Quantcast

Author Topic: High Total Testosterone, Low SHBG and non-existent Free Testosterone???  (Read 4663 times)

tre

  • Full Member
  • ***
  • Posts: 247
    • View Profile
I thought I had my blood work reasonably figured out, but my most recent blood work showed that my Total Testosterone is just over 1200ng/dl, SHBG at 8.3, Estradiol at 19.9 and Free Testosterone at less than .2pg/ml.  My new doctor said it all looks good and handed me the bloodwork for my own records.  However, I don't think that .2 pg/ml is good at all.  I didn't notice it until I left the office and I'm really baffled by it.  I have been getting blood work done regularly and my Free Testosterone is ALWAYS high along with my Total Testosterone.  My SHBG is always low.  This makes some sense to me, but having non-existent Free Testosterone does not.  Any ideas?  I can't help but think that this is a lab error, but it stated on the lab report that "results were verified by repeat testing" specifically regarding the Free Testosterone test. How can I have Low SHBG and non-existent Free Testosterone when my overall total Testosterone is high (slightly higher than most tests I might add)?
« Last Edit: September 27, 2016, 11:07:36 pm by tre »

Kierkegaard

  • Moderator
  • Hero Member
  • *****
  • Posts: 3623
  • Hormone Shrink
    • View Profile
Re: High Total Testosterone, Low SHBG and non-existent Free Testosterone???
« Reply #1 on: September 28, 2016, 12:35:32 am »
I thought I had my blood work reasonably figured out, but my most recent blood work showed that my Total Testosterone is just over 1200ng/dl, SHBG at 8.3, Estradiol at 19.9 and Free Testosterone at less than .2pg/ml.  My new doctor said it all looks good and handed me the bloodwork for my own records.  However, I don't think that .2 pg/ml is good at all.  I didn't notice it until I left the office and I'm really baffled by it.  I have been getting blood work done regularly and my Free Testosterone is ALWAYS high along with my Total Testosterone.  My SHBG is always low.  This makes some sense to me, but having non-existent Free Testosterone does not.  Any ideas?  I can't help but think that this is a lab error, but it stated on the lab report that "results were verified by repeat testing" specifically regarding the Free Testosterone test. How can I have Low SHBG and non-existent Free Testosterone when my overall total Testosterone is high (slightly higher than most tests I might add)?

Lol, your doc thought .2 looked good.  Man, they keep setting records. 

I'd look into causes and corrections for low SHBG, such as possible liver or insulin resistance issues.  Peak has an excellent page on the area: http://www.peaktestosterone.com/Low_SHBG
"The same thing that makes you live can kill you in the end." -- Neil Young

March 2014: Dx low T (158ng/dl)
September 2015: Dx hypothyroidism, other adrenal hypofunction
2016: chronic fatigue, unspecified

Depression and anxiety guide: http://www.peaktestosterone.com/Help_Anxiety_Depression

Peak Testosterone Forum

Re: High Total Testosterone, Low SHBG and non-existent Free Testosterone???
« Reply #1 on: September 28, 2016, 12:35:32 am »


tre

  • Full Member
  • ***
  • Posts: 247
    • View Profile
Re: High Total Testosterone, Low SHBG and non-existent Free Testosterone???
« Reply #2 on: September 28, 2016, 01:08:05 am »
My thinking is that he only glanced at the blood work as he walked into the room and missed it.  He came highly recommended by my pharmacist when my last doc moved out of state (my favorite doc).  He isn't particularly bad IMO as I've experience MUCH MUCH worse.  At least he's open minded and is prescribing a good dose of Testosterone, Arimidex, HCG, etc..  He's also prescribing me Nature-throid which is the only form of Thyroid med I would accept. Basically, he's keeping my protocols the same.   Today, he seemed to be more focused on other things like the Allergy test, Total Testosterone and Estradiol.  He didn't bring up the SHBG or Free Testosterone results.  Again, I'm used to my SHBG being between 6 and 14...it's never been higher than that. I have been somewhat fatter (14%bf) and then I've been pretty lean(8%)...SHBG just doesn't go past 14.  Again, the SHBG blood results didn't surprise me at all.  What surprised me is the non-existent Free Testosterone in the presence of low SHBG.  If I had extremely high SHBG, then this might make some sense. 

This doc is extremely strict when it comes to TRT so I'll be getting another blood draw in less than 3 months (EVERY 3 months).  This is, hopefully, a one-time blood result.  I really hope I don't truly have NO Free Testosterone as this would make life miserable longer-term.  This just can't be a normal result...still hoping to make some sense of it. 

Cataceous

  • Administrator
  • Hero Member
  • *****
  • Posts: 6776
    • View Profile
Re: High Total Testosterone, Low SHBG and non-existent Free Testosterone???
« Reply #3 on: September 28, 2016, 01:38:31 am »
That directly-measured free testosterone is nonsensical. The calculated value is 45.1 ng/dL  =  3.76 %, high as expected.
I am not a medical doctor; any suggestions are meant to be discussed with your doctor.
Age: 60, Ht: 5'10", Wt: 154 lbs
Protocol: 3.2 mg TE subQ qd, 2.4 mg TP subQ qd, 20 mcg GnRH subQ 5.25x/d, 6.25 mg DHEA bid, 12.5 mg enclomiphene qod
Approximate levels (peak): TT: 700 ng/dL, E2: 30 pg/mL, DHEA-S: 300 ug/dL, SHBG: 30 nMol/L

Peak Testosterone Forum

Re: High Total Testosterone, Low SHBG and non-existent Free Testosterone???
« Reply #3 on: September 28, 2016, 01:38:31 am »


Dr Justin Saya, MD

  • Hero Member
  • *****
  • Posts: 701
    • View Profile
    • Defy Medical
Re: High Total Testosterone, Low SHBG and non-existent Free Testosterone???
« Reply #4 on: September 28, 2016, 01:38:57 am »
The fact that your doc didn't notice/mention the free T result is more concerning to me than the actual result itself...which is more than likely lab error. Recheck to confirm, if still that low, would run at a different lab/different assay method.
Lead Physician & Medical Director
http://www.defymedical.com

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

  • Administrator
  • Hero Member
  • *****
  • Posts: 38446
    • View Profile
    • Peak Testosterone
Re: High Total Testosterone, Low SHBG and non-existent Free Testosterone???
« Reply #5 on: September 28, 2016, 01:55:33 am »
I thought I had my blood work reasonably figured out, but my most recent blood work showed that my Total Testosterone is just over 1200ng/dl, SHBG at 8.3, Estradiol at 19.9 and Free Testosterone at less than .2pg/ml.  My new doctor said it all looks good and handed me the bloodwork for my own records.  However, I don't think that .2 pg/ml is good at all.  I didn't notice it until I left the office and I'm really baffled by it.  I have been getting blood work done regularly and my Free Testosterone is ALWAYS high along with my Total Testosterone.  My SHBG is always low.  This makes some sense to me, but having non-existent Free Testosterone does not.  Any ideas?  I can't help but think that this is a lab error, but it stated on the lab report that "results were verified by repeat testing" specifically regarding the Free Testosterone test. How can I have Low SHBG and non-existent Free Testosterone when my overall total Testosterone is high (slightly higher than most tests I might add)?

Question:  did you get the blood draw on the same day as your injection or maybe the day after?

Also, how often are you injecting and how much?
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
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.

tre

  • Full Member
  • ***
  • Posts: 247
    • View Profile
Re: High Total Testosterone, Low SHBG and non-existent Free Testosterone???
« Reply #6 on: September 30, 2016, 11:07:01 pm »
The fact that your doc didn't notice/mention the free T result is more concerning to me than the actual result itself...which is more than likely lab error. Recheck to confirm, if still that low, would run at a different lab/different assay method.

Yeah, this is my first follow-up with him so not a great start.    I've probably had 15+ lab results over the years while on TRT and my Free Testosterone has always been high.  I'm not going to worry about it as it has got to be a lab error.  I'll have another blood draw and follow-up appointment in 3 months.  I expect to see Free Testosterone high again....as usual.  I will also be sure to get an explanation why my doc didn't feel the need to inquire about the Free Testosterone result in my last blood test results. 

tre

  • Full Member
  • ***
  • Posts: 247
    • View Profile
Re: High Total Testosterone, Low SHBG and non-existent Free Testosterone???
« Reply #7 on: September 30, 2016, 11:27:16 pm »
I thought I had my blood work reasonably figured out, but my most recent blood work showed that my Total Testosterone is just over 1200ng/dl, SHBG at 8.3, Estradiol at 19.9 and Free Testosterone at less than .2pg/ml.  My new doctor said it all looks good and handed me the bloodwork for my own records.  However, I don't think that .2 pg/ml is good at all.  I didn't notice it until I left the office and I'm really baffled by it.  I have been getting blood work done regularly and my Free Testosterone is ALWAYS high along with my Total Testosterone.  My SHBG is always low.  This makes some sense to me, but having non-existent Free Testosterone does not.  Any ideas?  I can't help but think that this is a lab error, but it stated on the lab report that "results were verified by repeat testing" specifically regarding the Free Testosterone test. How can I have Low SHBG and non-existent Free Testosterone when my overall total Testosterone is high (slightly higher than most tests I might add)?

Question:  did you get the blood draw on the same day as your injection or maybe the day after?

Also, how often are you injecting and how much?

I injected Monday night and the blood draw was on Wednesday morning.  I inject .5mls 3x per week....300mg/week total.  I have low SHBG so I expect to have high Free Testosterone.  While the Total Testosterone is slightly high (it's most often lower than this result), I think it's not that high considering the weekly amount I'm taking.  I used to be prescribed 400mgs/week of Testosterone which is the dose I've mostly used over the many years I've been on TRT.  I requested to go down to 200mgs/week and then back up to 300mgs....which is where I feel the best.  If your going to stick yourself with a pin 3x week anyway, may as well have the dose that makes you feel the best.  SHBG doesn't seem to go up or down with dose, but I did notice an increase when I went Primal (all time high of 14).  The problem with Primal is that you start to feel "stale" after awhile.  I also noticed that I was losing strength and muscle mass over time.  I'm now going through phases with carbs and phases without carbs (bulk and cut I suppose) so that I can avoid Metabolic Damage/ Insulin Resistance that I've experienced in the past. 

« Last Edit: September 30, 2016, 11:29:00 pm by tre »

Hydranted

  • Moderator
  • Hero Member
  • *****
  • Posts: 828
    • View Profile
Re: High Total Testosterone, Low SHBG and non-existent Free Testosterone???
« Reply #8 on: October 01, 2016, 12:32:03 am »
Assuming that the same testing assay was used for all of your free T testing, this is most certainly a lab error.  If a different test with a different range was used, that could explain the oddball number...although I've never seen a range that .2 would fit nicely into here in the US.

It's nearly an impossibility to have a total testosterone of 1200 ng/dl, but a barely detectable free testosterone.

All of your other lab tests have shown your free testosterone to be high, so that leaves us with a lab error being the likely culprit.  I wouldn't stress too much over this right now.  Lab errors happen, and it appears that you've fallen victim to one.


Peak Testosterone Forum

Re: High Total Testosterone, Low SHBG and non-existent Free Testosterone???
« Reply #8 on: October 01, 2016, 12:32:03 am »