Doc's answer to "why don't you test for free testosterone......."

[RomanMVP]

Just got this email from a client of mine, on my suggestion that he get his test levels check. It can back but only as TTest. I told him it would be nice to know what his Free Test looked like. So, he sent an email off to the doc. I've never heard of free test accuracy being questioned
This is what he responded with: "

Thanks for your question. Your trainer is right that our bodies do use free testosterone. However, what your trainer may not know is the variability in accuracy in most free testosterone assays around the US. There are small subsets of patients that might benefit from measuring free testosterone via expensive, more accurate assays, but treatment decisions are based on total testosterone levels in almost all cases rather than free levels. Since your total testosterone level was in the normal range (yeah!), you wouldn't see clinical benefit from testosterone therapy. That is good in a way as there are potential harms from testosterone replacement as well. Since measuring free testosterone would not change our therapy and is more difficult and expensive to do accurately, probably not worth your time or money to do."

 

[Theworm]

They are trying to blow him off

 

[strongsafety41]

Sounds like the insurance company will not pay for testing free testosterone testing as it’s not needed for TRT. Agree with the worm, docs blowing him off as he didn’t qualify for TRT and ordering more testing (free test) will not change anything.

 

[GymRaccoon]

Just pay out of pocket at DiscountedLabs or similar if in the US. It's not THAT expensive. If TRT is warranted find a doctor willing to look at free test.

 

[TRENdy07]

He’s correct. The free test isn’t always accurate. There is a formula that is supposed to be more accurate. I’ve gotten this from some of the trt forums.

Free & Bioavailable Testosterone calculator

 

[ericsr43]

The doctor is a fucking idiot, just like doctors I've encountered in the past. There is a "Equilibrium dialysis" free testosterone test and a "Immunoassay" (more common, direct) "cheaper" Free Testosterone test. Both are measured in pg/ml, but one is more accurate then the other and that is the Equilibrium free test. The direct one only measures 1/8th of free test in my blood, but is still pretty accurate. Its always a smaller number and you usually multiply it by 8 to see what it would be for "Equilibrium" test. Quest uses the Equilibrium test and lab corps uses the direct. Most people don't know that. I tell people of forums "my free Testosterone levels are looking amazing at 40pg/ml because I get the Lab Corps direct test. So people who get the more expensive one who are used to seeing their free testosterone levels in the hundreds say "40pg/ml, that's so low of a level" which is actually the equivalent of 320pg/ml of a Equilibrium free testosterone test. Both are accurate.

 

[RomanMVP]

Just pay out of pocket at DiscountedLabs or similar if in the US. It's not THAT expensive. If TRT is warranted find a doctor willing to look at free test.

The problem with that idea is that any of these labs that do this type of testing are at least 3 hrs. driving distance from here. We don't have ready access to such labs, Yes, sucks.

 

[Fattyone]

My (old) doctor told me they never test for it because the insurance companies don’t care what it is. They only care about total T and nothing else. Just that one number. Not how they feel or any other numbers (in the context of TRT).

I go through a private clinic now. Someone who actually knows something about hormones.