While this chart doesn’t show average free testosterone levels, I like the fact that it shows the T levels of men in the bottom five and ten percentiles as well as the T levels of the men in the top 95%. You can see how you compare to men with the lowest and highest T levels. According to this chart, my beginning T level (383 ng/dl) was near the bottom 5% and 10% across all age groups. Even for 55-59-year-old men. (Boo!) My testosterone level after 90 days of good living (778 ng/dl), was above average for my age group (Bully!). These charts are a much better source than labs’ reference ranges to check if your T levels are normal. If your doctor tells you that your T levels are normal, make sure to compare the results to these charts to ensure he’s not shortchanging you. As far as normal percentages of free testosterone go, ~2-3% is considered normal. If you’re significantly below that percentage range, you’ll likely experience symptoms of low T even if your total T is average or abovemeasurement. The problem is that , which is why endocrinologists typically don’t use saliva or urine samples when diagnosing low testosterone levels. Instead they use blood serum tests. While blood tests are much more accurate and sensitive than saliva or urine tests, they’re also much more expensive — blood tests for total and free testosterone can set you back $130. Because I wanted the most accurate results, I went with the blood serum testing. What I didn’t know before I got tested was that there are different kinds of testosterone blood tests, some more accurate than others. As I mentioned at the beginning of the post, there isn’t much standardization amongst labs when it comes to testing. Some labs use one method, while another lab will use another test. I later learned that the blood test I used to measure my total testosterone for my experiment wasn’t the most accurate on the market and wasn’t what the CDC is recommending labs use in their goal to standardize hormone testing.(I tested myself a month after my 90-day experiment with the blood test the CDC recommends. I’ll share my results in a bit.) I also learned that measuring free testosterone is pretty dang hard and that most free T measurements that labs give are typically just estimates. Below I share what I learned about the confusing world of testosterone blood tests. Blood Tests for Total Testosterone ECLIA Method. When I tested myself for total testosterone for my experiment, the method the lab used was ECLIA, short for Electrochemiluminescent Immunoassay. It’s a fast and affordable method to measure total testosterone in your blood. Many labs use this method because it’s automatic and doesn’t require too much work on a lab technician’s part. However, some studies have shown that values obtained with ECLIA are significantly higher compared to the more reliable LC/MS method. Which brings me to… LC/MS Method. LC/MS is short for liquid chromatography-mass spectrometry. It’s considered the goldstandard method by many researchers in measuring small molecules. Its accuracy and consistency is why the CDC is recommending LC/MS to be the standard method used when testing total testosterone. Because LC/MS is more sensitive than ECLIA, doctors typically use this method when testing patients with really low testosterone levels, such as women and children. While it’s more accurate and sensitive, the LC/MS method is more expensive than ECLIA. And it takes a bit longer to get your results. A month after my 90-day experiment, I got tested again, but this time using the LC/MS method. My total testosterone level using this method was 826.9 ng/dl. Meaning my T levels increased even more since starting my testosterone changes. You’ll have to make the call on which method you go with. If you don’t think you have extremely low T, ECLIA will work just fine. Just know that most researchers see LC/MS as the method that produces the most accurate and consistent results. Labs often offer bothECLIA and LC/MS tests. Later on, I’ll share where you can get tested using either method. Blood Tests for Measuring Free Testosterone Reading about the myriad of ways to measure free testosterone has nearly put me in the nut house. It’s confusing. The problem that labs face is that there is so little free testosterone in our body, it’s hard to measure directly. Below I lay out the methods available right now to measure free T. RIA Direct. It’s cheap, fast, but not very accurate. Recent studies have been calling into question the use of RIA direct methodology to measure free testosterone. Unfortunately, most labs across the country only use RIA direct because of its cost effectiveness. LabCorp, the lab I used, only measures free T using RIA direct. Despite the criticisms levied at RIA direct tests, many researchers believe it’s an adequate method for routine tests. Equilibrium Ultrafiltration. Many in the field of endocrinology argue that equilibrium ultrafiltration is a superior andmore accurate testing method to RIA direct. The problem is that many commercial labs don’t offer the method because it’s so time consuming and requires well-trained technicians. If you can find a lab that uses equilibrium ultrafiltration, expect to spend a bit more than you would for a RIA direct. Calculated free testosterone. Instead of directly measuring free testosterone in your blood, . The problem with this method is that 1) it’s not very accurate and 2) it requires you to pay for three different tests: albumin, SHBG, and total testosterone. This can get pretty expensive, pretty fast. As you can see, you have a variety of options when getting tested for T levels. My recommendation is to try to get your total testosterone number using the LC/MS method and use whatever method is available and cost effective to measure free testosterone. Of course, I’m just a guy who writes a blog about manliness, so take that recommendation with a grain of salt. Where to Get Tested for TestosteroneAlright, so you might be asking your computer screen, “Where do I get tested?” If you’re suffering symptoms of low testosterone, ask your doctor to order a blood test for you. Insurance might cover it. If you’re just curious about your T levels, you actually don’t need a doctor’s order. You can sign-up for a test yourself. Here’s how: Order the test. You’ll need to order a blood test using a website that sells blood tests to consumers. No, you don’t send the website a blood sample. These sites contract with labs across the country to draw blood. They basically act as a middleman.Here are the sites I used to buy my tests: . You can order a . Just be aware the methods that Health Testing Center will request are ECLIA for total testosterone and RIA direct for free testosterone. . You can order. They say you can order an equilibrium ultrafiltration free testosterone test, but when I got my lab results back, it showed that the direct method was used. I’m still looking into that, but wantedto give you the heads up. You can also order albumin and SHBG tests from both Health Testing Centers and Request a Test so you can use the calculation method to figure out your free testosterone levels. Go to a local lab. After you pay for your blood test, you’ll get an email from the website with your order information. You’ll also be told which lab you need to visit in your area to have the test done. Both Health Testing Centers and Request a Test sent me to . If you’ve ever applied for a job that requires a drug test, you’ve probably been to LabCorp yourself, as they are a national company. Get blood drawn. A nice nurse will draw some blood samples. The whole process takes less than 2 minutes. It’s best to get your blood drawn first thing in the morning, as T levels are at their highest in the morning and steadily decline throughout the day. Get your results. Two or three days later, you’ll get an email from the lab with your results. Test more than once. Because testosterone levelsare sensitive to a whole host of environmental factors, it’s important to get tested more than once when diagnosing low T. You could have below average T levels one week, but slightly above average the next. This is particularly important if your doctor is considering putting you on testosterone replacement therapy. You don’t want him to make the decision from a single test! Conclusion Whoo, that was a lot of info. If you feel a little lost, here’s a crib sheet: Don’t use lab reference numbers to determine if your T is low. They’re not usually accurate. Use the charts above for your specific age range. Take a blood test to determine your total T levels. You can get this blood test at the doctor, or by signing up online and going to a local lab. Make sure to get tested in the morning! If you can, take the LC/MS test to measure your total T — it’s the most accurate. If that’s not available, the ECLIA test will work okay. To find your free T, try to use the Equilibrium Ultrafiltrationtest — it’s the most accurate. If that method isn’t available, the RIA Direct test will work okay. I hope this information was useful. I definitely learned a lot in the process. Again, if anybody sees any corrections that need to be made or if I missed anything, please offer your constructive and friendly feedback. Tomorrow we’ll cover that long awaited subject : how to boost your testosterone naturally. Testosterone Week Series: Tags:
