Normal Total T, Normal SHBG and Estradiol.. but low Free T??? why?

[Arcane]

Got my bloodwork back. Im not on TRT. for some reason everything looks fine besides my free T. any idea why that might be?

 

[madman]

Got my bloodwork back. Im not on TRT. for some reason everything looks fine besides my free T. any idea why that might be?View attachment 39248View attachment 39249

Was your blood work done in the early am in a fasted state?

Did you make sure to take a week off from training if you train with weights?

Were you well rested?

After all these years you spent here, you should very well know that the FT direct immunoassay is known to be inaccurate and should not be used/relied upon for testing free testosterone.

This has been beaten to death on here.

Hard to believe you would test your TT using the most accurate assays (LC/MS-MS) yet use a known to be inaccurate assay to test the most critical blood marker FT.

You need to have your FT tested using the most accurate assays (Equilibrium Dialysis or Ultrafiltration) to know where it truly sits.

The panel for TT/FT (LC/MS-MS/Equilibrium Dialysis) is dirt cheap through Nelson's discounted labs.

No excuse for anyone to waste their time testing FT with a known to be inaccurate assay.

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Even then if you do not have access to such (highly doubtful) if you live in the US then you would need to use/rely upon the cFTV method.

Keep in mind that as of now it tends to overestimate slightly when compared to the gold standard Equilibrium Dialysis.

The direct immunoassay used on your labs has your FT at 9.5 pg/mL (just above the bottom-end of the reference range (8.7-25.1 pg/mL).

I would put more faith in the cFTV than I would in the direct FT immunoassay.

If we take your descent TT 518 ng/dL, normal SHBG 34.3 nmol/L, and Albumin 4.3 g/dL (default) then your FT would be around 10.7 ng/dL which is far from low as the bottom end for the reference range would be around 5 ng/dL.

Even if you had it tested using the most accurate assay (gold standard Equilibrium Dialysis) it may very well come back the same or slightly lower but it would still not fall near 5 ng/dL.

Most healthy young males are only hitting a FT 13-14 ng/dL and this is at peak which is short-lived.

Although your FT is not stellar it is far from low and if you feel good overall then I would not fret!

 

[madman]

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[madman]

Search results for: 'free testosterone'

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As you can see the direct immunoassay for testing FT is nowhere to be found!

No one should be using/relying upon such an assay.

Those in the know would understand this.

Testosterone Assays

Testosterone Assays (2022) Brendan King, MD, Caleb Natale, MD, Wayne J.G. Hellstrom, MD The accurate detection and quantification of serum testosterone levels are necessary for the diagnosis of hypogonadism in men, evaluation of endocrine abnormalities, and monitoring and titration of...

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*IAs are highly inaccurate and, although widely available and inexpensive, are not recommended

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[Deleted member 42882]

Someday we're going to find out that madman's occupation is lobbyist for the lab trade, and we'll all have that "Aha" moment.