(28-04-2014, 01:44 AM)AnnabelP Wrote: Lotus, Denita, anyone else with knowledge!
When I finally managed to persuade our NP to order a test of my testosterone levels, she ordered three tests. One was total T, one was SHBG, and I don't know what the third one was. I only got told the result of the total T which was less than 0.7 (presumably nmol/litre, which would translate to less than 20 ng/dl in the units normally used in the US), and I suspect represents the lowest level measurable in that particular lab. I asked what the other tests showed and she said it was less than 1. Now if that was the SHBG test, then the figure seems extraordinarily low, whatever the applicable units. I normally have joint sessions at the NP with my wife but she wasn't with me on that occasion. She said I was far too unassertive (true) and should have insisted on extracting more information. I don't think the NP is strong in this area, and I would guess that she requisitioned some standard test panel. Has anyone any idea what the third test might have been, or was it just a requisition for a value for free T calculated from the total T and SHBG figures, which wouldn't be possible if total T was that low?
Any thoughts?
(28-04-2014, 01:44 AM)AnnabelP Wrote: Lotus, Denita, anyone else with knowledge!
When I finally managed to persuade our NP to order a test of my testosterone levels, she ordered three tests. One was total T, one was SHBG, and I don't know what the third one was. I only got told the result of the total T which was less than 0.7 (presumably nmol/litre, which would translate to less than 20 ng/dl in the units normally used in the US), and I suspect represents the lowest level measurable in that particular lab. I asked what the other tests showed and she said it was less than 1. Now if that was the SHBG test, then the figure seems extraordinarily low, whatever the applicable units. I normally have joint sessions at the NP with my wife but she wasn't with me on that occasion. She said I was far too unassertive (true) and should have insisted on extracting more information. I don't think the NP is strong in this area, and I would guess that she requisitioned some standard test panel. Has anyone any idea what the third test might have been, or was it just a requisition for a value for free T calculated from the total T and SHBG figures, which wouldn't be possible if total T was that low?
Any thoughts?
(28-04-2014, 09:56 PM)AnnabelP Wrote: Thank you Lotus and Clara,
While there is endless material on line about the effects of low testosterone, I have not found any discussion of the effects of levels as low as I have. Have you?
(28-04-2014, 09:56 PM)AnnabelP Wrote: Thank you Lotus and Clara,
So far as calculating free T is concerned, it seems that 'less than' figures would be useless for any further calculation, so that if a calculated figure was requested, it probably was not provided. And if the SHBG figure really was <1, then this seems extraordinarily low. What could cause it to fall so low? Indeed how did the total T get that low, even assuming no testicular output. I know that Sammie reported a very low figure, but at the time she was taking substantial AA doses, whereas I have taken none for some considerable time - there didn't seem any point.
While there is endless material on line about the effects of low testosterone, I have not found any discussion of the effects of levels as low as I have. Have you?
The NP was taking the position that the low testosterone and severe testicular and penile atrophy (no, she didn't examine them) were just normal manifestations of andropause and something to be expected at my age, which I reckon is nonsense. Nor has anyone, including the stand-in urologist I eventually saw, who also didn't examine me, explained why my PSA count, after being stable at around 4 for years, has now dropped effectively to zero in my last two tests. I'm inclined to think that it could have something to do with PM, which is supposed to be prostate friendly.
As to SHBG, does it only bind to natural or bio-identical human sex hormones, or can it bind also to phytoestrogens? Could a low level simply result from there being nothing for it to bind to?