Caveat, these tests were done at 3:30 PM
T4 = 6.9 (reference 4.6-12.0 ug/dL)
TSH = 1.11 (reference 0.34-5.60 uIU/ml)
Total T = 227 (reference 250-1100 ng/dL)
Total Free T = 54.7 (reference 35.0-155.0 pg/mL)
Progesterone = 0.4 (reference < 1.4 ng/ml)
These tests were taken by my endo. I showed them to my uro and he threw them away and eclaimed “These tests are worthless, they were taken at 3:30. Your endo should know better than that!”
Even at 3.30pm your T looks low. Get retested in the morning and get Free T4 and Free T3 instead. Total T4 is pretty much worthless.
The range for progesterone is normally 0.3 - 1.2 ng/dl, so yours is pretty low.
Why not add LH, FSH, Estradiol, SHBG and DHT, they are relevant too?
JH
I’m with your urologist on this one, it is nice to hear such passion about what is important correct procedure.
These tests are of little diagnostic value.
Furhtermore they are far from comprehensive.
You need;
LH
required to assist in diagnossi if testosterone s low
FSH
LH is less reliable than FSH unless pooled and FSH tallies with LH values
SHBG
Crucial in evaluating free testosterone when only total testosterone is tested. Imprtant even when free testosterone is tested when evaluating estradiol levels.
Total or serum Testosterone
Primary male androgen in the blood
Free Testosterone
Get this tested if possible, free testosterone is the portion of testosterone that your body can actually use that isn’t bound in the blood to SHBG or albumin etc
Dihydrotestosterone (DHT)
This is a potent androgen that is important when it comes to libido, erections and drive and sits on the scales alongside other androgens like testosterone in the androgen to estrogen balance. A lack of it, like a lack of testosterone can also result in the development of gynecomastia.
A lack of DHT equates to hypogonadism even if testosterone is normal. Given that finasteride’s principle mechanism of action results in lowered DHT levels; having hormone pathology without testing DHT is the equivalent of investigating the cause of lung cancer whilst ignoring the fact you smoke cigarettes.
Estradiol
The most potent estrogen in the body, in basic terms at elevated levels it acts against the actions of testosterone in the male.
Some people believe in testing for thyroid and adrenal issues as well. If this is something that concerns you, you should also test for TSH, free T4, free T3 and 24 hour urinary cortisol.
When I had my total T tested a month ago around 9:00 AM, it came to about 450. I know that T drops off as the day progresses, but going from 450 at 9:00 to low 200s at 3:30 is a HUGE drop off - more than 100%. Is this a normal rate of reduction, or is Total T supposed to drop off at a slower rate?
bump…
does anyone have an opinion as to my question above?
I have not seen studies that look at the natural decline of testosterone across the day in eugonadal (normal functioning) men.
All I can say is the reference ranges and testing is callibrated around the natural male cicadian hormonal cycle and the levels found in the morning between 8 or 9 and 11am.
The best way to ascertain if an individual has a problem is via a symptomatic assesment via careful questioning, a physical examination, a taking of medical history and of pathology at the correct time.
I honestly think you would be better asking questions related to a correct evaluation as oposed to one made in error.
I hope that makes sense.
Yes, it makes sense, but it sure may explain why I feel so tired, unmotivated, and mentally confused by the time it’s 4:00 in the afternoon. The low 200s is pretty low for a 26 y/o male, in my opinion.
I can see what you are saying but don’t get caught up in it. You may be able to prove that you have a problem going about things in the way that endocrinologists respond to.
There is no point tilting at windmills, at least not yet.
So, I just received a letter from my endo asking to retake my Total and Free T tests, however, there was no instruction as to what time I should take the test… The time I took the original test is displayed right next to the results, so I’m sure he is aware that I took the tests at 3:30 PM. Therefore, I will retake the tests in the afternoon again.
That doesn’t make any sense.
Phone the endocrinologists or his secretary and state the nature of the problem and the reason the tests were re-ordered.
If he is not going to conduct these tests properly then you need to fire his ass and get an endocrinologist who will take the tests at the appropriate time.
If you are having any difficutlies getting the tests taken correctly let me know what city and state you live in an I will try and get you some contact details for endocrinologists in your area that will do the job properly.
I just walked into my endo’s office and spoke with his assistance who contacted him, and again no intruction to take the Total and Free T test in the morning. I asked the assistant if I should take it in the morning, and she said it doesn’t matter…so… I dunno, this endo works for one of the best med schools in the country, so it’s hard to question his competency… It’s about 1:00 PM right now, and I should be called into the lab to take the test in any minute now.
Fire them right now and tell me where you live- city and state and I’ll get you new contact details for endocrinologists in your area. You can then phone a few up and find out if they know their arse from their elbow and book an appointment.
You simply cannot have these tests in the afternoon- this is completely incompetant medicine. If they know this little you shouldn’t want them anywhere near you.
When you tell me where you live I will get your the details.