Free Testosterone - Changes to Reference Range in Canada

[KCinToronto]

I'm trying to figure out what this means, my quarterly blood work was done in October and the range came back with a different reference range.

For Free Testosterone I was at 480 pmol/L and the reference range was 179-475 pmol/L
It refers to "using Vermeulen's Algorithm.
It says:" Effective September 29, 2014, please note changes in methodology and reference interval"

My results from July 2014 were 74.8 pmol/L with reference range of 25.0 - 80.0 pmol/L

Does anyone know what the difference might be or why the change?

Keep in mind I am in Canada. I was recently advised that some of their fees are no longer covered by OHIP (Ontario Gov't Insurance) and I'm also wondering if anyone heard about that. I'm always afraid that government healthcare does it's best to make sure you are not in the range needed for actual care.

Thanks for any input.

 

[halfwit]

It's just a different formula used to calculate the values. If you look at both of your tests, you'll see the ratio is about the same. It's kind of like Celsius vs Fahrenheit; they both can tell you how cold it is outside, but Fahrenheit is a much larger scale, which aids in precision.

My .02c

Edit: I wouldn't worry about being slightly out of range unless your doc mentions it. Free testosterone is almost always going to be high for us on TRT as androgens reduce SHBG along with an AI if you use one. Hell, I've been QUADRUPLE the top end of the range (forgot to stop proviron before the test), and my doc didn't even bat an eye.

 

[KCinToronto]

It's just a different formula used to calculate the values. If you look at both of your tests, you'll see the ratio is about the same. It's kind of like Celsius vs Fahrenheit; they both can tell you how cold it is outside, but Fahrenheit is a much larger scale, which aids in precision.

My .02c

Edit: I wouldn't worry about being slightly out of range unless your doc mentions it. Free testosterone is almost always going to be high for us on TRT as androgens reduce SHBG along with an AI if you use one. Hell, I've been QUADRUPLE the top end of the range (forgot to stop proviron before the test), and my doc didn't even bat an eye.

Thanks for the response. My doc wanted to lower my test, saying he wants me in mid range. Of course I ignored him. LOL. I'm only on 100 mg a week, and he wanted me to go to 80. I to take arimidex as I feel I need it, but more or less 0.25mg twice a week. I was taking 0.5mg twice a week and my esto was really low last test.

 

[halfwit]

Thanks for the response. My doc wanted to lower my test, saying he wants me in mid range. Of course I ignored him. LOL. I'm only on 100 mg a week, and he wanted me to go to 80. I to take arimidex as I feel I need it, but more or less 0.25mg twice a week. I was taking 0.5mg twice a week and my esto was really low last test.

Yeah, you're the "boss" in the relationship - I hate when doctors forget that. Sure, if there are health concerns stemming from being at the top end, he can certainly address them - but it is ultimately up to you. If they don't play nice, you just go shop for one that has a clue.

 

[KCinToronto]

Yeah, you're the "boss" in the relationship - I hate when doctors forget that. Sure, if there are health concerns stemming from being at the top end, he can certainly address them - but it is ultimately up to you. If they don't play nice, you just go shop for one that has a clue.

Shopping in Canada is never easy. In my case, I'm forced to keep the terrible ones and monitor their advice.
My Urologist is supposed to be an expert in the area, and even gives talks about TRT. Over a year ago my bloodwork was borderline low and he said he could not do anything. I was advised to go to a different lab and it would show "low" as it had a different reference range. Well, it showed low. I never went back to him, but will bring it up on my annual visit.

KC

 

[Alpin]

Shopping in Canada is never easy. In my case, I'm forced to keep the terrible ones and monitor their advice.
My Urologist is supposed to be an expert in the area, and even gives talks about TRT. Over a year ago my bloodwork was borderline low and he said he could not do anything. I was advised to go to a different lab and it would show "low" as it had a different reference range. Well, it showed low. I never went back to him, but will bring it up on my annual visit.

KC

Who's your doc now ?
Is it the cream prescribing quack?
What lab is this with that ridiculous Free T test?
I'll be sure to avoid it.

 

[Alpin]

Thanks for the response. My doc wanted to lower my test, saying he wants me in mid range. Of course I ignored him. LOL. I'm only on 100 mg a week, and he wanted me to go to 80. I to take arimidex as I feel I need it, but more or less 0.25mg twice a week. I was taking 0.5mg twice a week and my esto was really low last test.

Lower the dose by 20 mg...For what?
Ridiculous. ..
whats your TT 2 days from shot?

 

[KCinToronto]

Who's your doc now ?
Is it the cream prescribing quack?
What lab is this with that ridiculous Free T test?
I'll be sure to avoid it.

Hey Appolon, same doc as before. I'm educating him. LOL. Ya, that's the one that started me on cream.
I'm at 100 mg a week now, .25mg Adex twice a week and 250 IU HCG twice a week. Have to admit I feel pretty good.
So even with a bad doctor and roidology guidance I've made out OK.

I've had 3 doctors now tell me they don't test for Total T on a regular basis. I've read numerous times it is the Free T that they are looking at and never the Total T. I asked the question on here but never saw a response. Why does everyone give there total T numbers when it is Free T that really tells if you are low?

Thanks,


KC

 

[KCinToronto]

What lab is this with that ridiculous Free T test?
I'll be sure to avoid it.

Appolon, it was Gamma-Dynacare Labs. Tell me, does you doc charge for your visits? Mine advises us that TRT visits are no longer covered by OHIP. Curious if you heard anything. He is charging $100.00 per visit now. With any luck I can renew scripts direct from pharmacy although I'd like to monitor blood of course.

KC

 

[Nuclearbark]

Baloney. I was on TRT with a GTA based doctor and there was never any charge. My guess is that the doctors are being overwhelmed by people who come in complaining of low T. That, or the number of people being treated for it has forced the government to stop covering the cost.

My current doc who is A+ in my books tells me to only get blood tested at Lifelabs. I just had a test in late Dec and had the same range as your July results.

 

[KCinToronto]

Baloney. I was on TRT with a GTA based doctor and there was never any charge. My guess is that the doctors are being overwhelmed by people who come in complaining of low T. That, or the number of people being treated for it has forced the government to stop covering the cost.

My current doc who is A+ in my books tells me to only get blood tested at Lifelabs. I just had a test in late Dec and had the same range as your July results.

I can't seem to get my GP to assist with this. She referred me to a urologist who refused to treat me. So I ended up at a quack hormone replacement "specialist". I mentioned above, for my urologist it seems I went to the wrong lab, with higher ranges. LOL. When I see my urologist again I'll see if he can jump in since I am already on it. I'll ask my GP again too if I can see her quarterly and she can prescribe the scripts. We'll see how it plays out. Even if I pay a few hundred a year it's not so bad. I've heard of TRT clinics and Hormone replacement clinics charging much more than that. I have a feeling the government has realized that paying docs $100.00 per visit, and the fact that this may make us live longer and collect more government pension, is not something they want to promote. Why would they want us healthy right?

KC

 

[Alpin]

I can't seem to get my GP to assist with this. She referred me to a urologist who refused to treat me. So I ended up at a quack hormone replacement "specialist". I mentioned above, for my urologist it seems I went to the wrong lab, with higher ranges. LOL. When I see my urologist again I'll see if he can jump in since I am already on it. I'll ask my GP again too if I can see her quarterly and she can prescribe the scripts. We'll see how it plays out. Even if I pay a few hundred a year it's not so bad. I've heard of TRT clinics and Hormone replacement clinics charging much more than that. I have a feeling the government has realized that paying docs $100.00 per visit, and the fact that this may make us live longer and collect more government pension, is not something they want to promote. Why would they want us healthy right?

KC

They don't charge $100 bucks a visit. Its about half that.
why would the urologist jump in after treatment?
Remember he wanted you out the door to begin with.
You're still seeing that quack cream doc?
I understand your stuck and have no choice.

 

[Alpin]

Appolon, it was Gamma-Dynacare Labs. Tell me, does you doc charge for your visits? Mine advises us that TRT visits are no longer covered by OHIP. Curious if you heard anything. He is charging $100.00 per visit now. With any luck I can renew scripts direct from pharmacy although I'd like to monitor blood of course.

KC

You can't renew scripts from the pharmacy without a doc providing the scripts....
Doesn't work that way brother...
he doesn't charge for visits but in no way should it be $100 per visit.
you been away a long time from the board.

 

[Alpin]

I can't seem to get my GP to assist with this. She referred me to a urologist who refused to treat me. So I ended up at a quack hormone replacement "specialist". I mentioned above, for my urologist it seems I went to the wrong lab, with higher ranges. LOL. When I see my urologist again I'll see if he can jump in since I am already on it. I'll ask my GP again too if I can see her quarterly and she can prescribe the scripts. We'll see how it plays out. Even if I pay a few hundred a year it's not so bad. I've heard of TRT clinics and Hormone replacement clinics charging much more than that. I have a feeling the government has realized that paying docs $100.00 per visit, and the fact that this may make us live longer and collect more government pension, is not something they want to promote. Why would they want us healthy right?

KC

I doubt your GP will treat this...
you were borderline you say?
Some docs are of the belief they can pull you off TRT and your body might start producing more of its own again...
Remember to watch out for these types....
don't forget a lot of docs that were borderline ok with TRT got spooked last fall after that TRT study.
Ball is in their court now to do as they please with it.
They can smile at you and say they are probably saving your life not giving you TRT.

 

[KCinToronto]

You can't renew scripts from the pharmacy without a doc providing the scripts....
Doesn't work that way brother...
he doesn't charge for visits but in no way should it be $100 per visit.
you been away a long time from the board.

Yes this is my same doctor, I really am stuck. At least he stopped prescribing creams. LOL. I did check one other place but wanted something like $500.00 just to open a file for me. Another Advanced Medicine Doctor. I'm thinking the urologist may consider taking me on when he hears how stupid this doc is. LOL. But his only concern seems to be to see me once a year, and get me out the door. You know, a 9:00 AM appointment and you show up and 25 people are in there with 9:00 AM appointments. So if he pushes them all through he makes $2500.00 an hour. (Damn, don't get me started)

From what I remember, any specialist in Ontario, Urologists etc, charge $100.00 per visit no matter what. GP only get to charge $15.00 or $20.00 I believe. So if there is any truth to his statement, he is trying to cover the $100.00. Used to be $100.00 for the year with this guy. He claims that most HRT docs will charge $400.00 to $1000.00 per year, (which I've seen) and still bill OHIP.

I realize the pharmacy can't renew scripts, but he does not seem to mind contacting the doc without me visiting again. Of course the doc now wants to charge $75.00 for prescription renewal. I wish my GP would take this over. Seems pretty simple for them to monitor as I am dialed in pretty good lately.

I mentioned above, with everyone help, and his prescriptions, and pushing him, I've managed to get him on board with real Test, Adex and HCG. If he can give me scripts for 6 months I have no problem paying him a couple hundred a year.

I know I have not been here for a bit, work got crazy busy and still is. Hard to get here just to read.
Thanks for responding Apollon.


KC

 

[Alpin]

You look like you workout...
hopefully you haven't mentioned anything regarding AAS to your doctor.
G.P's don't really have to treat it if they don't feel "comfortable". Thats why I said if you have a lifting background they wont be to keen on treating it.
and they can justify it to cause they are not endocrinologists or "specialists". Mind you many GP'S have a good idea of whats going on.

 

[KCinToronto]

You look like you workout...
hopefully you haven't mentioned anything regarding AAS to your doctor.
G.P's don't really have to treat it if they don't feel "comfortable". Thats why I said if you have a lifting background they wont be to keen on treating it.
and they can justify it to cause they are not endocrinologists or "specialists". Mind you many GP'S have a good idea of whats going on.

I've never brought it up with any doctors. Try to where baggy shirts when I see them too. LOL
Even my GP is a bit of an idiot. First physical with her. Height weight taken, standing with shirt off she goes, "we'll have to keep an eye on your weight as it is high for the BMI chart. Good Doctors in Canada seem scarce (Fuck my life). And the good ones are probably not accepting new patients. Government healthcare, never a great idea as it runs just like the Government. Slow and incompetent.

Thanks again Apollon,

 

[Maurice B]

I've never brought it up with any doctors. Try to where baggy shirts when I see them too. LOL
Even my GP is a bit of an idiot. First physical with her. Height weight taken, standing with shirt off she goes, "we'll have to keep an eye on your weight as it is high for the BMI chart. Good Doctors in Canada seem scarce (Fuck my life). And the good ones are probably not accepting new patients. Government healthcare, never a great idea as it runs just like the Government. Slow and incompetent.

Thanks again Apollon,

I feel for you.

I'm in Burlington and can't tell you the nightmare I've been through with our system.