Revising guidelines for testosterone testing could more accurately diagnose deficiencyShow Citation Antonio L, frre al. J Clin Endocrinol Metab. Androgen deficiency-related symptoms were found among men with low calculated free testosterone, even if they had normal total testosterone. Researchers suggest that calculated free testosterone levels be assessed in men with suspected hypogonadal symptoms. Dirk VanderschuerenMD, PhD, clinical endocrinologist and head of clinic at the department of endocrinology at University Hospitals Leuven in Belgium, and colleagues evaluated data from the European Male Aging Study on 3, men aged free testosterone low total normal to 79 years to determine whether low calculated free testosterone or low total testosterone is associated more with androgen-related clinical endpoints.
Normal Free Testosterone Levels — The Most Important Measure of Your Testosterone
Although they vary greatly between men and women, normal free testosterone levels are important starting points for anyone considering testosterone replacement therapy. For both men and women, free testosterone is one of the most important measures of hormonal health. You might not technically have low free testosterone, but you might still have testosterone levels that are too low for your body.
We do this for both men and women — and this is especially important for women, where the amounts involved are much smaller making precision that much more important. Here are the normal free testosterone levels for both men and women. We often see mostly female patients who are diagnosed with excessive testosterone, when in reality, they have too little testosterone.
Their free testosterone levels have not been measured correctly, and the role of sex hormone binding globulin SHBG has not been assessed properly. SHBG has a perfectly descriptive name — it binds to your sex hormones, and, along with albumin, renders them effectively inert.
And if you have too much SHBG in your body, even if your total testosterone is normal or even high! To learn more about how to get your testosterone levels tested, click here. Augie Juan Augustine Galindo Jr. He became interested in testosterone treatment after seeing how hormone replacement doctors helped those suffering from low testosterone.
I have an interesting situation. She said I have low t. Prescribed of course for an injury. Exercising with weights again now too. I am dubious regarding your free testosterone report. My first inclination is to assume that your provider ordered an analog test clinically useless and inaccurate instead of a calculated free T. Cessation of opioids, regular workouts and other lifestyle changes can definitely set the stage for improved testosterone production. Testosterone can certainly induce weight gain, but this would be by an increase in lean mass.
I have seen no evidence, in the literature or in clinical practice, that would suggest that TRT would make someone gain fat. This is invariably due to other factors that include dietary habits and caloric expenditures. Improving a low free testosterone level will help in improving body composition when coupled with exercise and a healthy diet. This does not necessarily mean that one would lose weight, but it would not lead to an increase in body fat.
Thank you for responding to My question and I strongly agree and my question is what would you suggest he take that is not shots or pellets he refuses to do that is natural that we could find maybe at a health food store or online any input would be greatly appreciated I do have him on the DHEA and we have discussed several items from GNC like Nugenix and several items that is on Amazon not sure what to do.
I have been on trt for a number of years. I can tell you that it most certainly can make you gain weight rapidly. When I begin trt I will easily put on lbs in a week of water weight. The only solution for me is to take a diaretic. A small bit of cardio will help as well. This is not a common response.
I would assume mismanaged estradiol levels may be playing a part in that. I am not sure why you would want to, but if you sleep poorly and infrequently, consume a lot of alcohol and trans fats, never work out or have sex, and focus on coping with stress in unhealthy ways, you would be sure to see a reduction in your free testosterone levels. I am a female over 50 and get testosterone pellet therapy. My recent blood levels show my total testosterone is a little high but my free testosterone is negligible.
Normally when my free is negligible, my gynecologist puts in another pellet, however this time he is wanting to wait a few wks because my total testosterone is higher than normal range.
Why would this happen and is it bad to have the pellet placed especially if my free testosterone level is severely low. That being said, managing your care by your total T levels vs. It is typical for females to need a much higher than normal total testosterone level to achieve a desirable free testosterone level. My sex hormone binding globulin is My free testo calc Can you please tell me your opinion.
The units of measure here are different from what I typically see, but I can tell you that with SHBG dysfunction, it is even more important make decisions and recommendations based off of your free testosterone levels. I have high shgb and low free testosterone, but normal testosterone levels. How can I increase my free T? There are a few OTC supplements that claim to do exactly that, but I have never seen demonstrable improvement in patients who tried those before coming to see me.
Often, replacement is necessary. You may, however, want to look into your thyroid function. Congratulations on your progress. It is often assumed, for overweight individuals, that isolated weight loss will fix all that ails you. Unfortunately, this is not always the case. Definitely proceed with checking your calculated free testosterone level.
I have a very low sex drive and suffer from ED symptoms. I have gotten my blood work done and they are as follows:. Keep in mind that I have not studied your medical history or performed and exam, but based on the limited information I have I would say that your levels are not normal. Furthermore, your symptoms are almost certainly influenced by testosterone deficiency. Based on this information alone, and without the benefit of a full medical history, physical exam, and confirmatory labs, I would say that you are correct.
If this is a well established, properly diagnosed, and worsening process, then TRT may in fact be your best option. There are many things to be considered, however, so make sure that you find an experienced provider for a second opinion. Hello, I am 55 yo female with successfully treated hashimotos tsh normal with good t4 and t3 and treated mild bipolar II and depression. I must keep my tsh at a very sold range to alleviate depression.
I am post menopausal. My hormones are dhea , progesterone. I am not overweight but I try to be very fit and am petite. I have seen very positive benefits from TRT with patients who have diagnoses similar to yours. Additionally, I have not seen any adverse effects specific to bipolar disorder with the addition of TRT. I am a female aged 32, feel like I have low testosterone but confused by the blood test results. My total testosterone is Does this look like low testosterone?
The mismatch appears to be due to utilization of a bad test. Per The Endocrine Society, a direct or analog free testosterone assay is clinically useless. Make sure they look at your calculated free T, with your total only being 13, you almost undoubtedly have a low free testosterone.
I am 59 and have been on androgel for about 10 years. My test came back showing my free Testosterone at Your range is different. The most important thing to evaluate is whether they are even using the same test. I agree with The Endocrine Society in saying that this test is clinically useless. Now, each individual reference lab is at liberty to create their own reference range. It changes from lab to lab, and even analyzer to analyzer.
The range we use, however, is the most widely accepted and matches up with the calculated free testosterone range that Blue Cross Blue Shield uses. My libido and performance have fallen greatly in the past year and a half.
I would suggest first having your calculated free testosterone looked at. The free testosterone direct assay is terribly flawed and clinically useless. You will have a much better understanding of your levels once you have the right metrics. A 24hr x 4 sample cortisol saliva test indicated very low free cortisol — my GP ignored this in favour of the serum value.
Based on your labs, your calculated free testosterone cFT is likely skirting the bottom end of normal. Your Aug numbers would have your cFT at under This could certainly be contributing to symptoms and you definitively exhibit sex hormone binding globulin dysfunction AND you are hypergonadotrophic. Your estradiol very well may be elevated, and yes, this could increase your SHBG level, and that could create a testosterone deficiency, and yes that COULD be linked to antidepressants.
Only careful monitoring and comparison to baseline labs could correlate that, though. I have a blog about my journey on TRT where I write articles I think are relevant for others to read.
Maybe you can help me, or point me in the right direction to find the answers. Why is so much of our testosterone bound? Why do we need so little free testosterone in our blood compared to total testosterone? This will be more than I can cover here, but the free hormone theory is not specific to testosterone. Albumin is the most ubiquitous blood protein, and binds to a myriad of substances.
Think of this as a buffering and reserve system. Bound testosterone is inactive, only free molecules can bind to androgen receptors and affect change.
There is a constant production, binding, cleaving, conversion, and metabolism chain going on within the body.