Test Details
Methodology
Ammonium sulfate precipitation; radioassay
Result Turnaround Time
1 - 6 days
Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.
Test Includes
Total testosterone
Use
Free and weakly bound testosterone (FWBT), also referred to as bioavailable testosterone, is thought to reflect an individual's biologically active, circulating testosterone. FWBT includes free testosterone and testosterone that is bound to albumin. FWBT does not include sex hormone binding globulin-bound testosterone. The SHBG-bound fraction is biologically inactive because of the high binding affinity of SHBG for testosterone. The rapid dissociation of “weakly bound” testosterone from albumin results in the availability of essentially all albumin-bound testosterone for steroid-receptor interaction.1
Special Instructions
This panel includes Testosterone, Total, which may exhibit interference when sample is collected from a person who is consuming a supplement with a high dose of biotin (also termed as vitamin B7 or B8, vitamin H, or coenzyme R). It is recommended to ask all patients who may be indicated for this test about biotin supplementation. Patients should be cautioned to stop biotin consumption at least 72 hours prior to the collection of a sample.
Footnotes
References
Custom Additional Information
Free and weakly bound (bioavailable) testosterone measurement involves the selective precipitation of SHBG with ammonium sulfate. Tritiated testosterone is added to serum which is then allowed to come to equilibrium at physiologic temperature. Testosterone bound to SHBG is then selectively precipitated with 50% ammonium sulfate, leaving free and albumin-bound testosterone in solution. The percentage of tritiated label not bound to SHBG is multiplied by the total testosterone to produce the bioavailable testosterone.
Elevated levels of FWBT are observed in female hirsutism.2 The measurement of free and weakly bound testosterone in women, when used in conjunction with the assay of the DHEA-S and SHBG, can be used to establish etiology of hirsutism. In males, decreased serum concentrations are associated with hypogonadism. FWBT levels tend to increase during pregnancy but have been found to remain below the upper limit of the reference interval.3 Total testosterone levels in women decrease by approximately 30% after menopause.4 Administration of exogenous estrogens has the physiologic effect of increasing SHBG concentrations and suppressing the production of androgens by the ovary.4 This results in a net decrease in FWBT. Decreased FWBT levels have been associated with diminished libido4 and loss of bone density.5 FWBT levels in males fall with age6 at a rate that exceeds that of total testosterone and parallels the drop in DHEA sulfate. This decrease is thought to be caused by diminished testicular production and not due to hypothalamic/pituitary insufficiency.7 Decreased FWBT was not, however, found to correlate with diminished potency.8 Since SHBG has been found to increase with age, the FWBT level may be a more reliable indicator of testosterone production than total testosterone.
Specimen Requirements
Specimen
Serum
Volume
2.3 mL
Container
Red-top tube or gel-barrier tube
Collection Instructions
If a red-top tube is used, transfer separated serum to a plastic transport tube.
Stability Requirements
Temperature | Period |
---|---|
Room temperature | 14 days |
Refrigerated | 14 days |
Reference Range
• % free and weakly bound: male: 9.0% to 46.0%, female: 3.0% to 18.0%
• Free and weakly bound: male: 40.0−250.0 ng/dL, female: 0.0−9.5 ng/dL
Storage Instructions
Room temperature
Causes for Rejection
Gross lipemia; recently administered isotopes
LOINC® Map
Order Code | Order Code Name | Order Loinc | Result Code | Result Code Name | UofM | Result LOINC |
---|---|---|---|---|---|---|
143255 | Testosterone,Free+Weakly Bound | 58716-2 | 004227 | Testosterone | ng/dL | 2986-8 |
143255 | Testosterone,Free+Weakly Bound | 58716-2 | 143257 | Testost., % Free+Weakly Bound | % | 6891-6 |
143255 | Testosterone,Free+Weakly Bound | 58716-2 | 143260 | Testost., F+W Bound | ng/dL | 2990-0 |
Order Code | 143255 | |||||
Order Code Name | Testosterone,Free+Weakly Bound | |||||
Order Loinc | 58716-2 | |||||
Result Code | 004227 | |||||
Result Code Name | Testosterone | |||||
UofM | ng/dL | |||||
Result LOINC | 2986-8 | |||||
Order Code | 143255 | |||||
Order Code Name | Testosterone,Free+Weakly Bound | |||||
Order Loinc | 58716-2 | |||||
Result Code | 143257 | |||||
Result Code Name | Testost., % Free+Weakly Bound | |||||
UofM | % | |||||
Result LOINC | 6891-6 | |||||
Order Code | 143255 | |||||
Order Code Name | Testosterone,Free+Weakly Bound | |||||
Order Loinc | 58716-2 | |||||
Result Code | 143260 | |||||
Result Code Name | Testost., F+W Bound | |||||
UofM | ng/dL | |||||
Result LOINC | 2990-0 |