question from a user
Why don’t more clinics put an emphasis on free testosterone over total? I was initially prescribed 200mg weekly but find 120mg puts total test in 700-800 but free testosterone is still on the high to just past high range weather Labcorp or quest testing. My SHBG is on the lower end. Shouldn’t SHBG and free test labs take WAY more consideration than it does?
AlphaMD's Answer
Two reasons:
On initial dosing Total Testosterone is far more important to find a starting dose, and then on follow-up labs combined with how your symptoms have changed is when examining Free Testosterone is usually makes the most sense both for seeing where you're at and the bank account.
For many clinics, they don't really look too closely at your lab results other than to make sure you aren't widely above range so that they look good on an audit. Those clinics have generic dosing & may not have providers directly review labwork but rather run off of standing orders that other staff may just follow for the sake of saving time & money. You can probably spot those types of clinics if they just raise your dose whenever you have an issue rather than look to adjust/lower it, run larger labs, or not add any other medications.
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