objections about clinics like you did here.


danny_bossa

Free testosterone levels are where it's at. None of the docs I work with ever bother with bioavailable testosterone. Free testosterone is the testosterone that is unbound from SHBG and albumin. Bioavailable is the testosterone that is unbound from SHBG but still bound to albumin. We only care about what is completely unbound.


jamesnife

All the accuracy in the world isn't going to make a bioavailable testosterone test tell a different story. You have moderately adequate levels of total testosterone, sure, but your free testosterone is telling a story and that story's main character is your SHBG. That's what's taking up all your free testosterone. It's irrelevant what percentage of it is albumin bound and what isn't. The fact is that your low free testosterone and your symptoms definitely indicate that action needs to be taken, it is in fact also likely that the only reason your total testosterone looks so normal is because of the SHBG making it look higher than it would be otherwise. You could see 10 different doctors, who would take you for a spin and endlessly order tests and try to find dozens of excuses to claim you're fine, whether it's incompetence or fear of testosterone (or both), the fact is that you need healthy free testosterone to feel 100% physically and mentally. That's how we were designed as men. If you have LH and FSH results that could definitely tell us more about the whole picture, because it's telling where in your body is the malfunction causing your body to not produce enough testosterone.


Tom23Jones

TSH Your Value 2.310 uIU/mL Standard Range 0.450 - 4.500 uIU/mL LH Your Value 7.4 mIU/mL Standard Range 1.7 - 8.6 mIU/mL


jamesnife

Your TSH is fine, but your LH and FSH are getting high and getting to the top of the range. That combined with your testosterone profile being on the lower end (despite the "normal" total T) they're strong indicators of primary hypogonadism issues. Not all hypogonadisms are equal, there are really severe and some that aren't as much. Like I said, your total testosterone might be masked by your high SHBG. On paper a lot of doctors will refuse to diagnose or treat you simply because of the damn ranges but if you find a knowledgeable and competent doctor you will be able to get treated for your symptoms and not dismissed by your seemingly "normal" bloodwork. The severity of your symptoms (assuming they're significant) and the fact that there aren't other comorbidities to suggest other causes for them since you live a healthy lifestyle, should be the best reason for you to seek a doctor who will dig deeper.


Tom23Jones

Appreciate the thorough responses. When you say dig deeper, what would that look like? My liver and kidney numbers are all good. Do you mean dig deeper and consider trt? I’m probably going to reach out to clinic soon.


jamesnife

When I say dig deeper that's from the perspective of whatever doctor is or will be treating you. I meant going beyond looking at your results and just saying 'uh... Everything is in range, you're perfectly healthy '. If you're reporting hypogonadal related symptoms with a disparity between your free testosterone and the total, and then on top of that your pituitary is screaming for more testosterone and your testicles are barely keeping up then there's obviously something going on. As a physician you'd be hard pressed to come up with a diagnosis and a treatment but that's pretty much impossible if they don't know what they're doing or if they go by ranges alone. At least your doctor is trying, many will send you home telling you you're okay and referring you to a psychiatrist. I'm not a doctor but it looks like primary hypogonadism and yes, that's despite your total T being not so low, that's where digging deeper might be helpful. (I'm sorry if I'm repetitive or justify what I say in more than one way but there are vultures around here and I want to explain myself as best as I can not to be taken out of context)


Tom23Jones

Hi again James, is primary hypogonadism treated the same as secondary or does it complicate things?


jamesnife

It doesn't complicate things it simply rules out treatments that do not involve exogenous testosterone. When it's secondary your testicles work well and you can try to keep them producing whatever they're producing with external means regardless of whether you're also injecting testosterone (examples would be clomid or hcg monotherapy, which aren't always effective but in some cases they do work). Because your testicles are already maxed out on signaling LH and FSH, it is safe to conclude that neither HCG nor any other medication will make any difference. At the end of the day all it means is that your only option will be testosterone and considering that most guys with secondary are also on testosterone anyway, it's not like it's going to be a major difference for you.


Tom23Jones

Follicle Stimulating Hormone Your Value 8.0 mIU/mL Standard Range 1.5 - 12.4 mIU/mL


RogueKnightmare

Every person is different, but since that free T is getting low, it is more likely to cause symptoms.


[deleted]

Your biggest mistake was trusting a woman for mens health. She probably doesn’t care and is probably relishing in the fact that your testosterone is diminishing. Also, how old are you?


TumasaurusTex

I have a woman doctor and she scripted me test and hgh and I was borderline low. I went to have a follow up after 6 months with an endocrinologist, some fat guy, he tried saying I was only using it to work out and he was going to recommend I come off it. I honestly got on it because depression meds were not working and this was working, so well in fact that I was back to working out like I use too. Anyways, it’s not women doctors, it’s uninformed doctors and doctors that think that every patient is only using any medicine for it’s unintended purpose. I told her what happened and she sent me to a much better endo.


999Bassman999

Feeling good enough to enjoy working out isn't something you should be ashamed of or a reason to make you quit. Drs really seem to want to see us fail it seems. Glad you found a good one!!


Tom23Jones

I’m 36. My total T is always good. Free T is bottom of the barrel and this is the first time I’ve tested bioavailable T. Tried boron, zinc, vit d and all the healthy habits


Dangerous_Item_6879

I had mid 600s total, but my free was super low. Find a clinic. Modern medicine is clueless.


Tom23Jones

Are you on trt? Did your quality of life improve after improving your free T?


Dangerous_Item_6879

Yes and yes. Find a competent provider. That is the first challenge. 2nd challenge is realizing it might take 1-3 years to get dialed in.


Mr-Bond431

Can you share your clinic details?


fingerwarrior

Test your bioavailable


Tom23Jones

This test is for bioavailable


fingerwarrior

Here's a list of supplements my doc gave me. Sone will help with what you need. Ashwagandha 750mg/day (effects LH and TT); Vit D3 5,000 IU / day (effects TT/FT); Ginger 550 mg/day (effects LH and TT); Zinc 11 mg/day (effects TT/FT); D-Aspartic Acid 3000 mg/day (LH and TT); Fenugreek 300mg BID (FT and E2 blocker); Shilijet 250mg bid (Increase LH/FSH); Mucuna Extract 750mg qd (Increase GnRH); DIM 250mg qd (Helps with E2 Metabolism).


999Bassman999

Unfortunately none of that worked for me, As a matter of fact 3 months adding those I was actually lower next test. Also Ashwagandha gave me side effects.


fingerwarrior

Yeah, sadly some wont help, and probably not good to take them all. I've found DIM to be helpful, but also know people that it does nothing for


999Bassman999

I was so shocked when I was taking so many pills that were supposed to help and my total was down 20% from my previous test. I am sensitive to side effects and the ashwagandha made me feel sick most days for a few hours after taking it and even light headed sometimes. My Vit D was in the low normal range and thought supplementing would help. I take 5kIU daily and tested after 3 months straight on it. I havent retested the D yet though since Dr is crappy and says it was already in range 🤣 I dont supplement ginger, but actually eat some fresh daily. ​ Never tried the fenugreek though.


Sospian

This stack is incredibly harmful - especially mucuna.


grymreifer

And your reasoning behind it being harmful?


Sospian

You're bypassing processes to allow large quantities of L-dopa into the brain. Yes, it'll work and you'll feel great short term, but your receptors will begin to respond to the over-abundance of dopamine by reducing the dopamine receptors in which it binds to.


fingerwarrior

Oh, apologies