Testosterone Replacement Therapy (TRT) – Part 3 – IronMag Bodybuilding & Fitness Blog

Regular Testosterone & Estrogen Ranges and Methods to Measure

Methods to learn regular bloods, the place to get bloods, and the best way to learn a chart
It’s very important to know the place you stand earlier than a cycle, throughout and after, particularly evaluating numbers and conserving a file, time and dates and what compounds the place used!

It’s essential to get a blood evaluation, pre cycle, halfway (5 weeks into cycle/blast) and submit cycle (4-6 weeks after PCT is full for optimum outcomes..
I additionally recommend getting bloods within the morning AM hrs, when take a look at ranges are at peak. I additionally added some additional information on regular E2 and different hormonal ranges.

What’s a “Regular” Testosterone Degree and Methods to Measure Your Testosterone
At the moment we’ll be looking at what’s thought of a traditional testosterone degree and how one can get your testosterone ranges examined. As I started researching testosterone ranges and hormone testing for this collection, I shortly discovered that there’s loads of conflicting and complicated info on the market — some web sites will say that “X” is a traditional testosterone degree, whereas one other web site says “Y” is the best vary. Even medical labs give conflicting numbers on what’s a traditional testosterone degree.

Why a lot confusion?
The issue is that there hasn’t been a lot standardization in hormone testing, significantly concerning T ranges. Completely different labs use totally different strategies (and measurements), which has solely created confusion amongst shoppers and even household docs about what testosterone degree outcomes even imply.

Hopefully, the present state of confusion will quickly change. The Middle for Illness Management right here within the U.S. began a undertaking in 2010 to get labs to agree on standard hormone testing procedures. It’s slowly gaining floor, however not each lab has signed on.

I additionally discovered that the underside vary of what’s thought of “regular” by many docs is definitely woefully underestimated. Medical doctors are telling males who come to them with signs of low testosterone,

“Properly, you’re barely inside regular vary, but it surely’s nonetheless regular, so… you’re fantastic!”

No, Dr. The whole lot’s not-A-Okay. It’s not fantastic.

I hope on this submit I can make clear among the confusion surrounding testosterone ranges and hormone exams. I’ll be straight with you. These things is tremendous complicated. I’ve performed my finest to synthesize all of the disparate information on the market into an easy-to-read format for the layman phrases and have sought to create probably the most accessible useful resource on the internet. Nonetheless, I’m not a scientist or physician, and should have gotten just a few issues mistaken. If anybody see an error, I welcome your corrections.

Let’s start…

Whole and Free Testosterone Ranges
Earlier than we start, I wish to reiterate the truth that there are three various kinds of testosterone floating in your physique: free testosterone, SHBG-bound testosterone, and albumin-bound testosterone. While you get examined, there are two exams you may get: complete testosterone and free testosterone.

Whole testosterone is the full quantity of T floating in your blood on the time of the take a look at: free, SHBG-bound, and albumin-bound mixed. Whole testosterone is usually measured in ng/dl, or nanograms per deciliter.

Free testosterone is the measurement of — you bought it — free testosterone (which frequently consists of albumin-bound testosterone as effectively as a result of it might simply convert to free T). Free T is usually measured in picograms per milliliter. As we’ll talk about later on this submit, as a result of free testosterone makes up such a tiny, tiny proportion of your complete T, it’s actually laborious to measure precisely. So, while you see analysis on regular testosterone ranges, it often focuses on complete testosterone. Consequently, a lot of the numbers on this submit shall be about complete T ranges. With that stated, I do embody some references to analysis that signifies what common and optimum free testosterone ranges are.

What’s a “Regular” Testosterone Degree?
While you go to get examined for testosterone, the lab will usually present you what’s thought of the “regular” vary amongst sufferers who’ve examined with that exact lab. It’s known as the “reference range.”

For instance, LabCorp (the lab I used to check my T ranges right here in Tulsa, OK) exhibits a reference vary of 348 – 1197 ng/dl (nanograms per deciliter) for complete testosterone ranges. In response to this reference vary, my complete testosterone degree of 383 ng/dl firstly of my experiment would imply my complete T ranges had been — barely — throughout the regular vary.
Right here’s the issue.

That reference vary consists of all kinds of males who examined with LabCorp: 80-year-old males and 20-year-old males; overweight males and tremendous match males; males with pituitary gland issues and males with glands that work like champs.

Certain, my 383 ng/dl was thought of regular, however regular in comparison with whom? An 80-year-old man with Kind 2 diabetes?

The truth that reference ranges don’t break sufferers down by age or well being standing explains why a 30-year-old man can go to his physician with the signs of low T, solely to be instructed that his T ranges are fantastic as a result of they’re throughout the “regular” vary. In the event you’re 30 (and even 50), however have the identical testosterone degree as an 8o-year-old, diabetic man, your doc might say you’re okay, however you’re nonetheless not going to really feel good. Plain and easy.

What’s fascinating is that for a few years, the underside variety of the reference vary for T ranges at many medical labs was a lot decrease. For instance, up till final yr, LabCorp’s reference vary for testosterone was 249-836 ng/dl. You might have had a testosterone degree of 250 (which is tremendous low) and nonetheless be instructed by your physician that you just had been regular.

All that is to say that the “regular” ranges put on the market by docs and labs aren’t all that helpful.

Common Testosterone Ranges by Age
When figuring out what’s thought of a traditional testosterone degree, it’s finest to have a look at what the reference vary is for males your age. Researchers have identified for years that T ranges sometimes drop by about 1% yearly after you hit your mid-30s. So for those who’re 35, evaluating your self to a bunch of 80-year-old males isn’t very helpful as a result of they doubtless have actually low T ranges.

Sadly, many labs don’t break down reference ranges by age. Nonetheless, research have been performed through which researchers just do that. Beneath, I embody the outcomes from two such research.

The above chart teams males into seven ten-year age increments. It’s primarily based on outcomes from this 1996 study. In response to this chart, my T degree firstly of the experiment (383 ng/dl) was nearer to the typical of an 85-100-year-old man. Yikes! This chart additionally lists the typical free testosterone ranges of the topics. My starting free testosterone was beneath the typical of males my age and my finish degree was above common.

In a research performed that very same yr by one other workforce of researchers, they produced the next chart of testosterone ranges damaged down by age:

Whereas this chart doesn’t present common free testosterone ranges, I like the truth that it exhibits the T ranges of males within the backside 5 and ten percentiles in addition to the T ranges of the lads within the high 95%. You possibly can see the way you examine to males with the bottom and highest T ranges.

In response to this chart, my starting T degree (383 ng/dl) was close to the underside 5% and 10% throughout all age teams. Even for 55-59-year-old males. (Boo!)
My testosterone degree after 90 days of excellent residing (778 ng/dl), was above common for my age group (Bully!).

These charts are a significantly better supply than labs’ reference ranges to test in case your T ranges are regular. In case your physician tells you that your T ranges are regular, ensure to check the outcomes to those charts to make sure he’s not shortchanging you.

So far as regular percentages of free testosterone go, ~2-3% is taken into account regular. In the event you’re considerably beneath that proportion vary, you’ll doubtless expertise signs of low T even when your complete T is common or above common.

Go For Optimum, Not Common
In case your testosterone ranges match up with the typical within the charts above, it’s secure to say that you’ve got enough quantities of T in your system. However we don’t wish to go for simply enough, we wish optimum testosterone ranges in order that we are able to derive as a lot profit as we are able to from this virile molecule.

What’s an optimum T degree, you ask? Nice query!

The reply is: “It relies upon.”

Each man is totally different, so their degree of optimum testosterone shall be totally different, too. For some males, a testosterone degree of 600 ng/dl will make them really feel nice, whereas different males have to be round 800 ng/dl with the intention to expertise the advantages of optimum T.

Clinical research still hasn’t determined a hard threshold level for when symptoms of low T begin appearing. Some latest analysis means that signs of low T may start showing in males when their total testosterone level dips below 320 ng/dl. In response to anecdotal proof from the proprietor of Peak Testosterone, many men start noticing low T symptoms when their total testosterone dips into the 400s. In fact, it’s anecdotal, so take it for what it’s value, but it surely’s most likely a good suggestion to remain above 500 ng/dl for those who don’t wish to expertise signs of low T.

In order that’s a superb rule of thumb for the decrease threshold. And from there you may shoot for ranges which can be within the greater vary on your age group.

However it’s vital to notice that optimum testosterone doesn’t essentially imply you want super-high ranges. Previous a sure degree, testosterone can truly trigger a bunch of not-so-good unwanted effects, like sleep apnea and overly thick blood. You sometimes solely have to fret about an excessive amount of testosterone for those who’re utilizing testosterone substitute remedy. Barring some physiological defect, an excessive amount of T often isn’t an issue present in males growing their testosterone naturally by means of adjustments in way of life and food plan.

Methods to Measure Your Testosterone Ranges
There are 3 ways to check your testosterone ranges: saliva pattern, urine pattern, and blood pattern. Every methodology has its professionals and cons.

Saliva and urine exams are comparatively cheap and quick. You possibly can even purchase a saliva test kit on Amazon for about $30. Simply spit within the cup, put it within the mail, and per week later you’ll get a complete testosterone measurement. The issue is that saliva and urine tests aren’t very accurate, which is why endocrinologists sometimes don’t use saliva or urine samples when diagnosing low testosterone ranges. As a substitute they use blood serum exams.

Whereas blood exams are rather more correct and delicate than saliva or urine exams, they’re additionally rather more costly — blood exams for complete and free testosterone can set you again $130. As a result of I needed probably the most correct outcomes, I went with the blood serum testing.

What I didn’t know earlier than I obtained examined was that there are totally different sorts of testosterone blood exams, some extra correct than others. As I discussed firstly of the submit, there isn’t a lot standardization amongst labs in terms of testing. Some labs use one methodology, whereas one other lab will use one other take a look at.

I later discovered that the blood take a look at I used to measure my complete testosterone for my experiment wasn’t probably the most correct in the marketplace and wasn’t what the CDC is recommending labs use of their purpose to standardize hormone testing. (I examined myself a month after my 90-day experiment with the blood take a look at the CDC recommends. I’ll share my leads to a bit.) I additionally discovered that measuring free testosterone is fairly dang laborious and that the majority free T measurements that labs give are sometimes simply estimates.

Beneath I share what I discovered in regards to the complicated world of testosterone blood exams.

Blood Exams for Whole Testosterone
ECLIA Technique. Once I examined myself for complete testosterone for my experiment, the strategy the lab used was ECLIA, brief for Electro chemiluminescent Immunoassay. It’s a quick and reasonably priced methodology to measure complete testosterone in your blood. Many labs use this methodology as a result of it’s automated and doesn’t require an excessive amount of work on a lab technician’s half. Nonetheless, some research have proven that values obtained with ECLIA are considerably greater in comparison with the extra dependable LC/MS methodology. Which brings me to…

LC/MS Technique. LC/MS is brief for liquid chromatography-mass spectrometry. It’s thought of the gold normal methodology by many researchers in measuring small molecules. Its accuracy and consistency is why the CDC is recommending LC/MS to be the usual methodology used when testing complete testosterone.
As a result of LC/MS is extra delicate than ECLIA, docs sometimes use this methodology when testing sufferers with actually low testosterone ranges, comparable to girls and kids. Whereas it’s extra correct and delicate, the LC/MS methodology is costlier than ECLIA. And it takes a bit longer to get your outcomes.

A month after my 90-day experiment, I obtained examined once more, however this time utilizing the LC/MS methodology. My complete testosterone degree utilizing this methodology was 826.9 ng/dl. Which means my T ranges elevated much more since beginning my testosterone adjustments.

You’ll should make the decision on which methodology you go along with. In the event you don’t suppose you’ve got extraordinarily low T, ECLIA will work simply fantastic. Simply know that the majority researchers see LC/MS as the strategy that produces probably the most correct and constant outcomes. Labs usually provide each ECLIA and LC/MS exams. Afterward, I’ll share the place you may get examined utilizing both methodology.

Blood Exams for Measuring Free Testosterone
Studying in regards to the myriad of the way to measure free testosterone has almost put me within the nut home. It’s complicated.

The issue that labs face is that there’s so little free testosterone in our physique, it’s laborious to measure instantly. Beneath I lay out the strategies obtainable proper now to measure free T.

RIA Direct. It’s low-cost, quick, however not very correct. Current research have been calling into query using RIA direct methodology to measure free testosterone. Sadly, most labs throughout the nation solely use RIA direct due to its price effectiveness. LabCorp, the lab I used, solely measures free T utilizing RIA direct. Regardless of the criticisms levied at RIA direct exams, many researchers imagine it’s an enough methodology for routine exams.

Equilibrium Ultrafiltration. Many within the area of endocrinology argue that equilibrium ultrafiltration is a superior and extra correct testing methodology to RIA direct. The issue is that many industrial labs don’t provide the strategy as a result of it’s so time consuming and requires well-trained technicians. If you could find a lab that makes use of equilibrium ultrafiltration, count on to spend a bit greater than you’ll for a RIA direct.

Calculated free testosterone. As a substitute of instantly measuring free testosterone in your blood, it’s possible to get a rough estimate by calculating the amount of albumin, SHBG, and total testosterone in your blood. The issue with this methodology is that 1) it’s not very correct and a pair of) it requires you to pay for 3 totally different exams: albumin, SHBG, and complete testosterone. This may get fairly costly, fairly quick.

As you may see, you’ve got a wide range of choices when getting examined for T ranges. My advice is to attempt to get your complete testosterone quantity utilizing the LC/MS methodology and use no matter methodology is on the market and value efficient to measure free testosterone. In fact, I’m only a man who writes a weblog about manliness, so take that advice with a grain of salt.

The place to Get Examined for Testosterone
Right here’s how: Order the take a look at. You’ll have to order a blood take a look at utilizing an internet site that sells blood exams to shoppers. No, you don’t ship the web site a blood pattern. These websites contract with labs throughout the nation to attract blood. They principally act as a intermediary. Listed here are the websites I used to purchase my exams:

You may also order albumin and SHBG exams from each Well being Testing Facilities and Request a Check so you should use the calculation methodology to determine your free testosterone ranges.

Go to a neighborhood lab. After you pay on your blood take a look at, you’ll get an e-mail from the web site together with your order info. You’ll even be instructed which lab you might want to go to in your space to have the take a look at performed. Each Well being Testing Facilities and Request a Check despatched me to LabCorp. In the event you’ve ever utilized for a job that requires a drug take a look at, you’ve most likely been to LabCorp your self, as they’re a nationwide firm.

Get blood drawn. A pleasant nurse will draw some blood samples. The entire course of takes lower than 2 minutes. It’s finest to get your blood drawn very first thing within the morning, as T ranges are at their highest within the morning and steadily decline all through the day.

Get your outcomes. Two or three days later, you’ll get an e-mail from the lab together with your outcomes.

Check greater than as soon as. As a result of testosterone ranges are delicate to a complete host of environmental components, it’s vital to get examined greater than as soon as when diagnosing low T. You might have beneath common T ranges one week, however barely above common the subsequent. That is significantly vital in case your physician is contemplating placing you on testosterone substitute remedy. You don’t need him to make the choice from a single take a look at!

Conclusion
Don’t use lab reference numbers to find out in case your T is low. They’re not often correct. Use the charts above on your particular age vary.

Take a blood take a look at to find out your complete T ranges. You will get this blood take a look at on the physician, or by signing up on-line and going to a neighborhood lab. Ensure to get examined within the morning!

In the event you can, take the LC/MS take a look at to measure your complete T — it’s probably the most correct. If that’s not obtainable, the ECLIA take a look at will work okay.

To search out your free T, attempt to use the Equilibrium Ultrafiltration take a look at — it’s probably the most correct. If that methodology isn’t obtainable, the RIA Direct take a look at will work okay.

Beneath is a few common info with regard to different hormonal ranges that point out the conventional ranges

Dihydrotestosterone (DHT) – This can be a stronger type of testosterone that’s metabolized by the physique from different androgens. In males most is comprised of testosterone, whereas in girls the principle supply is androstenedione (which is first transformed INTO testosterone). Present analysis signifies that DHT is accountable for male-pattern balding and extreme, undesirable hair in each sexes. In males it is usually accountable for non-cancerous prostate swelling (BPH).

DHT LEVELS
SEX	pg/ml
Females:
	Premenopausal	24-368
	Postmenopausal	10-181
Males:	250-990

LDL – that is the so-called “Unhealthy ldl cholesterol” and could also be an element for some individuals. Estrogen remedy tends to decrease the LDL degree whereas testosterone remedy makes it go up. You probably have a excessive LDL degree and are on TRT remedy, you will have to make changes to food plan or take different medicines to handle it.

Estradiol (E2) – that is the principle “feminine” hormone. There are two others, Estriol and Etrone, which can be additionally typically examined, however they’re metabolized from Estradiol, so it’s often the principle one checked. The total title is 17-beta-Estradiol, which can also be obtainable in a number of medicines for ERT remedy. Present analysis signifies that, in some individuals, this hormone might play a task within the lack of bone density, prevents male our bodies from clearing DHT out of the prostate gland, and might stimulate estrogen-sensitive tumor development (if estrogen-sensitive most cancers cells are already current).

ESTRADIOL LEVELS
SEX	pg/ml
Girls (> 18 years outdated)
	Follicular Part	30-120
	Ovulatory Peak	130-370
	Luteal Part	70-250
	Publish-Menopausal	15-60
Male	15-60

Progesterone (Pg) – This steroid hormone is a feminine intercourse hormone which, along with estrogens, regulates the accent organs throughout the menstrual cycle and it’s significantly vital in getting ready the endometrium for the implantation of the blastocyte and in sustaining being pregnant. In non pregnant girls progesterone is principally secreted by the corpus luteum, whereas in being pregnant the placenta turns into the foremost supply. Minor sources are the adrenal cortex for each sexes and the testes for males. Present analysis signifies it balances agaisnt overactivity of each testosterone and estrogen, and successfully blocks 5-alpha-reductase enzymatic conversion of testosterone into DHT. Progesterone additionally performs a task in stimulationg Osteoblast (bond constructing) enzymes, reducing levels of cholesterol, stimulating development of epithelial tissue and lobule-alveolar methods within the breasts, and upregulation of the P-53 cell-division gene, thus providing an anti-carcinogenic impact in opposition to run-away cell division in hormone delicate tumors.

PROGESTERONE LEVELS
SEX	ng/ml	nmol/l
Females
	Follicular section	0.2-1.4	0.64 – 4.45
	Luteal section	4 – 25	12.7 – 79.5
	Publish-Menopausal	0.1 – 1	0.32 – 3.18
Males	0.1 – 1	0.32 – 3.18
Conversion issue: 1 ng/ml = 3.18 nmol/l

Testosterone (T) – some of the vital male intercourse hormones. In males it’s primarily synthesized by the testes, in girls each the ovaries and by the adrenal cortex; it’s secreted into circulation. Testosterone is transported within the plasma by a beta-globulin, known as testosterone binding globulin. It’s estimated that about 98 % of the circulating testosterone is sure. The rest, current as free testosterone, is assumed to be the metabolicly energetic portion. Within the goal organ, it’s remodeled by 5-alpha-reductase into the physiologically efficient androgen DHT. In males the dedication of testosterone is used as an indicator for the perform of the testes: low hormone ranges are present in circumstances with Klinefelter’s syndrome, cryptorchism or anorchia. Male or feminine sufferers with an androgen producing tumor (ovaries, adrenal cortex, testes) present elevated values. Measurement of testosterone is used to substantiate hirsutism in lady. The dedication of free or not particularly protein-bound testosterone will be useful in circumstances of hyperprolactinemic girls or hyperandrogenism. It promotes the burning of fats and the constructing of lean muscle mass. It additionally seems to be the gasoline for the libido in each sexes. The position of testosterone in cardiovascular well being continues to be hotly debated, however it seems that it could have a detrimental impact over the long run. Testosterone, like progesterone, upregulates the P-53 gene to show off rampant mobile division, so in that sense is anti-carcinogenic. Testosterone additionally stimulates oil manufacturing within the pores and skin, which may result in zits issues.

Free or Unbound Testosterone (“Free T”) – As talked about above, about 98% of the testosterone in a person or lady’s physique is sure to blood proteins. Which means that solely a small portion is definitely “bio-available” and appearing on the physique’s tissues. A wholesome proportion for both males or girls is round 2.5%. One factor that typically frustrates gender sufferers is that the measurements for the biologically important free testosterone will not be simply in contrast between women and men. Labs usually will state the proportion free for males, however give a measurement in pg/ml for ladies. Or the male measurements shall be in ng/dl requiring a mathematical conversion for direct comparability to the “regular” vary of the other intercourse. The proportion is often greater in adolescents (as much as 5%) and fairly low in aged individuals (round 1%). Many docs imagine that any studying beneath 2% means the affected person ought to take testosterone dietary supplements, and that any studying beneath 1% signifies a totally absent intercourse drive. The extent readings between women and men are so vastly totally different as a result of the quantity represents a proportion of the TOTAL testosterone. Girls naturally begin with a decrease complete quantity, so 2.5% of 40ng/dl goes to be a lot lower than 2.5% of 800ng/dl in a person.

DHEA-S (Dehydroepiandrosterone sulfate) is secreted by the adrenal cortex. DHEA-S is considered a biologically weak androgen, however due to its excessive focus in blood, it contributes considerably to the androgenization course of. The physiological position of DHEA-S will not be well-known, but it surely appears to be intricately concerned in adrenarche (axillary and pubic hair development). DHEA-S seems to be a superb indicator of adrenal androgen manufacturing.

Elevated ranges of DHEA-S have been reported in states of extra androgen manufacturing comparable to cystic zits, hirsutism, infertility, enzymatic adrenal defects, Cushing’s syndrome resulting from bilateral adrenal hyperplasia, and virilizing adrenal tumors.

DHEA-S SERUM LEVELS
SEX	µg/ml	µmol/l
Females
	Premenopausal	0.8 – 3.9	2.1 – 10.1
	Being pregnant (3. Trimenon)	0.2 – 1.2	0.5 – 3.1
	Postmenopausal	0.1 – 0.6	0.3 – 1.6
Newborns (each sexes)	1.7 – 3.6	4.4 – 9.4
Males	1.0 – 4.2	2.6 – 10.9
Conversion issue: 1 µg/ml = 2,6 µmol/l

Androstenedione – this hormone is produced by the adrenals and gonads. Subsequently, the dedication of the extent of androstenedione in serum is vital within the analysis of the practical state of the glands. Androstenedione is a precursor of testosterone and estrone. Moreover the adrenals, in females, the ovaries have been proven to be an vital supply of androstenedione throughout the ovulatory cycle.The precept manufacturing of testosterone in females is from the conversion of different associated androgens, particularly androstenedione. An irregular testosterone degree in girls needs to be accompanied by the estimation of serum androstenedione. Using serum testosterone dedication along with Enzyme Immunoassay of androstenedione can be utilized to find out if supply of extra androgen manufacturing is adrenal or ovarian.

Leutenizing Hormone (LH) -LH stimulates Leydig cells within the testes to provide and secrete testosterone (T). Because the testosterone travels by means of the bloodstream it passes by means of the anterior pituitary gland and hypothalamus it creates a “unfavorable suggestions loop” that triggers a lower in GnRH and LH. LH additionally stimulates the adrenal gland to provide androstenedione and progesterone. An issue with LH ranges alone is never seen, so testing is barely wanted if testosterone degree is irregular, for instance, if the affected person is suspected to have been born with Klinefelters Syndrome. In girls a traditional LH degree is much like FSH. An LH that’s greater than FSH is one indication of PCOS.

Follicle Stimulating Hormone (FSH) – In girls FSH is commonly used as a gauge of ovarian reserve. Usually, below 6 is great, 6-9 is sweet, 9-10 honest, 10-13 diminished reserve, 13+ very laborious to stimulate. In PCOS testing, the LH:FSH ratio could also be used within the analysis. The ratio is often near 1:1, but when the LH is greater, it’s one attainable indication of PCOS. Fundamental hormone testing for males usually solely consists of testosterone and FSH. Nonetheless, in circumstances comparable to Klinefelters Syndrome docs will often have a look at each FSH and LH ranges. In males FSH stimulates the Sertoli cells within the testes to provide androgen-binding proteins, testosterone, and a protein known as inhibin. Inhibin, in flip, travels within the blood again to the pituitary gland whre it creates a “unfavorable suggestions loop” that decreases the output of FSH. Since FSH stimulates testosterone manufacturing, and testosterone will be transformed to DHT and estradiol, a rise of all or any three may also create a “suggestions loop” that decreases FSH secretion.

Intercourse Hormone Binding Globulin (SHBG) – that is the precept blood protein that ties up the majority of the steroids the physique produces. For instance, it bind with about 98% of the full testosterone, but additionally binds with different steroids as effectively. As androgen manufacturing will increase, obtainable SHBG decreases.