Free T vs Total T - Cutoffs and Symptoms - Where Are the Data?

madman

Super Moderator
25th Annual Fall Scientific Meeting of SMSNA!

Grapevine, Texas.




1:14:05-1:29:40
1760375353653.webp





Recommendatios for Dealing with Free T

1760382711192.webp





Concept of Total Hormonal Load
1760382791385.webp





Keep in mind all those men with normal TT and high SHBG!

Reasonable, Evidence-based Recommendation for Managing T
1760383087038.webp
 
As I have stressed in previous threads keep in mind that the bound fractions albumin/SHBG still serve a purpose and are not useless binding proteins as many stinking up all those so called HRT/men's health forums let alone those so called gurus polluting the net CLAIM!

As I have been preaching numerous times on the forum over the years although TT is important to know FT is what truly matters as it is the unbound fraction of T responsible for the positive effects.

As of now the true heavyweights in the field Dr. Bhasin and Dr. Jasuja (Brigham and Women's Hospital)), Dr. Fiers and his team (UZ Ghent), the father of testosterone Dr. Morgentaler and numerous top uros/andrologists including, Dr. Zitzmann, Dr, Traish, Dr. Corona, Dr. Anawalt, Dr. Khera, Dr. Mulhall and I could throw many more in there too have been stressing the importance of the most critical fraction free testosterone!







Misconceptions About Bioavailable T

*Hammes A, et al: 2005 Cell.

1760375779761.webp

1760375824407.webp

1760375855972.webp

1760375900323.webp






























------------














 
* There is no 1:1 mapping for TT:fT




Understanding Sensitivity/Specificity

...and the relevance of symptom-specific thresholds

1760377863923.webp






Sensitivity and Specificity Review
1760377986711.webp

1760378084232.webp





Summary of Sensitivity/Specificity
1760378145924.webp
 
Key Concepts - Tissue Thresholds
1760378592399.webp





Key Concept - Different Thresholds

* Different symptoms/findings will manifest at different thresholds

* But there is variability between individuals as well, these are just averages


1760378902704.webp





* While this average libido may be right here say 550 ng/dL or so your gonna have some people that its not until 700 ng/dL and your gonna have some people that its around 300 ng/dL so you have that natural variability in each of the populations that creates that spread

1760379153160.webp





Combined Concepts

* Set the threshold at say at 200 (6.9 ng/dL) for a study your gonna capture all those with low PSA, most anemias, some osteopenia, and a very small percentage of the libido group so you have to take that into account when interpreting the data for that particular threshold so again you will have high sensitivity for some things low specificity and vice versa as that flips


1760379558876.webp





* Now you set it again a little bit higher say at 400 (13.9 ng/dL) now you are going to capture all the measures but your not very specific for any of the measures so your going to capture all these people but your treatment isn't going to be very effective

1760379633321.webp
 
Total T and Free T Are Two Different Tests
1760380951070.webp





Can't Extrapolate Just Because They Both Assess T
1760381152466.webp





We Don't Have Much Data on Free T
1760381244555.webp
 
* Hormones are more complex than testosterone


* E2 plays a role in the 'feel good' side of the total hormone load





Concept of Total Hormonal Load


1760381861072.webp





Concept of Total Hormonal Load
1760381930164.webp





Case in point - Anastrozole
1760382088546.webp
 

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

Beyond Testosterone Podcast

Online statistics

Members online
9
Guests online
404
Total visitors
413

Latest posts

Back
Top