Just saw an endo about low T-levels. My total T has been low on 3 different tests over the past 6 months. Additionally, my LH and FSH have also been low. My endo said I am fine because my free testosterone is within the normal range. Is this correct?? I expected her to check my pituitary or at least offer me T replacement.
Your endocrinologist is correct. The free testosterone reading says everything there
is to say about the chemical potential (activity) of testosterone in your blood,
and how active it will be at the receptors.
“Total testosterone” is simply a consequence
of free testosterone and how much SHBG you
have. So you can be completely fine in terms
of testosterone, but have low total testosterone
because you have low SHBG. There is no
problem with this.
Total testosterone (free + bound) is no
more significant than a “true total” which included all the T dissolved in fat in your body. Having more fat would result in more
“total testosterone” then, given same
free testosterone, but obviously would
not be of any help, any more than high SHBG
is of help.
What’s SHBG there for then? It is needed
to transport T (but mostly not androstenedione)
out of the testes, and to protect T from
metabolism as it travels through the body.
If your free T is fine, you are doing fine.
How do you get your T-levels tested? Can a normal doctor do it? Do I just ask for it during my check up and does it ussually cost extra? If so, is it an expensive procedure? Also, same questions for insulin sensitivity test. Sorry for all the questions but I will be making a doctors appointment soon just for a check up kind of thing and would like to know if these are possibilities for me.
Thanks Bill, you made me feel better. My free T was on the low end of normal ( 57 pg / 34-194 pg). If I asked my doc for androgel, would a moderately low dose further supress my LH and FSH?? (Trying to get the old lady pregnant).
I am in the USAF and got mine checked as part of a fertility work-up. I believe if you read Cy Wilson’s column “your doctor your dealer”, you could get your doc to check your t-levels.
What the normal range is, is the range
where 95% of those in normal health will
fall in that range. You are almost
50% higher than the bottom of that range,
and a very substantial percentage of
perfectly healthy and normal men have
your testosterone level or less. If your
levels were indicative of need for
drug therapy, something like 25% of men
would be needing such therapy. That’s
not the case – while you might like your
level to be higher it isn’t medically
abnormal at all, it’s perfectly well in
the healthy range.
I’m not familiar with how much Androgel
may inhibit LH and FSH but as a guess I’d
think the prescribed amount is probably
not too bad in that regard.