What is Testosterone Test : Interpret Low Testosterone( Low T) levels & Normal Range : Dr Kasi MD
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- čas přidán 9. 09. 2024
- #testosterone#infertility#lowT
interpretyourbl... for web exclusive content.Video describes the interpretation of testosterone and diagnostic approach in low testosterone
Disclaimer:
IYBT is not a substitute for your Doctor consultation. Blood work only acts as a supportive workup to your physical examination and always needs to correlated by a professional doctor before taking any step in the management. Hence, seeking the advice of a professional doctor in the related field is adviced for questions related to you symptoms , diagnosis and management.
If you have or suspect that you have a medical problem or condition, please contact a qualified health care professional immediately. You should never disregard or post pone the medical advice given by your doctor just because you have seen or read the content in the channel
What is the Testing Preparation ?
Sample : Venous blood is collected
Fasting : Required
Time : Ideally sample is drawn between 8 to 10 AM.
What is the normal range of Testosterone ?
Males :
PrePuberty : Less than 43 ng/dL
20-49 yrs : 241 to 827 ng/dL
Over 50 yrs : 181 to 770 ng/dL
Females :
Pre Puberty : Less than 28ng/dL
Ovualating : 20 to 92 ng/dL
Post menopausal : 4 to 74 ng/mL
Where is it produced and how is it regulated ?
In males testosterone is produced in males , However in females the testosterone is produced in ovaries as a precursor to estradiol.
The Two major cells present in the testis are
Leydig cells
Seratoli cells
Leydig cells produce testosterone while seratoli cells produce Inhibin B which helps in feed forward inhibition. Both these cells act upon stimulation received from anterior pituitary gland in the form of LH and FSH.
Hypothalamus: It is the master regulator in the production of testosterone. The Arcuate nucleus region of hypothalamus initiates the production of testosterone by secreting Gonadotropin releasing hormone( GnRH ). The secretion of GnRH is pulsatile.
Action of GnRH:
It stimulates the Anterior pituitary to release gonadotrophins ( FSH&LH)
The release of FSH & LH is pulsatile vowing to the nature of pulsatility of GnRH
Action of Gonadotropins
Gonatrophins act on the testicular tissues to help in spermatogenesis.
LH stimulates the leydig cells of testis to release testosterone.
The exact role of FSH is still incompletely understood in
Feedback Control of gonadotropins:
1.At the Hypothalamic level: testosterone secreted by leydig cells will inhibit the production GnRH
2.At the pituitary level : Inhibin B secreted by seratoli cells inhibit the release of FSH & LH
3.Clinically whenever the levels of testosterone is decreased, LH & FSH levels are increased and viceversa
Transport of Testosterone :
Testosterone in circulation exsists as
Bound form to SHBG-44%
Bound form to Albumin -54 %
Free Testosterone-2%
Sex Hormone Binding Globulin and Albumin are the proteins which transports testosterone. Protein bound testosterone is unavailable and not active. The free testosterone is the active component. Levels of SHBG are around 30 - 50 % higher in females , hypogonadal men and children before reaching puberty
Testosterone interpretation
Testing for Total testosterone is the best initial test in the evaluation of the Hypogonadism . Levels of LH and FSH will help in diagnosing primary and secondary Hypogonadism.
Primary Hypogonadism : Decreased testosterone with increased FSH and LH essential indicates the disorder to be primary, indicating problem in the testicular tissue. Increased FSh it self is sufficient to diagnose the primary disorder even in the presence of low normal testosterone and normal LH.
Secondary Hypogonadism : Levels of the testosterone together with LH and FSH are low . This indicates the problem with pituitary gland.
Role of SHBG : SHBG levels are significant in regulating the freely available testosterone.
Conditions which increase SHBG : Hyperthyroidism , Estrogen administration ,Aging, HIV, Epileptic medication
Conditions with decreased SHBG: Obesity , Hypothyroidism, Androgen administration , Type 2 DM , Increased GH, progestins, nephrotoxic syndrome
Role of Free testosterone:
Testing for free testosterone is specifically important in the presence of equivocal total testosterone levels . Ideally it is always ordered together with SHBG.
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I’m 39.5 years old and just had my “Free Testosterone” analyzed and it came back. RESULT : 15.8 pg/ml , REFERENCE VALUE 1.0 - 28.3 , SAMPLE : Serum 4-8 degrees C . I have no idea what any of that means and I am still clueless as to whether my free testosterone is normal high or low.
I’m in the same boat
Hi Sir thank you for such important information and your explanation is very easy to understand thanks lot
Hi sir i am 26 year old height 5.5. Current my FSH -1.88, LH-2.17, Testosterone -528.86 (all serum by CMIA) i am very tense so please give me suggestion regarding body growth thanks in advance
my SHBG result comes 17.6 nmol/L. i am male with 28 age. it is normal? should i take test testosterone?
Bhai mera testosterone totel 6.46 ng/ml hai ye normal hai ya kam hai
Just got off phone with nurse from hospital, I had lab work tested for Testosterone and expected numbers between 300 - 1000 but they gave me results at 3.3 and told me my testosterone results are normal, totally confused...... by the way when I initially asked for testosterone test during doctor visit, my doctor seemed kinda against it really weird.....
So your level is 330 ng/dl how old are you?
@@Simon-wz6km I’m 36
@@eaj2900
I had my levels tested in 2018 and my level was 317 ng/dl and they said this was in the normal range but this level is actually very low and does affect the quality of your life, especially if you're under 40 years old.
I started to take 3000IU of vitamin D3 and also take 50mg of zinc daily. I was retested a few weeks ago and my level had increased to 410 ng/dl so If you're around the 300 level then this may increase your level by around 30%.
@@Simon-wz6km Hi mate, i just had my Testosterone tested and it came back as 10.5nmol/l which is 303ng/dl, they said i was in the normal range, do you think this is low? Im 40 years old