Free T direct testing accuracy. (NOT)

I've been having Labcorp's free direct test all along and it seemed pretty on par with SHBG and Total T. Results were pretty consistent at and just a bit over "normal range, and in agreement with TruT calculator.

However, I currently have a unique situation. I have leukemia, and from that, anemia, and as a result of that, iron overload from all the transfusions. These things along with the powerful cancer and bone marrow stimulating drugs have thrown off many aspects of my blood chemistry. Part of this is alarmingly high SHBG.

-SHBG 138.
-Total T 1397
-Labcorp Free T direct 7.1

But plugging the numbers into TruT calculator, the Free T was 37.35, still above their "normal range"

So what to do with such wild variation? I got a Labcorp Testosterone LC/MS/MS with Free-T ultrafiltration.
-Total T 1385,
-Labcorp Free T Ultrafiltration 32.96.

What would you do regarding Free T direct? I know what I'll be doing from here on.
 
I've been having Labcorp's free direct test all along and it seemed pretty on par with SHBG and Total T. Results were pretty consistent at and just a bit over "normal range, and in agreement with TruT calculator.
You have gotten consistently inaccurate Free T results and wouldn't bother using the direct method any longer.

What would you do regarding Free T direct?

There is just no point to using such inaccurate testing methods and I would stop wasting your money on it.
 
I've been having Labcorp's free direct test all along and it seemed pretty on par with SHBG and Total T. Results were pretty consistent at and just a bit over "normal range, and in agreement with TruT calculator.

However, I currently have a unique situation. I have leukemia, and from that, anemia, and as a result of that, iron overload from all the transfusions. These things along with the powerful cancer and bone marrow stimulating drugs have thrown off many aspects of my blood chemistry. Part of this is alarmingly high SHBG.

-SHBG 138.
-Total T 1397
-Labcorp Free T direct 7.1

But plugging the numbers into TruT calculator, the Free T was 37.35, still above their "normal range"

So what to do with such wild variation? I got a Labcorp Testosterone LC/MS/MS with Free-T ultrafiltration.
-Total T 1385,
-Labcorp Free T Ultrafiltration 32.96.

What would you do regarding Free T direct? I know what I'll be doing from here on. ($$$)


TT (LC/MS-MS) 1385 ng/dL (reference range 264-916 ng/dL)
FT (Equilibrium Ultrafiltration) 32.96 ng/dL (reference range 5.00 -21.00 ng/dL)
SHBG 138 nmol/L




TT 1385 ng/dL, with an absurdly high SHBG 138 nmol/L.....FT is just over the top end!

As I have stated numerous times on the forum one can easily achieve a healthy let alone high-end or in many cases absurdly high FT even in cases of high/highish SHBG.

Hitting an absurdly high TT is not needed even in cases of highish/high SHBG.

The only way to know where your FT level truly sits is to have it tested using the most accurate assays such as the gold standard Equilibrium Dialysis or Ultrafiltration.

Especially in cases of ALTERED SHBG!

The sad fact of the matter is many are using/relying upon inaccurate assays when testing.

Many are running FT levels much higher than they think and some of these individuals are struggling with such protocol.
 

hCG Mixing Calculator

HCG Mixing Protocol Calculator

TRT Hormone Predictor Widget

TRT Hormone Predictor

Predict estradiol, DHT, and free testosterone levels based on total testosterone

⚠️ Medical Disclaimer

This tool provides predictions based on statistical models and should NOT replace professional medical advice. Always consult with your healthcare provider before making any changes to your TRT protocol.

ℹ️ Input Parameters

Normal range: 300-1000 ng/dL

Predicted Hormone Levels

Enter your total testosterone value to see predictions

Results will appear here after calculation

Understanding Your Hormones

Estradiol (E2)

A form of estrogen produced from testosterone. Important for bone health, mood, and libido. Too high can cause side effects; too low can affect well-being.

DHT

Dihydrotestosterone is a potent androgen derived from testosterone. Affects hair growth, prostate health, and masculinization effects.

Free Testosterone

The biologically active form of testosterone not bound to proteins. Directly available for cellular uptake and biological effects.

Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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