Testosterone (T+F), Estradiol and DHT Panel

This panel contains testosterone and its downstream metabolites: Estradiol and DHT. All three hormones are measured using Liquid Chromatography/Mass Spectrometry (LC/MS), the most accurate assay for hormones. No interactions with supplements like biotin are present.

Around 0.4% of testosterone aromatizes to estradiol in fat mass, testicles, and liver. Around 10% of testosterone converts to DHT via the alpha reductase enzyme. This enzyme is produced in many tissues in both males and females, including the reproductive tract, testes and ovaries, skin, seminal vesicles, prostate, epididymis, and many organs, including the nervous system.

Testosterone, Total, LC/MS and Free (Equilibrium Ultrafiltration)

This panel includes free testosterone percent by equilibrium dialysis/ultrafiltration, free testosterone calculated from percent free T, and total testosterone measured using the most precise method (liquid chromatography/mass spectrometry LC/MS). It is adequate for men who expect high T levels and women (LC/MS is accurate for high and low T levels as well).

Total Testosterone:

–   Liquid chromatography tandem mass spectrometry (LC/MS/MS)- No upper limit

–   Analytical sensitivity: 1.0 ng/dL

–   Analytical specificity: no cross-reactivity with other steroid compounds

–   Analytical Measurement Range: 1.0 ng/dL to 2,000 ng/dL

Free and Total Testosterone:

–   Percent free: equilibrium dialysis/ultrafiltration

–   Free: calculated based on total and percent free testosterone

Ultrasensitive Estradiol Test

This test may take up to 7 business days to obtain results. The body produces estrogen by aromatizing testosterone in the testicles, liver, and fat tissue. Estradiol is involved in bone health, cognitive function, sex drive, and body composition in both men and women. Depending on lifestyle factors, liver issues, medications, body fat mass, and genetics, some people may have higher estradiol conversions from testosterone.

The commonly used estradiol test may overestimate estradiol. That test uses immunoassay technology that cannot differentiate C-Reactive Protein (involved in inflammation) from estradiol, so it reads the combination of the two as estradiol. This overestimation can lead to excessive use of an aromatase inhibitor that can result in low estradiol, which can cause several health issues. This ultrasensitive estradiol test is based on liquid chromatography/mass spectrometry (LC/MS), an assay technology that does not have that limitation.

DHT Test

Dihydrotestosterone (DHT) is synthesized from testosterone in the prostate gland, testes, hair follicles, and adrenal glands by 5-alpha reductase. Dihydrotestosterone exerts its action similarly to testosterone, which binds to and activates androgen receptors. Dihydrotestosterone is responsible for the formation of male primary sex characteristics and most male secondary sex characteristics during puberty, such as muscular growth, facial and body hair growth, and deepening of the voice.

Excess DHT has been associated with hair loss, prostate volume increase, and acne in men with a genetic predisposition to those issues. Blocking or decreasing DHT to low levels may cause sexual dysfunction. More information on DHT in men.