What is Free Testosterone and Total Testosterone?

Testosterone is a steroid hormone present in both men and women (men have much more). Some testosterone floats about the body in the blood without being attached to anything else. This is called 'free' testosterone.

The rest of the testosterone is attached (called bound), some to a protein called sex hormone binding globulin (SHBG ) and some to a protein called albumin.

'Total' testosterone is the sum of all the testosterone in the blood, no matter whether it is f'free' or bound.

Free testosterone is just the free stuff floating by itself (not bound). Only a small precentage of testosterone is free.

For years, doctos thought only free testosterone was biologically active, meaning it was thought that the free testosterone was doing all the things testosterone is supposed to do, while the bound testosterone attached to SHBG or albumin and doesn't do anything. Some researchers disagree with this and think that the testosterone bound to albumin is also active. The jury is still out.

If someone has normal levels of total testosterone, but a low SHBG, then it's likely there's more free testosterone. Alternatively, someone who has high SHBG would likely have a lower amount of free testosterone, since the SHBG will bind to more of it.

That's why it's useful to know free testosterone levels, rather than just total testosterone.

How to get Cheap Blood Work Online

Here's a way to get fairly inexpensive blood work performed without insurance. Understanding how testosterone (or any other steroids or prohormone) affects your various hormones and other levels is very important. most people don't get blood work, however, due to the expense or because you need to see a doctor to get it ordered.

Here's a way blood work done by scheduling your blood panel on-line. No need for a visit to the doctor or medical insurance. The blood work is done by Labcorp. Most cities and towns (in the United States) have a Labcorp within driving distance. If you can a Labcorp facility, you do this

Caveat: if you live in NY, NJ, or RI you can't due this due to state medical billing laws.

1. Go to PrivateMDLabs.com and select the hormone panel for females. This test comes with a CMP (liver, kidney values and more), CBC (blood counts), total Testosterone, total Estrogen, LH and FSH. Even though you are selecting the hormone panel for females, later on as you complete entering the information you will indicate you are a male, and the reference ranges will come back correct for males. Loophole!

2. Search for any current discount codes. You can usually find a 15% off. The total should come to around $50.

3. Select the Labcorp facility nearest you. You can make an appointment to have blood drawn. Just go to the Labcorp website after you pay for the blood work to schedule an appointment.

If you go Monday - Thursday, chances are you'll have the results in your email next day!

The basic female hormone panel doesn't include lipid levels, so if you want that you'll have to add it. That costs about another $50.

The trick is selecting female hormone panel to start, because when you complete the patient info you indicate male. Selecting the male hormonal panel costs about $150, three times as much as female for the same tests.

For $50 lousy bucks, you can get everything you'd want tested after a cycle (except lipids, which as mentioned can be added for $47.99 retail, before discounts): liver and kidney function, HPTA, estrogen, etc.

I'm getting my tests through the clinic, and covered by insurance, but I bet many of you aren't. If you're going to use performance enhancing drugs, take out the guess work and spend the money to make sure your health is on track.

TRT Update, 9 Week Blood Test

They call is "cruising" for a reason - I've just been cruising along, doing my test injections 1x per week and the hCG 2x. My initial prescription was for 10 weeks; at 9 weeks I had a Doctor consult scheduled and a blood test taken. Let's do the blood first, since that's probably what you're most interested in. These were my before-therapy levels:

Test	Result	Reference
Serum Testosterone	239 ng/dL	348 - 1197
Free Testosterone	8.0 pg/mL	6.8 - 21.5

And after 9 weeks of therapy (that would be 9 testosterone injections and 18 hCG injections):

Test	Result	Reference
Serum Testosterone	1,128 ng/dL	348 - 1197
Free Testosterone	29.4 pg/mL	6.8 - 21.5

So you can see that's a significant difference from my start numbers.

Serum Testosterone increased 889
Free Testosterone increased 21.4

My weight went from 184 to 196. They have an impedance body tester for body fat, not the most accurate I know, which showed me going from 14.9 to 13.7 percent.

I gotten stronger in bench (from 180x10 first set to 225x7), and the elbow and shoulder discomfort I had is mostly gone now. Unfortunately my back still bothers me, so I haven't been pushing on the squats and deadlifts. I did go from 275x6 on deadlift to 310x6, but that not really going all out.

So physically, there's been a very noticeable change. The more esoteric "mental" benefits have yet to manifest.

I still don't sleep well and frequently suffer from insomnia
No burst of mental clarity or increased motivation or focus
My energy levels do seem a bit higher during my workouts, but not increased overall.

The doctor didn't really have much to say when I pointed this out. She suggested a sleep aid supplement, which I declined.

I'm pretty happy as far as the gains go though, and I've decided to stick with it. So I continued the prescription with only one alteration, that being I decided (after consulting with the doc) to inject 2x a week, .5ml each time (for the same 1ml a week). I'd read this can provide more even test levels, plus it makes the shots a bit quicker and easier.

I'm still doing the shots myself using a 5/8 inch 28g needle in alternating quads on Mondays and Thursdays. No issues there. And the hCG in the stomach on Sundays and Wednesdays.

I did discover something interesting. With insurance, I was paying $78 a month for the testosterone cypionate and hCG, plus an additional $75 for the clinic fee, for a total $158 a month. So three months comes in at $474. If I use insurance, I can ONLY fill my prescription 1 month at a time.

If I "bulk" order from the clinics preferred prescription provider, I can get 3 months of testosterone cypionate and hCG for $425, a savings of about $50. So there you go....

Testosterone Repalcement Therapy, 5 Week Update

I've been meaning to write an update for a week and finally carved the time out today to do it. Yesterday was my sixth shot, marking the end of the fifth week since starting TRT. A good as time as any to give a status update, I suppose.

Energy-wise, I don't feel much different. Still tired, still sleep fitfully for about 6 hours a night. There's been no coalescing of focus, no sharpening of my mental acuity. I might  feel a bit more chipper, but I felt chipper for the most part to begin with. I wasn't depressed, but I still don't like my (admittedly well paying and fairly easy but completely unfulfilling) job.

Maybe a slight change on the sexual side of things. I wasn't having issues before, so no change there, although I have noticed a quality increase. By that I mean where I was maybe hitting an 8 or 9 on the "hardness" scale, I'm now hitting 10. Definitely a noticeable difference, accompanied by a bit more sensitivity as well. Maybe some other TRT users end up running around like randy teenagers, but not me. I'd say my level of desire is about the same as before.

I've gained some weight over the last 5 week, from 188 to 195, no change in waist size, but definitely more muscle. With this has come a cooresponding increase in strength. I don't feel a noticeable energy surge, but the weights float a bit easier, and I'm making gains again after a couple of years fighting to stay at the same place. Very nice to see a bit of muscle being added.

This relates to the above and is undoubtedly the source of my weight gain, but I've been much more hungry since starting the testosterone. Like craving food hungry, sitting down eating huge meals hungry. I'm definitely eating more (hence the weight gain) but it seems to be going to building muscle, not fat. Carb craving is a big part of this hunger, so I find myself eating stuff I'd put aside years ago: chips, candy, peanut butter and jelly sandwiches, pretzels.... I try to limit carbs and was doing so pretty successfully, but these new cravings have me stuffing them down. I need to clamp down a bit on that.

Anyone who's done a steroid or a prohormone is probably familiar with back pumps. Iv'e been gettingthose at a low level for a couple of weeks, to the point where it's difficult for me to run now. I've taken to jum[ping rope for my cardio. Running just cause my back to tighten up too much and is too painful. This si new and definitely related to the testosterone supplementation. I was running fine before, two miles three times a week. So the is for sure a TRT thing.

When it comes to going the bathroom, I've noticed the flow isn't as strong. My PSA levels were fine before hand. I need to do a bit of research on this. I'm not having and problems going, but still.... Related is my (still) waking up at  night to go to the bathroom. I generally wake up once, and occasionally twice. In the past, such nocturnal awakening where sometimes (50/50) accompanied by an erection. Now, every time, I've got to wait for the hydraulics to subside. Really, like every time. Annoying.

Overall, I'm happy with my progress. I especially like getting stronger and putting on some muscle. I don't like the back pumps and night time need-to-pee erections. My first blood test for levels comes at 12 weeks. I intend to continue with the testosterone replacement at least until that point and see how things are.

EDIT: I wrote this post 2 days ago, but didn't have a chance to proof and publish until now. I just finished my Wednesday workout and put up 255 on the bench. Not a lot to some folks, but, due to various shoulder and elbow issues (including elbow surgery a few years back), that's most I've done since I was in my 30s. I'm pretty pleased with that, and after only 5 weeks too!

Second Testosterone Shot - First Self-Administered

My first testosterone shot was at the clinic on a Monday. I chose that day because my weight training days are Mon/Wed/Fri, so I figured a Monday shot would provide the greatest benefit as far as test levels throughout the week.

As I mentioned here, I wasn't feeling much difference a week after getting the first shot. Maybe a bit hungrier over the week, but no renewed and sustained energy, no clarity of thought or purpose.... From the reading I did, most of the effects began to be felt in 2 - 3 weeks. I wasn't disappointed. Not yet anyway.

My prescription wasn't stored at the clinic - I had it at home. This, of course, meant I had to remember to bring it to work with me. The clinic was much closer to my workplace than home, a slight detour on my end-of-day commute.

I didn't even notice I'd forgotten it until it was time for me to leave. I shut down my computer, and stood up to leave, thinking, Well, off to get my - DAMMIT! I forgot the vial of testosterone!

Yes, friends, only my second shot and I'd already forgotten to bring the vial to work. So I had two choices: 1) wait and do it the following day or 2) do it myself at home.

Now I'd already self administered two hCG shots myself, simple easy things done to the abdomen with an insulin needle. The testosterone was quite a bit different though. Where hCG was water-based, the testosterone was oil-based and thick. The hCG was subcutaneous, the testosterone was intra-muscular. The hCG was administered with a tiny 29 gauge needle, the testosterone with a 25 gauge 1.5-inch harpoon.

I was a bit nervous on the ride home thinking about jabbing that thing into my leg.

An aside: I'd faced up to the realization that sooner or later I'd want to be doing the shots myself, and I'd done plenty of research in that direction. I'd found plenty of information supporting the subcutaneous injection of testosterone, and the practitioners of this method attested to it's ease and effectiveness, proving proof in the form of blood test results.

I'd also read about shallow intra-muscular, done with a 1/2-inch 27 or 28 gauge insulin needles, most commonly into the thigh or deltoid.

So I'd sort of decided I'd be doing one of those myself, to free me from the shackles of going to the clinic once a month. I'd even ordered some half-inch, 28 gauge insulin needles online.

So I get home and lo and behold the needles I'd ordered had arrived! At least now I wasn't faced with sticking that javelin into my leg.

The syringes I'd ordered (100 of them for $16 from an insulin supply company) had fixed 28 gauge needles a half-inch in length. Because testosterone is thick due to being oil based, it was a common practice to draw the fluid out of the vial with a larger needle (like an 18 or 20 gauge), then swap that needle out for the injection needle (usually a 25 gauge, or even 23 if you were fearless).

You COULD draw with a smaller gauge, but it would take longer. And the underground lab testosterone used by many bodybuilders was often so thick it couldn't even be drawn with anything much smaller than a 22 gauge. Since the needles I'd ordered were fixed, I could swap; I had to draw with teh 28 gauge.

I wasn't drawing underground lab testosterone though, I had nice, pharmaceutical grade testosterone courtesy of my hormone replacement therapy doctor. And from everything I'd read, I'd be able to draw fine, albeit slowly, with the 28 gauge needles I'd ordered.

I grabbed my vial, two alcohol swabs, and a syringe. The fluid is much thicker than water - it took me about a minute or two to draw out 1ml, my weekly dose. I swabbed my right thigh, upper/outer part, and arrived at the moment of truth.

I was surprised at how easily the needle went in, with nothing more than the faintest sensation of a pinch. It took maybe about 20 seconds or so to complete the injection, and I pulled the needle out. That was it. No stinging, no pain, just a bit of pressure and a feeling somewhat akin to slight heat as I'd emptied the syringe into my leg.

I massaged the injection spot for about 30 seconds and BAM! I'd just completed my first testosterone shot, delivered as a shallow intra-muscular injection!

Overall, there was less discomfort than when I'd gotten the shot at the clinic. Smaller needles, shallow IM versus deep IM maybe. Maybe the clinic nurse pressed the plunger a lot faster where I'd taken my time.

All I know is I felt quite a bit of relief knowing I could, henceforth, do the injection myself.

My First hCG (human chorionic gonadotropin) Shots

Starting with Monday being as day 1 (the day I get the testosterone shot), my treatment plan calls for hCG (human chorionic gonadotropin) shots on days 5 and 7. My hCG was already mixes up, courtesy of my first visit to the clinic.

While the testosterone solution can be kept at room temperature, the hCG has to be kept refrigerated. The test injection was done with a 1.5 inch 25g needle; the hCG would use a 29g 1/2 inch insulin needles (provided along with the prescription).

I confess to a bit of nervousness the first time. I'd done some reading, and injecting with a 29 gauge was supposed to be pretty much undetectable. Heck, diabetics injected insulin multiple times a day with the same thing. Only one way to do it though, and that was to do it.

I got my syringe (fixed needles 29g, as mentioned), the hCG vial from the fridge, and two alcohol wipes. I wiped the top of the syringe the way they showed me in the clinic - a good, vigorous wiping for about 5 seconds. I popped the cap on the syringe, and drew in air for 40u (the syringe has a 50u capacity, with 50u being .5ml).

Carefully, (and wearing my reading glasses - yes I need reading glasses) I inserted the syringe into the vial and injected the air. I think turn the vial over and began slowly drawing in the hCG liquid. The syringe filled easily, took maybe 10 seconds. I filled it just past the 40u mark, flicked it a few times, and then injected the excess back into the vial. I withdrew the needle and capped it again.

Out came the second alcohol swab. I picked a spot about 1 inch to the right of my navel and swabbed it well for about 10 seconds, uncapped the syringe....

And poked it right in.

Barely more than a slight pinch. I pressed the plunger, took about 10 seconds or so to get it all in, and pulled out the needle. My first successful self-injection! Yeah, I know it was an insulin pin and hCG, but still.

Overall, a much less traumatic experience than I expected.

End of the First Week

I had my first testosterone shot Monday afternoon, and went through a normal week. My regular work schedule is 6:15am - 2:15pm, which gets me home about 3:15. My 14 year-old son gets home from school around 3:30. We have a home gym, a power cage we built ourselves along with an olympic bar and bumper plates and other weights up to 315 pounds. We lift together 3x per week, a reverse pyramid workout on Mondays, Wednesdays and Fridays.

I try to hit the hay around 9ish and read a bit, with lights out before 10. That typically gives me 6-7 hours of sleep a night, depending on how quickly I fall asleep, how many times I wake up to take a leak, and how (or if) I'm able to fall back asleep again.

Boring stuff, I know, but I'm telling you all this so you'll have an idea of my schedule. Maybe you'll see some aspects of your own in it....

As I mentioned at the end of my first shot post, I didn't feel any different in the days following the injection. No increased energy or coalescing of mental focus, still sleeping fitfully, no sudden reversal of the lethargy I'd been in the grip of for some time.

However...

That first weekend following the shot, I was was hungry. And I don't mean a bit peckish, I mean hungry. Like can't get full hungry. So I ate. A lot. Generally, I kept it healthy (I tend to eat fairly healthy most of the time anyway). But I powered through a more than normal amount of food, no doubt.

I don't generally pay much attention to my weight. I mentioned in an earlier post that I've been within a pound or two of 185 for a long time. But my hunger and the resulting feeding frenzy over the weekend made me curious enough to step on the scale, where I was greeted by a surprise: 189.

So it looked as though I'd gained a few pounds. Maybe I'd been eating more all week? I hadn't been bothered by hunger until that weekend, but it's a possibility.

So end of first week, not feeling any different, but up around 4 pounds. Make of that what you will.