Blood Test Results questions

[buck3Maureen]

I am working on getting various blood work into the optimal range per Dr. Bredesen.

I have used his new book as a reference and I just got back some results that confuse me.

I am a menopausal female taking bio-identical hormones. bi-est and testosterone.

My blood work shows total testosterone of 765ng/dl, This is comfortably in Dr. B's ideal range, but is way outside of labcorp's normal range of 3-41ng/dl. My free testosterone according to my blood work is 10.5pg/ml. - converting this to ng/dl it is 1.05ng/dl - Dr. B's lowest optimal is 6.5 ng/dL which I am way under but labcorp reports this as HIGH. I am not having any negative effects such as acne or growing a beard.


My progesterone is OK by both Labcorp and Dr. B, but the estradiol while it passes the labcorp normal - is almost twice what dr. B suggests.

I am just now forwarding this to my Dr., just wondered if anyone else is struggling with this or has any thoughts on it.

Thanks, Maureen

[Julie G]

Great question, Maureen. My guess is that optimal levels of both testosterone & free testosterone will be quite different for men and women. Dr. Bredesen's book doesn't differentiate between the two... strange. I'll shoot an email to him for clarification.

[Julie G]

I got a reply. As suspected, the reference range in the book refers to men only. He's promised to get back to me with a reference range for women. I'll follow-up if I don't hear back by tomorrow. Stay tuned.

[buck3Maureen]

That makes a lot of sense, Julie. Thank you for checking.

[Julie G]

I still haven't heard from Dr. Bredesen, but checked in with Dr. Hathaway. Here's her response:

I look for a testosterone level between 25 and 45 in women. That being said some women do well with a slightly lower or higher level than that. You need to worry about scalp hair loss in some women if they’re testosterone is on the higher end of that.

I do not use free testosterone measurement in women. The free testosterone test and levels were developed for men. The amount of free testosterone in women is so low that I don’t trust the free testosterone level to be accurate.

[circular]

Very helpful, thanks Julie! I’ll add that to the spreadsheet when I get a chance ...

[TheBrain]

I still haven't heard from Dr. Bredesen, but checked in with Dr. Hathaway. Here's her response:

I look for a testosterone level between 25 and 45 in women. That being said some women do well with a slightly lower or higher level than that. You need to worry about scalp hair loss in some women if they’re testosterone is on the higher end of that.

I do not use free testosterone measurement in women. The free testosterone test and levels were developed for men. The amount of free testosterone in women is so low that I don’t trust the free testosterone level to be accurate.

Maureen, thanks for asking this question. Julie, thanks for finding an answer from Dr. Hathaway.

I'm thinking I shouldn't be using the compounded testosterone cream at all. Okay, so ignoring the free testosterone, per Dr. Hathaway because I'm a woman, here are my test results for total testosterone:

Prior to using the compounded testosterone cream:
05/18/2015: 28 ng/dl
11/20/2015: 32 ng/dl
02/17/2017: 32 ng/dl

With using the compounded testosterone cream (w/ dosage changes):
04/05/2017: 124 ng/dl (can't find records of what dose I started on, but it was larger than the dose that followed)
06/07/2017: 63 ng/dl (2 mg/ml - 1 click 2x/day)
09/14/2017: 260 (2 mg/ml - 1 click 2x/day)

Per my bHRT doctor's nurse, in response to my 9/14/2017 labs: "The testosterone is high, but his philosophy on that is if you feel good, stay on the same dose. He lowers the dose if it is over 300 or if the patient has acne of excessive heir growth. He looks at FSH closely- your's is not over 40, so you are good."

I haven't noticed that that the testosterone cream has helped with any of my symptoms (nor has the estradiol patch or oral progesterone). I'm thinking I'm wasting my money on the testosterone cream. But at least my blood work for estradiol and progesterone has improved.

For various reasons, I've already decided to switch to another bHRT healthcare practitioner for 2018. I'm curious as to what my new practitioner will suggest.

[TheBrain]

I also wanted to mention that I had a blood draw yesterday at my bHRT doctor’s office. His nurse noted that my blood is always bright red. She said that’s good; it means my blood is well oxygenated. She showed me my tube of blood and a tube of blood from another patient. The other patient’s blood was dark red. I could see a big difference between the two.

Of course, I’m happy about this, but I wonder why my blood is so well oxygenated. Is it my moderate aerobic exercise? One or more of the many supplements I’m taking? Living at sea level (as compared to living at 9,100 ft altitude in Colorado, where I developed hypoxia during sleep)?

[Julie G]

I also appreciate Maureen bringing this topic up. I looked at a previous test and mine was also quite high. Testosterone was 123 and Free testosterone was .86. I was using a drop of Testim (for men!) on my forearm at the time. The high numbers scared me so much that I've backed off completely. I see my gyn in a few days for my annual exam. I'll ask her to retest my testosterone with no supplementation to see if I even need it. FWIW, I didn't have an acne or facial hair issues, but my hair has been thinning. Could this have been the culprit?

[Bettylacy]

Maurine- Thanks for starting the conversation on hormones/ Testosterone. Here’s a great article I just came across reminding me of many benefits of testosterone including, vaginal health, muscle. Mass, bone density, energy and focus, mood.

{www.huffingtonpost.com/2013/07/30/testo ... ne-therapy}

Have you had a bone density lately? My sis was diagnosed with borderline osteoparosis and has improved significantly with BHRT, testosterone along with exercise and supplements. Some of us on the ketogenic-plan are at low BMI’s which puts us at greater risk of osteoparosis. I recently talked with my naturopath about a urine test that can measure osteoblastic activity, which I’ll send out. I’ve been working on increasing my Estradiol since, <25 so changed from transdermal to Mylar patch for better absorption. I was @ .05mg but was having lots of breast tenderness, so cut back to .025mg and feeling better. I looked up my TTest which is @ 40. THo my FSH is 80. Is there a reason your practitioner is gaging the TT by your FSH? Both Testosterone and Estradiol come from pregnenolone. Did you get that And DHEA checked too? I supplement with DHEA and have a level in 260 above normal values but below what DR B recommends for optimization. Most all levels Dr. B recommends are for “optimization”, so usually fall above normal labs.