Testosterone levels

[Marmitemyway]

Hi
i had a blood test last week as i think i should try testosterone, results have come back as 0.5% (a free androgen test) - normal saying 0-4 and serum sex hormone binding glob 104nmol . Due to see GP - both say normal on paper but is 0.5% low for testosterone , would it explain my brain fog, low energy and fatigue and low mood. I'm on HRT highest dose and mirena coil and have been for 4 years, should i push to try testosterone ? any advice welcome TIA

The BMS guidelines have recently changed - they used to advise using the FAI but now advise total testosterone as being the assessment level.

Anything less than 1.0 nmol/l is low and could benefit from testosterone supplementation.

It can help with the symptoms you mentioned but the NHS will only prescribe for low libido.

It’s also important that your oestrogen levels are optimised before starting testosterone.

As the symptoms you mentioned are also indicative of low oestrogen, if you haven’t already done so, I recommend having a blood test to check you are absorbing the HRT effectively.

@Hellomisterpleasedtomeetyou thanks would that be a different testosterone test then that I should have ?
they said they were doing an estrogen test so I assumed the serum sex hormone test was for this
many advice welcome so I can push for the right tests
i take 2 x 1mg sandrema sachets daily
thankx got your advice

the NHS will only prescribe for low libido

At the risk of sounding cynical: i.e. you have a better chance of getting help if there's a chance that a man might be in any way inconvenienced by what you're going through.

An oestradiol test checks your oestrogen levels (pmol/L).
As you are on a high dose of HRT this should be reflected in your levels if you are absorbing well.

The testosterone test is a separate test and measures three elements:
Total (serum)testosterone (nmol/l)
SHBG (nmol/l)
Free androgen index (%)

Absolutely. No question.

My GP was very happy to prescribe, though when I said the words 'low libido' she smiled as she knew I was playing the game properly I think!

My results were less than 0.4 and the FAI couldn't be calculated which I assume means I was very very low.

Am also on max oestrogen and the mirena coil.. My fatigue started after the coil went in.

I also wanted testosterone for fatigue and brain fog, and NOT libido, but that's the impression I gave the GP.

My recent appointment was similar - consultant was very clear that I could try testosterone for low libido and then asked did I want to do that - so that was what I said back to her.

It's ridiculous but that's the only way to get Nhs prescription or so it seems.

It's early days still but I do think it's helping with strength and stamina and general energy levels too.

My appointment with my GP was very similar - she reiterated numerous times that testosterone could only be prescribed for low libido and asked if I understood. I went along with it, but I think we both knew it wasn’t why I was pursuing it.

I was eventually told that the practice were unable to prescribe as it wasn’t on their local formulary so I had to go down the private route.

Overall, getting the right balance of HRT is an extremely frustrating process - peri/menopause just isn’t a priority and many of us are left to educate ourselves as many GPs have limited, if any, knowledge. Then there are the endless supply issues and it’s ridiculous that Testosterone isn’t wholly recognised as a vital female hormone.

Hopefully we are paving the way for future generations to have an easier ride.

My testosterone levels were 0.9 and I’ve been advised by my consultant that this is the upper end of normal so they wouldn’t prescribe testosterone. I’m suffering badly with low energy levels (obviously said the whole low libido line which is also true but tbh much less concerning than the low energy to me). So do you think I should be fighting harder for testosterone? It sounds like 0.9 isn’t that high then 🤔

@Blueberry40 I have just checked my most recent T blood test results.

Normal range is 0.0 - 1.8

Mine is currently 0.8 after nearly a year of using it.

Mine was 0.8 and I was prescribed it with no argument at all. Frustrating that it’s not consistent.

I wonder if another brand or type of oestrogen would suit you better, OP. Also maybe have a look at what Louise Newson says about higher doses. I think your two sachets are the equivalent of a 100 patch, maybe you need more or you aren't absorbing that brand of gel well. I'm not sure oestrogen can be reliably measured until full menopause as the levels can fluctuate.

@Apileofballyhoo my private consultant just measured my oestrogen level, but I've been on high dose oestrogen for 18months so I am assuming it should be fairly stable by this point.

@Blueberry40 checked my test after 12 months or so of using testosterone gel

0.6 with normal range shown as 0.22 to 2.9

I have nhs prescriptions after consultant prescribed and wrote to gp

I'm also on testosterone (second time trying it, the local pharmacy couldn't fill my whole order the first time and I ran out, then they couldn't give me the rest that had been missing because my prescription had timed out... So I let it lapse) and not really feeling a difference, but must book my 8 week bloods and was told over that phone by the prescribing menopause clinic gynae that I need to give it at least 4-6 months to see an effect. And yes, I knew the script and had to say OUR sex life was suffering, even though I desperately want it to improve my energy and brain fog mostly! 😆

Mine was on 0.8. Really hoping I'm not too high after about 9 weeks on it to get more, because I really want to give it a proper trial this time. Maybe some women need a bit more? I don't have a beard (yet).

I tried it via Newson clinic who said my levels were low - increasing the doses as advised. After 3 years I concluded that it was making no difference to my low energy levels. I’ve stopped it and have noticed no difference at all. Sad as I hoped it would be the magic bullet for making me feel like my old self.