Free Androgen Index

Discussion in 'Men's Health Forum' started by zadok, Jun 23, 2007.

  1. #1

    zadok Junior Member

    Just want to clarify something. I always thought that FAI was calculated by Total testosterone/SHBG. However on the last blood work I had done FAI was the most expensive test. Is there an actual blood test done to confirm the calculation or did I just get ripped off?

  2. #2

    JanSz Junior Member

    Give the name of laboratory that you have used.
    Free Androgen Index (FAI), Serum
    Next time use Quest Diagnostics,
    ask for
    Free, Bioavailable, and Total Testosterone,
    as a output you will get
    Testosterone, Free, Bio/Tot
    Testosterone Total (included in T panel)
    Testosterone Free(included in T panel)
    Testosterone Bioavailable(included in T panel)
    SHBG(included in T panel)

    just be careful, they have similar test (that you do not want)
    Free and Total Testosterone
  3. #3

    HeadDoc Psychologist; Super Moderator

    I don't have the answer. It would require going to the website for the lab you used and getting that information. On the other hand, I have found the following calculator useful.
  4. #4

    JanSz Junior Member
    Use this chart (freeT)
    input your SHBG,
    run line thru 160-250
    on left read TotalT that you need,
    Chart assumes Albumin=4.3
    The calculator...
    I was using it, but no more.
    Do not waste money if cant use Quest.
    The gold standard at the moment is BioAvailableTestosterone from Quest Diagnostics.
    In one of the posts (that I cannot find now) I used mine and somebody elses BioT results as done by Quest and compared them with results from calculator.
    Results from calculator are not even related.
    There is a problem with accuracy of BioT assays or/and calculation algorytms.
    I found two papers, 2006 and 2007.
    2006 paper says the error is (1.5–2.2) that is huge
    2007 paper says it is even larger 2.28 vs 3.48

    to make it worst it vary with the age.

    I invite help on this thread:
    age-associated Bio-T
  5. #5

    cpeil2 Junior Member

    It depends. Yes, it is a calculated value. If you got TT and SHBG done, then calculating FAI should have been a simple matter of using the already available TT and SHBG values.

    But if FAI was the only thing ordered, then they would have had to do TT and SHBG in order to calculate FAI - effectively two tests plus a calculation. That would have cost a few bucks.
  6. #6

    zadok Junior Member

    SHBG and TT were ordered, along with E2, prolactin, DHT, LH, FSH, and i paid for all of those as well. Also all these were in the right range.

    The reason why I am asking this question about FAI is that I have used a couple of different labs, on uses FAI and the other measures Free T. The FAI alway comes back around 1 (good) but when I have the free test measured it is around 50 pmol/L (45-149). I know free test is not necessarily an accurate measurement, but this has happened around 4 times.

    I feel like crap. Nobody can quite explain to me why TT and E2 are at normal levels but FT is so low...

  7. #7

    HeadDoc Psychologist; Super Moderator

  8. #8

    zadok Junior Member

    Good thought, however that is also well within range. I have seen about 6 different Endo's in Dubai (none who appear to have much experience with sex hormones). Not one of them has any idea what is wrong me. Especially when they see the set of results with the FAI, everything is perfect.

    I have been told that it it could be phsycological, but there are too many physical symptoms for me to believe that. My penis is small and shrunken, I find it hard to get erection, even with viagra. I am bloated all the time, I have lost weight, I am tired and irritable all the time and I have absolutely no drive or libido.
  9. #9

    JanSz Junior Member

    Post link to post that contains your blood test results with ranges and units.
    Also medicine and supplements that you have been taking, that coresponds to that blood test.
  10. #10

    HeadDoc Psychologist; Super Moderator

    thyroid? adrenals? lifestyle consistent with good health?
  11. #11

    Megazoid Junior Member

    zadok, i started putting everything down to testosterone (total/free), E2 and DHT for my problems but the true fact was that my adrenals (which produce the important cortisol hormone) and thyroid were out of whack causing almost all my problems (even though my T did drop a fair bit from it's original value).

    Our symptoms seem very simmilar, the shrunken penis, hard to get erections, no libido, etc. The problem here is thyroid/adrenals. I speak to a friend Chris (cjones) who posted on AM forum's a few months back and literally developed similar symptoms to us but with NO change in testosterone, E2, etc. His total T and free t were both top of the range and E2 mid range. However his TSH was identical to mine at 2.5 and thus he is in the "hypothyroid" range. Hypothyroidism can give the shrinkage, ED, low libido, etc and can also lower T (among other hormones).

    HeadDoc is right, get your adrenals and thyroid checked in full. I went to see Dr Marianco for proper diagnoisis and it seem's i have hypothyroidism (even though i am very skinny) and adrenal fatigue.
  12. #12

    zadok Junior Member

    Here are my results:

    SHBG: 37 (13-71)
    Free T: 57.7 (49.7-149)
    Total T: 25.6 (9-27)
    LH: 5.6 (0.8-6.2)
    FSH: 10.4 (1.5-12.4)
    Cortisol: 605 (221-690)
    prolactin: 340 (83-600)
    Albumin: 46 (35-50)
    T4: 69 (63-151)
    t3: 2.4 (1.3-3.1)
    TSH 2.21 (0.27-4.2)
    ACTH 3.5 (2.2-10.7)
    DHT: 2.58 (1.13-4.13)

    How do you test for adrenal fatigue?

  13. #13

    Megazoid Junior Member

    I am sure JanSz will give a better rundown of your labs but your T4 seem's low and TSH high, in fact your lab's look similar to mine. I am willing to bet thyroid is your problem, you should consult with a Dr like Marianco to get proper treatment, this kind of thing is hard to treat right.
  14. #14

    MacDonnell Junior Member

    This is true. Anything above 2.0 (for TSH) is suspect for hypothyroidism. Hey Mega! How was your trip back? Mine was a bitch. Check your PM mailbox.
  15. #15

    zadok Junior Member

    Marianco, any comments/advice?


  16. #16

    zadok Junior Member

  17. #17

    JanSz Junior Member

    You really have to get longer blood test.
    Even with good blood test is hard enough, without it is hopeless.
    Your testosterone is indeed low.
    Cortisol looks just about right.
    ACTH 3.5 (2.2-10.7)
    See what this people have to say.
    Bottom line, try Cortef, no more than 20mg/day see if it makes difference.
    Isocort, which is over the counter does not work (often enough).

    Not enough thyroid data. Get FreeT3 to the top range Using Armour, then get FreeT4 llittle higher (Synthroid) (only if real low), then if that is not enough start digging deeper.

    You should not start with supplementation of testosterone.
    Check everything else first.
    To do that get good test.
    Below is a list, it pays on a long run to do that test. It is one time event, latter you will do much shorter tests. With out tests you need somebody to be clairvoyant and help you.
    Good doctor looking at you could possibly figure out something, he still need tests.
    Somebody who do not see you have no chance without tests.
    Card readers do that, but I am not sure about success ratio.

    0 iodine
    1 CBC w/ diff
    2 Calcium
    3 Carbon dioxide
    4 Chloride
    5 Copper, serum
    6 Ferritin
    7 Magnesium
    8 Potasium
    9 Selenium
    10 Sodium
    11 Zinc
    12 Alkaline phosphase
    13 ALT
    14 AST
    15 BUN/creatinine ratio
    16 Creatinine
    17 Globulin, calculated
    18 Protein Total
    19 Urea nitrogen
    20 Bilirubin, Total
    21 Bilirubin, Direct
    22 EGFR non afr american
    23 RPR W/Titer & Conf RFX RPR screen
    24 C-reactive protein CRP
    25 Fibrinogen
    26 Hematocrit
    27 Hemoglobin A1C
    28 Homocysteine, cardio
    29 Lipoprotein (A) Lp(A)
    30 Folate, Serum
    31 Folate, Serum
    32 Cholesterol, Total
    33 HDL cholesterol
    34 cholesterol/HDL ratio
    35 LDL chol, calculated
    36 Triglycirides
    37 VLDL
    38 Vitamin A
    39 Vitamin B12, serum
    40 Vitamin D, panel
    43 T3 Free
    44 T3 uptake
    45 T3,Total
    46 T4,Free
    47 T4,Total
    48 TSH
    49 Glucose, fasting
    50 Insuline, serum
    51 PSA, Total
    52 PSA, %, free
    53 IGF Binding protein-3
    54 igf-1
    55 Aldosterone
    56 Cortisol AM/PM
    57 DHEA sulfate
    58 Prolactin
    59 FSH
    60 LH
    61 Progesterone
    62 Pregnenolone
    63 Estradiol, Bioavailable
    64 Estradiol, Free
    65 Estradiol, Fractionated, serum
    66 Estradiol, Ultra-sensitive (is part of fractionated)
    67 Estrone,serum (is part of fractionated)
    68 Estrogens, Total, Serum
    69 Testosterone, Free, Bio/Total (LC/MS/MS)
    70 Testosterone Total (included in T panel)
    71 Testosterone Free(included in T panel)
    72 Testosterone Bioavailable(included in T panel)
    73 SHBG(included in T panel)
    74 Albumin, serum(included in T panel)
    75 Dihydrotestosterone DHT

    SHBG: 37 (13-71)
    Free T: 57.7 (49.7-149)
    Total T: 25.6 (9-27)
    LH: 5.6 (0.8-6.2)
    FSH: 10.4 (1.5-12.4)
    Your testis are getting enough signal and they are producing enough testosterone.
    Your freeT is low, (who knows if really true, freeT test is not reliable).
    Your SHBG is on higer side, not really very high, it binds testosterone so not enough free is available.
    You may try to lower SHBG.
    To do that use:
    Compounded Chrysin cream from
    good and inexpensive
    also this two types of pills (they ship everywhere:
    Super MiraForte with Maximum Strength Chrysin
    Advanced Natural Prostate Formula with 5-Loxin®

    Eventually you will need to control estrogens, I use DualAction, 6 pills (they recomend one/160# body weight, not enough for me)
    Dual-Action Cruciferous Vegetable Extract With Resveratrol & Cat's Claw
    If you really want to get little extra T into your body, you have to be real careful because you have good working testis.
    Using hcg and often enough is very important in your case, at least every other day.
    Otherwise you will loose your own T and end up lower than you have started.
    So you could have
    Depo-Testosterone or Enanthate, strenght 200mg/mL
    100mg/week and HCG
    Every other day, E2D
    =100/7*2/200=0.143=14 units on insuline syringe

    Tshot=14 units on insuline syringe

    I do my T & HCG shots both on same day.
    Then you can have day free of shots in between.
    For both shots you can use the smallest syringe there is, subQ shots around navel.
    I rub a lot after T shot to spread the oil, not sure if I really need to do that, just playng safe.
    BD Ultrafine II U-100 Insulin Syringe 31 Gauge 3/10cc 5/16inch Short Needle--1/2 Unit Markings 100/b Price: $25.95

    There is same size syringe that should also work.
    Easy Touch U-100 Insulin Syringe 31 Gauge 3/10cc 5/16 inch Short Needle 100/Box Sale Price: $13.99
    Last edited: Jun 30, 2007
  18. #18

    zadok Junior Member


    Thanks heaps for the reply. I have tried supplementing with Test about a year ago, it only drove my Free T levels lower and made me feel terrible. Also, why do you mention taking Cortef? If my cortisol levels are normal, why would I need this, or is there something im missing?


  19. #19

    JanSz Junior Member

    When supplementing with T you have to do it the smart way, you do not want to suppress you own production.
    If you have no choice, then you need larger T dose to cover all what your body needs,

    I am not sure about your ACTH results, that is why I mentioned about Cortef.
    If you are lazy about blood testing, trying little Cortef is a way of testing. If it makes a difference, you know you have identified a problem that needs attention.
    Better check at
    they deal with this on daily basis.

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