Free Testosterone vs/Total-Disproportionate Totals!

[dragonfire101]

I noticed people posting Lab Results with Total testosterone levels over 2,000 up past 4,000 while their free Test are in high 200s to low mid 300s. This just seems very Disproportionate.

Does this mean- is that much gear really necessary if its not getting free test levels up?

I take 150mg Test week and my total Test is 800-900 and my free Test range from 240-300 on that dosage depending how consistent I am with doing at least 3 x week injects.

 

[ccohen]

Good question…

Most circulating testosterone is bound to (SHBG). A lesser fraction is albumin bound and a small proportion exists as free hormone. Historically, only the free testosterone was thought to be the biologically active component. However, testosterone is weakly bound to serum albumin and dissociates freely in the capillary bed, thereby becoming readily available for tissue uptake. All non-SHBG-bound testosterone is therefore considered bioavailable.

I think more importantly, you can get receptor saturation.
If you have 1000 cars that need to park and only 500 parking spots those other 500 cars are going to have to go somewhere(side effects or metabolites)

 

[alter]

(I take 150mg Test week and my total Test is 800-900)

free Test range from 240-300 on that dosage depending how consistent I am with doing at least 3 x week injects.

First part sounds correct same as mine 100mg/week total 830.8 based on labs just drawn.

The second part does not look correct at all are you taking anything to help supress shbg...? and thus free up test...?

Normal free-t in Males is: 9-30 ng/dL, mine was 20.9

Mayo clinic also list a bioavailble range: 72-235 ng/dL maybe this is what your looking at...

I understand what this last one means but im not too familiar with it.

 

[dragonfire101]

First part sounds correct same as mine 100mg/week total 830.8 based on labs just drawn.

The second part does not look correct at all are you taking anything to help supress shbg...? and thus free up test...?

Normal free-t in Males is: 9-30 ng/dL, mine was 20.9

Mayo clinic also list a bioavailble range: 72-235 ng/dL maybe this is what your looking at...

I understand what this last one means but im not too familiar with it.

Free Test and Bioavailable is 46-224 pg My doc feels free test levels are most important and likes see patients between 200-250.

I use Quest these are their ranges


Testosterone, LC/MS/MS


Free Test and Bioavailable 46-224 Yes that what ur body uses, just free alone is 35-155ng

 

[dragonfire101]

Measurement of total testosterone (TTST / Testosterone, Total, Serum) is often sufficient for diagnosis, particularly if it is combined with measurements of LH and follicle-stimulation hormone (FSH) (LH / Luteinizing Hormone [LH], Serum and FSH / Follicle-Stimulating Hormone [FSH], Serum). However, these tests may be insufficient for diagnosis of mild abnormalities of testosterone homeostasis, particularly if abnormalities in SHBG (SHBG / Sex Hormone Binding Globulin [SHBG], Serum) function or levels are present. Additional measurements of free testosterone or bioavailable testosterone are recommended in this situation; bioavailable testosterone (see TTBS / Testosterone, Total and Bioavailable, Serum) is the preferred assay.
Total Testosterone and General Interpretation of Testosterone Abnormalities:

Males:
Decreased testosterone levels indicate partial or complete hypogonadism. Serum testosterone levels are usually below the reference range. The cause is either primary or secondary/tertiary (pituitary/hypothalamic) testicular failure.

Primary testicular failure is associated with increased luteinizing hormone (LH) and follicle stimulating hormone (FSH) levels, and decreased total, bioavailable, and free testosterone levels. Causes include:
-Genetic causes (eg, Klinefelter syndrome, XX males)
-Developmental causes (eg, testicular maldescent)
-Testicular trauma or ischemia (eg, testicular torsion, surgical mishap during hernia operations)
-Infections (eg, mumps)
-Autoimmune diseases (eg, autoimmune polyglandular endocrine failure)
-Metabolic disorders (eg, hemochromatosis, liver failure)
-Orchidectomy

Secondary/tertiary hypogonadism, also known as hypogonadotrophic hypogonadism, shows low testosterone and low, or inappropriately "normal," LH/FSH levels; causes include:
-Inherited or developmental disorders of hypothalamus and pituitary (eg, Kallmann syndrome, congenital hypopituitarism)
-Pituitary or hypothalamic tumors
-Hyperprolactinemia of any cause
-Malnutrition or excessive exercise
-Cranial irradiation
-Head trauma
-Medical or recreational drugs (eg, estrogens, GNRH analogs, cannabis)

Increased testosterone levels:
-In prepubertal boys, increased levels of testosterone are seen in precocious puberty. Further workup is necessary to determine the cause(s) of precocious puberty
-In adult men, testicular or adrenal tumors or androgen abuse might be suspected if testosterone levels exceed the upper limit of the normal range by more than 50%.

Monitoring of testosterone replacement therapy:
Aim of treatment is normalization of serum testosterone and LH. During treatment with depot-testosterone preparations, trough levels of serum testosterone should still be within the normal range, while peak levels should not be significantly above the normal young adult range.
Bioavailable and Free Testosterone:
Usually, bioavailable and free testosterone levels parallel the total testosterone levels. However, a number of conditions and medications are known to increase or decrease the SHBG (SHBG / Sex Hormone Binding Globulin [SHBG], Serum) concentration, which may cause total testosterone concentration to change without necessarily influencing the bioavailable or free testosterone concentration, or vice versa:
-Treatment with corticosteroids and sex steroids (particularly oral conjugated estrogen) can result in changes in SHBG levels and availability of sex-steroid binding sites on SHBG. This may make diagnosis of subtle testosterone abnormalities difficult.
-Inherited abnormalities in SHBG binding.
-Liver disease and severe systemic illness.
-In pubertal boys and adult men, mild decreases of total testosterone without LH abnormalities can be associated with delayed puberty or mild hypogonadism. In this case, either bioavailable or free testosterone measurements are better indicators of mild hypogonadism than determination of total testosterone levels.
-In polycystic ovarian syndrome and related conditions, there is often significant insulin resistance, which is associated with low SHBG levels. Consequently, bioavailable or free testosterone levels may be more significantly elevated.

Either bioavailable (TTBS / Testosterone, Total and Bioavailable, Serum) or free (TGRP / Testosterone Total and Free, Serum) testosterone should be used as supplemental tests to total testosterone in the above situations. The correlation coefficient between bioavailable and free testosterone (by equilibrium dialysis) is 0.9606. However, bioavailable testosterone is usually the preferred test, as it more closely reflects total bioactive testosterone, particularly in older men. Older men not only have elevated SHBG levels, but albumin levels also may vary due to coexisting illnesses.

 

[Simpllyhuge]

Emeric would know the answer

 

[Stewie]

**broken link removed**

LETTER TO THE EDITOR: An Extraordinarily Inaccurate Assay for Free Testosterone Is Still with Us

Conversely, we are told, the DSL direct method is simple and rapid. The only difficulty is that “the equilibrium dialysis method gave values approximately 4 times higher than did the DSL kit."

And

Testosterone Test - Summary

Equilibrium dialysis
Equilibrium dialysis is a complex measure of free testosterone in which a blood sample is diluted and passed through a special semi-permeable membrane into a buffer solution. Only some of the testosterone in the sample can pass through the membrane- the rest remains in the blood sample. After filtering the sample through the semi-permeable membrane, the amount of testosterone in the buffer solution and the sample is measured and used to calculate the concentration of free testosterone This test is considered the gold standard for measuring free testosterone but is impractical for routine use.

Centrifugal ultrafiltration
Centrifugal ultrafiltration is also an accurate measure of free testosterone, however considered impractical for routine use. The method involves adding a substance called testosterone tracer (usually a coloured substance which binds to testosterone and can then be easily identified because of its colour) to blood samples, which are then incubated at 37oC and centrifuged (spun at a high speed) to separate the testosterone in the sample. The concentration of free testosterone can then be measured by examination of the filtrate (the separated portion of the sample).

Direct immunoassay test kits
Direct immunoassay test kits are the easiest and fastest available methods of assessing free testosterone. They are test kits in which reagents containing testosterone antibodies and tracer particles (either radioactive or non-radioactive) which bind to free testosterone in the sample. The tracer particles are easily identifiable and can be counted to measure the concentration of free testosterone in the sample. The results are less accurate than other methods though and lower results are typically obtained compared to equilibrium dialysis.

Calculated free testosterone
There are also a number of equations for calculating the concentration of free testosterone in a blood sample, without making an actual measurement of free testosterone. Other substances in the blood which interact with testosterone are measured instead. For example, measuring total testosterone and sex hormone binding globulin allows a measure of total testosterone called the Free Androgen Index to be calculated.