Confused on my Testosterone blood work?

[BIG-MOFO]

Lately my total testosterone range has been as low as 152ng & only a high of 362ng the past few years. That is very low for those who follow. Now there this free testosterone test that has me at 4.4 (not sure if that's ng or %). That's double the normal range I read up that this is a good thing...I really don’t know. I feel like sh*t. I'm tired all the time, not as sharp as I was, depress, sex with my wife is out the question & I've been sterile for who knows how long. I've never did drugs but my quality of life has just been going down hill over the years. I'm almost 36 & seeing a endo. I pray to god he puts me on a better HRT. I'm on the gel now but that ain't working. But can someone explain the Free testosterone & any other suggestions to lock a effective HRT. T/Y.
P.S: I work hard to look the way I do 17 years in the army. In the gym 6 days out the week. I do have a dedicated life style but I get it done & man-up the best I can.

[redback]

You cant compare readings. The lab sets the reference range themselves. Your reading is related to the reference range they give you for the test. I would be interested to see a complete printout of your test, eg: free test, shgb etc, that will give us a better understanding.

[BIG-MOFO]

It was over the phone I do know the normal range for total test & free test. I had a full hormone panel that did LH / FSH also. Everything at one time or another was borderline low or below normal range. Except for the free test that was twice as normal & I don't know if that's a good or bad thing & I don't want the endo to go oh your free test is fine so you're ok guy. Have a nice life sorry no HRT. It's been 8 months since my last cycle.

[Bouncer]

you really need to talk to the doc that did the test. like redback said, sounds like the lab has there own set of guidelines making it impossible for us to help.

what i do know is, it sure doesn't sound like your test levels are very high. going by the symptoms you describe, i would say your test levels are pretty low.

[3v1lj03]

It was over the phone I do know the normal range for total test & free test. I had a full hormone panel that did LH / FSH also. Everything at one time or another was borderline low or below normal range. Except for the free test that was twice as normal & I don't know if that's a good or bad thing & I don't want the endo to go oh your free test is fine so you're ok guy. Have a nice life sorry no HRT. It's been 8 months since my last cycle.

If you can't get what you need from the endo I would highly recommend you see a longevity doc. The will give you what you want . They hand out hormones like candy. Insurance can be harder to deal with but I would rather pay for it myself then live life feeling like crap all the time.

[Bouncer]

If you can't get what you need from the endo I would highly recommend you see a longevity doc. The will give you what you want . They hand out hormones like candy. Insurance can be harder to deal with but I would rather pay for it myself then live life feeling like crap all the time.

not as easy as that any more. more and more longevity places are getting busted. the ones that havent been busted have got much more strict.

[3v1lj03]

If i can find one in backwards arse indiana they can be found.

[INTIMID8OR]

Some good info on blood work ...


Common questions ..

,,,
Well do I have to take a blood test?
Most insurance plans do cover blood work. Yes, if possible, a bloodwork 20 days after your PCT is very advisable. If money is not an issue, while using Ph's /AAS, 2 blood works a year is very advisable.

If my libido bounces back after a PCT, does that mean all is well?
In most cases yes, but it is NOT a rule of thumb. There have been cases when libido is back and the boys are ok, but blood work reveals that the HTPA is messed up.
Also, with the lipid profile getting hit hard in some, it is always better to be safe than sorry.

So where can I get this stuff done?
Like I mentioned before, if you have a family doc and you are covered with a good plan then you can take this option. Some however may want to avoid this and thus online options are available.

ON-LINE BLOODWORK SITES
• Quest Diagnostics: Patient and consumer information on our diagnostic testing, lab tests, and services
Men's Health Profile - $115
Thyroid Health Screen - $40
Lipid Panel - $40
Liver Health Panel - $40
PSA - $45

• Direct Labs - Quest Diagnostics: Patient and consumer information on our diagnostic testing, lab tests, and services

• Health-Tests-Direct - Quest Diagnostics: Patient and consumer information on our diagnostic testing, lab tests, and services

United Kingdom
Lab Tests Online UK: Welcome!

So what am I looking at to get tested?
Based on what your doctor recommends or if you have had some good advice you can go ahead choosing your tests.Here is a sample for reference.

Major Hormones:
• Testosterone (normal range: 300 – 1200 ng/dl)
• Free testosterone (normal range: 8.7 – 25 pg/ml)
• IGF-1 (normal range: 109 – 284 ng/ml)
• Estradoil (normal range: 5 – 53 pg/ml)
•DHEA/DHEA-s (normal range: 120 – 520 ug/dl)

Full Thyroid Panel:
• T4 (normal range: 4.5 – 12 ug/dl)
• T3 (normal range: 2.3 – 4.2 pg/ml)
• TSH (normal range: .350 – 5.500 uIU/ml)

Lipid Profile: *** very imp ***
• Total Cholesterol (normal healthy range 100 – 199 mg/dl)
• HDL (normal range: 40 – 59 mg/dl)
• LDL (normal range: 0 – 99 mg/dl)
• Triglycerides (normal range: 0 – 149 mg/dl)
• C-reactive protein (< 2.0 mg/l)
• Homocycteine (normal range: 6.3 – 15 umol/L)

Major Liver Function:
• Alkaline Phosphate (normal range: 25 – 150 umol/L)
• GGT (normal range: 0 – 65 IU/L)
• SGOT (AST) (normal range: 0 – 40 IU/L)
• SGPT (ALT) (normal range: 0 – 40 IU/L)
• Total Protein (normal range: 6.0 - 8.5 g/dl)
• Albumin (normal range: 3.5 - 5.5 g/dl)
• Globulin (normal range: 1.5 - 4.5 g/dl)
• Albumin/Globulin Ratio (normal range: 1.1 - 2.5)
• Bilirubin, Total (normal range: 0.1 - 1.2 mg/dl)

Major Kidney Function:
• Creatinine (normal range: 0.5 – 1.5 mg/dl)
• BUN (normal range: 5 – 26 mg/dl)
• Creatinine/BUN ratio (normal range: 8 – 27)

Prostate Profile:
• PSA (normal range: 0.0 – 4.0 ng/dl)



So what on earth does all this mean?
Its a 5 minute read, but its highly worth it......

Lipid Panel: The lipid profile is a group of tests that are often ordered together to determine risk of coronary heart disease. The tests that make up a lipid profile are tests that have been shown to be good indicators of whether someone is likely to have a heart attack or stroke caused by blockage of blood vessels (hardening of the arteries).

Tests in a Lipid Profile: The lipid profile includes total cholesterol, HDL-cholesterol (often called good cholesterol), LDL-cholesterol (often called bad cholesterol), and triglycerides. Sometimes the report will include additional calculated values such as HDL/Cholesterol ratio or a risk score based on lipid profile results, age, sex, and other risk factors.

Cholesterol: is a steroid lipid, found in the cell membranes of all body tissues, and transported in the blood plasma of all animals. Most cholesterol is not dietary in origin, it is synthesized internally. It is present in higher concentrations in tissues which either produce more or have more densely packed membranes; for example the liver, spinal cord, brain and atheroma.
Cholesterol is primarily synthesized from acetyl CoA through the HMG-CoA reductase pathway in many cells/tissues. About 20–25% of total daily production (~1 g/day) occurs in the liver, other sites of higher synthesis rates include the intestines, adrenal glands and reproductive organs

HDL: HDL is simply the "good" lipoprotein that acts as a scavenger molecule and prevents a buildup of material.

LDL: LDL is the "bad" lipoprotein which collects in arterial walls and causes blockage or a reduction in blood flow.

Triglycerides: Triglycerides are the chemical form in which most fat exists in food as well as in the body. They're also present in blood plasma and, in association with cholesterol, form the plasma lipids. Excess triglycerides in plasma is called hypertriglyceridemia. It's linked to the occurrence of coronary artery disease in some people.

Homocysteine: The metabolic intermediate homocysteine is an amino acid created by the single carbon chemistry of S-adenosyl methionine. It can be converted back to methionine, or converted to cysteine or taurine via the transsulfuration pathway. A good number of lifters should be concerned with this value as homocysteine levels rise with anabolic steroid usage.
A high level of blood serum homocysteine is considered to be a marker of potential cardiovascular (risk factor for heart attack and stroke) disease. Note that as a consequence of the chemistry in which homocysteine is involved, deficiencies of the vitamins folic acid, pyridoxine (B6), or cobalamin (B12) can lead to high homocysteine levels


BUN (Blood Urea Nitrogen): This test is used to evaluate kidney function under a wide range of circumstances and to monitor patients with acute or chronic kidney dysfunction or failure. The test measures the amount of urea nitrogen that's present in the blood. When protein is metabolized, the end product is urea which is formed in the liver and excreted from the bloodstream via the kidneys. This is why BUN is a good indicator of both liver and kidney function.

Creatinine: is a breakdown product of creatine phosphate in muscle, and is usually produced at a fairly constant rate by the body (depending on muscle mass). Measuring serum creatinine is a simple test and it is the most commonly used indicator of renal function. A rise in blood creatinine levels is observed only with marked damage to functioning nephrons; therefore this test is not suitable for detecting early kidney disease. A better estimation of kidney function is given by the creatinine clearance test, which, however, is less convenient and unsuitable as a screening test because it requires the collection of urine over 24 hour
In the United States, creatinine is typically reported in mg/dL, while in Canada and Europe μmol/liter may be used. 1 mg/dL of creatinine is 77.2 μmol/l.

BUN/Creatinine Ratio: Determine whether your kidneys are functioning normally.
• Determine whether your kidney disease is getting worse.
• Monitor treatment of your kidney disease.
• Determine whether severe dehydration is present. A BUN-to-creatinine ratio may help your health professional determine whether decreased kidney function is the result of dehydration or kidney disease. Dehydration usually causes BUN levels to rise more than creatinine levels, resulting in an increased BUN-to-creatinine ratio. Kidney disease or blockage of the flow of urine from your kidney usually causes both BUN and creatinine levels to increase equally, resulting in a BUN-to-creatinine ratio that is normal.
How To Prepare For a Bun-C Test
If possible, avoid eating a diet high in meat or other protein before having a blood urea nitrogen (BUN) test.
Total Protein: This measures the total level of albumin and globulin in the body.

Albumin: is a blood plasma protein that is produced in the liver and forms a large proportion of all plasma protein. It is also found in egg white.
The normal range of albumin concentrations in human blood is 3.5 to 5.0 g/dL, and albumin normally constitutes about 60% of plasma protein; all other proteins present in blood plasma are referred to collectively as globulin. Albumin is essential for maintaining the oncotic pressure needed for proper distribution of body fluids between intravascular compartments and body tissues. Albumin is negatively charged. The glomerular basement membrane is also negatively charged; this prevents the filtration of albumin in the urine. In nephrotic syndrome, this property is lost, and there is more albumin loss in the urine. Nephrotic syndrome patients are given albumin to replace the lost albumin.

Gamma globulins are a class of proteins in the blood, identified by their position after serum protein electrophoresis. The most significant gamma globulins are antibodies. Gamma globulin injections are sometimes given in an attempt to temporarily boost a patient's immunity against disease. .

Bilirubin: Bilirubin is one of the many constituents of bile, which is formed in the liver. An increase in levels of bilirubin can be indicative of liver stress or damage/inflammation. Drugs that may increase bilirubin include oral anabolic steroids (17-AA), antibiotics, diuretics, morphine, codeine, contraceptives, etc. Drugs that may decrease levels are barbiturates and caffeine. Non-drug induced increased levels can be indicative of gallstones, extensive liver metastasis, and cholestasis from certain drugs, hepatitis, sepsis, sickle cell anemia, cirrhosis, etc.

Alkaline Phosphate: Alkaline phosphatase is an enzyme found throughout the body. Like all enzymes, it is needed, in small amounts, to trigger specific chemical reactions. When it is present in large amounts, it may signify bone or liver disease or a tumor.
Medical testing of alkaline phosphatase is concerned with the enzyme that is found in liver, bone, placenta, and intestine. In a healthy liver, fluid containing alkaline phosphate and other substances is continually drained away through the bile duct. In a diseased liver, this bile duct is often blocked, keeping fluid within the liver. Alkaline phosphatase accumulates and eventually escapes into the bloodstream.

AST (some call this SGOT): Also known as serum glutamic oxaloacetic transaminase (SGOT), AST is an enzyme that is normally present in liver and heart cells. AST is released into blood when the liver or heart is damaged. The blood AST levels are thus elevated with liver damage (for example, from viral hepatitis) or with an insult to the heart (for example, from a heart attack). Some medications can also raise AST levels

ALT (Alanine Aminotransferase, some call this SGPT):

An alanine aminotransferase (ALT) test is a blood test that measures the level of alanine aminotransferase enzyme found mainly in the liver, but also in smaller amounts in the kidneys , heart , muscles, and pancreas . ALT formerly was called serum glutamic pyruvic transaminase (SGPT).
ALT is measured to determine whether the liver is damaged or diseased. Low levels of ALT are normally found in the blood. However, when the liver is damaged or diseased, it releases ALT into the bloodstream, causing levels of the enzyme to rise. Although ALT is found in organs other than the liver, most increases in ALT levels are due to liver damage.
The ALT test often is done along with other tests that can determine whether the liver is damaged, including aspartate aminotransferase (AST), alkaline phosphatase, lactate dehydrogenase (LDH), and bilirubin. Both ALT and AST levels are reliable indicators of liver damage.
How to Prepare for an ALT/SGPT:
Strenuous exercise can affect alanine aminotransferase (ALT) test results. For this reason, avoid strenuous exercise just before having this test done.
Many medications can interfere with test results. Your health professional may instruct you to stop taking certain medications for several days before this test is done. Some herbal medicines and natural products (such as echinacea, valerian, and Chinese fructus schizandrae sinensis) also can affect ALT results. Tell your health professional if you are taking any of these products.


Prostate Specific Antigen (PSA): PSA is produced by normal, hyperplastic, and cancerous prostatic tissue. Serum PSA has been found to be the most sensitive marker for monitoring individuals with prostate cancer and to enhance efficacy in monitoring progression of disease and response to therapy.

Gamma-Glutamyl Transpeptidase (GGT): A test that measures the amount of the enzyme GGT in the blood. This test is used to detect diseases of the liver, bile ducts, and kidney; and to differentiate liver or bile duct (hepatobiliary) disorders from bone disease. GGT participates in the transfer of amino acids across the cellular membrane and in glutathione metabolism. High concentrations are found in the liver, bile ducts, and the kidney.

Estradiol: (17-beta estradiol) is a sex hormone. Labelled the "female" hormone but also present in males it represents the major estrogen in humans. Critical for sexual functioning estradiol also supports bone growth. However, it's the primary estrogen that's responsible for the negative feedback loop which suppresses endogenous Testosterone production. Estradiol also has carcinogenic metabolites, and a liver problem sometimes associated with AAS use, hepatic cholestasis, is caused not by androgen but by an estrogen metabolite..

Thyroid (T3, T4 Total and Free, TSH)

T3 (Triiodothyronine): T3 is the more metabolically active hormone out of T4 and T3. When levels are below normal it's generally safe to assume that the individual is suffering from hypothyroidism. Drugs that may increase T3 levels include estrogen and oral contraceptives. Drugs that may decrease T3 levels include anabolic steroids/androgens as well as propanolol (a beta adrenergic blocker) and high dosages of salicylates. Increased levels can be indicative of Graves disease, acute thyroiditis, pregnancy, hepatitis, etc. Decreased levels can be indicative of hypothyroidism, protein malnutrition, kidney failure, Cushing's syndrome, cirrhosis, and liver diseases.

T4 (Thyroxine): T4 is just another indicator of whether or not someone is in a hypo or hyperthyroid state. It too is rather reliable but free thyroxine levels should be assessed as well. Drugs that increase of decrease T3 will, in most cases, do the same with T4. Increased levels are indicative of the same things as T3 and a decrease can be indicative of protein depleted states, iodine insufficiency, kidney failure, Cushing's syndrome, and cirrhosis.

Free T4 or Thyroxine: Since only 1-5% of the total amount of T4 is actually free and useable, this test is a far better indicator of the thyroid status of the patient. An increase indicates a hyperthyroid state and a decrease indicates a hypothyroid state. Drugs that increase free T4 are heparin, aspirin, danazol, and propanolol. Drugs that decrease it are furosemide, methadone, and rifampicin. Increased and decreased levels are indicative of the same possible diseases and states that are seen with T4 and T3.

TSH (Thyroid Stimulating Hormone): Measuring the level of TSH can be very helpful in terms of determining if the problem resides with the thyroid itself or the pituitary gland. If TSH levels are high, then it's merely the thyroid gland not responding for some reason but if TSH levels are low, it's the hypothalamus or pituitary gland that has something wrong with it. The problem could be a tumor, some type of trauma, or an infarction. Drugs that can increase levels of TSH include lithium, potassium iodide and TSH itself. Drugs that may decrease TSH are aspirin, heparin, dopamine, T3, etc. Increased TSH is indicative of thyroiditis, hypothyroidism, and congenital cretinism. Decreased levels are indicative of hypothyroidism (pituitary dysfunction), hyperthyroidism, and pituitary hypofunction.