Blues Man replied: "I'm sending you a page & a site that will answer your question & any more you may have. I have serum testosterone of 452. I am a 39 year old white male. The refrence range is 241-827. I have a free testestorone of 4.02 the refrence range is 1 - 2.70. What can this mean. I have an igf1 of 417 the refrence range is 114-492. Could I be producing too much testosterone and its bieng converted to estrogen. My erections arent as hard or as frequent as they were 1 year ago. Any help ? Answer Subject: Re: free and total testosterone levels. Answered By: richard-ga on 12 Oct 2002 09:03 PDT Hello and thank you for your question. As you may have discovered in your own Internet search, one of the factors implicated in the decline of free testosterone levels is excessive binding of testosterone to carrier proteins that divert it for use in the production of other proteins/hormones, including estrogen. The therapy that directly addresses this situation is testosterone replacement, but there is some controversy about whether testosterone replacement correlates with increased risk of prostate cancer. Obviously you should consult with a qualified urologist about whether that route is appropriate for you at this time. "Testosterone within the circulation is principally bound to proteins, the most important of which is sex hormone binding globulin (SHBG). Only about 2 percent of testosterone is unbound (bio-available) and therefore free to enter cells in order to effect its biological actions by binding to androgen receptors...." "Hypotestosteronaemia levels [that is, low levels] quoted in papers vary between around 300 ng/dl (10.4 nmol/L) and 400 ng/dl (13.9 nmol/L)." HYPOGONADISM - WHAT IS A LOW LEVEL OF TESTOSTERONE? "Bioavailable testosterone refers to the 'free' portion of the hormone unbound to carrier proteins which is able to act directly upon target tissues." Sexual Dysfunction and Male Hormones "It is well known that androgen levels decline in men with age. Furthermore, as a result of the increase in binding capacity for testosterone in serum, there is an early and more dramatic decline in free testosterone, the physiologically functioning component of serum testosterone, than in the total testosterone concentration...." "The ideal therapy should consist of creating physiologic testosterone concentrations (400 to 700 ng/dL in blood taken in the morning) and restoring circadian variations." Hormone Replacement Therapy for Aging Men Since your score is higher than the 300-to-400 range that normally merits treatment, you are still within the 'normal' range, albeit at the low end of it. So you should look before you leap into a course of treatment. The following article talks about estrogen conversion and hormone replacement, but I think it's a bit over-entusiastic in its promotion of the treatment: MALE HORMONE MODULATION THERAPY Not to scare you, but here's one more thing that you should be aware of: "Of great interest is a recent finding that men with coronary artery disease have significantly lower levels of plasma testosterone than controls and that intracoronarv testosterone infusion in men with coronary artery disease increases coronary blood flow. Such findings suggest that age related declines in testosterone in men may be associated with heart disease ...." So besides discussing hormone replacement with a urologist, if you haven't had a general physical in the last few years you should do that too. Search terms used: free testosterone serum decline hypogonadism I hope you find this information useful and responsive to your question. Of course you should not consider this answer as medical advice (and I'm not a physician). Sincerely, richard-ga -------------------------------------------------------------------------------- Request for Answer Clarification by gapgapgap-ga on 12 Oct 2002 10:12 PDT You may have misunderstood my question. My free testosterone is almost 2 times higher than it is supposed to be while my total is at the low end. -------------------------------------------------------------------------------- Clarification of Answer by richard-ga on 12 Oct 2002 12:53 PDT Hello again. My answer focused on the 452 total score because that is somewhat in the low range and is consistent with the symptoms you describe. Is the 4.02 figure that you gave a calculation of your Free Androgen Index (FAI)? I assume it is, because my research indicates that FAI's reference range is 1.6 to 2.9. If it is your FAI that is being reported to you, you need not be concerned. Normal SHBG levels vary widely. The data given below puts the SHBG range at 13 to 71 nmol/L . Because SHBG is the denominator of the fraction it generates wide swings in FAI values. "The FAI is the ratio of total testosterone to SHBG. It provides a simple assessment of physiologically active testosterone. FAI = 100 x TT (in nmol/L) / SHBG (in nmol/L)" Reproductive Endocrinology Free Testosterone (Bioavailable Testosterone): Adult Male Reference Interval Free Testosterone: 47.0-244.0 pg/mL % Free Testosterone: 1.6 - 2.9% Testosterone Age 20 - 39 years: 400 - 1080 ng/dL 40 - 59 years: 350 - 890 ng/dL 60 years and over: 350 - 720 ng/dL Sex Hormone Binding Globulin [SHBG]: Age 13 - 15 years 13 - 63 nmol/L 16 - 18 years 11 - 54 nmol/L 19 - 150 years 13 - 71 nmol/L LABORATORY SERVICES HANDBOOK Male Hormones "Measurement of free androgen index (FAI) is a method sometimes used to measure free testosterone levels. There is much difficulty in using this as a measurement of free testosterone in men as the FAI was a method designed for use in women. The reference range appears to differ widely across Australia. There does not seem to be a reason for this variation." Male Hormones Please confirm what units your figure for free testosterone has been calculated in. If it is something other than FAI, I will take another look at it. Thanks, richard-ga -------------------------------------------------------------------------------- Request for Answer Clarification by gapgapgap-ga on 14 Oct 2002 07:00 PDT Sorry once again I made a mistake I have a free testosterone count of 18.17 out of a range of 5 - 21. My ratio of free to total was 4.02 which was almost 2x as high as normal. What can you find out about this ? -------------------------------------------------------------------------------- Clarification of Answer by richard-ga on 14 Oct 2002 15:42 PDT Hello again: I think it's best to look at the serum testosterone and free testosterone figures separately. You report serum testosterone of 452, free testosterone of 18.17, and 18.17/452 = 4.02% free. The reference range for serum testosterone is 241-827 (this source says 350-1030 with a mean of 627 over ages 20-50); the reference range for free testosterone is 5-21 (this source says 5.2-28); and the reference ratio is 1-2.7 (this source says 1.5-3.2). (page 36-37) I really think you shouldn't worry about the ratio. True, your serum number is a little on the low side and your free number is a little on the high side. But to say your ratio is twice as high as normal exaggerates the effect. Here's an arithmetical example. Say a ratio of 2.5% is 'normal', and arises from a ratio of 12.5/500. If you couple a 30% increase to the numerator with a 30% decrease to the denominator, the fraction becomes 16.25/350 or about 4.6%. So there's nothing unusual about your numbers. As for your symptoms, a visit to a urologist would still be a good idea. Sincerely, richard-ga Comments Subject: Re: free and total testosterone levels. From: dani32-ga on 17 Feb 2005 15:04 PST Hi: I am a 30 yr old male and have experienced hot flashes now for about 3.5 months. I have seen my regular PCP who did all the bloodwork and found absolutely nothing. I have gone to an endocrinologist who has repeated all the bloodwork, has ordered a 24 hr urine 5hiaa, and an octrioscan, and still nothing. My testosterone level is 334 ng/dL and free test is 2.4% or 80.5pg/mL. Do you believe I could suffer from Hypogonadism? If yes, what should I do to convince my doctor that he should give me the proper treatment? Many thanks for your reply. -------------------------------------------------------------------------------- Important Disclaimer: Answers and comments provided on Google Answers are general information, and are not intended to substitute for informed professional medical, psychiatric, psychological, tax, legal, investment, accounting, or other professional advice. Google does not endorse, and expressly disclaims liability for any product, manufacturer, distributor, service or service provider mentioned or any opinion expressed in answers or comments. Please read carefully the Google Answers Terms of Service. I hope this helps you."

John I replied: "Hormones are produced by glands, you seem to have glands that are working overtime!"