Testosterone Labs Explained

Testosterone Labs Explained- Normal does not = optimal

By Haley Scellick, ARNP

So often I hear of patients saying they have had labs drawn and their levels are normal from their provider. In a conventional setting, a provider often will tell the patient if the reading is outside of the lab normal reference range. But is this optimal? The answer is often No! Many lab markers have very wide reference ranges, for example vitamin D ranges from 30-100 ng/ml. Even though 30 is “normal,” this is not optimal. Optimal is 60-80 ng/ml for vitamin D. What about testosterone for men? This is a very common one that has gained more attention, and while ideal that this is being checked more often, the ordering provider may not be checking all the levels for optimizing testosterone. For example, for testosterone to be considered low by conventional range and insurance approval for testosterone coverage, total testosterone has to be below 300 ng/dl on 2 separate lab draws. By definition, 301 ng/dl will not classify the patient with low testosterone. Again, this is certainly not optimal. But for men, the total testosterone is not near as important as the free testosterone, which is often not checked. The free testosterone is what is the active testosterone in men. Testosterone should not be bound up and should be free (active). The free testosterone reference range is from 2.3-20 ng/dl, so 2.3 would by definition be within range, but certainly not optimal. The optimal range for free testosterone for men ages 35+ is 15 ng/dl. The optimal range for total testosterone is based upon the free testosterone ranges. Furthermore, checking the sex hormone binding globulin (SHBG) can also be useful to ensure that too much of the total testosterone is not bound up. There are many root causes as to why testosterone is bound and not active.

At First Responder Health and Wellness, we utilize a comprehensive lab approach to not have ‘normal’ but optimal results as these are where the symptomatic changes improve.