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My blood test results

#1
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I got my blood test results today. Here is what my hormone levels are:

Testosterone, Serum = 404 ng/dL (reference interval 348-1197)
Free Testosterone (Direct) = 0.6 pg/mL* (reference interval 7.2-24.0)

* Below Normal Low

Estridiol = 9.5 pg/mL (reference interval 7.6-42.6)


I'm combing the Internet for interpretation. The only thing I know for sure is my Free T is extremely low. I don't think SP lowers Free T (doesn't it just prevent the formation of DHT)? I had only been on PM for about 2 weeks when I got the test. Could it lower my Free T so much, so fast?

Thanks for any input you can give!

Misty
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#2

OK, I met with my doctor to review the blood test results. He is very concerned about the low (almost non-existent) free testosterone. What he said is so troubling is that my serum testosterone is fine (normal, but at the lower end of normal) because the two numbers usually track together.

He's going to call an endocrinologist, and said he may need to refer me to be seen by him.

So, two questions...

1) Does anyone here have a similar issue (discordance between free-T and total-T), and what if anything is there to worry about?

2) Should I tell the doctor about the PM usage? I'm currently taking 1500mg/day (which from what I've read on this forum is actually a quite low dosage). Also, I had only been taking the PM for about 2 weeks before I had the tests done.

Thanks for ANY input you can give me!

Misty
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#3

I have not had total T measured. My free T after a few years on PM is rather low, but inside the low end of the normal range. If you want your doctor to have a fighting chance to be of any use to you, then you need to let him know what you are taking.
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#4

(06-02-2013, 10:00 PM)Misty0732 Wrote:  1) Does anyone here have a similar issue (discordance between free-T and total-T), and what if anything is there to worry about?

2) Should I tell the doctor about the PM usage? I'm currently taking 1500mg/day (which from what I've read on this forum is actually a quite low dosage). Also, I had only been taking the PM for about 2 weeks before I had the tests done.

Thanks for ANY input you can give me!

Misty

I'm going to be seeing my doctor near the end of this month. My difficulty with running hasn't improved at all and I'm starting to think this isn't just a matter of being out of shape. Since I'm out of town I'm hoping the culprit is environmental, such as a poor quality of air. I suppose another possibility is low blood pressure, as my blood pressure has been low sometimes during the last several months.

If she decides to do a blood test to measure my testosterone levels, I'll let you know what results I get.
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#5

(07-02-2013, 01:14 AM)flamesabers Wrote:  
(06-02-2013, 10:00 PM)Misty0732 Wrote:  1) Does anyone here have a similar issue (discordance between free-T and total-T), and what if anything is there to worry about?

2) Should I tell the doctor about the PM usage? I'm currently taking 1500mg/day (which from what I've read on this forum is actually a quite low dosage). Also, I had only been taking the PM for about 2 weeks before I had the tests done.

Thanks for ANY input you can give me!

Misty
I'm going to be seeing my doctor near the end of this month. My difficulty with running hasn't improved at all and I'm starting to think this isn't just a matter of being out of shape.

I had a good friend who was experiencing a lot of problems with running (even though he had been running all his life). It turned out to be adult-onset diabetes. I certainly hope that isn't your problem -- (I'm sure the doctor will check your blood sugar levels, probably first). Good luck and let us know how it turns out!

Misty
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#6

(06-02-2013, 10:00 PM)Misty0732 Wrote:  OK, I met with my doctor to review the blood test results. He is very concerned about the low (almost non-existent) free testosterone. What he said is so troubling is that my serum testosterone is fine (normal, but at the lower end of normal) because the two numbers usually track together.

He's going to call an endocrinologist, and said he may need to refer me to be seen by him.

So, two questions...

1) Does anyone here have a similar issue (discordance between free-T and total-T), and what if anything is there to worry about?

2) Should I tell the doctor about the PM usage? I'm currently taking 1500mg/day (which from what I've read on this forum is actually a quite low dosage). Also, I had only been taking the PM for about 2 weeks before I had the tests done.

Thanks for ANY input you can give me!

Misty

I don't know if the doctor also checked SHBG, but depending on the lab, free T may be calculated incorrectly. The doctor can calculate free T from SHBG (sex hormone binding globulin) and total T. Such low free T would tend to suggest a problem possibly with aromatization of T into E, but not necessarily. Unless the doc also checked estradiol, there isn't a complete picture. Furthermore, it is also important to have the right ratio of T to E. Most doctors seem lost when it comes to all of this.

Really low free T can lead to diabetes, high cholesterol, osteoporosis, weight gain, low sex drive, erectile dysfunction, muscle wasting and weakness, fatigue, depression, and probably a few more things I'm forgetting such as memory issues and gynecomastia.

It probably would have helped to know all those numbers before starting PM so you'd know if it is the cause. It would probably be wise to let the doc know about the PM. I'm not sure what other reasons there are for taking PM, other than feminization, but do a little research and find some other reasons, if admitting to gender issues is something you don't want to do.
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#7

(07-02-2013, 03:49 AM)MonikaT Wrote:  I don't know if the doctor also checked SHBG, but depending on the lab, free T may be calculated incorrectly. The doctor can calculate free T from SHBG (sex hormone binding globulin) and total T. Such low free T would tend to suggest a problem possibly with aromatization of T into E, but not necessarily. Unless the doc also checked estradiol, there isn't a complete picture. Furthermore, it is also important to have the right ratio of T to E. Most doctors seem lost when it comes to all of this.

Really low free T can lead to diabetes, high cholesterol, osteoporosis, weight gain, low sex drive, erectile dysfunction, muscle wasting and weakness, fatigue, depression, and probably a few more things I'm forgetting such as memory issues and gynecomastia.

It probably would have helped to know all those numbers before starting PM so you'd know if it is the cause. It would probably be wise to let the doc know about the PM. I'm not sure what other reasons there are for taking PM, other than feminization, but do a little research and find some other reasons, if admitting to gender issues is something you don't want to do.

Thanks, Monika! I'm pretty sure the doctor is going to recommend some additional blood tests, so I will suggest SHBG. They did check estridiol. At 9.5 pg/mL I am in the normal range there.

From what I read today, it is unlikely the PM is the culprit. Free-T has a long half-life and since I was only on PM for two weeks prior to the tests there wasn't time for the levels to be affected in a major way. I do have high cholesterol (I have all my life) but I have none of the other symptoms you list (other than some gynecomastia Wink). The more likely culprit is the Saw Palmetto (which I have been taking for some 8 months).

SO what do you all think? Should I lay of the SP? Chances are I don't really need it as I have low to none DHT (I have very little body hair and all the hair on my head).

Misty
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#8

(07-02-2013, 04:05 AM)Misty0732 Wrote:  I do have high cholesterol (I have all my life) but I have none of the other symptoms you list (other than some gynecomastia Wink). The more likely culprit is the Saw Palmetto (which I have been taking for some 8 months).

SO what do you all think? Should I lay of the SP? Chances are I don't really need it as I have low to none DHT (I have very little body hair and all the hair on my head).

Misty

You're lucky your doc checked estradiol. I've been to 4 different medical professionals, and none have seen fit to check it, yet. All I get are excuses about insurance not liking to pay for it in males unless there are other symptoms. I've had moobs since I began to gain weight at age 7. In jr. high and high school, I had larger breasts than many of the girls in my class, but that's not enough. I've always been at odds with my chest because boys/men shouldn't have boobs, but as a CD, I kind of like them. I've finally decided to just make them official and try to enlarge them.

My new doc just ran a whole bunch of tests this past Monday. It will be interesting to see what my results are. I've been taking 1280 mg of SP extract since August. Then again, I look like Chewbacca under my clothes, and I've been losing hair on top of my head for 34 years and have a hair style like Larry David at this point. If my free T has dropped substantially, that would give some credence to your suspicion it is SP.

Some here say PM is enough of an anti-androgen that nothing else is needed. It still could be PM or the combination of both. Unfortunately, since PM hasn't really been studied (most other herbals also have not) nobody really knows. We are each in our own personal drug trial, and nobody is collecting all the data to study it. Laying off the SP certainly can't hurt.

I've said this in other posts, but most doctors don't like to see high cholesterol as a symptom, preferring instead to treat it as a discrete condition. However, it is a symptom of some sort of hormone imbalance. The trick is to find the hormone(s) that is/are (typically) low. The body uses cholesterol to make hormones. Low sex hormones, low thyroid, low insulin levels, and various other hormone issues can all cause high cholesterol. They've even found low sex hormones might be involved in macular degeneration, finding evidence the eyes are trying to manufacture sex hormones to compensate for low levels in the body.
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#9

SP is most likely not responsible for the low T. It has been studied well enough that there was no evidence of it having an effect on free T.

I've had low free T all my life, a combination of lifestyle factors can affect it, such as poor exercise, poor sleeping habits and poor diet. I hated mornings (when T is highest) and still do, I never feel good but uneasy, so I would stay up late often contributing to lower T levels for most of my life. Lack of exercise and red meat can also cause lower T levels.

I had similar results to yours when I first took a blood test shortly after starting PM, but my free T was lower. I was happy about it obviously but my GP was concerned, I definetly think PM is an antiandrogen because after using it for a few months then taking another blood test before starting Spiro, my serum T was in the 200s.
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#10

(07-02-2013, 02:53 AM)Misty0732 Wrote:  I had a good friend who was experiencing a lot of problems with running (even though he had been running all his life). It turned out to be adult-onset diabetes. I certainly hope that isn't your problem -- (I'm sure the doctor will check your blood sugar levels, probably first). Good luck and let us know how it turns out!

I got my basic stats checked: blood pressure, oxygen saturation, heart rate. The doctor listened to my heart and lungs and said nothing sounded abnormal. The doctor gave me an inhaler to help with breathing, so hopefully that will make a big difference. If not, I'll make another appointment and possibly get some bloodwork done.
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