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Testosterone Replacement, Low T, HCG, & Beyond
Blood Test Discussion
Calculate Free Testosterone with TruT by FPT
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<blockquote data-quote="madman" data-source="post: 144911" data-attributes="member: 13851"><p><img src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" class="smilie smilie--sprite smilie--sprite8" alt=":D" title="Big Grin :D" loading="lazy" data-shortname=":D" /></p><p></p><p><strong><span style="color: rgb(184, 49, 47)">About TruT</span></strong></p><p></p><p><strong><span style="color: rgb(0, 0, 0)">Current problems with accurate free testosterone determination</span></strong></p><p></p><p><strong>Current <span style="color: rgb(184, 49, 47)">methods</span> for measuring f<span style="color: rgb(184, 49, 47)">ree testosterone (fT) </span>are <span style="color: rgb(184, 49, 47)">technically </span>challenging and <span style="color: rgb(184, 49, 47)">not accurate.</span></strong> <strong>The widely used <span style="color: rgb(184, 49, 47)">direct immunoassay </span>and <span style="color: rgb(184, 49, 47)">tracer analog</span> techniques for <span style="color: rgb(184, 49, 47)">measuring fT</span> have been shown to be <span style="color: rgb(184, 49, 47)">inaccurate.</span> </strong>Equilibrium dialysis, the reference method against which other methods are compared, is labor-intensive and cumbersome, and therefore has had limited clinical adoption. As an alternative, free testosterone can be computed from the <em>total</em> testosterone, SHBG, and albumin concentrations. <strong>Recently, <span style="color: rgb(184, 49, 47)">Endocrine Society’s Expert Panel</span> acknowledged the <span style="color: rgb(184, 49, 47)">experimental problems</span> in <span style="color: rgb(184, 49, 47)">fT </span>measurements and concluded that "...the <span style="color: rgb(184, 49, 47)">calculation of free testosterone</span> is the most useful <span style="color: rgb(184, 49, 47)">estimate of</span> <span style="color: rgb(184, 49, 47)">free testosterone</span> in plasma..." However, we have demonstrated that even the <span style="color: rgb(184, 49, 47)">calculated fT values</span> derived from the <span style="color: rgb(184, 49, 47)">prevailing equations</span>, based on <span style="color: rgb(184, 49, 47)">linear law-of-mass action models</span> or <span style="color: rgb(184, 49, 47)">empiric equations</span>, differ systematically from <span style="color: rgb(184, 49, 47)">free testosterone measured by equilibrium dialysis</span> by as much as <span style="color: rgb(184, 49, 47)">40%.</span></strong></p><p></p><p></p><p></p><p></p><p><strong><span style="color: rgb(0, 0, 0)">Improved </span><span style="color: rgb(184, 49, 47)">TruT</span><span style="color: rgb(0, 0, 0)"> Companion Diagnostics</span></strong></p><p></p><p><strong>Based on the <span style="color: rgb(184, 49, 47)">fundamental discovery</span> of <span style="color: rgb(184, 49, 47)">testosterone partitioning</span>, our team has developed an <span style="color: rgb(184, 49, 47)">accurate free testosterone determination method.</span></strong> <strong>While examining the <span style="color: rgb(184, 49, 47)">mechanistic origin</span> of this <span style="color: rgb(184, 49, 47)">systematic inaccuracy in free testosterone values </span>using the <span style="color: rgb(184, 49, 47)">linear model of SHBG:testosterone association</span>, we discovered that the <span style="color: rgb(184, 49, 47)">SHBG dimer exhibits conformational allostery in binding testosterone.</span> Our <span style="color: rgb(184, 49, 47)">TruT™ companion diagnostic</span>, incorporating the <span style="color: rgb(184, 49, 47)">correct parameters</span> and <span style="color: rgb(184, 49, 47)">non-linear dynamics in T:SHBG association</span> has resulted in a framework for <span style="color: rgb(184, 49, 47)">accurate determination of free testosterone values.</span></strong></p><p></p><p><strong>The <span style="color: rgb(184, 49, 47)">TruT algorithm</span> improves the <span style="color: rgb(184, 49, 47)">accuracy of free-T calculations</span>, reducing the potential for misdiagnosis, and better informing providers when designing treatments.</strong></p><p></p><p><strong><span style="color: rgb(184, 49, 47)">Testosterone</span>, like other hormones (estrogen, vitamin D), is a <span style="color: rgb(184, 49, 47)">hydrophobic molecule</span> with limited <span style="color: rgb(184, 49, 47)">solubility in water/blood.</span></strong> Accordingly, nature has devised transport proteins that carry testosterone from the primary synthesis site (testes) to the target organs. <strong>In blood, <span style="color: rgb(184, 49, 47)">testosterone</span> is therefore <span style="color: rgb(184, 49, 47)">partitioned </span>into <span style="color: rgb(184, 49, 47)">bound form (albumin and SHBG bound)</span> and <span style="color: rgb(184, 49, 47)">free fraction</span>; <span style="color: rgb(184, 49, 47)">free testosterone molecules </span>enter the target cells and trigger signaling cascades. Therefore, </strong><em><strong><span style="color: rgb(184, 49, 47)">accurate determination</span> of <span style="color: rgb(184, 49, 47)">free testosterone</span> is central to <span style="color: rgb(184, 49, 47)">definitive diagnosis of hypogonadism.</span></strong></em></p><p></p><p><strong>Circulating <span style="color: rgb(184, 49, 47)">testosterone</span> is <span style="color: rgb(184, 49, 47)">bound tightly to the SHBG protein</span> with <span style="color: rgb(184, 49, 47)">high affinity</span> and to <span style="color: rgb(44, 130, 201)">albumin</span> with substantially <span style="color: rgb(44, 130, 201)">lower affinity</span>; therefore, <span style="color: rgb(184, 49, 47)">alterations in SHBG </span>greatly affect <span style="color: rgb(184, 49, 47)">free testosterone concentrations.</span></strong> <strong>SHBG levels are quite <span style="color: rgb(184, 49, 47)">sensitive</span> to <span style="color: rgb(184, 49, 47)">overall health status and age.</span></strong> <strong>This has <span style="color: rgb(184, 49, 47)">significant clinical implications</span>; for example, two patients may produce <span style="color: rgb(184, 49, 47)">equal amounts of</span> <span style="color: rgb(184, 49, 47)">total testosterone</span> but one may express <span style="color: rgb(184, 49, 47)">higher level of binding protein</span>, lowering the <span style="color: rgb(184, 49, 47)">free testosterone concentrations.</span></strong> <strong>Accordingly, if sole clinical marker for diagnosis is based on <span style="color: rgb(184, 49, 47)">total testosterone</span>, individuals with <span style="color: rgb(184, 49, 47)">high binding protein levels</span> will be <span style="color: rgb(184, 49, 47)">misdiagnosed</span> and not receive the necessary care.Therefore, <span style="color: rgb(184, 49, 47)">accurate determination of free testosterone levels</span> is central to <span style="color: rgb(184, 49, 47)">definitive diagnosis of androgen related disorders.</span></strong></p><p></p><p><strong>Conditions that <span style="color: rgb(184, 49, 47)">lower SHBG</span> – obesity, type 2 diabetes, nephrotic syndrome, liver disease, hypothyroidism, use of androgens or glucocorticoids – can <span style="color: rgb(184, 49, 47)">lower total testosterone levels </span>to <span style="color: rgb(184, 49, 47)">below the normal range</span>, while<span style="color: rgb(184, 49, 47)"> free testosterone levels </span>might remain <span style="color: rgb(184, 49, 47)">within the normal range.</span> </strong>In these instances, sole reliance on total testosterone to establish a diagnosis of hypogonadism could result in misclassification</p><p><strong>Conditions that <span style="color: rgb(184, 49, 47)">increase SHBG</span> – advanced age, hyperthyroidism, anticonvulsants, HIV infection, or polymorphisms in the SHBG gene – can <span style="color: rgb(184, 49, 47)">raise total testosterone levels </span>to <span style="color: rgb(184, 49, 47)">well above 400 ng/dL</span> and sometimes into the <span style="color: rgb(184, 49, 47)">high-normal range</span>, despite <span style="color: rgb(184, 49, 47)">normal or even low free testosterone.</span></strong> <strong>Accordingly, the <span style="color: rgb(184, 49, 47)">Endocrine Society </span>recommends <span style="color: rgb(184, 49, 47)">determination of free testosterone</span> in the<span style="color: rgb(184, 49, 47)"> diagnostic evaluation of hypogonadism </span>in conditions that <span style="color: rgb(184, 49, 47)">alter SHBG levels</span> to avoid <span style="color: rgb(184, 49, 47)">misclassification </span>in the <span style="color: rgb(184, 49, 47)">diagnosis of hypogonadism.</span></strong></p><p></p><p><strong><span style="color: rgb(184, 49, 47)">Current diagnostics</span>, including the most widely used <span style="color: rgb(184, 49, 47)">tracer analog method</span>, have been shown to be <span style="color: rgb(184, 49, 47)">inaccurate </span>and its use is <span style="color: rgb(184, 49, 47)">not recommended.</span></strong> <strong><span style="color: rgb(184, 49, 47)">Equilibrium dialysis</span> is widely considered the <span style="color: rgb(184, 49, 47)">reference method </span>but most care providers and commercial laboratories do not offer <span style="color: rgb(184, 49, 47)">equilibrium dialysis assays </span>due to <span style="color: rgb(184, 49, 47)">operational complexities</span> in performing the assay and <span style="color: rgb(184, 49, 47)">difficulties automating</span> the procedure.</strong> <strong>Recognizing the <span style="color: rgb(184, 49, 47)">practical difficulties</span> that clinicians face in <span style="color: rgb(184, 49, 47)">obtaining accurate measurement </span>of <span style="color: rgb(184, 49, 47)">free testosterone by equilibrium dialysis</span>, an expert panel of the <span style="color: rgb(184, 49, 47)">Endocrine Society</span> concluded that "...<span style="color: rgb(184, 49, 47)">calculated free testosterone</span>, using <span style="color: rgb(184, 49, 47)">high quality testosterone and SHBG assays</span>, is the most useful <span style="color: rgb(184, 49, 47)">clinical marker</span>". </strong></p><p></p><p><strong>Our <span style="color: rgb(184, 49, 47)">patent protected, novel TruT™</span> companion diagnostic framework provides <span style="color: rgb(184, 49, 47)">accurate determination of free testosterone concentrations.</span></strong> <strong>This <span style="color: rgb(184, 49, 47)">algorithm </span>is based on <span style="color: rgb(184, 49, 47)">experimental data</span> demonstrating that <span style="color: rgb(184, 49, 47)">testosterone’s binding to SHBG is a multi-step process </span>involving an <span style="color: rgb(184, 49, 47)">allosteric interaction </span>between the <span style="color: rgb(184, 49, 47)">two binding sites on the SHBG dimer.</span> Estimates of <span style="color: rgb(184, 49, 47)">free testosterone</span> derived incorporating the <span style="color: rgb(184, 49, 47)">allosteric coupling of SHBG monomers</span> within the <span style="color: rgb(184, 49, 47)">dimer </span>provide <span style="color: rgb(184, 49, 47)">accurate determination of free testosterone</span> without <span style="color: rgb(184, 49, 47)">systematic deviation </span>from values obtained using <span style="color: rgb(184, 49, 47)">equilibrium dialysis. </span></strong></p><p></p><p></p><p></p><p><strong><span style="color: rgb(0, 0, 0)">Development</span></strong></p><p></p><p>Ongoing development is focused around continued study and validation in common conditions characterized by altered binding protein concentrations. Further, the incorporation of estradiol interactions will allow for wider adoption in women where estradiol levels vary greatly across the menstrual cycle. Because hyperandrogenism in women is the second most frequent indication for free testosterone determination, understanding the competitive binding and displacement dynamics is important for proper diagnosis in both healthy menstruating women and women with hyperandrogenic disorders, such as PCOS.</p><p></p><p><strong>Through <span style="color: rgb(184, 49, 47)">collaborations and partnerships</span>, the <span style="color: rgb(184, 49, 47)">TruT™ platform </span>presents a unique opportunity to <span style="color: rgb(184, 49, 47)">aggregate large volumes of data and metadata</span> across <span style="color: rgb(184, 49, 47)">diverse populations</span>, ultimately enabling <span style="color: rgb(184, 49, 47)">deeper understanding</span> of the basis of <span style="color: rgb(184, 49, 47)">androgen disorders</span> and other conditions.</strong></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p><a href="https://tru-t.org/" target="_blank">TruT Free Testosterone Calculator by FPT</a></p><p></p><p></p><p>[ATTACH=full]7226[/ATTACH]</p><p></p><p></p><p></p><p></p><p>If we use the linear law-of-mass action model using the <strong>Vermeulen calculated FT method </strong>which is freely available to everyone online:<a href="http://www.issam.ch/freetesto.htm" target="_blank">Free & Bioavailable Testosterone calculator</a></p><p></p><p></p><p>Using my <strong>TT 1200 ng/dL</strong> and <strong><span style="color: rgb(184, 49, 47)">SHBG 30 nmol/L </span></strong>and <span style="color: rgb(184, 49, 47)"><strong>Albumin 4.3 g/dL</strong></span> <strong>(mean) </strong>than my <strong><span style="color: rgb(184, 49, 47)">FT is 32.1 ng/dl=2.67%</span></strong></p><p></p><p></p><p>Now if I take these values <strong>(TT/SHBG/Albumin) </strong>and use the <strong>Calculate free testosterone with <span style="color: rgb(184, 49, 47)">TruT </span>by FPT</strong></p><p></p><p></p><p>Than my <strong><span style="color: rgb(184, 49, 47)">FT is 43.88 ng/dl</span></strong> or 1.52 nMol/L</p><p></p><p></p><p></p><p>What a difference <strong>Vermeulen calculated method FT 32.1 ng/dl</strong> compared to the <strong><span style="color: rgb(184, 49, 47)">TruT calculated method FT 43.88 ng/dl</span></strong></p></blockquote><p></p>
[QUOTE="madman, post: 144911, member: 13851"] :D [B][COLOR=rgb(184, 49, 47)]About TruT[/COLOR][/B] [B][COLOR=rgb(0, 0, 0)]Current problems with accurate free testosterone determination[/COLOR][/B] [B]Current [COLOR=rgb(184, 49, 47)]methods[/COLOR] for measuring f[COLOR=rgb(184, 49, 47)]ree testosterone (fT) [/COLOR]are [COLOR=rgb(184, 49, 47)]technically [/COLOR]challenging and [COLOR=rgb(184, 49, 47)]not accurate.[/COLOR][/B] [B]The widely used [COLOR=rgb(184, 49, 47)]direct immunoassay [/COLOR]and [COLOR=rgb(184, 49, 47)]tracer analog[/COLOR] techniques for [COLOR=rgb(184, 49, 47)]measuring fT[/COLOR] have been shown to be [COLOR=rgb(184, 49, 47)]inaccurate.[/COLOR] [/B]Equilibrium dialysis, the reference method against which other methods are compared, is labor-intensive and cumbersome, and therefore has had limited clinical adoption. As an alternative, free testosterone can be computed from the [I]total[/I] testosterone, SHBG, and albumin concentrations. [B]Recently, [COLOR=rgb(184, 49, 47)]Endocrine Society’s Expert Panel[/COLOR] acknowledged the [COLOR=rgb(184, 49, 47)]experimental problems[/COLOR] in [COLOR=rgb(184, 49, 47)]fT [/COLOR]measurements and concluded that "...the [COLOR=rgb(184, 49, 47)]calculation of free testosterone[/COLOR] is the most useful [COLOR=rgb(184, 49, 47)]estimate of[/COLOR] [COLOR=rgb(184, 49, 47)]free testosterone[/COLOR] in plasma..." However, we have demonstrated that even the [COLOR=rgb(184, 49, 47)]calculated fT values[/COLOR] derived from the [COLOR=rgb(184, 49, 47)]prevailing equations[/COLOR], based on [COLOR=rgb(184, 49, 47)]linear law-of-mass action models[/COLOR] or [COLOR=rgb(184, 49, 47)]empiric equations[/COLOR], differ systematically from [COLOR=rgb(184, 49, 47)]free testosterone measured by equilibrium dialysis[/COLOR] by as much as [COLOR=rgb(184, 49, 47)]40%.[/COLOR][/B] [B][COLOR=rgb(0, 0, 0)]Improved [/COLOR][COLOR=rgb(184, 49, 47)]TruT[/COLOR][COLOR=rgb(0, 0, 0)] Companion Diagnostics[/COLOR][/B] [B]Based on the [COLOR=rgb(184, 49, 47)]fundamental discovery[/COLOR] of [COLOR=rgb(184, 49, 47)]testosterone partitioning[/COLOR], our team has developed an [COLOR=rgb(184, 49, 47)]accurate free testosterone determination method.[/COLOR][/B] [B]While examining the [COLOR=rgb(184, 49, 47)]mechanistic origin[/COLOR] of this [COLOR=rgb(184, 49, 47)]systematic inaccuracy in free testosterone values [/COLOR]using the [COLOR=rgb(184, 49, 47)]linear model of SHBG:testosterone association[/COLOR], we discovered that the [COLOR=rgb(184, 49, 47)]SHBG dimer exhibits conformational allostery in binding testosterone.[/COLOR] Our [COLOR=rgb(184, 49, 47)]TruT™ companion diagnostic[/COLOR], incorporating the [COLOR=rgb(184, 49, 47)]correct parameters[/COLOR] and [COLOR=rgb(184, 49, 47)]non-linear dynamics in T:SHBG association[/COLOR] has resulted in a framework for [COLOR=rgb(184, 49, 47)]accurate determination of free testosterone values.[/COLOR][/B] [B]The [COLOR=rgb(184, 49, 47)]TruT algorithm[/COLOR] improves the [COLOR=rgb(184, 49, 47)]accuracy of free-T calculations[/COLOR], reducing the potential for misdiagnosis, and better informing providers when designing treatments.[/B] [B][COLOR=rgb(184, 49, 47)]Testosterone[/COLOR], like other hormones (estrogen, vitamin D), is a [COLOR=rgb(184, 49, 47)]hydrophobic molecule[/COLOR] with limited [COLOR=rgb(184, 49, 47)]solubility in water/blood.[/COLOR][/B] Accordingly, nature has devised transport proteins that carry testosterone from the primary synthesis site (testes) to the target organs. [B]In blood, [COLOR=rgb(184, 49, 47)]testosterone[/COLOR] is therefore [COLOR=rgb(184, 49, 47)]partitioned [/COLOR]into [COLOR=rgb(184, 49, 47)]bound form (albumin and SHBG bound)[/COLOR] and [COLOR=rgb(184, 49, 47)]free fraction[/COLOR]; [COLOR=rgb(184, 49, 47)]free testosterone molecules [/COLOR]enter the target cells and trigger signaling cascades. Therefore, [/B][I][B][COLOR=rgb(184, 49, 47)]accurate determination[/COLOR] of [COLOR=rgb(184, 49, 47)]free testosterone[/COLOR] is central to [COLOR=rgb(184, 49, 47)]definitive diagnosis of hypogonadism.[/COLOR][/B][/I] [B]Circulating [COLOR=rgb(184, 49, 47)]testosterone[/COLOR] is [COLOR=rgb(184, 49, 47)]bound tightly to the SHBG protein[/COLOR] with [COLOR=rgb(184, 49, 47)]high affinity[/COLOR] and to [COLOR=rgb(44, 130, 201)]albumin[/COLOR] with substantially [COLOR=rgb(44, 130, 201)]lower affinity[/COLOR]; therefore, [COLOR=rgb(184, 49, 47)]alterations in SHBG [/COLOR]greatly affect [COLOR=rgb(184, 49, 47)]free testosterone concentrations.[/COLOR][/B] [B]SHBG levels are quite [COLOR=rgb(184, 49, 47)]sensitive[/COLOR] to [COLOR=rgb(184, 49, 47)]overall health status and age.[/COLOR][/B] [B]This has [COLOR=rgb(184, 49, 47)]significant clinical implications[/COLOR]; for example, two patients may produce [COLOR=rgb(184, 49, 47)]equal amounts of[/COLOR] [COLOR=rgb(184, 49, 47)]total testosterone[/COLOR] but one may express [COLOR=rgb(184, 49, 47)]higher level of binding protein[/COLOR], lowering the [COLOR=rgb(184, 49, 47)]free testosterone concentrations.[/COLOR][/B] [B]Accordingly, if sole clinical marker for diagnosis is based on [COLOR=rgb(184, 49, 47)]total testosterone[/COLOR], individuals with [COLOR=rgb(184, 49, 47)]high binding protein levels[/COLOR] will be [COLOR=rgb(184, 49, 47)]misdiagnosed[/COLOR] and not receive the necessary care.Therefore, [COLOR=rgb(184, 49, 47)]accurate determination of free testosterone levels[/COLOR] is central to [COLOR=rgb(184, 49, 47)]definitive diagnosis of androgen related disorders.[/COLOR][/B] [B]Conditions that [COLOR=rgb(184, 49, 47)]lower SHBG[/COLOR] – obesity, type 2 diabetes, nephrotic syndrome, liver disease, hypothyroidism, use of androgens or glucocorticoids – can [COLOR=rgb(184, 49, 47)]lower total testosterone levels [/COLOR]to [COLOR=rgb(184, 49, 47)]below the normal range[/COLOR], while[COLOR=rgb(184, 49, 47)] free testosterone levels [/COLOR]might remain [COLOR=rgb(184, 49, 47)]within the normal range.[/COLOR] [/B]In these instances, sole reliance on total testosterone to establish a diagnosis of hypogonadism could result in misclassification [B]Conditions that [COLOR=rgb(184, 49, 47)]increase SHBG[/COLOR] – advanced age, hyperthyroidism, anticonvulsants, HIV infection, or polymorphisms in the SHBG gene – can [COLOR=rgb(184, 49, 47)]raise total testosterone levels [/COLOR]to [COLOR=rgb(184, 49, 47)]well above 400 ng/dL[/COLOR] and sometimes into the [COLOR=rgb(184, 49, 47)]high-normal range[/COLOR], despite [COLOR=rgb(184, 49, 47)]normal or even low free testosterone.[/COLOR][/B] [B]Accordingly, the [COLOR=rgb(184, 49, 47)]Endocrine Society [/COLOR]recommends [COLOR=rgb(184, 49, 47)]determination of free testosterone[/COLOR] in the[COLOR=rgb(184, 49, 47)] diagnostic evaluation of hypogonadism [/COLOR]in conditions that [COLOR=rgb(184, 49, 47)]alter SHBG levels[/COLOR] to avoid [COLOR=rgb(184, 49, 47)]misclassification [/COLOR]in the [COLOR=rgb(184, 49, 47)]diagnosis of hypogonadism.[/COLOR][/B] [B][COLOR=rgb(184, 49, 47)]Current diagnostics[/COLOR], including the most widely used [COLOR=rgb(184, 49, 47)]tracer analog method[/COLOR], have been shown to be [COLOR=rgb(184, 49, 47)]inaccurate [/COLOR]and its use is [COLOR=rgb(184, 49, 47)]not recommended.[/COLOR][/B] [B][COLOR=rgb(184, 49, 47)]Equilibrium dialysis[/COLOR] is widely considered the [COLOR=rgb(184, 49, 47)]reference method [/COLOR]but most care providers and commercial laboratories do not offer [COLOR=rgb(184, 49, 47)]equilibrium dialysis assays [/COLOR]due to [COLOR=rgb(184, 49, 47)]operational complexities[/COLOR] in performing the assay and [COLOR=rgb(184, 49, 47)]difficulties automating[/COLOR] the procedure.[/B] [B]Recognizing the [COLOR=rgb(184, 49, 47)]practical difficulties[/COLOR] that clinicians face in [COLOR=rgb(184, 49, 47)]obtaining accurate measurement [/COLOR]of [COLOR=rgb(184, 49, 47)]free testosterone by equilibrium dialysis[/COLOR], an expert panel of the [COLOR=rgb(184, 49, 47)]Endocrine Society[/COLOR] concluded that "...[COLOR=rgb(184, 49, 47)]calculated free testosterone[/COLOR], using [COLOR=rgb(184, 49, 47)]high quality testosterone and SHBG assays[/COLOR], is the most useful [COLOR=rgb(184, 49, 47)]clinical marker[/COLOR]". [/B] [B]Our [COLOR=rgb(184, 49, 47)]patent protected, novel TruT™[/COLOR] companion diagnostic framework provides [COLOR=rgb(184, 49, 47)]accurate determination of free testosterone concentrations.[/COLOR][/B] [B]This [COLOR=rgb(184, 49, 47)]algorithm [/COLOR]is based on [COLOR=rgb(184, 49, 47)]experimental data[/COLOR] demonstrating that [COLOR=rgb(184, 49, 47)]testosterone’s binding to SHBG is a multi-step process [/COLOR]involving an [COLOR=rgb(184, 49, 47)]allosteric interaction [/COLOR]between the [COLOR=rgb(184, 49, 47)]two binding sites on the SHBG dimer.[/COLOR] Estimates of [COLOR=rgb(184, 49, 47)]free testosterone[/COLOR] derived incorporating the [COLOR=rgb(184, 49, 47)]allosteric coupling of SHBG monomers[/COLOR] within the [COLOR=rgb(184, 49, 47)]dimer [/COLOR]provide [COLOR=rgb(184, 49, 47)]accurate determination of free testosterone[/COLOR] without [COLOR=rgb(184, 49, 47)]systematic deviation [/COLOR]from values obtained using [COLOR=rgb(184, 49, 47)]equilibrium dialysis. [/COLOR][/B] [B][COLOR=rgb(0, 0, 0)]Development[/COLOR][/B] Ongoing development is focused around continued study and validation in common conditions characterized by altered binding protein concentrations. Further, the incorporation of estradiol interactions will allow for wider adoption in women where estradiol levels vary greatly across the menstrual cycle. Because hyperandrogenism in women is the second most frequent indication for free testosterone determination, understanding the competitive binding and displacement dynamics is important for proper diagnosis in both healthy menstruating women and women with hyperandrogenic disorders, such as PCOS. [B]Through [COLOR=rgb(184, 49, 47)]collaborations and partnerships[/COLOR], the [COLOR=rgb(184, 49, 47)]TruT™ platform [/COLOR]presents a unique opportunity to [COLOR=rgb(184, 49, 47)]aggregate large volumes of data and metadata[/COLOR] across [COLOR=rgb(184, 49, 47)]diverse populations[/COLOR], ultimately enabling [COLOR=rgb(184, 49, 47)]deeper understanding[/COLOR] of the basis of [COLOR=rgb(184, 49, 47)]androgen disorders[/COLOR] and other conditions.[/B] [URL='https://tru-t.org/']TruT Free Testosterone Calculator by FPT[/URL] [ATTACH=full]7226[/ATTACH] If we use the linear law-of-mass action model using the [B]Vermeulen calculated FT method [/B]which is freely available to everyone online:[URL='http://www.issam.ch/freetesto.htm']Free & Bioavailable Testosterone calculator[/URL] Using my [B]TT 1200 ng/dL[/B] and [B][COLOR=rgb(184, 49, 47)]SHBG 30 nmol/L [/COLOR][/B]and [COLOR=rgb(184, 49, 47)][B]Albumin 4.3 g/dL[/B][/COLOR] [B](mean) [/B]than my [B][COLOR=rgb(184, 49, 47)]FT is 32.1 ng/dl=2.67%[/COLOR][/B] Now if I take these values [B](TT/SHBG/Albumin) [/B]and use the [B]Calculate free testosterone with [COLOR=rgb(184, 49, 47)]TruT [/COLOR]by FPT[/B] Than my [B][COLOR=rgb(184, 49, 47)]FT is 43.88 ng/dl[/COLOR][/B] or 1.52 nMol/L What a difference [B]Vermeulen calculated method FT 32.1 ng/dl[/B] compared to the [B][COLOR=rgb(184, 49, 47)]TruT calculated method FT 43.88 ng/dl[/COLOR][/B] [/QUOTE]
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