Testosterone (Total Testosterone, Free Testosterone, SHBG, Albumin)
Testosterone, a crucial hormone primarily synthesized from cholesterol via DHEA and androstenedione, is produced predominantly in the testicles and adrenal glands. Additionally, it is generated in the skin and fat cells. This hormone facilitates the release of fats from adipose tissue.
Furthermore, testosterone can undergo conversion into dihydrotestosterone (DHT) by the enzyme 5-alpha-reductase, which is the biologically active form of testosterone responsible for male characteristics like increased body hair, beard growth, and a deep voice. Alternatively, if not converted to DHT, testosterone can be transformed into estradiol by the enzyme aromatase. Testosterone also plays a role in preventing the accumulation of abdominal fat.
In men, maintaining an adequate synthesis of testosterone is vital for performance, fat metabolism, spermatogenesis, and libido. Reduced testosterone levels may be attributed to factors like inflammatory processes or circulatory disorders. Symptoms of testosterone deficiency may include diminished libido, sexual dysfunction, muscle decline, fat deposits on the abdomen and breasts, cellulite, varicose veins, weakened facial and arm muscles, wrinkles, dry skin, reduced hair growth, low stamina, fatigue, anxiety, depression, and forgetfulness.
Conversely, excessive testosterone can lead to more aggressive and irritable behavior, acne, oily skin, sleep apnea, high blood pressure, and increased muscle mass.
It is essential to differentiate between bound testosterone (bound to either albumin or SHBG) and free testosterone (not bound) when assessing testosterone levels. Total testosterone comprises both types, with free testosterone constituting approximately 2% of the total.
SHBG levels can fluctuate due to various factors such as thyroid problems, obesity, or inflammation processes in the body, potentially resulting in a disproportionately high or low amount of testosterone even when the total testosterone level falls within the reference range. Therefore, evaluating all four results is crucial for a comprehensive understanding of one’s testosterone levels.
Cortisol, a stress hormone produced by the adrenal cortex, is essential for managing the body’s response to stress, alongside adrenaline. It influences metabolism and aids immune functions by reducing inflammation and allergies. Cortisol levels can rise during physical exertion, emotional stress, or illness, without distinguishing between positive and negative stressors.
Elevated cortisol can result from various factors such as stress, infections, fasting, or certain medical conditions, leading to symptoms like skin problems, abdominal fat, and immune issues. Conversely, low cortisol levels can cause fatigue, dizziness, skin and hair problems, and more.
In severe cases, extremely low cortisol levels can trigger a life-threatening crisis, particularly in individuals with adrenal gland issues, necessitating immediate medical attention.
DHEA, primarily produced in the adrenal glands, serves as a precursor to both male and female sex hormones, such as testosterone and estrogen. DHEA levels fluctuate throughout one’s daily rhythm and age, declining significantly, by up to 80%, between the ages of 25 and 75.
Low DHEA levels can manifest as dry skin, brittle hair, decreased motivation, anxiety, reduced stress tolerance, sparse body hair, and a diminished libido. Such deficiency can also affect productivity and hormone balance.
Conversely, elevated DHEA levels, if not due to medication or adrenal hormone issues, are viewed positively from a preventive medical standpoint. However, since DHEA can lead to increased sex hormone levels, it may bring about related symptoms when exceptionally high.
Cholesterol, a vital fat-like substance, plays a crucial role in the body’s normal functions. It travels through the bloodstream within lipoprotein complexes, namely HDL and LDL. Total cholesterol represents the combined amount of various cholesterol components in the blood.
Regularly monitoring cholesterol levels is advisable if you have a family history of high cholesterol, high blood pressure, excess weight, or if you smoke. Elevated cholesterol levels can potentially harm health, increasing the risk of narrowed blood vessels and heart disease. Consequently, assessing cholesterol levels helps gauge the risk of cardiovascular disease.
Hemoglobin (Hb) is a protein within red blood cells responsible for carrying oxygen throughout the body. Glucose can permanently attach to hemoglobin, forming glycosylated hemoglobin (HbA1c), with the rate of formation corresponding to blood glucose levels over the past six to eight weeks, rather than daily fluctuations.
Slightly elevated HbA1c levels signal an increased risk of future diabetes (prediabetes), while high levels indicate poor blood glucose control, often with no noticeable symptoms. Prolonged high sugar levels can lead to fatigue, increased thirst, frequent urination, and delayed wound healing.
Lowering HbA1c levels can involve dietary changes, exercise, or medications, with personalized guidance from a doctor or nutritionist being the most effective approach.
The clinical significance of low HbA1c values is not fully understood, but recent studies suggest potential increased mortality risk in individuals without diabetes when HbA1c falls below a certain threshold.
Thyroid-stimulating hormone (TSH), produced by the brain’s pituitary gland, regulates thyroid hormone production. TSH levels adjust based on free T4 (fT4) and free T3 (fT3) concentrations, ensuring stable thyroid hormone levels. Normal TSH, along with normal T3 and T4 levels, indicates a healthy thyroid.
TSH plays a critical role in distinguishing primary hyperthyroidism (thyroid gland malfunction) from secondary hypothyroidism (pituitary or hypothalamus disorders). Low TSH with high fT4 and/or fT3 suggests primary hyperthyroidism, while elevated TSH with low fT4 and/or fT3 indicates primary hypothyroidism. Slightly raised TSH levels with normal fT4 and fT3 are considered early-stage hypothyroidism (subclinical), and increased TSH with high fT4 and/or fT3 points to secondary hyperthyroidism. TSH serves as a key marker in thyroid condition assessment.
PSA, a protein produced in the prostate and released into seminal fluid, can also be found in the blood, although in significantly lower concentrations. When malignant cells are present in the prostate, they often produce more PSA. Consequently, PSA testing plays a crucial role in the early detection and monitoring of prostate cancer and other prostate-related conditions. A small blood sample is all that’s required for the PSA test.
Consider checking your PSA levels if you have a family history of prostate diseases or if you’re 49 years old or older. The PSA test serves as a screening tool to assess the potential risk of prostate cancer. A low PSA result is reassuring for low-risk individuals.
However, a raised PSA level, especially at or above 4, is non-specific and can have various causes unrelated to prostate cancer. It doesn’t necessarily indicate a high risk of prostate cancer. In such cases, further investigation by a healthcare provider is needed, leading to individualized therapy recommendations. Elevated PSA levels can also result from prostate enlargement or inflammation, which, if left untreated, may lead to chronic issues like urinary problems and erectile dysfunction.
Regardless of the test outcome, it’s important to follow up with your primary care physician for a comprehensive evaluation.