T-level question

[nicktheory]

Ok, I asked my GP for free testoterone levels. I figured I would get the whole list of endos. No. Just three figures: Total (383) Free (45.4) and Free % (1.19). Any reason to believe these figures point to a cause of gyno, like hypogonadism? I'm looking, probably in vain I know, for the cause, as I am considering surgery and want to reduce the chances of regrowth.

[nicktheory]

A follow up: I read somewhere on the internet that the range for normal free testosterone is between 9 and 30. Well, if I am in the 40s, what does this mean?

[daddynubbie]

I can sense your desperation to find an answer, I dont have any knowlege that can help but you are in the right place for answers.

It may take a little while for someone who knows to answer so be patient.

[nicktheory]

Thanks. Not so desperate. Just thorough and trying to cover all bases. Will be patient.

[brm]

I may  not be right. But the extracting methods may vary from one lab to another. That's why the range values differ, to, with labs. So, Some average mean value may not always make sense, which explains why the bracket may appear  to be wide. In the same way, the interpretation of docs may vary as well; Some may believe that a given T value is too weak  whereas another will find it perfectly normal. Then, what counts may just the symptoms you feel, whether in terms of low or high T. But i'm no doc. I just give you here my own personal conclusions about bloodworks.

[phantom]

Taking bloods to test for testosterone and diagnosing hypogonadism is not straight forward.

In the UK, bloods are usually taken on two separate occsions and in the morning - when testoterone is at its peak.

I don't follow the numbers you quote for your test results.  Again,by UK standards, the 'normal' range for testoterone in an adult male is between 10 and 35 nmol/l.

However, men can be above that level but be symptomatic of hypogonadism or be below the clinical range and be asymptomatic.

A broader investigation is needed to establish if a male is hypogonadic which tends to focus on symptoms such as mood and libido (depression and low sex drive), lack of male pattern baldness, little or no body hair, muscle tone and strength.

[phantom]

Just re-read your initial post.

True gynaecomastia is caused by oestrogen.  This 'female' hormone can cause any pre-existing breast tissue to grow further.  If this tissue is removed via surgery, then there is nothing for any oestrogen to grow back.

Pseudo gynaecomastia (fatty tissue) is not sensitive to hormones.  Diet and exercise can have some impact on the shape and size of a male breast.  More extreme cases can result in redundant tissue that actually make the male breast 'hang' in a pendular way, similar to that of a female breast.

Note that as testosterone aromatises (breaks down or metabolises) one of the metabolites is oestrogen, which is why body-builders can develop gynaecomastia because any existing breast tissue grows.

[nicktheory]

Thanks. I guess I need a US intepretation of the numbers.

[Hypo-is-here]

I have left details of endocrinologists for you in the other thread.

If you want any laymans information and help regarding the hormones you can pm should you wish.

[nicktheory]

Just to follow up on my labs:

(Background: White Male, 50, gyne since age 12 along with some other slight feminizing characteristics.)
   
 1. Total T - 474 with 241-827 ng/dl the reference range.  
2. Free T - 113 with 34-194 pg/ml the range  
3. Free and weakly bound T - 238 with 84-402 ng/dl the range.  
4. SHBG - 29 with 7-50 NMOL/L the range  
 
Hmmmm:  
 
1. T3 reverse - 0.22 with 0.19-0.46 the range  
2. High-sensitivity estradoil - 13 with 10-50 the range  
 
Overall, the doc says there is nothing wrong (out of range) with my labs (except for high cholesterol). NB: He is a very aggressive HRT proponent, so these ranges are reasonable, I believe. (If my total was below 400 he would have considered treatment, he said.)
 
Questions:
 
1. Does this really mean my gyne is ideopathic?  
2. What is a T3 reverse and what does it mean? It's called non-approved by FDA on the sheet.  
3. I am a hair away from being out of range for low estrogen. I just had a bone density scan -- just in case. Is concern warrented for borderline low estrogen? Beside the bone stuff what other things can I worry about this holiday season?  
4. Doesn't gyne and low estrogen/normal testosterone sound, intuitive at least, odd?  
 
Thanks in advance.  

[Hypo-is-here]

Nick,

Nothing stands out as being blatently wrong from the bloods- but that is just playing a numbers game.  

It is important that symptoms are taken into account along side the bloods as often the bloods themselves are inadequate for varying methodological reasons.

How do you feel in yourself, do you feel well?

If not what are your complaints?

Do you suffer from any of the following.

Depression.
Back pain or any osteo conditions/joint pain.
Nervousness
Poor/irritable mood/anxiety
Low libido
Erection dificulties
Fatigue/loss of energy/tiredness
Poor memory/concentration problems
Excessive sweating


The above relates to testosterone/estrogen issues, but may also relate in part to other issues and in fact testosterone and estrogen are not the only issues that maybe a factor.

I would say that you may also want to have a full evaluation of your thyroid hepatic and renal functions.

You have had reverse T3 tested but that alone is a little odd.

I would have thought a full thyroid panel should cover TSH, free T4, free T3 and a thyroid antibodies test.

I hope that helps.