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Should I take testosterone if my free testosterone is high?

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Posted 6/21/2023 11:40 AM (GMT -5)
Im a woman in my early thirties. I have chronic lyme. My functional medicine doc wanted me to take testosterone because my total testosterone was 5 ng/dl when he said it should have been 40. My free testosterone was 2.5 pg/ml. I chose to have a second test done. This time my total was 15 and my free was 5 which the lab marked as high. Now my doc is taking his time getting back to me and I cant get an appointment with a hormone doc for months. Do you guys think I should try the testosterone?
Posted 6/21/2023 11:54 AM (GMT -5)
Its hard to measure any hormones. This is similar to thyroid labs. Im a guy and had low testosterone when ill and had low thyroid at the same time. Thyroid level influences other hormones.

How are your thyroid levels? that could be the main problem, its worth looking at if it has not been done already.

The "free" in any hormone test is whats available in your blood. If your receptors are working 100%, this is what they have to use. That is why its important not to go over the suggested "free" level. BUT in times of stress, sometimes the cells simply wont use whats there. So the free level can elevate without being consumes. Kind of like a sick kid looking at a plate of food who doesn't feel hungry, and a parent keeps adding more food to the plate. As you can see, this can be confusing.

"Total" hormone measurements are apparently not that great to make judgments from. It sounds like that's a measurement of whats in the cells, but that's not exactly what it is.
Posted 6/22/2023 5:31 AM (GMT -5)
i would say do not start or stop hormone based medications based on one test result

these test are a snapshot in time- and levels can bounce around quite a bit even in healthy persons - let alone sick ones
and people with lyme - especially women - tend to have a hard time in general with hormone instability - especially sex hormones - which can start doing odd things at odd times in the monthly cycle.

often these disruptions in our hormone levels are just driven by things like general inflammation which blocks the mechanisms by which they are regulated - and can be aggravated by thing like gut issues - driven by lyme/bart - stress ( chronic illness is v stressful) etc

so often we are looking at an effect of the illness - rather than the cause that needs to be addressed

in people who have confirmed ongoing low levels they have their place - but they are typically not a miracle cure and have their own issues - for instance - these are very delicate interconnected systems - and once you are taking exogenous hormones - you are overriding the normal system and having to manually control your levels - whereas the best outcome is that the body does this for itself)

so - i would look for several readings in a row - all being low - before deciding to add exogenous hormones

rather than medicate the system - there are things that you can do that help to settle your system and thereby help to settle your hormones.
all the regular things like - optimising sleep, diet, doing some gentle exercise, and managing stress levels help - these things never sound like the answer as we all want quick radical fixes that make us feel better quickly - but often they are the best tools we have to help calm the system and restore balance.
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