FT using TruT vs Dialysis methods

Larry P

New Member
I recently had by TT using the LC/MS-MS method and got 837ng/dl. I used the Dialysis method to test for FT and got 8.4ng/dl. Normal range for TT is 264-916ng/dl. Normal range for FT is 5.2-28.0ng/dl. This equates to 1.5-3.2%. My FT is only at 1% using this method.
When I use the TruT calculator I get 27.77ng/dl, which is over 3%. Albumin 4.2, SHBG 52 and TT 837.
For me there does not seem to be any real correlation between using the more accurate dialysis test for FT and the TruT method.
Comments?????
 

Abuser200

Member
This is what i get.
5149F72A-9B68-42A9-8E77-D10316822BA3.png
 

Abuser200

Member
My lab always uses a calculation method to measure free t. And its always the same as when i calculate it on that website. So my lab seems pretty accurate. When i calculate m free t with Trut im over the range.. but i still have symtoms. So i dont use the Trut method because it does not match my symtoms. So your free t is only 14! If you still have symtoms you have a lot of room to go up!
 

DragonBits

Well-Known Member
My lab always uses a calculation method to measure free t. And its always the same as when i calculate it on that website. So my lab seems pretty accurate. When i calculate m free t with Trut im over the range.. but i still have symtoms. So i dont use the Trut method because it does not match my symtoms. So your free t is only 14! If you still have symtoms you have a lot of room to go up!

Maybe your lab uses the same calculator as the website. It doesn't make it accurate just because it matches.

The LC-MS/MS method of testing FT seems the most accurate, but personally I think people get too anal over the FT number. I look at it but don't pay so much attention to it, just treat how you want to, I would be reluctant to go over 1200 ng/dl total T on a regular basis, and would like to be above 600 ng/dl total t but that leaves a lot of room to work with. I haven't seen any endo or urologist that use FT as a primary tool for treatment. FT is interesting if it's way out of line with what one would expect, and for research I am sure it's important. (I know FT is the active form of T, but the main way you change it is by raising or lower total T, unless you go to another hormone like deca.)
 

xqfq

Active Member
This is really interesting, thank you for sharing it Larry.

I’d love to hear from anyone else who’s had their Dialysis method free T measured!

For me, the Vermeulen method (classic free T calculator) matches my “direct” free T assay almost always, for what that’s worth.
 

Larry P

New Member
I actually had both methods tested at the same time. I had the dialysis and the standard non dialysis done. The result are very close. the TT using LC/MS was 837 reference range 264-916 and the standard tests that LabCorp uses shows 896 reference range 264-916. Not much difference. The FT results using dialysis are 84 with reference range 52-280, or about 1% of TT. Standard method shows 12.9 for FT reference range 6.6-18.1 or about 1.4% The Tru T shows me at over 3%. The Omni calculator shows me at 1.74%, which is much closer to the standard and dialysis results. Still this FT testings and results are confusing and I agree it matters more how you feel then the lab result numbers. I think I can raise my TT and FT and feel a little better. But I do feel pretty good now.
 

Larry P

New Member
I have no idea which method is the most accurate. My doc only goes by TT and does not think FT is important. I keep mentioning I would like my FT higher, but he keeps telling me that my TT is too high. My natural TT when I was 66 (three years ago) was 841. Last year it crashed down to 321 and my FT was down to less than .5%, I show him the LabCorp results from three years ago and he is starting to think perhaps my natural TT when I was a young man could be over 1000. He thinks I am a freak of nature. His ideal TT range is between 300-700. I am only using 40mg Cypionate every five days. At this dose I have zero bad side effects.
 

Cataceous

Super Moderator
The main question: Is this a single instance, or do you have other free T dialysis measurements that disagree with Tru-T? The results of any one reading should be considered tentative.

I'd like @madman to weigh in as well, as he is the primary promulgator of the Tru-T method.

A couple other comments: Ignore the percentage free T; it's not useful information. The LabCorp direct free T test with a range of 6.6-18.1 has units of pg/mL. So apart from being poorly correlated with equilibrium dialysis, its results are not remotely comparable to the true physiological range of many ng/dL—your percent free T calculation would actually yield 0.14%, not 1.4%.
 

Gman86

Member
I have no idea which method is the most accurate. My doc only goes by TT and does not think FT is important. I keep mentioning I would like my FT higher, but he keeps telling me that my TT is too high. My natural TT when I was 66 (three years ago) was 841. Last year it crashed down to 321 and my FT was down to less than .5%, I show him the LabCorp results from three years ago and he is starting to think perhaps my natural TT when I was a young man could be over 1000. He thinks I am a freak of nature. His ideal TT range is between 300-700. I am only using 40mg Cypionate every five days. At this dose I have zero bad side effects.

Omg your doctor would hate me. Ive found that subjectively I feel my best with total T around 1800 lol. When I was at my most symptomatic of hypogonadism, my total was almost 700. He would of thought that was literally perfect. But my free T was at the bottom of the range on one test, and next time I tested it, it was actually below the bottom of the range. Going by just the total is literally insane.
 

Gman86

Member
With this whole free T thing, and which method is best, I personally don’t think it even matters. For me, it’s more important to just pick one testing method and stick to it. I’ve been getting labs done for so long, and have them all saved in a file, and know how I’ve felt at different levels, based on the same free T test.

obviously the tru-T method is the most accurate. But without a ton of anectodal stories of where men seem to do well, or a bunch of anectodal stories of where your doctor’s patients seem to do well, what good is it? It’s just numbers. Where’s the subjective evidence that goes along with it?

but again, we’re all individual, and we’re all going to do best at different free T levels. So for me, it seems logical just to learn where my free T is when I feel best, and try to keep it there. If you’re someone that hasn’t found that range yet, you can just start low and continue increasing until you find it. There’s more than one way to skin a cat. Even the way I do it might not be the best method for others, it just seems logical to me.
 

ncsugrad

Member
The truT calculator gives me insanely high free T numbers despite super high shbg. Is it accurate at 100+ SHBG? I don’t know. But if it really is accurate then I probably need to dial my dose back some.
 

madman

Super Moderator
I recently had by TT using the LC/MS-MS method and got 837ng/dl. I used the Dialysis method to test for FT and got 8.4ng/dl. Normal range for TT is 264-916ng/dl. Normal range for FT is 5.2-28.0ng/dl. This equates to 1.5-3.2%. My FT is only at 1% using this method.
When I use the TruT calculator I get 27.77ng/dl, which is over 3%. Albumin 4.2, SHBG 52 and TT 837.
For me there does not seem to be any real correlation between using the more accurate dialysis test for FT and the TruT method.
Comments?????



Before jumping to conclusions.....I would say that there is a strong possibility of lab error.

Find it hard to believe that with aTT 837 ng/dL even with an SHBG 52 nmol/L on the higher end (far from very high) that your FT tested using Equilibrium Dialysis is only a dismal 8.4 ng/dL.....almost bottom end of the reference range of 5.2-28.0 ng/dL.

Seems very odd.

Where were your labs done and I would like you to post lab work just keep your personal information covered up.

Even though Equilibrium Dialysis is considered the gold standard/most accurate method for testing FT (reference method against which other methods are compared) followed by Ultrafiltration (next best) they are both suffer from chance of errors.



Reappraisal of Testosterone’s Binding in Circulation: Physiological and Clinical Implications
-----------------------------------------------------------------------------------------------------
Equilibrium dialysis and its various embodiments

Equilibrium dialysis is widely considered the reference method against which other methods are compared. It is technically demanding, and its performance is affected by assay conditions, which can result in high assay variability (192). Typically, the equilibrium dialysis procedure involves the dialysis of serum or plasma samples across a semipermeable cellulose membrane with a low-molecular-weight cutoff; protein-bound testosterone is retained, whereas free testosterone equilibrates across the dialysis membrane and can be measured in the dialysate either directly using a liquid chromatography-tandem mass spectrometry (LC-MS/MS) assay or immunoassay or indirectly using a tracer. Indirect methods require adding a trace amount of radioactively labeled testosterone to the sample, and after equilibrium has been achieved, the proportion of tracer in the dialysate provides a measure of the percentage of free testosterone. Because free testosterone concentration can then be calculated by multiplying the percentage of free fraction with the total testosterone concentration obtained from the same sample in a separate assay, accurate determination of total testosterone levels is necessary for accurate determination of free testosterone levels by this method.

Although a diligently conducted equilibrium dialysis assay accurately measures free testosterone level, the method is fraught with operator-dependent errors. The protocol itself is labor-intensive, requiring repeated purification of the radioactive tracer, and is not readily amenable to high throughput. Even some large commercial diagnostic laboratories have stopped offering this assay. Although equilibrium dialysis is widely considered to be the gold standard for measuring free testosterone, this method is subject to various sources of error that may contribute to inaccuracy and imprecision. For instance, the dilution of serum or plasma may disturb the equilibrium between SHBG and its ligands (193). Results may also be altered when solutes become attached to the dialysis apparatus or membrane or when there is unequal distribution of free ligands between the two compartments as a result of (1) inadequate time to reach equilibrium; (2) release of materials from the plate or membrane that interferes with the determination of concentration; and (3) the Donnan effect at low ionic strengths, which alters the distribution of charged particles near a semipermeable membrane so that they may not distribute evenly across the two sides of the membrane (194, 195). The ionic strength and pH of the dialysis buffer and the temperature at which dialysis is performed affect the equilibrium and the estimates of binding parameters. The batch-to-batch variability in adsorption characteristics of dialysis plates from different manufacturers may be an additional source of interassay variation. The Centers for Disease Control and Prevention’s (CDC’s) hormone standardization program is invested in improving clinical assays and minimizing factors that affect measurement variability (196).

Effects of temperature variations
Steroid binding is affected by the temperature and may be 2.5 times higher at 4°C than at 37°C (9, 197, 198). The seminal testosterone-binding experiments were performed at varying temperatures—some studies were performed with ice-cold ammonium sulfate (4°C) (2) or at 25°C (9), which may affect binding equilibrium (Table 1). For example, in a separate study characterizing temperature effects on cortisol protein binding by the equilibrium dialysis method, raising the temperature from 37°C to 41°C led to an increase of ∼80% in serum free cortisol level (199).

Effects of assay buffer composition and buffer volumes
The composition and ionic strength of the dialysis buffer affect the results of equilibrium dialysis experiments. Experiments should ideally be performed using a dialysis buffer with an ionic composition that resembles that of human plasma, but this has not been the case in all studies. The assumption that the concentration of free ligands is equal on both sides of the membrane at equilibrium is not always valid (Table 1). Most proteins have a charge and accumulate a set of neutralizing counterions. The Donnan effect, discussed previously, is a consequence of maintaining the overall electrical neutrality of the solution and may give spurious evidence of an association between a ligand and a protein of opposite charge when charged counterions are present in the buffer. Differences in the ratios of volumes of dialysis buffer to sample may also affect estimates of free testosterone; when the binding is nonlinear, the decrease in total analyte concentration can alter the free fraction (Table 1).

Alteration of equilibria during physical separation of free and bound testosterone fractions
Traditional assays for determining stoichiometry and association constants usually involve separation of bound and free forms of testosterone using equilibrium dialysis, ultracentrifugation, ammonium sulfate precipitation, or other chromatographic separation methods with a subsequent Scatchard plot of the ratio of bound testosterone to unbound testosterone [(bound/free testosterone); ordinate] plotted against the bound testosterone concentration [(bound); abscissa] (200). The Scatchard analysis is a method of “linearizing” data from a saturation binding experiment to determine binding constants and estimates of stoichiometry of the noninteracting sites. However, under several experimental conditions, the underlying assumptions in the Scatchard analysis are not met, and the use of the Scatchard analysis may yield inaccurate parameter estimation (Table 1)

Achieving standardization of dialysis conditions across laboratories has been difficult, resulting in substantial interlaboratory variations in reported results. Authors who measure free testosterone by equilibrium dialysis should provide details about their methodology to ensure reproducibility and interlaboratory comparability.
-----------------------------------------------------------------------------------------------------



Now getting back to why I think your FT result 8.4 ng/dL could be due to a lab error.....we have had other members test FT using Equilibrium Dialysis or Ultrafiltration and their results seemed to be comparable to the TruT calculated if we look at it in the basic sense of trying to convert units such as you have (I will follow up on this further down my post).....but the main issue is the reference ranges between testing methods from the various labs for FT by Equilibrium Dialysis or Ultrafiltration are different and not on the same scale as TruT.....so until reference ranges are standardized and there are harmonized reference ranges for Free Testosterone as have been previously done for Total Testosterone (CDC and its Hormone Assay Standardization program) than doubtful you could do an accurate comparison.



-----------------------------------------------------------------------------------------------------
Lack of Standardization of Free Testosterone Measurement Methods and Unavailability of Harmonized Reference Ranges for Free Testosterone

Le et al. (222) surveyed 120 academic and community laboratories in the United States to characterize the distribution of assays and the associated reference values for free testosterone. In all, 84% of the surveyed laboratories sent their samples for free testosterone measurement to larger centralized reference laboratories (222). These large commercial laboratories offered a variety of methods, including ultracentrifugation, radioimmunoassay, and calculation-based algorithms, as well as equilibrium dialysis (222). Many clinical laboratories used calculated free testosterone based on published linear equations (3). The laboratories reported wide variations in the reference ranges. Only 30 of the laboratories surveyed would confirm that validation studies had been performed, and the authors advised that reference ranges provided by manufacturers and laboratories should be interpreted with caution.

In a survey of 12 academic laboratories, 12 community medical laboratories, and one national laboratory, Lazarou et al. (223) found 17 and 13 different sets of reference values for total and free testosterone, respectively, which were established largely without clinical considerations. Recently, Bhasin et al. (224) reported reference ranges for calculated free testosterone concentrations in a large, rigorously collected sample of community-dwelling men. In healthy young men of the Framingham Heart Study who were 19 to 40 years of age, the lower limit of the normal range, defined as the 2.5th percentile of calculated free testosterone, was 70 pg/mL (242.7 pmol/L) (198).




Clinical Implications and Recommendations

Male hypogonadism is a clinical condition characterized by the presence of typical signs and symptoms in the setting of consistently low serum testosterone concentrations. The Endocrine Society guidelines currently suggest measuring free testosterone levels in men in whom total testosterone concentrations are near the lower limit of the normal range and in men with conditions that affect SHBG concentrations and render total testosterone a less reliable index of gonadal function (206). If the free hormone hypothesis is correct, free testosterone should serve as the benchmark for biochemical confirmation of hypogonadism. Accurate determination of free testosterone values is therefore central to an accurate diagnosis of hypogonadism.

The direct analogue assays for free testosterone determination are inaccurate and should not be used. However, a confluence of factors related to the regulatory process, economic considerations, and difficulties in performing equilibrium dialysis methods in many hospital laboratories has led to their surprising endurance despite their known inaccuracy. Historically, laboratory-certifying bodies, such as the Clinical Laboratory Improvement Amendments, have certified laboratories and assays mostly on the basis of process measures; unlike the CDC and its Hormone Assay Standardization program for testosterone, these bodies have generally not required accuracy-based benchmarks. Similarly, the requirement in the assay approval process for demonstration of comparability to a previously approved assay enables new tracer analogue assays to be approved because they can demonstrate comparability to previously approved analogue methods.

Equilibrium dialysis is the reference method for free testosterone determination, but this assay is not always available to clinicians in all hospital laboratories; in addition, there are substantial interlaboratory variations because of the lack of standardization of assay conditions, making it difficult for practicing endocrinologists to interpret free testosterone levels. Mechanisms to harmonize the equilibrium dialysis procedure across laboratories are needed. Until equilibrium dialysis methods can be standardized across laboratories, a computational framework that accurately captures the dynamics of testosterone to SHBG and HSA interactions in calculating free testosterone values is an unmet need for precise clinical diagnosis. The EAM appears to be an accurate and testable model for calculating free testosterone levels, but this model needs further validation in large populations.

Total testosterone, which can be measured with high accuracy using LC-MS/MS assays in CDC-certified laboratories, and free testosterone are highly correlated, and it is only in individuals with altered binding-protein concentrations that the associations begin to diverge. For the time being, we therefore suggest continuing to follow the Endocrine Society’s guidelines to measure total testosterone level and, in circumstances of suspected alterations in SHBG and albumin concentrations and/or binding, checking free testosterone level by equilibrium dialysis. Efforts are underway to standardize the procedures for free testosterone measurement and to generate harmonized reference ranges. Until that time, clinicians should be aware that inaccuracies in free testosterone measurements and calculations and poorly defined reference ranges can increase the risk of misclassification in the diagnosis of androgen disorders.
------------------------------------------------------------------------------------------------




Key points here:

*Efforts are underway to standardize the procedures for free testosterone measurement and to generate harmonized reference ranges. Until that time, clinicians should be aware that inaccuracies in free testosterone measurements and calculations and poorly defined reference ranges can increase the risk of misclassification in the diagnosis of androgen disorders.



From one of my previous threads.....and trust me when I tell you that the implementation of the TruT platform will be a big part of this!

Congress Funds AACC-Led Harmonization Initiative - AACC.org

The $1.3 trillion omnibus spending bill passed by Congress in March will fund efforts to harmonize laboratory tests, the culmination of more than a decade of AACC advocacy efforts. AACC worked closely with Rep. Kevin Yoder (R-Kan.) and other lawmakers, as well as a partnership of 17 clinical associations. The bill provides $2 million to the Centers for Disease Control and Prevention (CDC). The agency plans to use the new funding for materials and monitoring that will enable harmonization of tests for free testosterone, thyroid stimulating hormone, and estrogen.


I will follow up regarding the other members results from testing their FT using Equilibrium Dialysis or Ultrafiltration.

Just need to dig up posts!
 
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xqfq

Active Member
I mentioned this in another thread, but I don’t see it being possible to accurately compute free testosterone from just SHBG, albumin and total testosterone. We know that there are other things that affect SHBG <-> testosterone binding, such as magnesium:

The Interplay between Magnesium and Testosterone in Modulating Physical Function in Men

Perhaps on a population-wide basis, a model that approximates based on SHBG, albumin and total testosterone could fit the data well. But that doesn’t mean it’s necessarily accurate for a given person, especially if they’re having symptoms.

I emailed the TruT team about this but haven’t heard back.

While searching around on this topic, I found this study on the topic of the standard free testosterone assay and equilibrium dialysis. It concludes that it matches well and is clinically useful:

Free testosterone by direct and calculated measurement versus equilibrium dialysis in a clinical population. - PubMed - NCBI
 

Cataceous

Super Moderator
Here's a long post from madman with research demonstrating the good correlation between Tru-T and equilibrium dialysis: Calculate free testosterone with TruT by FPT
Snippets:

[0023] Figs. 4A-4B demonstrate a comparison of the Free Testosterone Concentrations Derived Using the Vermeulen Equation (23) as implemented by Mazer (24) or the New Algorithm Based on the new Multi-step Dynamic Binding Model with Complex Allostery with those measured using the equilibrium dialysis in samples from the 5alpha reductase trial. Fig. 4A depicts a graph of a comparison of the free testosterone concentration calculated by the Vermeulen equation and the new algorithm based on the new Multi-step Dynamic Binding Model with Complex Allostery to that measured by equilibrium dialysis in samples from a randomized testosterone trial in men. (■) free testosterone concentrations derived using an algorithm based on new Multi-step Dynamic Binding Model with Complex Allostery; (•) free testosterone concentrations derived using the Vermeulen model (23) as implemented by Mazer (24). Solid lines are lines of best linear fit. Regression lines fit new Multi-step Dynamic Binding Model with Complex Allostery calculation (slope = 1.01±0.01, regression line fitting the squares), and the Vermeulen model (slope 0.77±0.02, lower line fitting the dots). Magenta dashed line is the line of prefect correlation. Fig. 4B depicts Bland Altman plots of the relative frequency distribution of % difference of calculated and measured free testosterone using either the Vermeulen equation (squares) or the new algorithm based on the new Multi-step Dynamic Binding Model with Complex Allostery (black dots) The relative deviations from the measured value are distributed around 0 for new Multi-step Dynamic Binding Model with Complex Allostery model and are different from zero for the Vermeulen model.
 

DragonBits

Well-Known Member
I don't often measure shbg along with total T/FT, but over the years I have 7 measurements. Only once in 2011 did I use lc/MS/MC to measure FT, but I didn't measure SHBG at the time.

These are tests from 2015-2019, with and without TRT, there are more tests but I didn't test for SHBG often.



Total T

FT (6.6-18.1)

%T

TruT (16-31)

E2

SHBG

326

4.7

1.44

8.79

<5

42.2

478 *1

7.7

1.61

14.66

27.6

37.9

348

7.5

2.16

9.99

11.1

35.9

690 *2

20.7

3%

21.1

20.3

41.1

638

9

1.41

12.3

12.3

66.2

932

16.5

1.77

26.5

?

73.7

1492

24.7

1.66

48.64

32.6

58



*1, no TRT but I was using clomid which created the rise in total T and big rise in E2.

*2, the %T increased, maybe due to I was taking DHEA at the time and my level of DHEA was 450.5 (30.9-295.6). Maybe DHEA caused the lab to read a higher FT assay result without raising Total T, maybe FT wasn't really that high, maybe something else. i hadn't been taking DHEA for the other measurements. Without taking DHEA, my DHEA levels will read around 100 (ug/dl (30.9-295.6) age adjusted.

IMO the FT direct assay is close enough for hormone work, if you adjust for the range it agrees with TruT, they aren't wildly different outside of the *2 test.
 

Cataceous

Super Moderator
...
IMO the FT direct assay is close enough for hormone work, if you adjust for the range it agrees with TruT, they aren't wildly different outside of the *2 test.
Arguably it might work for you, though these results could be better than average; I've seen other guys have extremely inconsistent results with this same test.
Untitled 22.jpeg

Edit: In fact I would bet money that value of 20.7 is completely wrong. Look at how estradiol doubles along with total testosterone, but this measured free T value triples.
 
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madman

Super Moderator
I recently had by TT using the LC/MS-MS method and got 837ng/dl. I used the Dialysis method to test for FT and got 8.4ng/dl. Normal range for TT is 264-916ng/dl. Normal range for FT is 5.2-28.0ng/dl. This equates to 1.5-3.2%. My FT is only at 1% using this method.
When I use the TruT calculator I get 27.77ng/dl, which is over 3%. Albumin 4.2, SHBG 52 and TT 837.
For me there does not seem to be any real correlation between using the more accurate dialysis test for FT and the TruT method.
Comments?????



Not only does it seem odd that with a TT 837 ng/dL and an SHBG on the higher end 52 nmol/L that your FT is only 8.4 ng/dL (reference range 5.2-28.0 ng/dL) which is closer to the bottom end.....it would be hard to believe that anyone at such FT level would feel well let alone pretty good.....and you stated that....."Still this FT testings and results are confusing and I agree it matters more how you feel then the lab result numbers. I think I can raise my TT and FT and feel a little better. But I do feel pretty good now"

Now if we want to try and compare as you have done......again keeping in mind that the main issue is the reference ranges between testing methods from the various labs for FT by Equilibrium Dialysis or Ultrafiltration are different and not on the same scale as TruT.....so until reference ranges are standardized and there are harmonized reference ranges for Free Testosterone as have been previously done for Total Testosterone (CDC and its Hormone Assay Standardization program) than doubtful you could do an accurate comparison.

Here is some of the labs posted by members that had FT tested using ED or Ultrafiltration:

Below is the members lab results testing his FT at Labcorp using.....Testosterone, F EQLIB + T LC/MS (Final).

As you can see his TT is 1004 ng/dL, SHBG 60.1 nmol/L (high) and Albumin 4.6 g/dL and his FT 18.47 ng/dL (reference range 5.00-21.00 ng/dL).....so even with a high SHBG of 60.1 nmol/L his FT is close to the top end of the reference range.

Your TT 837 ng/dL which is not an extreme difference compared to his TT 1004 ng/dL, your SHBG 52 nmol/L is a little lower than his 60.1 nmol/L, and your Albumin 4.2 g/dL is slightly lower than his 4.6 nmol/L.....your FT is 8.4 ng/dL (close to the bottom end of the reference range) and his FT is 18.47 ng/dL (close to the top end of the reference range).

Seems odd to have such a significant difference in FT levels when not only is his TT not significantly higher than yours but his SHBG is higher and Albumin is only slightly higher.
1574017144352.png





Now if we take those numbers and use the TruT calculated method.....albeit the reference ranges are on a different scale.
.

TT 1004ng/dL, SHBG 60.1 nmol/L, Albumin 4.6 ng/dL than his FT is 30.73 ng/dL (reference range 16-31 ng/dL).....so his FT is right at the top end of the reference range.
1574014267152.png

Now again as you can see when he tested FT using Equilibrium Dialysis his FT 18.47 ng/dL (reference range 5.00-21.00 ng/dL).....is close to the top end of the reference range.




Here is another members lab results testing his FT at Quest Labs using.....Testosterone, FR (DIALYSIS) AND TOTAL (LC/MS/MS).

The Quest Labs reference range for FT and the units are 35.0-155.0 pg/mL.....different from the previous members Labcorp reference range/units 5.00-21.00 ng/dL.

As you can see his TT is very high 1627 ng/dL, SHBG 47 nmol/L and Albumin 4.8 g/dL and his FT is very high 303.3 pg/mL (reference range 35.0-155.0 pg/mL).....so even with a highish SHBG of 47 nmol/L his FT is almost double the top end of the reference range.
1574015871860.png

1574015824878.png




Now if we take those numbers and use the TruT calculated method.....albeit the reference ranges are on a different scale.


TT 1627 ng/dL, SHBG 47 nmol/L, Albumin 4.8 ng/dL than his FT is 52.75 ng/dL (reference range 16-31 ng/dL).....so his FT is over more than 3/4 the top end of the reference range.

TruT reference range is 16.4-31.6 ng/dL or 164-316 pg/mL.....so if we take his FT 52.75 ng/dL and covert to pg/mL it would be roughly 528 pg/mL.....so his FT is over 3/4 the top end of the reference range.
Screenshot (763).png
Now again as you can see when he tested FT using Equilibrium Dialysis his FT is 303.3 pg/mL (reference range 35.0-155.0 pg/mL).....is almost double the top end of the reference range.



Another members results tested using Equilibrium Dialysis, Vermuelen and TruT calculated.....unfortunately he did not post up labs.....which is needed!
1574018204007.png



Below is another members lab results testing his FT at Labcorp using.....Testosterone, F EQLIB + T LC/MS (Final).



He has posted numerous labs stating he normally has high SHBG in the 60-70 nmol/L range.

These are his labs from 4/2019.

As you can see his TT is 972 ng/dL, SHBG was not tested? but from other labs posted he usually runs high 60-70 nmol/L and Albumin 4.3 g/dL (mean) and his FT 30.62 ng/dL (reference range 5.00-21.00 ng/dL).....so even with a high SHBG 60-70 nmol/L his FT is over 3/4 the top end of the reference range.
Screenshot (766).png





Now if we take those numbers and use the TruT calculated method.....albeit the reference ranges are on a different scale.

Mind you we do not have know his SHBG but will use the higher end number of 70 nmol/L as he usually has SHBG in the 60-70 nmol/L range.

TT 972 ng/dL, SHBG 70 nmol/L, Albumin 4.3 ng/dL (mean) than his FT is 30.25 ng/dL (reference range 16-31 ng/dL).....so even with a high SHBG of 70 nmol/L his FT is almost top end of the reference range.
Screenshot (767).png

Now again as you can see when he tested FT using Equilibrium Dialysis his FT 30.62 ng/dL (reference range 5.00-21.00 ng/dL).....is over 3/4 the top end of the reference range.

Again we have no idea what his SHBG level was when he had lab work done but he is very well know to have high SHBG as he has stated many times let alone show in lab work he has posted previously.
 
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