The measurement of free testosterone in serum is used to evaluate hirsutism and masculinization in women as well as to evaluate testicular function in clinical situations where serum testosterone binding proteins may be affected (obesity, cirrhosis, thyroid disorders).
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Testosterone is the primary male hormone. It is responsible for the development of external genitalia and secondary sexual characteristics in males. In women, its main role is as a precursor to estrogen. In both sexes, it exerts anabolic effects and affects behavior.
In men, testosterone is the main androgen and is secreted by the interstitial cells of the testes, known as Leydig cells. Testosterone promotes the growth and development of the genitals in males, contributes to muscle growth, stimulates hair growth in the armpits, face, and pubic area, and promotes spermatogenesis. Testosterone is usually measured in tests for the detection of impotence and in the investigation of infertility.
In women, testosterone is secreted in small amounts by the ovaries and adrenals. The maximum levels are noted in the middle of the menstrual cycle. Testosterone measurement is commonly used for the evaluation of ovarian tumors, hirsutism, and in the investigation of infertility.
The measurement of blood testosterone levels, in combination with the measurement of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels, helps assess the potential dysfunction of the gonads (testes and ovaries) in both sexes. Testosterone circulates in the blood both as free and as bound in plasma proteins (sex hormone-binding globulin, SHBG). Total testosterone is a measure of total circulating testosterone (free and bound). Free or unbound testosterone is the active form of testosterone.
The concentration of free testosterone is very low, usually less than 2% of the total testosterone concentration. In most men and women, approximately 50% of total circulating testosterone is bound to the sex hormone-binding globulin (SHBG) and most of the remainder is bound to albumin. Common laboratory methods of analysis used to measure total testosterone are not sensitive enough for the measurement of free testosterone, which makes the interpretation of results more difficult.
Very good alternative tests to free testosterone measurement are bioavailable testosterone and free androgen index.
Important Note
Laboratory test results are the most important parameter for the diagnosis and monitoring of all pathological conditions. 70%-80% of diagnostic decisions are based on laboratory tests. The correct interpretation of laboratory results allows a doctor to distinguish "healthy" from "diseased".
Laboratory test results should not be interpreted from the numerical result of a single analysis. Test results should be interpreted in relation to each individual case and family history, clinical findings, and the results of other laboratory tests and information. Your personal physician should explain the importance of your test results.
At Diagnostiki Athinon we answer any questions you may have about the test you perform in our laboratory and we contact your doctor to get the best possible medical care.
