What does it mean when total testosterone is high but free T is low?

[TencentQQmaps]

Total: ng/dl 124
Free: pg/ml 0.4
?
Averages in pg/ml:
Females   
0.6 - 6.8
Males   
47.0-244.0

[Dena]

This is pretty complex to understand but free T isn't exactly a useful number because there is other T that's effective as well. Free T is a low number and the fact that you have so little total T may be the reason your free T is lower than normal. I am going to give you a link that explains it but don't worry if you don't understand it.
http://www.mayomedicallaboratories.com/test-catalog/Clinical+and+Interpretive/83686

[Maybebaby56]

That is normal.  Sex hormone binding globulin binds about 98-99% of total circulating sex hormone in the blood. Only the unbound fraction is biologically active.  The total serum level is indicative of how much is being produced by the gonads.

If you want an in-depth explanation, you should PM KayXo (once you have 15 posts).  She is really on top of that stuff.

With kindness,

Terri

[TencentQQmaps]

I just saw on the internet that free testosterone is much more accurate to use in testing that total.  It said that many people who have regular total testosterone levels still have symptoms of low testosterone because of low free testosterone.  All I know is that free t is in the bloodstream.  I don't know much more about free and total other than that.
Don't forget that I am still just starting puberty so I could have low anything.  Its just that I have high estrogen compared to testosterone so yeah...

[Dena]

Most of the time you just worry about the total number as the body will convert between the two as needed. The same is true of Estrone and Estradiol in that Estrone is storage for Estradiol and if more Estradiol is needed the body will convert some Estrone. The body does many of these conversions and they are quite complex. This link will show you just how complex this is and the reason we really only  worry about total testosterone and estradiol. If there is a problem with the body, an Endo will look into the conversions in more detail.

[HughE]

Total: ng/dl 124
Free: pg/ml 0.4
?
Averages in pg/ml:
Females   
0.6 - 6.8
Males   
47.0-244.0

Your total T is about double what it'd ideally be in someone on MTF trans HRT, but off the charts low for a man. You haven't given your SHBG (sex hormone binding globulin) level, but my guess is that it's quite high, and SHBG is binding up almost all the (already relatively low) amount of testosterone present, and that's why your free T is so low.

Free T, not total T, is actually the important thing as far as the biological effects of testosterone are concerned, however free T is very difficult to measure accurately. Total T tends to be the one that's looked at simply because it's a lot easier to measure, so more laboratories are capable of doing the measurement.