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Author Topic: Dr. Crisler Speaks on the New LabCorp TT "normal range"  (Read 715 times)

Dr. John Crisler

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PeakT

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Re: Dr. Crisler Speaks on the New LabCorp TT "normal range"
« Reply #1 on: December 07, 2017, 09:30:10 am »
It's the same thing, all over again.

http://drjohncrisler.com/the-new-ldquonormal-rangerdquo-for-total-testosterone.html

For anyone reading, the new Lab Corp upper end is now 916 ng/dl and, of course, Lab Corp is the 600 lb gorilla of drug testing so doctors less knowledge about hormones, which is most of them, will be highly influenced by this.  Lots of men on here are in the 916-1200 ng/dl range and doing very good with no side effects, so this is not a good development in my opinion. 

Dr. Crisler:  Did you notice if they dropped down the top of free testosterone as well?
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Re: Dr. Crisler Speaks on the New LabCorp TT "normal range"
« Reply #1 on: December 07, 2017, 09:30:10 am »

Dr. John Crisler

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Re: Dr. Crisler Speaks on the New LabCorp TT "normal range"
« Reply #2 on: December 07, 2017, 10:01:37 am »
It's the same thing, all over again.

http://drjohncrisler.com/the-new-ldquonormal-rangerdquo-for-total-testosterone.html

For anyone reading, the new Lab Corp upper end is now 916 ng/dl and, of course, Lab Corp is the 600 lb gorilla of drug testing so doctors less knowledge about hormones, which is most of them, will be highly influenced by this.  Lots of men on here are in the 916-1200 ng/dl range and doing very good with no side effects, so this is not a good development in my opinion. 

Dr. Crisler:  Did you notice if they dropped down the top of free testosterone as well?
I know this is kind of quantum, but 916 IS 1197 in that world.

It's all about testing methodologies.

As long as we TRULY understand the nature of hormones, we will continue to properly treat our patients. I've seen many come in under 1197 on the old methodology, but now over 916 on the new. Same dose. But they were tuned up before, we had stepwise increased their dose to get them that way (so we knew we hadn't overshot the mark), so we just continue on.
Physician in Age Management Medicine private practice. www.DrJohnCrisler.com

NOTE: Comments on this forum are NOT medical advice and are no substitute for individualized patient care. Please consult your personal physician prior to initiating or changing ANY treatment regimen.

Sean Mosher

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Re: Dr. Crisler Speaks on the New LabCorp TT "normal range"
« Reply #3 on: December 07, 2017, 10:32:56 am »
Thats why many of us are so thankful for these forums and doctors like Dr. Crisler.
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Re: Dr. Crisler Speaks on the New LabCorp TT "normal range"
« Reply #3 on: December 07, 2017, 10:32:56 am »


PeakT

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Re: Dr. Crisler Speaks on the New LabCorp TT "normal range"
« Reply #4 on: December 07, 2017, 10:41:58 pm »
It's the same thing, all over again.

http://drjohncrisler.com/the-new-ldquonormal-rangerdquo-for-total-testosterone.html

For anyone reading, the new Lab Corp upper end is now 916 ng/dl and, of course, Lab Corp is the 600 lb gorilla of drug testing so doctors less knowledge about hormones, which is most of them, will be highly influenced by this.  Lots of men on here are in the 916-1200 ng/dl range and doing very good with no side effects, so this is not a good development in my opinion. 

Dr. Crisler:  Did you notice if they dropped down the top of free testosterone as well?
I know this is kind of quantum, but 916 IS 1197 in that world.

It's all about testing methodologies.

As long as we TRULY understand the nature of hormones, we will continue to properly treat our patients. I've seen many come in under 1197 on the old methodology, but now over 916 on the new. Same dose. But they were tuned up before, we had stepwise increased their dose to get them that way (so we knew we hadn't overshot the mark), so we just continue on.

Well, what’s 30% here or there, eh?  No, thx for the info!
« Last Edit: December 07, 2017, 10:43:59 pm by PeakT »
THE MOST COMPREHENSIVE BOOK ON TRT/TESTOSTERONE:
https://www.amazon.com/Natural-Versus-Testosterone-Therapy-Myer/dp/1523210532/ref=sr_1_1?ie=UTF8&qid=1499116128&sr=8-1&keywords=natural+versus+testosterone+therapy
And check out my New Peak Testosterone Program: http://www.peaktestosterone.com/peak_testosterone_program.aspx
If you are on medications or have a medical condition, always check with your doctor first before making any lifestyle changes or taking new supplements.  And low testosterone is a medical condition.

IamTheOneWhoKnocks

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Re: Dr. Crisler Speaks on the New LabCorp TT "normal range"
« Reply #5 on: December 08, 2017, 03:33:54 am »
The worse part to this is the lowering of the "Low" side of the scale. 348 was once considered to be Low, and a reading of 349 will have Dr's saying "you are fine and in range". Now with it being at 264, GP's will not even touch Low T guys unless they fall below the 264. Sad that these guys will have no treatment for something that effects so many men.


https://www.labcorp.com/assets/11476

This PDF from LabCorp blames the changing of the test on Obesity. Basically you lose the weight you will be in range. however one of the symptoms of Low T is one loses the ability to lose weight, even though in reality Low T is a cause of weight gain in the mid section.


This PDF from LabCorp acknowledges that Low T causes weight gain.

https://www.labcorp.com/tests/related-documents/L9688
« Last Edit: December 08, 2017, 03:44:46 am by IamTheOneWhoKnocks »

Mindscape

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Re: Dr. Crisler Speaks on the New LabCorp TT "normal range"
« Reply #6 on: December 08, 2017, 11:33:34 am »
The worse part to this is the lowering of the "Low" side of the scale. 348 was once considered to be Low, and a reading of 349 will have Dr's saying "you are fine and in range". Now with it being at 264, GP's will not even touch Low T guys unless they fall below the 264. Sad that these guys will have no treatment for something that effects so many men.


https://www.labcorp.com/assets/11476

This PDF from LabCorp blames the changing of the test on Obesity. Basically you lose the weight you will be in range. however one of the symptoms of Low T is one loses the ability to lose weight, even though in reality Low T is a cause of weight gain in the mid section.


This PDF from LabCorp acknowledges that Low T causes weight gain.

https://www.labcorp.com/tests/related-documents/L9688

Question, what does it mean when they mention, "in some men with testosterone concentrations near the lower limit of the normal range and where alterations of SHBG are suspected" what does this mean? There must be a reason why those guys at the lower end of the normal range do not experience any symptoms of low T, perhaps something we have yet to understand. I'm sure as time passes they will be able understand why and provide a better method of diagnosing low T since we all know some guys in the 400 range experience symptoms.
« Last Edit: December 08, 2017, 11:37:41 am by Mindscape »
Age: 45, Ht: 6'0, Wt: 230 lbs
First Protocol: 75mg weekly
Second Protocol: 50mg T Cyp 2x/week
Third protocol: .25ml 100mg EOD

Pre-TRT labs:
Total Test: 119 ng/dL  348-1197 ng/dL
Free Test: 5 ng/dL
SHBG 25 nmol
TSH: .58  0.35 - 4.00 mcIU/mL
-------------------------
4 weeks into TRT May 2017:
Total Test: 531 ng/dL trough 451 ng/dL 264-916 ng/dL
Free Test: 15.2 ng/dL
SHBG 18 nmol

Cataceous

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Re: Dr. Crisler Speaks on the New LabCorp TT "normal range"
« Reply #7 on: December 08, 2017, 11:43:09 am »
Question, what does it mean when they mention, "in some men with testosterone concentrations near the lower limit of the normal range and where alterations of SHBG are suspected" what does this mean? There must be a reason why those guys at the lower end of the normal range do not experience any symptoms of low T, perhaps something we have yet to understand. I'm sure as time passes they will be able understand why and provide a better method of diagnosing low T since we all know some guys in the 400 range experience symptoms.

I'd guess it means that if your SHBG isn't operating efficiently then you could have much higher free testosterone than predicted by the standard methods; you should measure directly if this is suspected.
I am not a medical doctor; any suggestions are meant to be discussed with your doctor.
Age: 56, Ht: 5'10", Wt: 154 lbs
Protocol: 18 mg T cyptionate subQ qod, 250 IU hCG subQ qod, 6.25 mg DHEA orally bid, 7.5 mg preg. orally qd
5/2017 test results: TT: 800 ng/dL (348-1197), FT: 16 pg/mL (7.2-24), E2: 50 pg/mL sensitive (8.0-35.0), DHEA-S: 278 ug/dL (71.6-375.4)

Mindscape

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Re: Dr. Crisler Speaks on the New LabCorp TT "normal range"
« Reply #8 on: December 08, 2017, 12:17:32 pm »
Question, what does it mean when they mention, "in some men with testosterone concentrations near the lower limit of the normal range and where alterations of SHBG are suspected" what does this mean? There must be a reason why those guys at the lower end of the normal range do not experience any symptoms of low T, perhaps something we have yet to understand. I'm sure as time passes they will be able understand why and provide a better method of diagnosing low T since we all know some guys in the 400 range experience symptoms.

I'd guess it means that if your SHBG isn't operating efficiently then you could have much higher free testosterone than predicted by the standard methods; you should measure directly if this is suspected.

I remember Dr. Crisler mentioning that there's a variability in the stickiness of SHBG from one patient to the next, this must be an example. This might explain why my T levels (low SHBG guy) didn't drop much on weekly injections.
Age: 45, Ht: 6'0, Wt: 230 lbs
First Protocol: 75mg weekly
Second Protocol: 50mg T Cyp 2x/week
Third protocol: .25ml 100mg EOD

Pre-TRT labs:
Total Test: 119 ng/dL  348-1197 ng/dL
Free Test: 5 ng/dL
SHBG 25 nmol
TSH: .58  0.35 - 4.00 mcIU/mL
-------------------------
4 weeks into TRT May 2017:
Total Test: 531 ng/dL trough 451 ng/dL 264-916 ng/dL
Free Test: 15.2 ng/dL
SHBG 18 nmol

Dr Justin Saya, MD

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Re: Dr. Crisler Speaks on the New LabCorp TT "normal range"
« Reply #9 on: December 08, 2017, 01:42:07 pm »
The worse part to this is the lowering of the "Low" side of the scale. 348 was once considered to be Low, and a reading of 349 will have Dr's saying "you are fine and in range". Now with it being at 264, GP's will not even touch Low T guys unless they fall below the 264. Sad that these guys will have no treatment for something that effects so many men.

Sad indeed and I've seen this exact scenario play out many times since LabCorp made the change in July.
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NOTE: Comments on this forum are NOT medical advice and are no substitute for individualized patient care. Comments on this forum do not constitute or establish a physician-patient relationship. Please consult your personal physician prior to initiating or changing ANY treatment regimen.

PeakT

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Re: Dr. Crisler Speaks on the New LabCorp TT "normal range"
« Reply #10 on: December 09, 2017, 03:17:18 pm »


Sad indeed and I've seen this exact scenario play out many times since LabCorp made the change in July.

You know me:  I can't help but be suspicious that this is an insurance industry-backed changed.  This probably shaves millions of dollars off of necessary coverage.

Well, the bottom line:  sometimes you have to be responsible for your own health...
THE MOST COMPREHENSIVE BOOK ON TRT/TESTOSTERONE:
https://www.amazon.com/Natural-Versus-Testosterone-Therapy-Myer/dp/1523210532/ref=sr_1_1?ie=UTF8&qid=1499116128&sr=8-1&keywords=natural+versus+testosterone+therapy
And check out my New Peak Testosterone Program: http://www.peaktestosterone.com/peak_testosterone_program.aspx
If you are on medications or have a medical condition, always check with your doctor first before making any lifestyle changes or taking new supplements.  And low testosterone is a medical condition.

Mindscape

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Re: Dr. Crisler Speaks on the New LabCorp TT "normal range"
« Reply #11 on: December 09, 2017, 04:18:46 pm »


Sad indeed and I've seen this exact scenario play out many times since LabCorp made the change in July.

You know me:  I can't help but be suspicious that this is an insurance industry-backed changed.  This probably shaves millions of dollars off of necessary coverage.

Well, the bottom line:  sometimes you have to be responsible for your own health...

That's the direction healthcare seems to be going, larger premiums less coverage.
Age: 45, Ht: 6'0, Wt: 230 lbs
First Protocol: 75mg weekly
Second Protocol: 50mg T Cyp 2x/week
Third protocol: .25ml 100mg EOD

Pre-TRT labs:
Total Test: 119 ng/dL  348-1197 ng/dL
Free Test: 5 ng/dL
SHBG 25 nmol
TSH: .58  0.35 - 4.00 mcIU/mL
-------------------------
4 weeks into TRT May 2017:
Total Test: 531 ng/dL trough 451 ng/dL 264-916 ng/dL
Free Test: 15.2 ng/dL
SHBG 18 nmol

Joe Sixpack

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Re: Dr. Crisler Speaks on the New LabCorp TT "normal range"
« Reply #12 on: December 09, 2017, 04:29:26 pm »


Sad indeed and I've seen this exact scenario play out many times since LabCorp made the change in July.

You know me:  I can't help but be suspicious that this is an insurance industry-backed changed.  This probably shaves millions of dollars off of necessary coverage.

Well, the bottom line:  sometimes you have to be responsible for your own health...
My pet theory is that it is not the insurance industry.  I believe it is just part and parcel of the war on masculinity.  That this move is just the latest in a series.  Another milestone in that series of moves was the criminalization of testosterone, where they made T a scheduled controlled substance. 
Age: 55, Ht: 5'08", Wt: 150 lbs
Protocol: 35mg T Cyp 3x/week, 300 IU hCG 3x/week, 50mg DHEA + 50mg Pregnenalone daily.
1/2017 test results: TT: 1152 ng/dL (348-1197), FT: 23.7 pg/mL (7.2-24), E2: 22.0 pg/mL sensitive (8.0-35.0)

Osprey

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Re: Dr. Crisler Speaks on the New LabCorp TT "normal range"
« Reply #13 on: December 09, 2017, 07:41:11 pm »


Sad indeed and I've seen this exact scenario play out many times since LabCorp made the change in July.

You know me:  I can't help but be suspicious that this is an insurance industry-backed changed.  This probably shaves millions of dollars off of necessary coverage.


If TRT is supposed to result in better health outcomes then it implies that it would result in fewer health claims therefore saving the insurance companies money. What am I missing?

cujet

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Re: Dr. Crisler Speaks on the New LabCorp TT "normal range"
« Reply #14 on: December 10, 2017, 06:47:23 am »
So, in 20 years or so, when healthy male T levels drop another 30%, do the lab ranges get revised downward again? The new normal, so to speak? Or does someone finally understand that great great grandpa had a T level of 700 in old age. And that today's men aren't the robust men of yesterday.
54 years old
Autoimmune Hashimoto's, near zero natural T production
Cause: severe mononucleosis in my early 30's
Weight 200
Height 5' 10"
Very active, daily workouts and some cardio.
Topical 0.75g compounded 10% T cream, rotated daily to shaved armpits, shaved shoulders, remainder on scrotum
190mg NPthyroid (natural dessicated pigs thyroid)
Labs (Oct 2017) , my T=730, TSH 0.03, T3+T4 mid-range normal.


Daily workouts with weights, low-glycemic diet, high in clean protein, very low carb (salad/fish/low fat meats, uncooked veggies, nothing else, ever) Carbs/starch can cause me to have intestinal problems, so I avoid them.

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Re: Dr. Crisler Speaks on the New LabCorp TT "normal range"
« Reply #14 on: December 10, 2017, 06:47:23 am »