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[pepperminty]

Hi Ladies ,


Just had a testosterone test , but they couldn't calculate my free testosterone stating" Your free testosterone could not be calculated as your sex hormone binding globulin was above the top of the measurable range." My liver and thyroid are fine.

Can anyone shed light on this? I was considering taking testosterone, and now not sure.

Peppermintyx

[Robin]

Hi peperminty,

Mines off the scale too but ive still been able to use testosterone.

[Robin]

It shouldn't prevent you using testosterone. It's likely because your testosterone levels are so low and your SHBG high that available testosterone can't be quantified. If your testosterone levels were already high then they would be able to give you a figure

[pepperminty]

Hi Robin,

I reckon it must be low then and that may explain why I am knackered, no sex drive and achey. Can you still take it when you are on tablet form of HRT? Yep off the scale! Did it work for you taking it?

PMX

[pepperminty]

Hi Annamuller ,

that looks interesting. Thanks

PMX

[Robin]

Yes you can still take it on tablet form and those are symptoms of low testosterone so it's worth trying.

[Robin]

Yes it's definitely made a difference to me. I'm really glad I tried it.

[pepperminty]

Thanks Robin,

glad I can take it on tablet HRT. I have an appointment in JUne with the meno clinic, so I hope that they will, agree and ask my GP to prescribe it. If not i will have to go private. Glad you have sucess with it.

Thank you again for reassuring me , it is a flippin mare this meno stuff. If I am low this explains why I am unable to do any weight bearing exercise as my muscles wont work.

PMX

[Robin]

I had to go private but it was worth it. Hope gp lets you try it. Good luck

[Hurdity]

Hi there pepperminty

Firstly - if you take tablet HRT then this can have the effect of lowering free testosterone because oral HRT but not transdermal, increases SHBG from what I have read. Therefore the first thing you should do if you want to increase your (free) testosterone, and hopefully alleviate your symptoms if due to low testosterone, is to change to transdermal HRT - at least to transdermal oestrogen. This alone may well help but if not then you could try for replacement testosterone.

Secondly there is no need to do blood tests for testosterone because if your libido is vastly reduced or disappeared and you are taking HRT, then testosterone supplementation can be considered (off-licence) according to NICE Guidelines. It is not usual to calculate free testosterone from a blood test anyway - but if it is carried out (total T from blood test) the Free Androgen Index is calculated from total testosterone divided by SHBG (provided the units of measurement are the same) and expressed as a percentage (maybe this is what they meant?). However testosterone tests are inaccurate for women as they are not sensitive enough - our readings being at the lower end of the range. Nevertheless docs do suggest testing (and monitoring) T levels after supplementation to ensure levels remain within the range for women. My doc for example said that my (total) T levels were too high but I showed her the FAI calculation so once SHBG was taken into consideration then my FAI was within the normal range.

As far as I know salivary tests will not give any indication of actual testosterone levels either. No need to go down this route and pay for private expensive testing. Thanks for posting the link annamuller but the paper is not about using saliva tests to determine testosterone levels in an individual - it's about whether salivary measurements of testosterone can be correlated with other factors ie looking at relative differences in testosterone levels between individual women out of population study of women (or men).

I agree with Robin - your symptoms do sound like you could be low in T - but do try transdermal oestrogen first. Also you're not taking ADs or other medication are you - as this can also reduce libido?

Good luck at the menopause clinic anyway!

Hurdity x

[Saffy]

These medics make me laugh at times  . My SHBG was also out of range but as the top of the range was 200 I calculated the Free Androgen Index based on that and my specialist worked on the basis that it was therefore lower than the resulting figure  . Seemed reasonable to me!

[pepperminty]

Thanks everyone for replying.

Hi Hurdity,

I suppose at the moment I want to make sure my readings for everything aren't unusual in any way. I realise that how you feel is a good indication, but I am a just in case girl and I wanted to see where my levels were, I suspect that the meno clinic nurse wont have a clue about testosterone. I get better advice on here than at the clinic. I was concerned that my testosterone would be very high anyway and it may have nothing to do with my libido, or indeed energy and muscle strength. And if I took it I would end up loosing my hair, with a beard and greasy skin. I am not very mathematical- could write you a lovely piece of prose though- so calculating free T etc is all double dutch to me unfortunately.

Saffy , I haven't a scooby what figures I need to calculate the Free Androgen index, the test was supposed to give me that , and I agree it seems logical to calculate it at the top 200.

PMX

[Hurdity]

Hi again - not sure what you are wanting re the FAI - I did explain how to calculate it but may have been lost in the words?

Free Androgen Index = Total Testosterone/SHBG x 100
ie Total Testosterone divided by SHBG multiplied by 100.
You should have a calculator on your phone.

The units of measurement must be the same for the T and the SHBG (eg it might be in n mol/litre or something like that).

The reference range for the FAI is here: https://www.rcog.org.uk/globalassets/documents/careers-and-training/mrcog-exam/mrcog-normal-ranges.pdf and says it varies between 0.5 and 6.5 % but note that the ranges vary between different labs.

If your SHBG is high then as I explained this can be down to your using oral HRT so changing to transdermal is the first thing to do  before adding T which should reduce SHBG therefore increasing free T. (Most testosterone in the body is bound up to SHBG and isn't freely available, apparently).

Re T replacement - you shouldn't get side effects if replacement gives levels within normal physiological range for women.

Saffy - that sounds sensible - so even if you use the top value for SHBG - it will give a maximum FAI for you and in fact might be even lower!

Hurdity x

[pepperminty]

Hi Hurdity,

thanks, where do I get all those figures from?  Do I need to get another testosterone test to get the total testosterone? I got the test done on line, and they just said Albumin 39.1 gl. and no other figure.

 I don't have any other figures. All I got was out of range and the albumin. So  I am not sure what to mutiply and divide with what. i am probably being thick!

Peppermintyx

OMG I am going insane , I am so meno brained at the moment, I have found the other results. - and will try to calculate. Apologies.

[pepperminty]

Ok I have calculated my Free testosterone as


0.00650 nmol/L = 0.496%

biovailable testosterone 0.0197nmol/L= 1.51%


Is that Low?

I am so scatter brained at the moment.

Again thanks and apologies.

PMX