TESTOSTERONE- FREE

At Cadabams Diagnostics, we are committed to providing clear and comprehensive information about your health. This guide focuses on the Free Testosterone test, an important diagnostic tool for understanding your hormonal balance. We'll explore what TESTOSTERONE-FREE levels signify, why this test is performed, how to prepare, and what your results might indicate.

What Is the Free Testosterone Test and Why Is It Important? 

Testosterone is a vital hormone for both men and women, though present in different amounts. In your bloodstream, most testosterone is bound to proteins. However, a small percentage circulates as free testosterone, meaning it is unbound and active. The Free Testosterone test specifically measures this active component. 

Understanding TESTOSTERONE-FREE levels, the amount of this unbound active hormone, is critical because it reflects the testosterone that is available to exert its effects on your body's cells and tissues. Total testosterone tests measure both bound and unbound testosterone, but sometimes this total level doesn't accurately represent how much active hormone is available. For instance, if SHBG levels are abnormally high or low due to conditions like liver disease, thyroid problems, or certain medications, the total testosterone might be misleading. Measuring free testosterone provides a more precise picture of your active hormone status. 

The importance of this test lies in its ability to: 

• Help diagnose hormonal imbalances more accurately 
• Guide treatment decisions for conditions related to testosterone abnormalities 
• Monitor the effectiveness of hormone replacement therapies 
• Provide insights into symptoms such as low libido, fatigue, infertility, or changes in physical characteristics 

It's important to clarify a common point of confusion related to the term "testosterone-free". When we discuss TESTOSTERONE-FREE levels in a medical context, specifically with this test, we are referring to testosterone that is free from binding proteins in your bloodstream. This is distinctly different from products or supplements that are marketed as being "testosterone-free", meaning they do not contain the hormone testosterone. This test measures your body's own naturally occurring unbound testosterone.  

The Free Testosterone test quantifies the concentration of unbound testosterone in your bloodstream. This unbound form is the biologically active portion of the hormone, meaning it can readily enter cells and interact with androgen receptors to carry out its various functions. 

Here's a more detailed look at what this measurement signifies: 

• Biologically Active Hormone: Only free testosterone can bind to receptors in target tissues throughout the body. Bound testosterone, particularly that attached to SHBG, is generally considered inactive until it becomes unbound 
• Circulation in the Body: Testosterone is produced primarily by the testes in men and the ovaries in women, with smaller amounts from the adrenal glands in both sexes. Once released into the bloodstream, a large portion binds tightly to SHBG, while a smaller portion binds loosely to albumin. Only about 1–4% typically circulates as free testosterone 
• Physiological Roles: Free testosterone plays a crucial role in numerous bodily functions, including: 
• In Men: Development and maintenance of male reproductive tissues, secondary sexual characteristics, libido, sperm production, and mood regulation 
• In Women: Ovarian function, bone strength, libido, and overall energy levels. An excess of free testosterone in women can lead to symptoms of hyperandrogenism 

By measuring the TESTOSTERONE-FREE fraction, doctors can better assess whether an individual has an appropriate amount of biologically active testosterone to support these essential functions. 

Your doctor at Cadabams Diagnostics may recommend a Free Testosterone test if you are experiencing symptoms or have conditions that suggest an imbalance in your testosterone levels. The test is often considered when: 

Symptoms prompting the test in men: 

• Low libido 
• Erectile dysfunction 
• Infertility or low sperm count 
• Unexplained fatigue and decreased energy 
• Loss of muscle mass and strength 
• Increased body fat or gynecomastia 
• Loss of body or facial hair 
• Mood changes such as depression or irritability 
• Reduced bone density 
• Difficulty concentrating 

Symptoms prompting the test in women: 

• Hirsutism 
• Acne 
• Irregular menstrual periods or amenorrhea 
• Suspected PCOS 
• Infertility 
• Deepening of the voice 
• Clitoromegaly 
• Female pattern hair loss 
• Decreased libido 

Other situations where the test may be ordered: 

• Monitoring testosterone replacement therapy 
• Evaluating medication impact on testosterone or SHBG 
• Assessing children with early or delayed puberty 
• Investigating ambiguous genitalia in newborns 
• As part of pituitary or adrenal disorder evaluation 

The Free Testosterone test is generally safe, with minimal risks associated with blood draws: 

Risks: 

• Bruising 
• Dizziness or fainting 
• Infection at the puncture site 
• Temporary discomfort or pain 

Limitations: 

• Time of Day: Testosterone peaks in the morning 
• Medications: Can alter hormone levels 
• Illness: Can temporarily suppress testosterone 
• Age: Levels decline naturally with age 
• Obesity: Linked to lower testosterone 
• Chronic Conditions: Affect SHBG or hormone production 

Other limitations: 

• Must be interpreted with Total Testosterone, SHBG, LH, and FSH 
• Lab methods differ; use the same lab for consistency 

1. Free Testosterone: 
2. Measured directly or calculated 
3. Most biologically active hormone 
4. Total Testosterone: 
5. Includes both free and bound testosterone 
6. Contextualises the free testosterone level 
7. SHBG: 
8. Binds tightly to testosterone 
9. Affects how much is free 
10. Albumin: 
11. Binds weakly to testosterone 
12. Sometimes used in calculated free testosterone 

Your report from Cadabams Diagnostics will include your TESTOSTERONE-FREE value with age and sex-based reference ranges. 

• Men with symptoms of low testosterone 
• Women with signs of high androgen levels 
• People with pituitary or adrenal disorders 
• Those on hormone therapy 
• Anyone with abnormal SHBG levels 
• Cases where symptoms and total testosterone don't match 
• People with infertility 
• Children with early or delayed puberty 

1. Accurate Diagnosis: Especially where SHBG skews total testosterone 
2. Treatment Guidance: Supports PCOS, hypogonadism, or replacement therapy 
3. Therapy Monitoring: Ensures safe and effective hormone management 
4. Understanding Symptoms: Clarifies fatigue, mood issues, or sexual dysfunction 
5. Informed Lifestyle Decisions: Baseline data supports supplement or treatment plans 
6. Preventing Complications: Helps avoid bone loss, infertility, or PCOS-related issues 

In Men: 

• Primary or secondary hypogonadism 
• Testicular dysfunction 
• Erectile dysfunction 
• Infertility 

In Women: 

• PCOS 
• Hirsutism 
• Virilisation 
• Adrenal or ovarian tumours 
• Irregular menstruation 
• Infertility 

n Both: 

• SHBG-related conditions 
• Effectiveness of hormonal therapies 

In Children: 

• Delayed puberty 
• Precocious puberty 

Instructions: 

• Morning Blood Draw: Preferred between 7–10 AM 
• Fasting: Confirm with Cadabams or your doctor 
• Medication Disclosure: Especially hormone-impacting drugs or supplements 

Prerequisites: 

• Doctor’s referral 
• Discuss concerns with lab staff 

Eligibility: 

• Suitable for all with clinical indication 

Procedure: 

1. Area cleaned and tourniquet applied 
2. Needle inserted into vein 
3. Blood collected into tube 
4. Needle removed and site dressed 
5. Process takes only a few minutes 

Caution: 

• Always disclose all meds and supplements 
• Let your doctor know about hormone therapy or acute illness