total test= 26 nanograms per deciliter (normal 2 to 45)
free test= 1.0 picograms per ml (normal 0.1 to 6.4)
SHBG = 137 nanomoles (normal up to 107)
this is what they are prescribing; oral testosterone at 1mg twice a day for 2 weeks and increase by 1mg every 2 weeks to a maximum of 5mgs a day.
what you think ????????????????
What else did she have done? LH/FSH, TSH, oestradiol, progesterone?? BUN, Liver function, CBC?
It is not good practice to take one test in isolation. Interpreting lab results just doesn't work like that.
Are they prescribing this on just one test?
Has she had any previous blood work with similar results?
In all honesty, from the experience I have had with helping people out with their labs and what we do with patients in the UK, I think that there is a tendency to rush into giving people drugs, treatments, or loads of inappropriate further testing in the US.
Giving women testosterone gel is not liscenced in the UK, I just checked the British National formulary.
This is quite new territory in hormone replacement for women, I would go on the side of caution and either go with a lower dose, or an alternative therapy.
I have also been on call all night, but there is something that I want to check on about SHBG, as I said, we rarely measure it as my consultant thinks it is useless.
I just can't remember right now.
I do know that testosterone (and probably SHBG) are not that accurate to measure at the lower levels, so I am surprised they are going to do this on the basis of one test.