I got results today:
Total T = 14
Free Androgen Index (FAI) = 100
SHBG = 15
I’m confused about what they mean? Would be grateful for any comments.
I’d say not much,there is no scale or reference range so these figures are quite useless.
Forgot to stick them in. Here they are:
Total T = 14 (10 - 42 nmol/L)
SHBG = 15 (13 - 50 nmol/L)
Am I low in T? I’m confused about what they mean? Would be grateful for any comments
Your testosterone level is fair low for a young man and if you have symptoms of testosterone deficiency would point to a possible lack of free testosterone.
The FAI or Free Androgen Index is a method that some endocrinologists use to ascertain free testosterone status.
Unfortunately it was created for use in women and should NOT be used to evaluate testosterone status in men. At least this is what the Endocrine society in Australia say.
Often endocrinologists try and tell men with low/borderline low testosterone levels that they are fine because their SHBG is low and that their FAI shows that they have a good level of free testosterone.
Unfortunately this is deliberately misleading the patient and complete hogwash.
First of all the FAI is not a laboratory assay/test. It is a little theoretical calculation that gives a guide or guestimate as to how good free testosterone might be in an individual.
The guestimate can be at complete odds with the reality.
In fact completely absurd results occur with FAI levels when SHBG is very low or quite low and/or estradiol is elevated or high.
I had an FAI of around 170 (unit less figure). The result suggested that I was overdosed on testosterone replacement and needed to reduce treatment. Testosterone deficiency according to the FAI is when the result is less than 60/70.
However I had a free testosterone test (an actual test as opposed to a guestimate) and this showed that my actual free testosterone was actually smack bang in the middle of the reference range. In other words the FAI said I was vastly overdosed when in fact I wasn’t even close to the top of the reference range for testosterone.
Testosterone deficiency in men should take into account age and symptoms and not just bloods and should certainly never be ruled in or out on the basis of utterly flawed guestimates that were not even created for use in men.
The FAI calculation;
Total testosterone in nmol/l multiplied by 100 and divided by SHBG in nmol/l = FAI
Therefore a man with a testosterone level of 5nmol/l (average for a young man is about 25nmol/l) and bottom of almost all reference ranges regardless of age are 8/12nmol/l.
With an SHBG level of 4nmol/l….
5 X 100 / 4 = 125 which could be said to have high testosterone levels.
So with a virtually non existent level of testosterone you would be said to be A1 and if anything have too much testosterone.
The above shows that an individual showuld have a high free percentage of testosterone. But this does not mean that, the amount of free testosterone is remotely high enough.
Analogy;
If you were paid $20 a year and your bills came to $2 then you would have a relatively high percentage of free funds available, but that is not relevant as the total level would be of little use to the individual concerned.
The opposite would be if an individual was paid $1,000,000 a year and had bills amounting to $800,000 a year. In the latter case the percentage of free income would be low but the amount of total income might well be more than enough.
I hope I have busted the idea that the FAI should ever be used in ascertaining free androgen/testosterone levels and diagnosing or ruling out diagnosis of androgen issues.
I have deliberately laid out an extreme example to show how flawed the FAI is, but that is to show how its calculations become bizarre with certain levels (the individual concerned could expect an odd result with low their fairly low SHBG level).
Not only is the above ridiculous but that is without even mentioning the fact that elevated estradiol also lowers free testosterone and that doesn’t even form part of the FAI equation.
The FAI is not used in the US or Australia….it shouldn’t be used anywhere.
I would recommend that the person in question in the initial post obtains a free testosterone test to ascertain exactly what their free testosterone status is.
P.S
Anyone can print this out and take it to their endocrinologist.
Thank you for your permission to present your patented literature. Can I give my Endo your phone number so you can work with him over the phone? We talked about you and he mentioned you are an expert in male hormones…in laymens term ofcourse because none of the hormones are your own rather they’re in you via prescription/injections.
You’re just following me around webiste looking for arguments and trying to be destructive Rockin, I’m not giving you the entertainment that you are looking for.
Please think of others at the site and stop acting this way, being childish and vindictive helps no one and it doesn’t get us anywhere.
What I have posted in this thread was/is VERY relevant.
In terms of the endocrinology, I have actually spoken on the phone and engaged in various correspondance with endocrinologists on behalf of patients and made a real difference. I have educated quite a few endocrinologists on this one specific area of medicine because as a hypogonadal patient involved in support groups, I have sometimes understood more about certain aspects of the condition. I have also helped people obtain second opinions from differing endocrinologists. I have also helped some men ditch their endocrinologists where they were ill and got them appoitments with more able specialized endocrinologists who have helped them regain their health.
Rockin irrespective of whatever you think of me, what you are doing is not helping anyone and you need to stop it.
That’s fair.