Calculate Free Testosterone with TruT by FPT

[tareload]

Labcorp Direct FT

No, see above. The converted /adjusted FT direct is lower than dialysis tests.

But still much closer to ED results than the "piss poor" TruT calculator.

10% off cFTv will typically get you quite close to dialysis.

Note my SHBG has been cut roughly in half since starting TRT 5 years ago (from 60 to 30). Too much T LOL.

 

[sammmy]

My point was that cFTV and FT direct are pretty close before any adjustments so maybe they should use the same adjustment factor of 0.9, not the factor 0.7 for FT direct.

 

[tareload]

My point was that cFTV and FT direct are pretty close before any adjustments so maybe they should use the same adjustment factor of 0.9, not the factor 0.7 for FT direct.

No see this thread for where the 0.7 factor comes from for direct FT conversion from pg/ml to ng/dl...

Public Service Announcement: "Piss Poor" Direct RIA fT measurement (HELP is on the way)

Hey Folks, thought I would update the graph for free T reference ranges based on LC-MS/MS+ED and compare with Labcorp's direct RIA fT reference range. What the hell do you do with with your direct fT measurement if you want to compare with equibrium dialysis reference ranges? Take the Labcorp...

www.excelmale.com

The 0.9 is just simple factor I've noticed does a decent job lining up cFTv with dialysis. Typically cFTv within 20% of dialysis result hence mean of 0.8 and 1 is 0.9.

Sorry to be disagreeable but given the time I have put into this I want to make sure guys understand all the moving parts properly on this FT fiasco.

If this info gets through to 1 in 1M then I guess that is good enough. I don't think I quite achieved even that penetration at TNation. Same nutty stuff still being repeated over there now after I posted correct info countless times. Glad I left there.

Next we should make a top 10 list for the biggest lies in TRT world.


10. The units of Labcorp Direct fT test are listed wrong. They aren't pg/ml but ng/dl. False.
9. To be continued...

 

[madman]

Might as well throw this in here too for the time being so everyone can gloat!

Measurement of FT in Serum using ED Coupled with ID-UHPLC-MS/MS: in Comparison to cFTV

Reproductive Endocrinology ODP419 Measurement of Free Testosterone in Serum using Equilibrium Dialysis Coupled with ID-UHPLC-MS/ MS: in Comparison to Calculated FT Hui Zhou, Ph.D., Ashley Ribera, BS, Uliana Danilenko, Ph.D., Otoe Sugahara, BS, and Hubert Vesper, PhD Assessment of free...

www.excelmale.com

A majority of the calculated values overestimated FT concentration compared to measured values (ED UHPLC-MS/MS).

The mean bias was 34.5% and a higher bias (upwards of 60%) was seen in the samples with low FT concentrations.

Two of the cFT values had a negative bias.

Yet even after the data shown in Fiers 2018 study let and the most recent 2021 comparison posted above (CDC standardized high throughput ED device vs cFTV) the cFTZ camp is still dead set on proving that the liner law-of-mass action model/empiric equations are wrong.

Post #132/133 of this thread.

2023 and still pursuing it! (Science – XYone Therapeutics)

Just to be clear Bhasin's ED device (Harvard Apparatus DispoEquillibrium Dialyzers) is not the same as the CDCs reference ED device (Harvard Apparatus Micro-Equillibrium Dialyzer System, 1 mL cells) or the newer standardized CDC high throughput ED device (MD1000 dialyzer with customized in-house 3-D printed base plate) let alone any of the ED devices used across the different laboratories.

A critical point to be made here is everyone needs to keep in mind that some ED devices show a large bias compared to the CDCs reference device

This is why we need CDC harmonized/standardization of free testosterone.

We already know where Bhasin stands on the linear law-of-mass action/empiric equations.

Still going to be a few years before this s**t show comes to an end.

Better yet if this is still eating anyone up then grow some balls and contact Dr. Bhasin or Dr. Jasuja!

You may be able to pry something out of them LOL!

 

[madman]

Fair warning to any of those two-faced backstabbing snakes lurking on here.

I don't play that shit!

You know who you are.

 

[tareload]

Fair warning to any of those two-faced backstabbing snakes lurking on here.

I don't play that shit!

You know who you are.

Come on, I can't get a like from you on the above two posts - 136 and 137? I'm hurt. LoL.

You are correct I should grow some modestly sized ones and directly contact the PIs as you suggest. For the time being posts 136 and 137 describe the testing situation commercially available to the fellows / zellows.

 

[tareload]

 

[tareload]

For grins, take the Tru-T number of 38.9 ng/dL and do a linear mapping from its healthy normal range of 16-31 ng/dL to the cFTV range I use as healthy and normal, 10-20 ng/dL. I get 25.3 ng/dL, which when multiplied by the 0.9 correction factor yields 22.7 ng/dL, coincidentally a direct hit on the Labcorp FT. I think Tru-T is usable if you compare it to its own reference range and SHBG is not very high or low. Tru-T seems to perform worse than cfTV at more extreme SHBG, and of course the absolute numbers are out there.

Heroic mapping attempt. I see the average dude is completely SOL on free T ref range fiasco.

But it was nice for me to see that Quest and Labcorp are close regardless of their reported ref ranges.

 

[tareload]

A majority of the calculated values overestimated FT concentration compared to measured values (ED UHPLC-MS/MS).

The mean bias was 34.5% and a higher bias (upwards of 60%) was seen in the samples with low FT concentrations.

Two of the cFT values had a negative bias.

Yet even after the data shown in Fiers 2018 study let and the most recent 2021 comparison posted above (CDC standardized high throughput ED device vs cFTV) the cFTZ camp is still dead set on proving that the liner law-of-mass action model/empiric equations are wrong.

Excellent plots and summary. Thank you.

Any further analysis of FT calculations must explore the point you raise:

@madman says: Just to be clear Bhasin's ED device (Harvard Apparatus DispoEquillibrium Dialyzers) is not the same as the CDCs reference ED device (Harvard Apparatus Micro-Equillibrium Dialyzer System, 1 mL cells) or the newer standardized CDC high throughput ED device (MD1000 dialyzer with customized in-house 3-D printed base plate) let alone any of the ED devices used across the different laboratories.

A critical point to be made here is everyone needs to keep in mind that some ED devices show a large bias compared to the CDCs reference device
This is why we need CDC harmonized/standardization of free testosterone.

Fine to explore theoretical considerations and binding constants for constituitive models but as soon as you start comparing with practical FT measurements you've got to come clean and disclose we still don't know how to measure FT reproducibly and accurately using LCMS combined with ED.

 

[madman]

Phase IIB: Development of TruT Algorithm for Commercialization in Androgen Disorders (2022)

RePORT 〉 RePORTER

reporter.nih.gov

View attachment 26982


TruTTM (v2.0) algorithm

ABSTRACT

Background: Measurement of free testosterone (T) concentrations is indicated in the diagnosis of androgen disorders, including hypogonadism in men; hirsutism, polycystic ovary syndrome (PCOS), and androgenic alopecia in women; pubertal disorders in boys and management of gender-affirming hormone therapies for transgender and gender diverse (TGD) persons. This Phase IIB proposal aims to continue the development of the TruTTM algorithm by validating it in common conditions characterized by altered estradiol (E2), T, and SHBG concentrations and incorporating the interaction of E2 with T for wider commercial adoption in women in whom E2 levels vary greatly across the menstrual cycle and in TGD population.

Approach: This application follows the FDA’s published “Guidance for Industry: Bioanalytical Method Validation”.

The essential parameters to determine the acceptability of a bioanalytical method include its technical performance (accuracy, precision, sensitivity, selectivity, stability, and matrix effects).

Reference ranges should be determined in appropriate human samples.

The analytical method should be validated for the intended use (e.g., determination in conditions of intended use, such as persons with altered E2 and T levels, women with PCOS, TGD persons, etc.).

In studies through the Phase II, we demonstrated that the method has superior performance characteristics and extended the validation of TruTTM algorithm in conditions characterized by altered SHBG concentrations.

*In the proposed Phase IIB studies, we will generate the v2.0 of TruTTM algorithm by incorporating the dynamics of the E2 induced perturbation in free T levels, validate it in men, women, and TGD populations (Aim 1) and deploy HIPAA-compliant, secure integration of the algorithm into electronic medical records (EMR) workflow

*(Aim 2). Future Directions and Commercialization potential: The phase IIB program will enable the pilot commercial deployment of a HIPAA-compliant (FDA registered) platform for commercializing the TruTTM (v2.0) algorithm embedded into electronic medical record (EMR) for wider clinical adoption.

These studies will improve clinical care and advance our fundamental understanding of dynamic regulation of T bioavailability in diverse populations including unrepresented sexual and gender minorities.








Phase IIB: Development of TruT Algorithm for Commercialization in Androgen Disorders (2022)


Project Start Date: 15 September 2014

Project End Date: 31-August-2024
View attachment 26983
View attachment 26984


Phase II: Research and Commercialization of TruT Algorithm for Free Testosterone (2018)

RePORT 〉 RePORTER

reporter.nih.gov

Phase II: Research and Commercialization of TruT Algorithm for Free Testosterone (2017)

RePORT 〉 RePORTER

reporter.nih.gov

Novel Algorithm for Free Testosterone Determination (2014)

RePORT 〉 RePORTER

reporter.nih.gov

A multi-step, dynamic allosteric model of testosterone's binding to sex hormone binding globulin

Circulating free testosterone (FT) levels have been used widely in the diagnosis and treatment of hypogonadism in men. Due to experimental complexitie…

www.sciencedirect.com

A Reappraisal of Testosterone’s Binding in Circulation: Physiological and Clinical Implications

This appraisal of the dynamics of testosterone binding to proteins and of the free hormone hypothesis offers guidance for the application of free testoster

academic.oup.com

Allosterically coupled multi-site binding of T to human serum albumin

Allosterically coupled multi-site binding of testosterone to human serum albumin Abhilash Jayaraj, Heidi A. Schwanz, Daniel J. Spencer, Shalender Bhasin, James A. Hamilton, B. Jayaram, Anna L. Goldman, Meenakshi Krishna, Maya Krishnan, Aashay Shah, Zhendong Jin, Eileen Krenzel, Sashi N. Nair...

www.excelmale.com

The Dynamics of Allosteric Binding of Estradiol to SHBG

Estradiol induces Allosteric Coupling and Partitioning of Sex Hormone Binding Globulin Monomers Among Conformational States Ravi Jasuja, Daniel Spencer, Abhilash Jayaraj, Liming Peng, Meenakshi Krishna, Brian Lawney, Priyank Patel, B. Jayaram, Kelly M. Thayer, David L. Beveridge, Shalender...

www.excelmale.com

Phase IIB: Development of TruT Algorithm for Commercialization in Androgen Disorders (2023)

RePORT 〉 RePORTER

reporter.nih.gov

Project Start Date: 15 September 2014

Project End Date: 31-August-2024

 

[aloetard]

Fair warning to any of those two-faced backstabbing snakes lurking on here.

I don't play that shit!

You know who you are

Who was this anyway? The mysteries of life.

Props. This is definitely the best thread on this subject on the internet, no?