free testosterone vs total

Question

My old Doc. told me that many times a poz- person can have normal total testoterone and low levels of free testosterone. I am wondering if I am on the low side? I am 43-my total# is 729ng/dl-ref. range 350-890- My free is 85.9pg/ml ref. range 47-244- However, free is 1.2-ref. range is 1.6-2.9. In all of these #'s is there any indication that I am on the low side-It seems to me my free is low the 1.2 number and the 85.9 is in the normal range but leans toward the lower ref. of 47- rather than the higher. I suffer from extreme fatigue and if these numbers indicate I need testosterone-I would want to do it.Thank you-paesano

Answer

Hey there Paesano,

If you're Italian and your free testosterone is 1.2 with a reference range of 1.6-2.9, you are definitely low! We Italians should be off the scale on the high side, don't you think? The free testosterone refers to the active testosterone in your body. The remainder is protein bound and therefore not as biologically available to be active. You should definitely investigate all potential causes for your fatigue:

  1. Inadequate sleep, rest, diet, and/or exercise
  2. Medication side effects
  3. Unrecognized infection
  4. Depression/anxiety/stress
  5. Anemia
  6. Other hormonal causes

Your treatment should be directed at treating all the components found to be potentially contributing to your fatigue, including low testosterone. Good luck.

Dr. Bob