Page 2 - Free Testosterone Test

Embarking on the path of Testosterone Replacement Therapy (TRT) often evokes a blend of enthusiasm and concern among men. The allure of renewed vigor, heightened sexual desire, and robust muscle growth is enticing. However, there are a lot of less well-known aspects that your healthcare provider might not immediately disclose. For instance, were you aware that TRT could affect your fertility or exacerbate your sleep apnea? While TRT heralds a new dawn for many, it doesn’t offer a universal remedy. In light of this, we have meticulously curated a comprehensive list of 18 pivotal aspects that might elude your doctor's attention but are indispensable for you to grasp. Venture further to unearth the profundities of TRT. Low Blood Levels of Testosterone and Associated Risks: < 450 ng/dl (15.3 nmol/l) - Risk of metabolic syndrome Reference: Dhindsa, S., Miller, M. G., McWhirter, C. L., Mager, D. E., Ghanim, H., Chaudhuri, A., & Dandona, P. (2010). Testosterone concentrations in diabetic and nondiabetic obese men. Diabetes Care, 33(6), 1186-1192. PubMed < 400 ng/dl (15.3 nmol/l) - Venous leakage (internal penile damage) risk Reference: Yassin, A. A., & Saad, F. (2017). Testosterone Deficiency and Testosterone Treatment in Older Men. Gerontology, 63(2), 144–156. PubMed < 350 ng/dl (11.9 nmol/l) – All-cause death risk and anemia risk Reference: Khaw, K. T., Dowsett, M., Folkerd, E., Bingham, S., Wareham, N., Luben, R., ... & Day, N. (2007). Endogenous testosterone and mortality due to all causes, cardiovascular disease, and cancer in men. Circulation, 116(23), 2694-2701. PubMed < 300 ng/dL (10.2 nmol/L) - Lowered libido, weight gain & Diabetes risk increased Reference: Traish, A. M., Saad, F., & Guay, A. (2009). The dark side of testosterone deficiency: I. Metabolic syndrome and erectile dysfunction Journal of Andrology, 30(1), 10-22. PubMed < 300 ng/dL (10.2 nmol/L): Quartile risk of fractures (osteoporosis), memory-related issues and depression risk increases Reference: Orwoll, E., Lambert, L. C., Marshall, L. M., Phipps, K., Blank, J., Barrett-Connor, E.,... & Cummings, S. (2006). Testosterone and estradiol are common among older men. The Journal of Clinical Endocrinology & Metabolism, 91(4), 1336-1344. PubMed < 250 ng/dl (8.5 nmol/l): Arterial plaque (arteriosclerosis) & sleep quality affected Reference: Vlachopoulos, C., Ioakeimidis, N., Miner, M., & Aggelis, A. (2014). Testosterone deficiency: a determinant of aortic stiffness in men Atherosclerosis, 233(1), 278-283. PubMed < 235 ng/dl (8.0 nmol/l) hardening of arteries (dialysis patients) Reference: Carrero, J. J., Qureshi, A. R., Parini, P., Arver, S., Lindholm, B., Bárány, P., ... & Stenvinkel, P. (2009). Low serum testosterone increases mortality risk among male dialysis patients. Journal of the American Society of Nephrology, 20(3), 613-620. PubMed < 200 ng/dl (6.8 nmol/l) morning erections decrease Reference: O'Connor, D. B., Lee, D. M., Corona, G., Forti, G., Tajar, A., O'Neill, T. W., ... & EMAS Study Group. (2011). The relationships between sex hormones and sexual function in middle-aged and older European men. The Journal of Clinical Endocrinology & Metabolism, 96(10), E1577-E1587. PubMed < 150 ng/dl (5.1 nmol/l) - Increased inflammation (TNF-alpha) Reference: Malkin, C. J., Pugh, P. J., Jones, R. D., Kapoor, D., Channer, K. S., & Jones, T. H. (2004). The effect of testosterone replacement on endogenous inflammatory cytokines and lipid profiles in hypogonadal men. The Journal of Clinical Endocrinology & Metabolism, 89(7), 3313-3318. PubMed The Unspoken Implications of TRT Your doctor might overlook mentioning certain ramifications when you commence Testosterone Replacement Therapy (TRT): Fertility and TRT Sperm Count Drop: TRT lowers the levels of Luteinizing Hormone (LH) and Follicle Stimulating Hormone (FSH), two hormones that help make sperm. If preserving fertility is a priority, discuss with your healthcare provider incorporating Clomiphene or hCG into your TRT regimen. Hematological Effects Blood Viscosity Increase: TRT can escalate your blood's hematocrit level, thereby increasing its viscosity. Although some practitioners may advise halting TRT, this side effect can be managed adeptly through blood donations or therapeutic phlebotomy. Beware; frequent blood donations might deplete iron levels and induce fatigue. Impact on Natural Testosterone Production Suppression of Endogenous Testosterone: TRT suppresses your body’s natural testosterone synthesis, which may rebound anywhere between a few weeks and six months post-cessation. The Multifaceted Benefits and Varied Efficacy of TRT Muscle Mass, Fat Reduction, and Sexual Health Sex Drive and Physique Enhancement: TRT predominantly augments libido, muscle mass, and fat metabolism in men. However, its effectiveness varies, and meticulous dosage and frequency adjustments along with side effect management are imperative. It’s not a panacea. Administration Techniques Methods of Injection: Contrary to what most people think, testosterone can be injected superficially (IM) or deeply (subcutaneously) into the muscle using a 1/2-inch, 27-29-gauge insulin syringe. Topical Testosterone Efficacy of Gels and Creams: Testosterone gels and creams are efficacious but often under-dosed by physicians. More concentrated compounded products or dosage adjustments based on blood levels can rectify this. Dosage Frequency Optimized Injection Schedules: Shifting from biweekly 200mg injections to weekly 100mg or twice-weekly 50mg dosages can often yield better results. Addressing Concerns and Optimizing TRT Outcomes Sleep Apnea and TRT Sleep Apnea Dynamics: TRT could exacerbate central sleep apnea but might alleviate obstructive sleep apnea over time as weight loss occurs. Erectile Function Erectile Function and Libido: TRT enhances erectile function and libido in a majority of men. Some may benefit from adjunctive low-dose daily Cialis, which also harbors cardiovascular advantages. Self-Monitoring and Telemedicine Monitoring Blood Tests: Companies like DiscountedLabs.com enable self-monitoring of blood tests without a doctor visit. Moreover, telemedicine facilitates access to testosterone doctors nationwide, albeit mostly without insurance coverage. Debunking Misconceptions and Enhancing TRT Knowledge Prostate Health and Cardiovascular Effects Prostate Cancer and Heart Attacks: Contemporary evidence refutes the notion that TRT triggers prostate cancer or heart attacks, though vigilant monitoring is crucial for optimal cardiovascular outcomes. Community Support and Knowledge Sharing Leveraging Online Communities: Engage with seasoned TRT users on platforms like the ExcelMale forum or Testosterone Replacement Discussion Facebook group to broaden your understanding. Comprehensive Testing Holistic Blood Analysis: Ensure your doctor conducts a thorough blood analysis encompassing total and free testosterone, DHT, thyroid function, and prolactin (especially for those with extremely low T levels) to rule out pituitary adenomas. Insurance, Professional Expertise, and Addressing Common Hurdles Insurance and TRT Insurance Coverage: Insurance coverage for TRT products is often restrictive, but utilizing a compounding pharmacy can be a viable alternative. Expertise in TRT Management Urologists Leading the Charge: The burgeoning expertise of urologists in TRT management is notable, with extensive TRT-centric discussions now a staple at urology conferences. Identifying and Addressing Co-morbidities Co-morbid Conditions: Men with co-existing health issues may encounter challenges in reaping TRT benefits, warranting a thorough cardiovascular assessment for those experiencing water retention and hypertension. Estradiol Management Misconceptions About Estradiol: People often get the wrong idea about this hormone, which plays a big part in libido, bone health, and brain function, because it is not given enough attention when it comes to management. Emerging evidence suggests aromatase inhibition might be unnecessary in TRT management. Armed with this extensive knowledge, you’re now better positioned to make informed decisions on your TRT journey. Remember, individualized consultation with healthcare professionals is indispensable for optimizing your TRT experience.    

Free Testosterone (FT) is the active form of testosterone (T) that can enter the cell. The main binding of Testosterone is to SHBG and albumin. There are different ways to determine FT. Some use free androgen index method, which is done by a calculation formula. Recently the LC/MS-MS (liquid chromatography / mass spectroscopy) has become the most widely and easy-to-use method. Free T is usually 2 percent or greater of total T.  Values under 2 percent are associated with higher SHBG or albumin. As shown in the figure above, about 2 percent of the testosterone in the body is active. This “free testosterone” is not attached to binding proteins that would prevent it from interacting with its receptor.About 40 percent of the body's testosterone is attached to albumin. This is a protein that can release the hormone as the need for it arises in the body. Free testosterone and testosterone attached to albumin are referred to as “bioavailable testosterone.”In a healthy young male, about 60 percent of his testosterone is attached to sex hormone-binding globulin (SHBG). Hormones bound to SHBG can't be used by the body and lose their anabolic effect. As males grow older or if an illness is present, SHBG sweeps up more and more testosterone, lowering free testosterone and its benefits.Total testosterone is the sum of bioavailable testosterone and testosterone bound to SHBG. Measuring the total testosterone in the blood may not provide the whole picture and let you know how much “active” or usable testosterone you have. Types of Testosterone Blood Tests- How to Choose the Best One?   A new study indicates that measuring free testosterone and total testosterone may provide a more accurate picture than measuring total testosterone levels alone when diagnosing a deficiency of this male hormone. There is concern that, under current clinical guidelines, some men are misdiagnosed with testosterone deficiency and receive inappropriate therapy. In contrast, others who should get treatment don't receive it, D.r Leen Antonio (University of Leuven, Belgium) explained when presenting her research here at the European Congress of Endocrinology (ECE) 2015. "I think it would be preferable to use free testosterone rather than total testosterone to measure deficiency, especially in men with borderline total testosterone levels. Our results suggest that free testosterone is more informative than total testosterone," she told attendees. Currently, total-testosterone levels are used to measure testosterone deficiency or hypogonadism. However, she explained that only free testosterone, unbound by sex-hormone–binding globulin (SHBG), can enter and activate androgen receptors in cells, resulting in testosterone-mediated effects. Source  

Table of Contents Today's Young Men Have Almost 30 Percent Less Testosterone Sleep Disruption: Stress and Fatigue Can Reduce Testosterone Levels Carrying Too Much Weight Can Reduce Testosterone Levels Poor Diet and Consumption of Marijuana Might Be a Problem Lack of Physical Exercise Leads to a Decrease in Testosterone Levels Check Your Testosterone Levels Often References: There is no need to emphasize the considerable importance of testosterone in the human body, especially for men. This hormone helps build muscle, maintains healthy bones, improves cognition, and enhances sleep quality, not to mention its essential role in fertility. However, recent studies show an alarming drop in testosterone levels, particularly for young men. In other words, today's teenagers have less testosterone circulating through their bloodstream than the youngsters of 15-20 years ago. If you're curious to learn the causes of this drop in testosterone levels, keep reading this article. You'll find insightful answers to questions you already have about testosterone and know what lifestyle changes you can make to increase the production of this vital hormone. Today's Young Men Have Almost 30 Percent Less Testosterone It might be hard to believe, but recent studies show that men between 15 and 39 have almost thirty percent less testosterone compared to men within the same age group of 15-20 years ago. More specifically, if the average testosterone level was around 600 nanograms per deciliter of blood almost two decades ago, now it's about 400 nanograms per deciliter for men aged 15-39. That's a significant decrease caused by multiple lifestyle and environmental factors. Let's look at some of these causes and see why today's young adults experience this significant drop in testosterone levels. Sleep Disruption: Stress and Fatigue Can Reduce Testosterone Levels One of the most important causes of testosterone decrease is excessive stress. Today's young adults are very busy, and they're constantly bombarded with information and stimulation from social media and other platforms. They are sleeping less and exposing themselves to light from electronics late at night. This light can disrupt sleep patterns.  Several studies have shown that most hormones, including testosterone, peak during the sleep cycle.  A disrupted sleep cycle and circadian rhythm negatively affects testosterone, growth hormone, thyroid, and other hormones. This makes the adrenal glands release more cortisol which is the main stress hormone in the body. Too much cortisol coupled with fewer hours of sleep per night results in testosterone levels that can plummet faster than ever. Ideally, adults should sleep around 7 hours per night and engage in activities that decrease cortisol levels in the bloodstream. One of the best ways to reduce your stress levels is to go to the gym, walk or run, practice yoga, or play a musical instrument, not to mention spend more time with people you love. Carrying Too Much Weight Can Reduce Testosterone Levels Obesity and being overweight is another important factor that can explain the testosterone decrease in young men. Several studies show that higher body mass index (BMI) can result in lower testosterone levels.  There is an obesity epidemic in the US and most countries not only in adults but also teenagers and children. At the same time, being overweight increases your chances for chronic diseases, reduces your stamina and energy levels, as well as makes the body produce more toxic hormones. Do your best to exercise at least three times a week and your testosterone levels will eventually get back to normal. Poor Diet and Consumption of Marijuana Might Be a Problem Eating a diet that lacks nutritional value is hands-down one of the key factors when it comes to testosterone production. In other words, if you eat a lot of junk food, drink many fizzy beverages, and don't take a multivitamin supplement, your testosterone levels might significantly decrease each year. You should provide your body with vitamins, minerals, and other nutrients to help it function optimally. Try to eat more vegetables, fruit, and lean meats such as chicken and turkey, as well as healthy fats coming from seeds and olive oil. The Mediterranean Diet is one of the best ways to increase testosterone levels and longevity. At the same time, an increasing body of evidence suggests that excessive marijuana consumption is associated with a decrease in testosterone levels. The occasional joint might not do too much harm but smoking every day can have an impact on your hormones, particularly your testosterone. Lack of Physical Exercise Leads to a Decrease in Testosterone Levels As mentioned earlier, doing just three or four workouts per week for a minimum of thirty minutes can prevent a decrease in testosterone levels. Today's young adults spend a lot of time in front of their computers doing their work or getting entertained. This sedentary lifestyle is one of the most important causes of disease in the United States and throughout the entire world. It also makes testosterone levels drop at an alarming rate. The solution is not to quit your IT job and go work in a field. Instead, you should compensate by consciously engaging in physical activities a few times per week. Go for a jog, take your friends, and play squash or another racket-based sport. If you love it, go for a swim, as this is a wonderful cardiovascular activity that works the entire body. The bottom line is not to get stuck in front of your computer or on your sofa all day long. Work out a few times weekly to help your blood move better throughout your body and improve your testosterone levels. Check Your Testosterone Levels Often You might be happy to find out that checking your testosterone levels is very easy these days. You don't even need to talk to your doctor. You can order a direct-to-consumer lab test from trustworthy providers such as DiscountedLabs.com. When you do this, you get a form that you use to visit a nearby clinic to draw blood. Your blood is analyzed in a certified laboratory by medical experts, and your results will be emailed in a few business days. The process is fast, confidential, and secure. Checking your testosterone levels often helps you to see where you stand. You can compare the results against reference values and see if you need to readjust your lifestyle. For example, most experts agree that normal testosterone levels should be between 350 and 1,000 nanograms per deciliter of blood. Go to DiscountedLabs.com today and order your own testosterone test today! This test is the most affordable in the U.S. for a gold standard accurate test based on liquid chromatography, the most trusted test by top physicians and clinics.   ============= References: Alarming Drop in Testosterone Levels Stress and Fatigue Affect Testosterone Obesity Decreases Testosterone Levels Testosterone Information | Mount Sinai - New York