T Blood Tests..

[Guest My_Genesis]

My therapist said that I can choose between two tests if I want to get my natural T levels tested: Complete (the total T level in your body, for anyone who doesn't know) and free (bioavailable T only). The free one costs more, so I'm guessing that would be the one that is done more often? I mean, I don't really know which test is taken for what, and which one is better in my case, where you just want to know how much you have...I'm guessing the complete one doesn't tell you how much your body is actually utilizing, and that's what I should be looking for? I've read up a bit about this and it's been said that biological men who had low free levels, that's where problems were usually seen, whereas low complete levels...well that doesn't say much, because if a good enough amount of it is free they could just have a normal bioavailable level.

So does anyone know which one is usually done in cases where you just want your natural T level?

[Guest Zabrak]

I'm not sure myself. All I know is my endo gets me to have bloodtests to watch my T level.

I'm sure someone smart like strand will come in and help you out though.

[Guest My_Genesis]

haha, oh yes and I meant to mention that my therapist just kinda gave me a choice so it's basically my call. I'm leaning towards the free one right now...

[Guest Cody_T]

The free one costs more

man, I just opened that and my eyes lit right on those words. I was kind of wondering what you were smoking

hmm, let's say hypothetically I were on who wants to be a millionaire, and I'd used my 50/50 and I was at the level where you still get as much as you've won so far if you miss the question and I was in the hot seat and the question was "which blood test is more effective for measuring testosterone levels in pre T transguys" and the two choices were "complete" and "free"...

I'd probably end up going with complete because it seems more comprehensive based on the name.

HOWEVER

On who wants to be a millionaire, I would not know what I do about the two tests. Knowing what I do about the two tests, I would go with the free

Bearing in mind that I'm not gonna lose any money on this answer.

So to recap: I know absolutely nothing aside from what you've told me, but from what you've told me I would not risk any money (but maybe a little of my pride) on deciding that I'd go with the free one. This is because all female bodied people will have amounts of testosterone, but only the testosterone that's being utilized should really count towards virilization. Like in physics when you can only measure the change in voltage or where people can have different baseline temps and the only really important thing is whether they're off their own equillibrium. I'd say that the variation (which would be the free T) is more important than the baseline (which would be the complete T). But then again I know nothing.

Where's stranded when you need him? lol

But congrats on looking into it, and good luck on getting the test.

[Guest StrandedOutThere]

Hopefully your doctor will choose the "right" test so you don't have to! I had my pre-T bloodwork handy, so I went and looked. On mine they got serum testosterone levels, which is how much testosterone is in your blood. I'm not sure if they were looking at free testosterone or total testosterone though. Both free and total testosterone are blood tests and as such would probably be described as serum levels.

As a side note, SOT's pre-T levels were 23 ng/dL, which is at the low end of the normal range for genetic females. : (

In my defense, when the test was done I was at the point in the dreaded menstrual cycle when T levels would have been lowest.

Soooo...I did a light googling of the topic. It looks like total testosterone is reported in ng/dL, like on my results sheet. Free testosterone looks like it is reported as some kind of ratio or percent. What I'm finding suggests that free testosterone is the proportion of total testosterone that ISN'T bound to this protein called SHBG...which seems to be pretty important.

I guess it looks like the pre-T bloodwork I got was total testosterone, not free testosterone. I'm not sure what they'll get when I do my follow-up in April. Maybe both. I'll ask someone at the clinic I go to.

As best as I can tell, it looks like either type of test is fine as long as you don't have any medical conditions that affect your SHBG levels (like hypothyroidism). That's what causes the differences between free and total T levels in genetic males. When your SHBG levels are screwy, it changes the results. From what I'm reading, it looks like people who are in the normal range for one kind of T are in the normal range for the other. If your SHBG levels are too high then you have normal levels of total T but lower than normal levels of free, bioavailable T.

I don't know how much the tests cost in total. I think the blood work I got done was about $50, but I get that for a reduced rate because I'm poor. Still, it doesn't look like there's any need to spring for the expensive test unless you have a thyroid problem or liver dysfunction or something like that.

You know, testosterone levels in saliva are pretty closely related to serum levels. If you're just curious you might look into getting the spit test. I think I saw a "home kit" online for like $30 once. You spit in a tube and send it off to a lab. Easy as pie.

[Guest StrandedOutThere]

Dude, no need to go for the expensive option for no reason! If I were a millionaire, I'd just get both and compare. Now I'm curious. I keep wondering what my body is doing with the T when I inject it. Judging from the amount of body hair that is sprouting, I guess my body's able to make good use out of what I'm injecting.

[Guest Little Sara]

Get both tests, both are important. Someone with normal total testosterone could still be hypogonadal (have sub-par free testosterone, and hence, sub-par effects).

I only get total T tested nowadays, but on the first one, I had both checked. Though for me it matters less since my total T is insignificantly low now.

[Guest My_Genesis]

LOL Cody yeah I said the same thing at first, she said it does sound counterintuitive

If I can spit in a tube for $30 it would probably be best to go that route lol.

Yeah I don't know if the doctor would decide, because when she was explaining it to me she kinda made it sound like it's up to me, depending on how much money I'm willing to spend and all. The free one costs about $145, complete I think was around $50, although she made it sound like the free one tells you more, which is the way I usually like to go just in general...

Maybe I'll just start with the saliva thing and take it from there.

[Guest StrandedOutThere]

LOL Cody yeah I said the same thing at first, she said it does sound counterintuitive

If I can spit in a tube for $30 it would probably be best to go that route lol.

Yeah I don't know if the doctor would decide, because when she was explaining it to me she kinda made it sound like it's up to me, depending on how much money I'm willing to spend and all. The free one costs about $145, complete I think was around $50, although she made it sound like the free one tells you more, which is the way I usually like to go just in general...

Maybe I'll just start with the saliva thing and take it from there.

If it's just for curiosity's sake, I'd look online for a home test kit. That would at least give you a ballpark figure. In that This American Life episode I posted they used a saliva test when the cast of TAL compared their T levels.

The free testosterone test probably includes the complete also. I think you have to get total to be able to calculate free, but I could be wrong about that.

Another thing to consider is when you get it done. Your T levels are going to bounce around a bit depending on where you are in your curse cycle. T levels peak around day 14 (I think), during ovulation. I'm not sure exactly how much the bounce around, but I do know that behavioral studies with females and testosterone levels are difficult because you have to make sure to measure the women at roughly the same point in their cycle. You can't compare one female's T level with another's unless you do that.

All of that gives me comfort because it lets me believe my pre-T levels weren't all that low. It was the red curse's fault that my levels were low!

[Guest My_Genesis]

If it's just for curiosity's sake, I'd look online for a home test kit. That would at least give you a ballpark figure. In that This American Life episode I posted they used a saliva test when the cast of TAL compared their T levels.

The free testosterone test probably includes the complete also. I think you have to get total to be able to calculate free, but I could be wrong about that.

Another thing to consider is when you get it done. Your T levels are going to bounce around a bit depending on where you are in your curse cycle. T levels peak around day 14 (I think), during ovulation. I'm not sure exactly how much the bounce around, but I do know that behavioral studies with females and testosterone levels are difficult because you have to make sure to measure the women at roughly the same point in their cycle. You can't compare one female's T level with another's unless you do that.

All of that gives me comfort because it lets me believe my pre-T levels weren't all that low. It was the red curse's fault that my levels were low!

Uhh...well one reason I want the test to begin with is because of a totally out of whack cycle situation in which it probably doesn't even really qualify as a "cycle" anymore

[Guest StrandedOutThere]

Uhh...well one reason I want the test to begin with is because of a totally out of whack cycle situation in which it probably doesn't even really qualify as a "cycle" anymore

Well, a testosterone test probably isn't the best and most direct way to address that particular problem. Unfortunately, you should just go see a doctor. I didn't want to get my bits checked, but I had to be a man about it and get it done. They wouldn't give me my T scrip unless I had a pelvic exam on file. The good part is that the worst of it was over in less than 2 minutes.

Seriously though, get to a doctor about that cycle. Sometimes an out of whack cycle is nothing and sometimes it's something bad.

Since you're a college fella and are likely still on your parents' insurance, you can probably get a testosterone test sneaked in with other blood tests that they'd need to do. Polycystic Ovary Syndrom (PCOS), which causes excess testosterone production, can cause irregular periods. Maybe they'll check you for that. It might be a good excuse to get your levels checked and have it covered by insurance.

Ya dig?

Go get yourself checked out!

[Guest Zack L]

Hmm...I hadn't thought about these types of tests before. Interesting. Who votes I ask my endo (I'm diabetic) to let me get one, saying that my periods been off lately and that I read online that a change in testosterone could cause it?

She might suspect I'm trans then though. Seemed surprised when she had to check my injection sites and I had boxers on. XD

Not like I already don't get tons of blood drawn regularly to regulate the diabetes...They could just take a bit extra next time I get it done and do that, no harm done... ^^

As for which test you should get...I know very little about...anything body-related, as I'm squimish, however I know you can have insulin in your body and still be diabetic because the blood can't use it. So if you were to measure insulin levels in a Type 2 diabetic it would show as normal or even high. So I'd suggest the one that gives you a ratio of what's being used for your first time, to see how well your body is using then insulin, and then get the other one subsequent times.

Or T and insulin could behave completely different, in which case I'm just rambling pointlessly.

[Guest My_Genesis]

Well that's just one of several reasons I want to get it done...I mean if they find something unusual they'll probably have to look more into it somehow..

Yeah the insulin thing definitely makes sense....although to have T in your body and not be able to use it...isn't that kinda like androgen insensitivity?

Now all I have to do is find a job so I can pay for this stuff.. :/

[Guest leo]

i feel bad that you guys gotta pay so much for stuff

here in the uk i get blood tests for free

get my prescriptions free, just say im a student

and accordin to sergi hes getting his top surgery free so far

[Guest Cody_T]

They wouldn't give me my T scrip unless I had a pelvic exam on file.

I don't think I'ma need T after all...

[Guest Elizabeth K]

For what it is worth - MTF, we are tested for both T and E, and they are full body.

Lizzy

[Guest StrandedOutThere]

Well that's just one of several reasons I want to get it done...I mean if they find something unusual they'll probably have to look more into it somehow..

Yeah the insulin thing definitely makes sense....although to have T in your body and not be able to use it...isn't that kinda like androgen insensitivity?

Now all I have to do is find a job so I can pay for this stuff.. :/

Yeah, androgen insensitivity syndrome is kind of like type II diabetes (you make insulin but your body doesn't use it or there isn't enough). With androgen insensitivity there's testosterone in the body but the body isn't able to use it, either there aren't enough receptors or the ones that are there don't work right. It's possible for a person with male chromosomes to develop as a female. They'd still have male internal sex organs, but outwardly would appear female. This is something that often gets diagnosed because the person never starts menstruating.

Now fellas, I feel I must say a few words about general health issues. My first pelvic exam was when I was 30 years old, so about 10 years later than your first one is supposed to be (you are supposed to start getting them some time between 18 and 21 years old). THIS IS NOT GOOD. I've had friends that I went to high school with who have had cancer. One passed away and one caught it in time. Neither was over 30 when it happened. It's no joke.

Genetic males have to get prostate and hernia checks, which are no fun. Transguys have to get pelvic exams. I know it is HORRIBLE, but it's better than the alternative. Trust me, I understand that if you have lower half dysphoria getting a pelvic exam is like looking your worst fear right in the eye. It's one of those things that you just have to get over. Your health is important!

[Guest Elizabeth K]

Your health is important!

Guys - sorry to butt in all the time, but regardless, please watch your healh no matter who you are and what you have or don't have. My HRT doctor is an ObGym (ironic - I go to a fertility clinic to see him) and already has told me to prepare for yearly mammograms. And I still have a prostate to be checked. Strange world.

[Guest Irielle]

Genetic males have to get prostate and hernia checks, which are no fun. Transguys have to get pelvic exams. I know it is HORRIBLE, but it's better than the alternative. Trust me, I understand that if you have lower half dysphoria getting a pelvic exam is like looking your worst fear right in the eye. It's one of those things that you just have to get over. Your health is important!

Guys, if I may also butt in here a moment. Never, never take risks with your health. Get your checkups no matter how much you want to skip them. I had testicular cancer and caught it soon enough and now am considered cured. 25 years ago they would have sent me home to die. We are all in the wrong bodies but they still belong to us - they ARE us - and deserve our care and attention and love.

[Guest StrandedOutThere]

Guys - sorry to butt in all the time, but regardless, please watch your healh no matter who you are and what you have or don't have. My HRT doctor is an ObGym (ironic - I go to a fertility clinic to see him) and already has told me to prepare for yearly mammograms. And I still have a prostate to be checked. Strange world.

Butt in anytime, Elizabeth. We always appreciate what you have to say!

[Guest Little Sara]

They'd still have male internal sex organs, but outwardly would appear female. This is something that often gets diagnosed because the person never starts menstruating.

Well, if they appear male at birth and simply skip puberty, without growing breasts during that time, they'll most likely be overlooked, like I was.

As for testing for health stuff, I never had prostate/hernia checks in my life (and I'm 26). I certainly don't intend on starting now. I wouldn't be averse to a MRI, but that's really for me to see what I got in there, not to scan for possible cancer. Mammograms will also wait a couple year at least, til the sex is the right one on my Ids (which requires surgery). Wether I get surgery now or in 20 years.

[Guest Jackson]

Well, I can answer this question.

The total T level is the whole amount of T in the blood. That's an easy test to do and therefore cheap. That's the one that's done more often because it's so quick and easy to do. Because the lab then has to do a second process to determine the free T level is why the free T level is more expensive.

But it is actually the free T level that tells health professionals what they really want to know. What happens is that the T is circulating in the blood. Some of it is bound to proteins in the blood. When the T is bound to proteins, then it cannot get into the cells of the body and work. So the free (bioavailable) T is the amount of active T that will enter the cells and work its magic.

So if you just want to know how much T your body produces naturally, then you could just get the total T level. But if you want to get more information and know really how much is active and working, then get the free T level.

What would I do? Ask your doctor. You will need a physician to order the lab work and the physician can determine which test will be more useful to you, your physician, and your therapist.

See? I might actually know what I'm talking about. I bet y'all can't tell that I graduated from college the first time 13 years ago already. Whoa.

My therapist said that I can choose between two tests if I want to get my natural T levels tested: Complete (the total T level in your body, for anyone who doesn't know) and free (bioavailable T only). The free one costs more, so I'm guessing that would be the one that is done more often? I mean, I don't really know which test is taken for what, and which one is better in my case, where you just want to know how much you have...I'm guessing the complete one doesn't tell you how much your body is actually utilizing, and that's what I should be looking for? I've read up a bit about this and it's been said that biological men who had low free levels, that's where problems were usually seen, whereas low complete levels...well that doesn't say much, because if a good enough amount of it is free they could just have a normal bioavailable level.

So does anyone know which one is usually done in cases where you just want your natural T level?

[Guest StrandedOutThere]

Thanks, Jackson. That's very helpful. I Googled stuff, but it's good to hear from someone who knows.

[Guest My_Genesis]

Well, I can answer this question.

The total T level is the whole amount of T in the blood. That's an easy test to do and therefore cheap. That's the one that's done more often because it's so quick and easy to do. Because the lab then has to do a second process to determine the free T level is why the free T level is more expensive.

But it is actually the free T level that tells health professionals what they really want to know. What happens is that the T is circulating in the blood. Some of it is bound to proteins in the blood. When the T is bound to proteins, then it cannot get into the cells of the body and work. So the free (bioavailable) T is the amount of active T that will enter the cells and work its magic.

So if you just want to know how much T your body produces naturally, then you could just get the total T level. But if you want to get more information and know really how much is active and working, then get the free T level.

What would I do? Ask your doctor. You will need a physician to order the lab work and the physician can determine which test will be more useful to you, your physician, and your therapist.

See? I might actually know what I'm talking about. I bet y'all can't tell that I graduated from college the first time 13 years ago already. Whoa.

Thanks buddy!

So one more question: if I do the free one, would I get a number for complete as well?

See I really don't know how the physician thing would work, because she told me I would go to an endo there...and that's about it.

[Guest Little Sara]

Its two different tests, you really need to order both to get both results.