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Re: Wide variability in laboratory reference values for serum testosterone.

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Posted
Posted

I'm curious, do you have an estradiol problem at your current dose that you're

controlling with meds?

>

> http://www.ncbi.nlm.nih.gov/pubmed/17100942

>

> J Sex Med. 2006 Nov;3(6):1085-9.

> Wide variability in laboratory reference values for serum testosterone.

> Lazarou S, Reyes-Vallejo L, Morgentaler A.

>

> Harvard Medical School, Division of Urology, Beth Israel Deaconess Medical

Center, Boston, MA, USA.

>

> Abstract

>

> INTRODUCTION: The laboratory determination of testosterone levels consistent

with a diagnosis of hypogonadism is complicated by the availability of multiple

testosterone assays and varying reference ranges.

>

> AIM: To assess current laboratory practices regarding availability of

testosterone assays and use of reference values.

>

> METHODS: A telephone survey of 12 academic, 12 community medical laboratories,

and one national laboratory.

>

> MAIN OUTCOME MEASURES: Types of androgen assays offered and determination of

reference values.

>

> RESULTS: All of the academic and eight of the community centers performed

total testosterone testing. Free testosterone was performed in-house by six of

the 12 academic and one community center. Testing for bioavailable testosterone,

free androgen index, and percent free testosterone was performed in-house by no

more than two centers. There were eight and four different assays used for total

and free testosterone, respectively. One national laboratory offered equilibrium

dialysis measurement of free testosterone. Of the 25 labs, there were 17 and 13

different sets of reference values for total and free testosterone,

respectively. The low reference value for total testosterone ranged from 130 to

450 ng/dL (350% difference), and the upper value ranged from 486 to 1,593 ng/dL

(325% difference). Age-adjusted reference values were applied in four centers

for total testosterone and in seven labs for free testosterone. All reference

values were based on a standard statistical model without regard for clinical

aspects of hypogonadism. Twenty-three of the 25 lab directors responded that

clinically relevant testosterone reference ranges would be preferable to current

standards.

>

> CONCLUSIONS: Laboratory reference values for testosterone vary widely, and are

established without clinical considerations.

>

> So - again I ask - how do we determine what our testosterone levels should be

if laboratory reference values are established WITHOUT clinical considerations??

>

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Posted
Posted

-----BEGIN PGP SIGNED MESSAGE-----

Hash: SHA1

I'm getting retested on 2/2 for test and E2

My question is the fact that the reference ranges for testosterone

are based on " a standard statistical model without regard for

clinical aspects of hypogonadism. "

So - the results are virtually meaningless then and my original

question stands.

On Wed, 26 Jan 2011 18:25:39 -0500 Barb <baba@...> wrote:

>I'm curious, do you have an estradiol problem at your current dose

>that you're controlling with meds?

>

>

>>

>> http://www.ncbi.nlm.nih.gov/pubmed/17100942

>>

>> J Sex Med. 2006 Nov;3(6):1085-9.

>> Wide variability in laboratory reference values for serum

>testosterone.

>> Lazarou S, Reyes-Vallejo L, Morgentaler A.

>>

>> Harvard Medical School, Division of Urology, Beth Israel

>Deaconess Medical Center, Boston, MA, USA.

>>

>> Abstract

>>

>> INTRODUCTION: The laboratory determination of testosterone

>levels consistent with a diagnosis of hypogonadism is complicated

>by the availability of multiple testosterone assays and varying

>reference ranges.

>>

>> AIM: To assess current laboratory practices regarding

>availability of testosterone assays and use of reference values.

>>

>> METHODS: A telephone survey of 12 academic, 12 community medical

>laboratories, and one national laboratory.

>>

>> MAIN OUTCOME MEASURES: Types of androgen assays offered and

>determination of reference values.

>>

>> RESULTS: All of the academic and eight of the community centers

>performed total testosterone testing. Free testosterone was

>performed in-house by six of the 12 academic and one community

>center. Testing for bioavailable testosterone, free androgen

>index, and percent free testosterone was performed in-house by no

>more than two centers. There were eight and four different assays

>used for total and free testosterone, respectively. One national

>laboratory offered equilibrium dialysis measurement of free

>testosterone. Of the 25 labs, there were 17 and 13 different sets

>of reference values for total and free testosterone, respectively.

>The low reference value for total testosterone ranged from 130 to

>450 ng/dL (350% difference), and the upper value ranged from 486

>to 1,593 ng/dL (325% difference). Age-adjusted reference values

>were applied in four centers for total testosterone and in seven

>labs for free testosterone. All reference values were based on a

>standard statistical model without regard for clinical aspects of

>hypogonadism. Twenty-three of the 25 lab directors responded that

>clinically relevant testosterone reference ranges would be

>preferable to current standards.

>>

>> CONCLUSIONS: Laboratory reference values for testosterone vary

>widely, and are established without clinical considerations.

>>

>> So - again I ask - how do we determine what our testosterone

>levels should be if laboratory reference values are established

>WITHOUT clinical considerations??

>>

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Posted
Posted

Your question is valid, but there is still SOME validity to a range. A level of

0 or 2000 is probably cause for alarm. Dr. no says that if you have to go

above 650 to feel well, something else might need to be looked at. Usually that

something else is thyroid.

> >>

> >> http://www.ncbi.nlm.nih.gov/pubmed/17100942

> >>

> >> J Sex Med. 2006 Nov;3(6):1085-9.

> >> Wide variability in laboratory reference values for serum

> >testosterone.

> >> Lazarou S, Reyes-Vallejo L, Morgentaler A.

> >>

> >> Harvard Medical School, Division of Urology, Beth Israel

> >Deaconess Medical Center, Boston, MA, USA.

> >>

> >> Abstract

> >>

> >> INTRODUCTION: The laboratory determination of testosterone

> >levels consistent with a diagnosis of hypogonadism is complicated

> >by the availability of multiple testosterone assays and varying

> >reference ranges.

> >>

> >> AIM: To assess current laboratory practices regarding

> >availability of testosterone assays and use of reference values.

> >>

> >> METHODS: A telephone survey of 12 academic, 12 community medical

> >laboratories, and one national laboratory.

> >>

> >> MAIN OUTCOME MEASURES: Types of androgen assays offered and

> >determination of reference values.

> >>

> >> RESULTS: All of the academic and eight of the community centers

> >performed total testosterone testing. Free testosterone was

> >performed in-house by six of the 12 academic and one community

> >center. Testing for bioavailable testosterone, free androgen

> >index, and percent free testosterone was performed in-house by no

> >more than two centers. There were eight and four different assays

> >used for total and free testosterone, respectively. One national

> >laboratory offered equilibrium dialysis measurement of free

> >testosterone. Of the 25 labs, there were 17 and 13 different sets

> >of reference values for total and free testosterone, respectively.

> >The low reference value for total testosterone ranged from 130 to

> >450 ng/dL (350% difference), and the upper value ranged from 486

> >to 1,593 ng/dL (325% difference). Age-adjusted reference values

> >were applied in four centers for total testosterone and in seven

> >labs for free testosterone. All reference values were based on a

> >standard statistical model without regard for clinical aspects of

> >hypogonadism. Twenty-three of the 25 lab directors responded that

> >clinically relevant testosterone reference ranges would be

> >preferable to current standards.

> >>

> >> CONCLUSIONS: Laboratory reference values for testosterone vary

> >widely, and are established without clinical considerations.

> >>

> >> So - again I ask - how do we determine what our testosterone

> >levels should be if laboratory reference values are established

> >WITHOUT clinical considerations??

> >>

> -----BEGIN PGP SIGNATURE-----

> Charset: UTF8

> Version: Hush 3.0

> Note: This signature can be verified at https://www.hushtools.com/verify

>

> wkYEARECAAYFAk1AsKEACgkQN8wMX1pcloYk/gCfa3kvQcRvLKdSBWi2rSeHcejBq/kA

> nieWP0FrCy+szNJ0Sr1BSf9aLAEV

> =k3HA

> -----END PGP SIGNATURE-----

>

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Posted
Posted

Can you provide more info re Dr no and his statement that if you need to

have your testosterone level above 650 to feel well something else - probably

the thyroid - needs to be looked at

> > >>

> > >> http://www.ncbi.nlm.nih.gov/pubmed/17100942

> > >>

> > >> J Sex Med. 2006 Nov;3(6):1085-9.

> > >> Wide variability in laboratory reference values for serum

> > >testosterone.

> > >> Lazarou S, Reyes-Vallejo L, Morgentaler A.

> > >>

> > >> Harvard Medical School, Division of Urology, Beth Israel

> > >Deaconess Medical Center, Boston, MA, USA.

> > >>

> > >> Abstract

> > >>

> > >> INTRODUCTION: The laboratory determination of testosterone

> > >levels consistent with a diagnosis of hypogonadism is complicated

> > >by the availability of multiple testosterone assays and varying

> > >reference ranges.

> > >>

> > >> AIM: To assess current laboratory practices regarding

> > >availability of testosterone assays and use of reference values.

> > >>

> > >> METHODS: A telephone survey of 12 academic, 12 community medical

> > >laboratories, and one national laboratory.

> > >>

> > >> MAIN OUTCOME MEASURES: Types of androgen assays offered and

> > >determination of reference values.

> > >>

> > >> RESULTS: All of the academic and eight of the community centers

> > >performed total testosterone testing. Free testosterone was

> > >performed in-house by six of the 12 academic and one community

> > >center. Testing for bioavailable testosterone, free androgen

> > >index, and percent free testosterone was performed in-house by no

> > >more than two centers. There were eight and four different assays

> > >used for total and free testosterone, respectively. One national

> > >laboratory offered equilibrium dialysis measurement of free

> > >testosterone. Of the 25 labs, there were 17 and 13 different sets

> > >of reference values for total and free testosterone, respectively.

> > >The low reference value for total testosterone ranged from 130 to

> > >450 ng/dL (350% difference), and the upper value ranged from 486

> > >to 1,593 ng/dL (325% difference). Age-adjusted reference values

> > >were applied in four centers for total testosterone and in seven

> > >labs for free testosterone. All reference values were based on a

> > >standard statistical model without regard for clinical aspects of

> > >hypogonadism. Twenty-three of the 25 lab directors responded that

> > >clinically relevant testosterone reference ranges would be

> > >preferable to current standards.

> > >>

> > >> CONCLUSIONS: Laboratory reference values for testosterone vary

> > >widely, and are established without clinical considerations.

> > >>

> > >> So - again I ask - how do we determine what our testosterone

> > >levels should be if laboratory reference values are established

> > >WITHOUT clinical considerations??

> > >>

> > -----BEGIN PGP SIGNATURE-----

> > Charset: UTF8

> > Version: Hush 3.0

> > Note: This signature can be verified at https://www.hushtools.com/verify

> >

> > wkYEARECAAYFAk1AsKEACgkQN8wMX1pcloYk/gCfa3kvQcRvLKdSBWi2rSeHcejBq/kA

> > nieWP0FrCy+szNJ0Sr1BSf9aLAEV

> > =k3HA

> > -----END PGP SIGNATURE-----

> >

>

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Posted
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http://www.definitivemind.com/forums/showthread.php?t=566 & highlight=good\

+target+achieve+ng%2FdL

> > > >>

> > > >> http://www.ncbi.nlm.nih.gov/pubmed/17100942

> > > >>

> > > >> J Sex Med. 2006 Nov;3(6):1085-9.

> > > >> Wide variability in laboratory reference values for serum

> > > >testosterone.

> > > >> Lazarou S, Reyes-Vallejo L, Morgentaler A.

> > > >>

> > > >> Harvard Medical School, Division of Urology, Beth Israel

> > > >Deaconess Medical Center, Boston, MA, USA.

> > > >>

> > > >> Abstract

> > > >>

> > > >> INTRODUCTION: The laboratory determination of testosterone

> > > >levels consistent with a diagnosis of hypogonadism is complicated

> > > >by the availability of multiple testosterone assays and varying

> > > >reference ranges.

> > > >>

> > > >> AIM: To assess current laboratory practices regarding

> > > >availability of testosterone assays and use of reference values.

> > > >>

> > > >> METHODS: A telephone survey of 12 academic, 12 community

medical

> > > >laboratories, and one national laboratory.

> > > >>

> > > >> MAIN OUTCOME MEASURES: Types of androgen assays offered and

> > > >determination of reference values.

> > > >>

> > > >> RESULTS: All of the academic and eight of the community centers

> > > >performed total testosterone testing. Free testosterone was

> > > >performed in-house by six of the 12 academic and one community

> > > >center. Testing for bioavailable testosterone, free androgen

> > > >index, and percent free testosterone was performed in-house by no

> > > >more than two centers. There were eight and four different assays

> > > >used for total and free testosterone, respectively. One national

> > > >laboratory offered equilibrium dialysis measurement of free

> > > >testosterone. Of the 25 labs, there were 17 and 13 different sets

> > > >of reference values for total and free testosterone,

respectively.

> > > >The low reference value for total testosterone ranged from 130 to

> > > >450 ng/dL (350% difference), and the upper value ranged from 486

> > > >to 1,593 ng/dL (325% difference). Age-adjusted reference values

> > > >were applied in four centers for total testosterone and in seven

> > > >labs for free testosterone. All reference values were based on a

> > > >standard statistical model without regard for clinical aspects of

> > > >hypogonadism. Twenty-three of the 25 lab directors responded that

> > > >clinically relevant testosterone reference ranges would be

> > > >preferable to current standards.

> > > >>

> > > >> CONCLUSIONS: Laboratory reference values for testosterone vary

> > > >widely, and are established without clinical considerations.

> > > >>

> > > >> So - again I ask - how do we determine what our testosterone

> > > >levels should be if laboratory reference values are established

> > > >WITHOUT clinical considerations??

> > > >>

> > > -----BEGIN PGP SIGNATURE-----

> > > Charset: UTF8

> > > Version: Hush 3.0

> > > Note: This signature can be verified at

https://www.hushtools.com/verify

> > >

> > >

wkYEARECAAYFAk1AsKEACgkQN8wMX1pcloYk/gCfa3kvQcRvLKdSBWi2rSeHcejBq/kA

> > > nieWP0FrCy+szNJ0Sr1BSf9aLAEV

> > > =k3HA

> > > -----END PGP SIGNATURE-----

> > >

> >

>

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Posted
Posted

I can't help but feel your acting about this the way most Endo's do by looking

at labs and ranges and not looking at how one feels. Most good Dr.'s don't go

by labs as much as they do about how your feeling.

Labs are just a tool not the last word.

Co-Moderator

Phil

> From: cvictorg <cvgrashow@...>

> Subject: Wide variability in laboratory reference values for

serum testosterone.

>

> Date: Wednesday, January 26, 2011, 5:57 PM

> http://www.ncbi.nlm.nih.gov/pubmed/17100942

>

> J Sex Med. 2006 Nov;3(6):1085-9.

> Wide variability in laboratory reference values for serum

> testosterone.

> Lazarou S, Reyes-Vallejo L, Morgentaler A.

>

> Harvard Medical School, Division of Urology, Beth Israel

> Deaconess Medical Center, Boston, MA, USA.

>

> Abstract

>

> INTRODUCTION: The laboratory determination of testosterone

> levels consistent with a diagnosis of hypogonadism is

> complicated by the availability of multiple testosterone

> assays and varying reference ranges.

>

> AIM: To assess current laboratory practices regarding

> availability of testosterone assays and use of reference

> values.

>

> METHODS: A telephone survey of 12 academic, 12 community

> medical laboratories, and one national laboratory.

>

> MAIN OUTCOME MEASURES: Types of androgen assays offered and

> determination of reference values.

>

> RESULTS: All of the academic and eight of the community

> centers performed total testosterone testing. Free

> testosterone was performed in-house by six of the 12

> academic and one community center. Testing for bioavailable

> testosterone, free androgen index, and percent free

> testosterone was performed in-house by no more than two

> centers. There were eight and four different assays used for

> total and free testosterone, respectively. One national

> laboratory offered equilibrium dialysis measurement of free

> testosterone. Of the 25 labs, there were 17 and 13 different

> sets of reference values for total and free testosterone,

> respectively. The low reference value for total testosterone

> ranged from 130 to 450 ng/dL (350% difference), and the

> upper value ranged from 486 to 1,593 ng/dL (325%

> difference). Age-adjusted reference values were applied in

> four centers for total testosterone and in seven labs for

> free testosterone. All reference values were based on a

> standard statistical model without regard for clinical

> aspects of hypogonadism. Twenty-three of the 25 lab

> directors responded that clinically relevant testosterone

> reference ranges would be preferable to current standards.

>

> CONCLUSIONS: Laboratory reference values for testosterone

> vary widely, and are established without clinical

> considerations.

>

> So - again I ask - how do we determine what our

> testosterone levels should be if laboratory reference values

> are established WITHOUT clinical considerations??

>

>

>

>

>

>

> ------------------------------------

>

>

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Posted
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If this were ture then all labs are useless because the ranges are all done

using SPC showen on a Bell Curve graph in standard deviations. It is a

statistic that tells you how tightly all the various examples are clustered

around the mean in a set of data.

I did this for a living before I retired as a Quality Engineer for Car. Co.'s.

Read this link it shows you what I am talking about.

http://www.intelligencetest.com/stan-deviation.htm

And in this link Testosterone levels by age the math was used testing men by age

and doing the math.

http://www.mens-hormonal-health.com/normal-testosterone-levels-in-men.html

Co-Moderator

Phil

> >I'm curious, do you have an estradiol problem at your

> current dose

> >that you're controlling with meds?

> >

> >

> >>

> >> http://www.ncbi.nlm.nih.gov/pubmed/17100942

> >>

> >> J Sex Med. 2006 Nov;3(6):1085-9.

> >> Wide variability in laboratory reference values

> for serum

> >testosterone.

> >> Lazarou S, Reyes-Vallejo L, Morgentaler A.

> >>

> >> Harvard Medical School, Division of Urology, Beth

> Israel

> >Deaconess Medical Center, Boston, MA, USA.

> >>

> >> Abstract

> >>

> >> INTRODUCTION: The laboratory determination of

> testosterone

> >levels consistent with a diagnosis of hypogonadism is

> complicated

> >by the availability of multiple testosterone assays and

> varying

> >reference ranges.

> >>

> >> AIM: To assess current laboratory practices

> regarding

> >availability of testosterone assays and use of

> reference values.

> >>

> >> METHODS: A telephone survey of 12 academic, 12

> community medical

> >laboratories, and one national laboratory.

> >>

> >> MAIN OUTCOME MEASURES: Types of androgen assays

> offered and

> >determination of reference values.

> >>

> >> RESULTS: All of the academic and eight of the

> community centers

> >performed total testosterone testing. Free testosterone

> was

> >performed in-house by six of the 12 academic and one

> community

> >center. Testing for bioavailable testosterone, free

> androgen

> >index, and percent free testosterone was performed

> in-house by no

> >more than two centers. There were eight and four

> different assays

> >used for total and free testosterone, respectively. One

> national

> >laboratory offered equilibrium dialysis measurement of

> free

> >testosterone. Of the 25 labs, there were 17 and 13

> different sets

> >of reference values for total and free testosterone,

> respectively.

> >The low reference value for total testosterone ranged

> from 130 to

> >450 ng/dL (350% difference), and the upper value ranged

> from 486

> >to 1,593 ng/dL (325% difference). Age-adjusted

> reference values

> >were applied in four centers for total testosterone and

> in seven

> >labs for free testosterone. All reference values were

> based on a

> >standard statistical model without regard for clinical

> aspects of

> >hypogonadism. Twenty-three of the 25 lab directors

> responded that

> >clinically relevant testosterone reference ranges would

> be

> >preferable to current standards.

> >>

> >> CONCLUSIONS: Laboratory reference values for

> testosterone vary

> >widely, and are established without clinical

> considerations.

> >>

> >> So - again I ask - how do we determine what our

> testosterone

> >levels should be if laboratory reference values are

> established

> >WITHOUT clinical considerations??

> >>

> -----BEGIN PGP SIGNATURE-----

> Charset: UTF8

> Version: Hush 3.0

> Note: This signature can be verified at https://www.hushtools.com/verify

>

> wkYEARECAAYFAk1AsKEACgkQN8wMX1pcloYk/gCfa3kvQcRvLKdSBWi2rSeHcejBq/kA

> nieWP0FrCy+szNJ0Sr1BSf9aLAEV

> =k3HA

> -----END PGP SIGNATURE-----

>

>

>

> ------------------------------------

>

>

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Guest guest

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Posted
Posted

Here is a link to his forum join it's free and the best reading you will ever

find.

http://www.definitivemind.com/forums/index.php

Also at the home page on the left click on files and open marianco7.zip it's

full of posts by him.

I need to say some thing here it is fine for some on to ask questions about low

T. But it helps if people here read about it in the links and files section

first.

Please try to read the links and files section here it helps you and us, some

days I feel like a broken record saying the same things over and over again.

Co-Moderator

Phil

> From: cvictorg <cvgrashow@...>

> Subject: Re: Wide variability in laboratory reference values

for serum testosterone.

>

> Date: Wednesday, January 26, 2011, 7:39 PM

> Can you provide more info re Dr

> no and his statement that if you need to have your

> testosterone level above 650 to feel well something else -

> probably the thyroid - needs to be looked at

>

>

>

> > > >>

> > > >> http://www.ncbi.nlm.nih.gov/pubmed/17100942

> > > >>

> > > >> J Sex Med. 2006 Nov;3(6):1085-9.

> > > >> Wide variability in laboratory reference

> values for serum

> > > >testosterone.

> > > >> Lazarou S, Reyes-Vallejo L, Morgentaler

> A.

> > > >>

> > > >> Harvard Medical School, Division of

> Urology, Beth Israel

> > > >Deaconess Medical Center, Boston, MA, USA.

> > > >>

> > > >> Abstract

> > > >>

> > > >> INTRODUCTION: The laboratory

> determination of testosterone

> > > >levels consistent with a diagnosis of

> hypogonadism is complicated

> > > >by the availability of multiple testosterone

> assays and varying

> > > >reference ranges.

> > > >>

> > > >> AIM: To assess current laboratory

> practices regarding

> > > >availability of testosterone assays and use

> of reference values.

> > > >>

> > > >> METHODS: A telephone survey of 12

> academic, 12 community medical

> > > >laboratories, and one national laboratory.

> > > >>

> > > >> MAIN OUTCOME MEASURES: Types of androgen

> assays offered and

> > > >determination of reference values.

> > > >>

> > > >> RESULTS: All of the academic and eight

> of the community centers

> > > >performed total testosterone testing. Free

> testosterone was

> > > >performed in-house by six of the 12 academic

> and one community

> > > >center. Testing for bioavailable

> testosterone, free androgen

> > > >index, and percent free testosterone was

> performed in-house by no

> > > >more than two centers. There were eight and

> four different assays

> > > >used for total and free testosterone,

> respectively. One national

> > > >laboratory offered equilibrium dialysis

> measurement of free

> > > >testosterone. Of the 25 labs, there were 17

> and 13 different sets

> > > >of reference values for total and free

> testosterone, respectively.

> > > >The low reference value for total

> testosterone ranged from 130 to

> > > >450 ng/dL (350% difference), and the upper

> value ranged from 486

> > > >to 1,593 ng/dL (325% difference).

> Age-adjusted reference values

> > > >were applied in four centers for total

> testosterone and in seven

> > > >labs for free testosterone. All reference

> values were based on a

> > > >standard statistical model without regard for

> clinical aspects of

> > > >hypogonadism. Twenty-three of the 25 lab

> directors responded that

> > > >clinically relevant testosterone reference

> ranges would be

> > > >preferable to current standards.

> > > >>

> > > >> CONCLUSIONS: Laboratory reference values

> for testosterone vary

> > > >widely, and are established without clinical

> considerations.

> > > >>

> > > >> So - again I ask - how do we determine

> what our testosterone

> > > >levels should be if laboratory reference

> values are established

> > > >WITHOUT clinical considerations??

> > > >>

> > > -----BEGIN PGP SIGNATURE-----

> > > Charset: UTF8

> > > Version: Hush 3.0

> > > Note: This signature can be verified at https://www.hushtools.com/verify

> > >

> > >

> wkYEARECAAYFAk1AsKEACgkQN8wMX1pcloYk/gCfa3kvQcRvLKdSBWi2rSeHcejBq/kA

> > > nieWP0FrCy+szNJ0Sr1BSf9aLAEV

> > > =k3HA

> > > -----END PGP SIGNATURE-----

> > >

> >

>

>

>

>

> ------------------------------------

>

>

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Posted
Posted

If " Twenty-three of the 25 lab directors responded that clinically relevant

testosterone reference ranges would be preferable to current standards. "

If " the ranges are all done using SPC shown on a Bell Curve graph in standard

deviations. It is a statistic that tells you how tightly all the various

examples are clustered around the mean in a set of data. "

Then tell me why the ranges are NOT useless - in one study they used 155 healthy

non-diabetic males between age 55-59 - are we supposed to base our treatment on

this small sample?

The study says nothing about lifestyle, exercise habits, diet, etc.

Also - if the range in one study was between 552-692 why then is the reference

range for Quest Labs 250-1100

I'm getting more confused.

> > >>

> > >> http://www.ncbi.nlm.nih.gov/pubmed/17100942

> > >>

> > >> J Sex Med. 2006 Nov;3(6):1085-9.

> > >> Wide variability in laboratory reference values

> > for serum

> > >testosterone.

> > >> Lazarou S, Reyes-Vallejo L, Morgentaler A.

> > >>

> > >> Harvard Medical School, Division of Urology, Beth

> > Israel

> > >Deaconess Medical Center, Boston, MA, USA.

> > >>

> > >> Abstract

> > >>

> > >> INTRODUCTION: The laboratory determination of

> > testosterone

> > >levels consistent with a diagnosis of hypogonadism is

> > complicated

> > >by the availability of multiple testosterone assays and

> > varying

> > >reference ranges.

> > >>

> > >> AIM: To assess current laboratory practices

> > regarding

> > >availability of testosterone assays and use of

> > reference values.

> > >>

> > >> METHODS: A telephone survey of 12 academic, 12

> > community medical

> > >laboratories, and one national laboratory.

> > >>

> > >> MAIN OUTCOME MEASURES: Types of androgen assays

> > offered and

> > >determination of reference values.

> > >>

> > >> RESULTS: All of the academic and eight of the

> > community centers

> > >performed total testosterone testing. Free testosterone

> > was

> > >performed in-house by six of the 12 academic and one

> > community

> > >center. Testing for bioavailable testosterone, free

> > androgen

> > >index, and percent free testosterone was performed

> > in-house by no

> > >more than two centers. There were eight and four

> > different assays

> > >used for total and free testosterone, respectively. One

> > national

> > >laboratory offered equilibrium dialysis measurement of

> > free

> > >testosterone. Of the 25 labs, there were 17 and 13

> > different sets

> > >of reference values for total and free testosterone,

> > respectively.

> > >The low reference value for total testosterone ranged

> > from 130 to

> > >450 ng/dL (350% difference), and the upper value ranged

> > from 486

> > >to 1,593 ng/dL (325% difference). Age-adjusted

> > reference values

> > >were applied in four centers for total testosterone and

> > in seven

> > >labs for free testosterone. All reference values were

> > based on a

> > >standard statistical model without regard for clinical

> > aspects of

> > >hypogonadism. Twenty-three of the 25 lab directors

> > responded that

> > >clinically relevant testosterone reference ranges would

> > be

> > >preferable to current standards.

> > >>

> > >> CONCLUSIONS: Laboratory reference values for

> > testosterone vary

> > >widely, and are established without clinical

> > considerations.

> > >>

> > >> So - again I ask - how do we determine what our

> > testosterone

> > >levels should be if laboratory reference values are

> > established

> > >WITHOUT clinical considerations??

> > >>

> > -----BEGIN PGP SIGNATURE-----

> > Charset: UTF8

> > Version: Hush 3.0

> > Note: This signature can be verified at https://www.hushtools.com/verify

> >

> > wkYEARECAAYFAk1AsKEACgkQN8wMX1pcloYk/gCfa3kvQcRvLKdSBWi2rSeHcejBq/kA

> > nieWP0FrCy+szNJ0Sr1BSf9aLAEV

> > =k3HA

> > -----END PGP SIGNATURE-----

> >

> >

> >

> > ------------------------------------

> >

> >

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Guest guest

Guest guest

Posted
Posted

Because the bottom 2 % of all the men Quest labs tested were at the bottom of

the range and the top 2 % were at the top of the range. It's going from one end

of the Bell Curve to the other did you read the link I gave you. Want your

talking about is the mean the center of the Bell Curve this is the most men

tested at this range.

Co-Moderator

Phil

> From: cvictorg <cvgrashow@...>

> Subject: Re: Wide variability in laboratory reference values

for serum testosterone.

>

> Date: Thursday, January 27, 2011, 11:20 AM

>

>

> If " Twenty-three of the 25 lab directors responded that

> clinically relevant testosterone reference ranges would be

> preferable to current standards. "

>

> If " the ranges are all done using SPC shown on a Bell Curve

> graph in standard deviations.  It is a statistic that

> tells you how tightly all the various examples are clustered

> around the mean in a set of data. "

>

> Then tell me why the ranges are NOT useless - in one study

> they used 155 healthy non-diabetic males between age 55-59 -

> are we supposed to base our treatment on this small sample?

>

> The study says nothing about lifestyle, exercise habits,

> diet, etc.

>

> Also - if the range in one study was between 552-692 why

> then is the reference range for Quest Labs 250-1100

>

> I'm getting more confused.

>

>

>

> > > >>

> > > >> http://www.ncbi.nlm.nih.gov/pubmed/17100942

> > > >>

> > > >> J Sex Med. 2006 Nov;3(6):1085-9.

> > > >> Wide variability in laboratory reference

> values

> > > for serum

> > > >testosterone.

> > > >> Lazarou S, Reyes-Vallejo L, Morgentaler

> A.

> > > >>

> > > >> Harvard Medical School, Division of

> Urology, Beth

> > > Israel

> > > >Deaconess Medical Center, Boston, MA, USA.

> > > >>

> > > >> Abstract

> > > >>

> > > >> INTRODUCTION: The laboratory

> determination of

> > > testosterone

> > > >levels consistent with a diagnosis of

> hypogonadism is

> > > complicated

> > > >by the availability of multiple testosterone

> assays and

> > > varying

> > > >reference ranges.

> > > >>

> > > >> AIM: To assess current laboratory

> practices

> > > regarding

> > > >availability of testosterone assays and use

> of

> > > reference values.

> > > >>

> > > >> METHODS: A telephone survey of 12

> academic, 12

> > > community medical

> > > >laboratories, and one national laboratory.

> > > >>

> > > >> MAIN OUTCOME MEASURES: Types of androgen

> assays

> > > offered and

> > > >determination of reference values.

> > > >>

> > > >> RESULTS: All of the academic and eight

> of the

> > > community centers

> > > >performed total testosterone testing. Free

> testosterone

> > > was

> > > >performed in-house by six of the 12 academic

> and one

> > > community

> > > >center. Testing for bioavailable

> testosterone, free

> > > androgen

> > > >index, and percent free testosterone was

> performed

> > > in-house by no

> > > >more than two centers. There were eight and

> four

> > > different assays

> > > >used for total and free testosterone,

> respectively. One

> > > national

> > > >laboratory offered equilibrium dialysis

> measurement of

> > > free

> > > >testosterone. Of the 25 labs, there were 17

> and 13

> > > different sets

> > > >of reference values for total and free

> testosterone,

> > > respectively.

> > > >The low reference value for total

> testosterone ranged

> > > from 130 to

> > > >450 ng/dL (350% difference), and the upper

> value ranged

> > > from 486

> > > >to 1,593 ng/dL (325% difference).

> Age-adjusted

> > > reference values

> > > >were applied in four centers for total

> testosterone and

> > > in seven

> > > >labs for free testosterone. All reference

> values were

> > > based on a

> > > >standard statistical model without regard for

> clinical

> > > aspects of

> > > >hypogonadism. Twenty-three of the 25 lab

> directors

> > > responded that

> > > >clinically relevant testosterone reference

> ranges would

> > > be

> > > >preferable to current standards.

> > > >>

> > > >> CONCLUSIONS: Laboratory reference values

> for

> > > testosterone vary

> > > >widely, and are established without clinical

> > > considerations.

> > > >>

> > > >> So - again I ask - how do we determine

> what our

> > > testosterone

> > > >levels should be if laboratory reference

> values are

> > > established

> > > >WITHOUT clinical considerations??

> > > >>

> > > -----BEGIN PGP SIGNATURE-----

> > > Charset: UTF8

> > > Version: Hush 3.0

> > > Note: This signature can be verified at https://www.hushtools.com/verify

> > >

> > >

> wkYEARECAAYFAk1AsKEACgkQN8wMX1pcloYk/gCfa3kvQcRvLKdSBWi2rSeHcejBq/kA

> > > nieWP0FrCy+szNJ0Sr1BSf9aLAEV

> > > =k3HA

> > > -----END PGP SIGNATURE-----

> > >

> > >

> > >

> > > ------------------------------------

> > >

> > >

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Guest guest

Guest guest

Posted
Posted

I understand - my question about the study was that in the age range 55-59 5% of

the subjects had test readings of greater than 866 (the 95th percentile) but the

study doesn't state what the highest (the 99.9th percentile) was

Was it over 1000, over 1100 - this is the unknown reading

> > > > >>

> > > > >> http://www.ncbi.nlm.nih.gov/pubmed/17100942

> > > > >>

> > > > >> J Sex Med. 2006 Nov;3(6):1085-9.

> > > > >> Wide variability in laboratory reference

> > values

> > > > for serum

> > > > >testosterone.

> > > > >> Lazarou S, Reyes-Vallejo L, Morgentaler

> > A.

> > > > >>

> > > > >> Harvard Medical School, Division of

> > Urology, Beth

> > > > Israel

> > > > >Deaconess Medical Center, Boston, MA, USA.

> > > > >>

> > > > >> Abstract

> > > > >>

> > > > >> INTRODUCTION: The laboratory

> > determination of

> > > > testosterone

> > > > >levels consistent with a diagnosis of

> > hypogonadism is

> > > > complicated

> > > > >by the availability of multiple testosterone

> > assays and

> > > > varying

> > > > >reference ranges.

> > > > >>

> > > > >> AIM: To assess current laboratory

> > practices

> > > > regarding

> > > > >availability of testosterone assays and use

> > of

> > > > reference values.

> > > > >>

> > > > >> METHODS: A telephone survey of 12

> > academic, 12

> > > > community medical

> > > > >laboratories, and one national laboratory.

> > > > >>

> > > > >> MAIN OUTCOME MEASURES: Types of androgen

> > assays

> > > > offered and

> > > > >determination of reference values.

> > > > >>

> > > > >> RESULTS: All of the academic and eight

> > of the

> > > > community centers

> > > > >performed total testosterone testing. Free

> > testosterone

> > > > was

> > > > >performed in-house by six of the 12 academic

> > and one

> > > > community

> > > > >center. Testing for bioavailable

> > testosterone, free

> > > > androgen

> > > > >index, and percent free testosterone was

> > performed

> > > > in-house by no

> > > > >more than two centers. There were eight and

> > four

> > > > different assays

> > > > >used for total and free testosterone,

> > respectively. One

> > > > national

> > > > >laboratory offered equilibrium dialysis

> > measurement of

> > > > free

> > > > >testosterone. Of the 25 labs, there were 17

> > and 13

> > > > different sets

> > > > >of reference values for total and free

> > testosterone,

> > > > respectively.

> > > > >The low reference value for total

> > testosterone ranged

> > > > from 130 to

> > > > >450 ng/dL (350% difference), and the upper

> > value ranged

> > > > from 486

> > > > >to 1,593 ng/dL (325% difference).

> > Age-adjusted

> > > > reference values

> > > > >were applied in four centers for total

> > testosterone and

> > > > in seven

> > > > >labs for free testosterone. All reference

> > values were

> > > > based on a

> > > > >standard statistical model without regard for

> > clinical

> > > > aspects of

> > > > >hypogonadism. Twenty-three of the 25 lab

> > directors

> > > > responded that

> > > > >clinically relevant testosterone reference

> > ranges would

> > > > be

> > > > >preferable to current standards.

> > > > >>

> > > > >> CONCLUSIONS: Laboratory reference values

> > for

> > > > testosterone vary

> > > > >widely, and are established without clinical

> > > > considerations.

> > > > >>

> > > > >> So - again I ask - how do we determine

> > what our

> > > > testosterone

> > > > >levels should be if laboratory reference

> > values are

> > > > established

> > > > >WITHOUT clinical considerations??

> > > > >>

> > > > -----BEGIN PGP SIGNATURE-----

> > > > Charset: UTF8

> > > > Version: Hush 3.0

> > > > Note: This signature can be verified at https://www.hushtools.com/verify

> > > >

> > > >

> > wkYEARECAAYFAk1AsKEACgkQN8wMX1pcloYk/gCfa3kvQcRvLKdSBWi2rSeHcejBq/kA

> > > > nieWP0FrCy+szNJ0Sr1BSf9aLAEV

> > > > =k3HA

> > > > -----END PGP SIGNATURE-----

> > > >

> > > >

> > > >

> > > > ------------------------------------

> > > >

> > > >

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Guest guest

Guest guest

Posted
Posted

All I can tell you is pick on lab and stick with them. Because each lab has

there own ranges. As a rule try to you your levels of TT on TRT up into the

upper 1/3 of the labs range your using. But as you going up on your dose if

your feel good at a lower level your better off staying at that lower level.

Co-Moderator

Phil

> From: cvictorg <cvgrashow@...>

> Subject: Re: Wide variability in laboratory reference values

for serum testosterone.

>

> Date: Thursday, January 27, 2011, 12:14 PM

> I understand - my question about the

> study was that in the age range 55-59 5% of the subjects had

> test readings of greater than 866 (the 95th percentile) but

> the study doesn't state what the highest (the 99.9th

> percentile) was

>

> Was it over 1000, over 1100 - this is the unknown reading

>

>

>

> > > > > >>

> > > > > >> http://www.ncbi.nlm.nih.gov/pubmed/17100942

> > > > > >>

> > > > > >> J Sex Med. 2006

> Nov;3(6):1085-9.

> > > > > >> Wide variability in laboratory

> reference

> > > values

> > > > > for serum

> > > > > >testosterone.

> > > > > >> Lazarou S, Reyes-Vallejo L,

> Morgentaler

> > > A.

> > > > > >>

> > > > > >> Harvard Medical School,

> Division of

> > > Urology, Beth

> > > > > Israel

> > > > > >Deaconess Medical Center, Boston,

> MA, USA.

> > > > > >>

> > > > > >> Abstract

> > > > > >>

> > > > > >> INTRODUCTION: The laboratory

> > > determination of

> > > > > testosterone

> > > > > >levels consistent with a diagnosis

> of

> > > hypogonadism is

> > > > > complicated

> > > > > >by the availability of multiple

> testosterone

> > > assays and

> > > > > varying

> > > > > >reference ranges.

> > > > > >>

> > > > > >> AIM: To assess current

> laboratory

> > > practices

> > > > > regarding

> > > > > >availability of testosterone assays

> and use

> > > of

> > > > > reference values.

> > > > > >>

> > > > > >> METHODS: A telephone survey of

> 12

> > > academic, 12

> > > > > community medical

> > > > > >laboratories, and one national

> laboratory.

> > > > > >>

> > > > > >> MAIN OUTCOME MEASURES: Types

> of androgen

> > > assays

> > > > > offered and

> > > > > >determination of reference values.

> > > > > >>

> > > > > >> RESULTS: All of the academic

> and eight

> > > of the

> > > > > community centers

> > > > > >performed total testosterone

> testing. Free

> > > testosterone

> > > > > was

> > > > > >performed in-house by six of the 12

> academic

> > > and one

> > > > > community

> > > > > >center. Testing for bioavailable

> > > testosterone, free

> > > > > androgen

> > > > > >index, and percent free

> testosterone was

> > > performed

> > > > > in-house by no

> > > > > >more than two centers. There were

> eight and

> > > four

> > > > > different assays

> > > > > >used for total and free

> testosterone,

> > > respectively. One

> > > > > national

> > > > > >laboratory offered equilibrium

> dialysis

> > > measurement of

> > > > > free

> > > > > >testosterone. Of the 25 labs, there

> were 17

> > > and 13

> > > > > different sets

> > > > > >of reference values for total and

> free

> > > testosterone,

> > > > > respectively.

> > > > > >The low reference value for total

> > > testosterone ranged

> > > > > from 130 to

> > > > > >450 ng/dL (350% difference), and

> the upper

> > > value ranged

> > > > > from 486

> > > > > >to 1,593 ng/dL (325% difference).

> > > Age-adjusted

> > > > > reference values

> > > > > >were applied in four centers for

> total

> > > testosterone and

> > > > > in seven

> > > > > >labs for free testosterone. All

> reference

> > > values were

> > > > > based on a

> > > > > >standard statistical model without

> regard for

> > > clinical

> > > > > aspects of

> > > > > >hypogonadism. Twenty-three of the

> 25 lab

> > > directors

> > > > > responded that

> > > > > >clinically relevant testosterone

> reference

> > > ranges would

> > > > > be

> > > > > >preferable to current standards.

> > > > > >>

> > > > > >> CONCLUSIONS: Laboratory

> reference values

> > > for

> > > > > testosterone vary

> > > > > >widely, and are established without

> clinical

> > > > > considerations.

> > > > > >>

> > > > > >> So - again I ask - how do we

> determine

> > > what our

> > > > > testosterone

> > > > > >levels should be if laboratory

> reference

> > > values are

> > > > > established

> > > > > >WITHOUT clinical considerations??

> > > > > >>

> > > > > -----BEGIN PGP SIGNATURE-----

> > > > > Charset: UTF8

> > > > > Version: Hush 3.0

> > > > > Note: This signature can be verified at

> https://www.hushtools.com/verify

> > > > >

> > > > >

> > >

> wkYEARECAAYFAk1AsKEACgkQN8wMX1pcloYk/gCfa3kvQcRvLKdSBWi2rSeHcejBq/kA

> > > > > nieWP0FrCy+szNJ0Sr1BSf9aLAEV

> > > > > =k3HA

> > > > > -----END PGP SIGNATURE-----

> > > > >

> > > > >

> > > > >

> > > > > ------------------------------------

> > > > >

> > > > >

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