Methanogen Bacteria Responsible For Risk Of CVD Assoc. PC (choline, TMAO)

[Zpol]

Mind blown. (Stupid holidays, I so want to dig into this article but I have to go celebrate holidays. Would rather stay home and research!!!)
The authors full hypothesis:
Hypothesis: Methanogen Bacteria Are Responsible for Increased Risk of Cardiovascular Disease Associated With Phosphatidylcholine and Its Metabolites (Choline, TMAO)

then there's this...
Proposed therapeutic use of archaea to prevent trimethylaminuria and cardiovascular disease

The first article talks about how methanogen prokaryotes contribute to CVD and the second theorizes they could be used to treat CVD.

Very opposite theories, but I think the if the specific strains were correctly identified (which ones are associated with CVD and which reduce risk of CVD), we would have clarity.

It's a big deal as I have SIBO-C (associated with methane producing archaea) and my boyfriend has Atherosclerosis. My research into these separate (or so I thought) issues is converging.

My research into this started because I'm trying to find something to reduce the achaea in my gut which is possibly causing my relentless constipation. I'm currently researching Squalamine as an 'antibiotic' of sorts to kill or reduce my overgrowth infection.

Hopefully I will get smart enough to fully understand all the biochem talk in these articles while I still have time.

 

[pimpnamedraypeat]

Hopefully I will get smart enough to fully understand all the biochem talk in these articles while I still have time.

Any luck with that?

 

[ddjd]

I'm currently researching Squalamine as an 'antibiotic' of sorts to kill or reduce my overgrowth infection.

Is squalamine the same as squalene?

 

[Zpol]

Squalamine, is a steroid found in the dogfish shark (and can be reproduced synthetically), it has antibiotic, antifungal, and antimicrobial properties.

Squalene was found to be produced in the body, it keeps your skin and other tissues lubricated.

They were both originally discovered in the livers of sharks, squalene was found to also be abundant in other sources like olive oil.

From what I understand, Squalene, as a supplement is similar to fish oil and probably high PUFA.

 

[goodandevil]

Squalamine, is a steroid found in the dogfish shark (and can be reproduced synthetically), it has antibiotic, antifungal, and antimicrobial properties.

Squalene was found to be produced in the body, it keeps your skin and other tissues lubricated.

They were both originally discovered in the livers of sharks, squalene was found to also be abundant in other sources like olive oil.

From what I understand, Squalene, as a supplement is similar to fish oil and probably high PUFA.

The dosage isn't very high. I have some squalamine on hand and wanted to test MICs for it, but unfodtunately that didnt happen. Maybe i can test it for my capstone project.

Besides squalamine, flagyl is effective against archea, but has severe side effects. I think abdominopelvic muscle weakness should be addressed in cases of idiopathic, and that can take a lot of effort, although ray would recommend progesterone and possibly topical dhea.

 

[Zpol]

The dosage isn't very high. I have some squalamine on hand and wanted to test MICs for it, but unfodtunately that didnt happen. Maybe i can test it for my capstone project.

Besides squalamine, flagyl is effective against archea, but has severe side effects. I think abdominopelvic muscle weakness should be addressed in cases of idiopathic, and that can take a lot of effort, although ray would recommend progesterone and possibly topical dhea.

Can you tell me the dosage you used?
I am doing ab exercises on my ab bench to strengthen muscle tone but I don't think that's my whole problem. I have seen a doctor for pelvic floor dysfunction, I religiously did the exercises she taught me, also my health coach taught me exercises, even back when I took kickboxing and dances classes 5 days a week and super fit, I still had this problem. I love the ab bench which I got based on your advice so thanks! I know targeting and strengthening pelvic floor muscles on the ab bench will help (maybe that's where I went wrong with the other exercises), plus it will help keep my posture and spine in good shape. Another bonus, the ab bench I got doubles as an inversion table when I put it at the highest incline.

I have considered Flagyl, another member took it and said he had some very awful die-off reaction. I don't know that I could get my doc to prescribe it anyway. Plus, I need something that I can do on and off long term so that the infection doesn't come back, I couldn't do that with flagyl.

I'm going to continue working on my abs and pelvic floor, but I'm going to give the squalamine a try in addition. I would really love to hear what you find in your testing! You must have access to a lab; how awesome!

 

[goodandevil]

Can you tell me the dosage you used?
I am doing ab exercises on my ab bench to strengthen muscle tone but I don't think that's my whole problem. I have seen a doctor for pelvic floor dysfunction, I religiously did the exercises she taught me, also my health coach taught me exercises, even back when I took kickboxing and dances classes 5 days a week and super fit, I still had this problem. I love the ab bench which I got based on your advice so thanks! I know targeting and strengthening pelvic floor muscles on the ab bench will help (maybe that's where I went wrong with the other exercises), plus it will help keep my posture and spine in good shape. Another bonus, the ab bench I got doubles as an inversion table when I put it at the highest incline.

I have considered Flagyl, another member took it and said he had some very awful die-off reaction. I don't know that I could get my doc to prescribe it anyway. Plus, I need something that I can do on and off long term so that the infection doesn't come back, I couldn't do that with flagyl.

I'm going to continue working on my abs and pelvic floor, but I'm going to give the squalamine a try in addition. I would really love to hear what you find in your testing! You must have access to a lab; how awesome!

Ha! I do actually have access to a lab, im ik school for cls, clinical lab science. In fact im takijg clinical micro right now. The ab ex3rcises can take a long time to get results. I think i was about to message you acrually, ive found lunges are a good addition. My program now is ab bench, lunges, glute bridges, deadlifts or sumo deadlifts, depending on which hits your pernium muscle better, i do something called woodchoppers for obliques, and finally flutter kicks. It's a lot but im having drastic improvements. A good test, i think, is weed. I just made adorable coconut oil cannabears, soas to better dose them, ajd if the weed relaxes ur muscles and things move, i would go so far as to say that's diagnostic for a muscular problem. Ive added in a bit of testosterone, for a woman, sometimes women are prescribed very small amounts of testosterone, but maybe @haidut could better comment on the ideal anabolic configuration for a female. But i think adequate progesterone is important. As time goes on, you start to feel the muscles you dont have amd are buildijg, and in fact it takes me back in time psychologically as i progress. It is an ardous but very rewwrdijg undertaking, and once you feel the initial progress it becomes a self-reijforcing cycle. Ray believes very strongly in good digestion, he said he agrees with hippocratewls on that fact, so i think peoppe dont focus enough on abdominopelvic function. Sea over at the other forum has mentioned that red light on his pancreas encouraged peristalsisx i havent tried this yet, but have yielded great results personally with my routine.

 

[Zpol]

@Broken man , you will go far in that field :)
I can't do cannabis due to drug testing at my work. CBD oil is a possibility though, I could try that.
Thank for sharing your strength training regimen. I'm starting very small, although I hope to work up to where I was 5 yrs ago, when I was very fit. The reason I stopped was because of GERD. Seems like anything even slightly strenuous causes acid and stomach contents to come up.
I've been tested for hormone imbalance, estrogen and testosterone are in range, just progesterone are low so have Rx progesterone to take.

 

[goodandevil]

@Broken man , you will go far in that field :)
I can't do cannabis due to drug testing at my work. CBD oil is a possibility though, I could try that.
Thank for sharing your strength training regimen. I'm starting very small, although I hope to work up to where I was 5 yrs ago, when I was very fit. The reason I stopped was because of GERD. Seems like anything even slightly strenuous causes acid and stomach contents to come up.
I've been tested for hormone imbalance, estrogen and testosterone are in range, just progesterone are low so have Rx progesterone to take.

I also think the probiotics are helping me manage thijgs a lot. I use klaire labs biospora, although ive heard many good things about the japanese clostridium butyrate product. Non-lactic acid producing bacteria are best.

 

[Zpol]

Yes I tried a few different ones. Ruteri and rhamnosus because they were recommended for methanogenic bacteria. Also I used another one recommended for SIBO. They both worked magically like a charm for awhile then just stopped having an effect. They took about 3 months before they started helping, then worked for several months then stopped for no conceivable reason. I tried others that had zero effect at all but not those that you mentioned.
I think where I went wrong was that I didn't start with a anti-microbe regimen first, which is what the standard SIBO protocol indicates.

 

[Broken man]

I saw study that cites that antibiotics are useless at some cases.
Are the estrogenic hormonal effects of environmental toxins affecting small intestinal bacterial and microfilaria overgrowth? - PubMed - NCBI

Thanks for the link. I am not surprised at all given the role of estrogen in autoimmne conditions, which the author also mentioned. Estrogen also suppresses the immune system and is likely to activate retroviruses like HIV, and promote chronic bacterial infections. The latter has been shown to result in chronic inflammation even after the infection has been resolved, as I posted in another study. This makes OTC aromatase inhibitors like aspirin, citrus flavonoids, progesterone, androsterone, DHT, etc good candidates for treating autoimmune conditions and their benefit has already been confirmed in many animal (and human studies). I think vitamin E and saturated PC (as in MitoLipin) may be able to get some of those xenoestrogens out of the cell and help the liver excrete them. Citrus flavonoids seem to be able to do the same.

If I would have same problems as you. I would go with niacinamide, aspirin ( if you dont have problems with it), oxidal as mentioned here.
Niacinamide Can Help Treat Highly Drug-resistant Bacterial Infections
Aspirin As A "novel" Potent Anti-bacterial Agent

You can add caprylic acid and malic acid .
Coconut Oil + Vinegar = Potent Antibiotic

Good luck.

 

[Zpol]

Good points, as usual @Broken man !

I have upped my Energin to 40drop dosages, 3x per day. This should correct deficiencies at least. The bacterial infection that niacinamide cured in @haidut 's thread was MRSA, this is not the type of infection I have so it'd be experimental if I did it, that's not to say it wouldn't work though.

Interesting you mention caprylic acid and malic acid. I was just researching these. However, in my own studies, I found monolaurin to be more effective than caprylic acid for bacteria, biofilm, and fungal overgrowth. As for the malic acid, I'm going to used Apple Cider Vingar on my carrot salads and possibly start taking it before all meals. That last part I've tried to do before, it's not easy to remember to do this but diligence is going to be key in all aspects of my self-designed protocol.

As for aspirin, I was holding off on this for two reasons; first, I have fibromyalgia and was considering the guaifenesin protocol (but for this to work all sources of salicylates would have to be strictly eliminated, second, my poor stomach is so sensitive right now, don't know how strong doses of aspirin would affect it. I could buffer it with baking soda but then baking soda has it's own problems. Milk alkali syndrome and someone reported sepsis from taking too much baking soda.
But, the aspirin could have multiple benefits for me so I've decided to skip the guaifenesin protocol for now and go with the aspirin. I'm starting with alka-seltzer (plain) and in process of formulating my own with Ph Adjust and pure aspirin powder. The problem here is that it's dangerous to play with your body's own pH balancing system. I would hope the salicylic acid would balance the alkaline properties and vice versa, but I don't have a way to know for sure. There is litmus paper but testing is only accurate if one hasn't eaten or drank in several hours. Me personally, I have to eat and/or drink every 2 or 3 hours, even at night (if wake up I take OJ or at least some MgBicarb water).
So if you've got any tips or magical @haidut quotes on that, that'd be cool :)

Thank you kindly for all help!

 

[Broken man]

Good points, as usual @Broken man !

I have upped my Energin to 40drop dosages, 3x per day. This should correct deficiencies at least. The bacterial infection that niacinamide cured in @haidut 's thread was MRSA, this is not the type of infection I have so it'd be experimental if I did it, that's not to say it wouldn't work though.

Interesting you mention caprylic acid and malic acid. I was just researching these. However, in my own studies, I found monolaurin to be more effective than caprylic acid for bacteria, biofilm, and fungal overgrowth. As for the malic acid, I'm going to used Apple Cider Vingar on my carrot salads and possibly start taking it before all meals. That last part I've tried to do before, it's not easy to remember to do this but diligence is going to be key in all aspects of my self-designed protocol.

As for aspirin, I was holding off on this for two reasons; first, I have fibromyalgia and was considering the guaifenesin protocol (but for this to work all sources of salicylates would have to be strictly eliminated, second, my poor stomach is so sensitive right now, don't know how strong doses of aspirin would affect it. I could buffer it with baking soda but then baking soda has it's own problems. Milk alkali syndrome and someone reported sepsis from taking too much baking soda.
But, the aspirin could have multiple benefits for me so I've decided to skip the guaifenesin protocol for now and go with the aspirin. I'm starting with alka-seltzer (plain) and in process of formulating my own with Ph Adjust and pure aspirin powder. The problem here is that it's dangerous to play with your body's own pH balancing system. I would hope the salicylic acid would balance the alkaline properties and vice versa, but I don't have a way to know for sure. There is litmus paper but testing is only accurate if one hasn't eaten or drank in several hours. Me personally, I have to eat and/or drink every 2 or 3 hours, even at night (if wake up I take OJ or at least some MgBicarb water).
So if you've got any tips or magical @haidut quotes on that, that'd be cool :)

Thank you kindly for all help!

I dont know much about infections, just only that they are living from iron and maybe sulphur. This is reason why alot of things against bacteria are good at lowering iron. The thing with niacinamide is that its increasing your NAD/NADH ratio which is the key because Haidut wrote somewhere that bacteria cant live in oxidized state. Second, if you read the study, I find it because of one member posted it in fb group. He wrote under it that you need to be in anabolic state if you want to have bacteria under control.

 

[Broken man]

I dont know much about infections, just only that they are living from iron and maybe sulphur. This is reason why alot of things against bacteria are good at lowering iron. The thing with niacinamide is that its increasing your NAD/NADH ratio which is the key because Haidut wrote somewhere that bacteria cant live in oxidized state. Second, if you read the study, I find it because of one member posted it in fb group. He wrote under it that you need to be in anabolic state if you want to have bacteria under control.

He wrote exactly this: "Will shifting to a more Anabolic Milieu change the Microbiota and Reduce Symptoms of Gastrointestinal Disease?
Current thinking puts bacteria at the center of two prominent gastrointestinal diseases:
Helicobacter pylori- peptic ulcer, and methane producing bacteria- Small Intestinal Bacterial overgrowth (SIBO). The addition of anabolic steroids in a manner to normalize the Free Androgen Index (FAI) correlates with symptomatic improvement in at least SIBO. Only on report in the medical literature has shown an improvement in Crohn’s Disease with added back testosterone. No one has connected that xeno-estrogenic effects of environmental toxins could be causing a relative testosterone/anabolic deficiency in gastro-intestinal disease. No one has looked at how changes in the hormonal milieu might affect the microfilaria in the gastrointestinal tract. This is important because the use of antibiotics is resulting in increased antibiotic resistance and greater than 30 percent treatment failures leaving patient suffers with SIBO and potentially H. Plyori without treatment options."

"This hypothesis and observational cases disrupts the commonly held belief that bacteria are the cause of gastro-intestinal diseases and propagate autoimmune and related disease. These observations support the concept that endocrine disrupting chemicals (EDCs), environmental toxins in fact cause a change in the microbiota that could lead to bacterial overgrowth, autoimmune and related diffuse diseases such as SIBO and IBD. The aforementioned discussion clearly shows that the antibiotics prescribed for methane producing bacteria of SIBO, rifaximin and a multitude of others, are not effective for treating the symptoms, the observed hormonal disruption, and changes in transit time that are components of these disease complexes. The host needs to stay anabolic to maintain the tight junction of enterocytes, the transit time must be maintained, and pathologic biota need to remain in the colon and not ascend to the small bowel. All these conditions are necessary for the gastro-intestinal tract to maintain homeostasis. Should the shift from an androgenic to estrogen milieu occur because of increased exposure to EDCs,the Wolbachia/ microfilaria infections are hypothesized to increase, and they may be the unrecognized causative agents for SIBO and other gastrointestinal disease states."

 

[Zpol]

My mind is reeling from all this information. All good stuff, so overwhelming and many things to consider.
There's no doubt in my mind that environmental toxins and EDC's are a big part of my diseases.

bacteria cant live in oxidized state

This part I understand after reading about Artemisinin. When I took this constipation worsened, but perhaps that was a 'die-off' symptom.
I see your point in NAD/NADH resulting in an anabolic state, this would theoretically be useful for all infections, not just MRSA. I think where I'm floundering is that there are so many methods that are effective for killing off bacteria overgrowths that I don't know which path to follow. Some are in vivo, some are in vitro, some are only on rats, some are on healthy human (which i am not), and of course some are inherently flawed but I have to scrutinize to figure that out. I'm trying to weed out the ones that don't specifically apply to me, but apparently that's not a good method either because I very nearly discounted the possibility of niacinamide as a contender.

from the Estrogen and SIBO study:
"Treatment with a mixture of anabolic steroids that raises the FAI and lowers SHBG results in dramatic improvement in the signs and symptoms and recovery of the vast percentage of severe SIBO sufferers the author has treated."

Sounds like this author has some effective protocol... wish he/she would have shared it.
I have done some research along these lines, hence I take progesterone. Sounds like it may need to be balanced with testosterone, but my doc won't prescribe it, she says my testosterone level is in range. There's Boron, but this can raise estridiol in women. I guess all there is to do is continue with Niacinamide, consider taking a 3 day regimen of 5g per day, and start with the daily aspirin.

 

[Broken man]

My mind is reeling from all this information. All good stuff, so overwhelming and many things to consider.
There's no doubt in my mind that environmental toxins and EDC's are a big part of my diseases.

This part I understand after reading about Artemisinin. When I took this constipation worsened, but perhaps that was a 'die-off' symptom.
I see your point in NAD/NADH resulting in an anabolic state, this would theoretically be useful for all infections, not just MRSA. I think where I'm floundering is that there are so many methods that are effective for killing off bacteria overgrowths that I don't know which path to follow. Some are in vivo, some are in vitro, some are only on rats, some are on healthy human (which i am not), and of course some are inherently flawed but I have to scrutinize to figure that out. I'm trying to weed out the ones that don't specifically apply to me, but apparently that's not a good method either because I very nearly discounted the possibility of niacinamide as a contender.

from the Estrogen and SIBO study:
"Treatment with a mixture of anabolic steroids that raises the FAI and lowers SHBG results in dramatic improvement in the signs and symptoms and recovery of the vast percentage of severe SIBO sufferers the author has treated."

Sounds like this author has some effective protocol... wish he/she would have shared it.
I have done some research along these lines, hence I take progesterone. Sounds like it may need to be balanced with testosterone, but my doc won't prescribe it, she says my testosterone level is in range. There's Boron, but this can raise estridiol in women. I guess all there is to do is continue with Niacinamide, consider taking a 3 day regimen of 5g per day, and start with the daily aspirin.

Look up what Haidut wrote me.

 

[Zpol]

Look up what Haidut wrote me.

Just did that; the one's pertaining to Androsterone and Progesterone that is. I see recommends progesterone for women. Not sure I understand this though because it appears progesterone raises SBHG. I've been taking progesterone for many years now so I sure hope this is not the case for me!
I'll keep searching on this topic.

 

[pimpnamedraypeat]

Look up what Haidut wrote me.

Where?

 

[Broken man]

Where?

I saw study that cites that antibiotics are useless at some cases.
Are the estrogenic hormonal effects of environmental toxins affecting small intestinal bacterial and microfilaria overgrowth? - PubMed - NCBI


If I would have same problems as you. I would go with niacinamide, aspirin ( if you dont have problems with it), oxidal as mentioned here.
Niacinamide Can Help Treat Highly Drug-resistant Bacterial Infections
Aspirin As A "novel" Potent Anti-bacterial Agent

You can add caprylic acid and malic acid .
Coconut Oil + Vinegar = Potent Antibiotic

Good luck.

 

[Zpol]

I saw study that cites that antibiotics are useless at some cases.
Are the estrogenic hormonal effects of environmental toxins affecting small intestinal bacterial and microfilaria overgrowth? - PubMed - NCBI


If I would have same problems as you. I would go with niacinamide, aspirin ( if you dont have problems with it), oxidal as mentioned here.
Niacinamide Can Help Treat Highly Drug-resistant Bacterial Infections
Aspirin As A "novel" Potent Anti-bacterial Agent

You can add caprylic acid and malic acid .
Coconut Oil + Vinegar = Potent Antibiotic

Good luck.

more on that topic from the same author...

Sex Hormone Binding Globulin

Author: Edward Lichten, M.D., Assistant Clinical Professor, Wayne State College of Medicine, Fellow, American College of Obstetricians and Gynecologists, Fellow, American College of Surgeons states:

Sex Hormone Binding Globulin (SHBG) is a normal protein produced in men and women. While S.H.B.G. has the function 'tie up' up to 98% of testosterone in men, it does so to maintain a normal balance and prevent 'too much' free or bio-available testosterone.

Women produce about 7 times more SHBG then men in normal situations. When women are exposed to estrogens as in pregnancy, when taking oral-contraceptions or estrogen supplementation in menopause the production of SHBG increases 3 to 10 fold. The production of SHBG during pregnancy ties up so much testosterone that a testosterone producing tumor would not affect the offspring.

What has not been realized is that all the environmental toxins are estrogens. They are called xeno-estrogens and endocrine disrupting chemicals (EDCs) and they raise SHBG in everyone. Increased SHBG is linked to the massive increase in obesity and many of us believe, the increase in diabetes, endometriosis (uterine bleeding, fibroids) and many chronic inflammatory diseases (ulcerative colitis, rheumatoid arthritis, heart disease, psoriasis...).

More than 40 years ago, CW Burke and DC Anderson in Lancet 1972 established the normal range of SHBG for men (5- 15nmol/liter) and for women (30- 45nmol/liter). While SHBG normally increases with age doubling by 50 and tripling by 70, the exposure to xeno-estrogens and EDCs has increased how quickly the SHBG increases.

When the SHBG is higher than normal, then the amount of free or (bio-available) testosterone in both men and women will be less. Burke and Anderson describes the simple and 'gold-standard' methodology of determining 'free' or true bio-available testosterone as the Free Androgen Index (FAI). Divide the Total Testosterone in nmol/Liter divided by SHBG in nmol/Liter. Ideal 18 year values for a man are between 0.75 and 1.0. For women, the Free Androgen Index (FAI) is .03 to .06.
Doctor Lichten has documented in his article that the FAI for a severe case of endometriosis was .003 less than 1/10th of expected. When Dr. Lichten was able to use F.D.A. approved medications to raise the FAI 100-fold, the severe inflammatory condition reversed and has done so for 8 years. In men, the F.D.A. approved medications increases the F.A.I. by 3- 5 fold.

Protocol:
The first treatment for women to raise the F.A.I. is the prescription medication Danocrine(R)/ danazol. The dosage of danazol starts at 200mg twice to three times per day for 25 days and off for 5 days. The addition of spirolactone 50-100mg twice daily protects most from hirsuitism (acne, fluid retention) and a grain of Nature-throid keeps weight stable. Laboratory tests at 3-months should show increase in the F.A.I. and this should correlate with improvement in the woman's symptoms of inflammatory diseases states.


When stronger therapy is need, Doctor Lichten has a U.S. patent using the unique combination of anabolic steroids. (1) Nandrolone (first derivative of testosterone) raises the free testosterone. Furthermore, nandrolone is 30x stronger than estrogen in binding to the cellular Androgen-Receptor where the environmental EDCs must enter to cause 'inflammation'.
(2) The second component of the patented protocol is stanozolol. Stanozolol is a first derivative of the normal dihydrotestosterone. Stanozolol blocks the liver production of SHBG. Therefore, to rectify the drop in Free Androgen Index, the doctor needs to increase testosterone AND reduce SHBG. Repeat laboratory every 3-months will show normalization of the FAI and resolution of inflammatory disease states.

Complications and Side-effects:
Increases in free testosterone may cause acne if the levels get too high. The treatment is to lower the dosage of testosterone and secondly stanozolol. The lower limits of SHBG for men is 10- 20nmol/liter.

Conclusion:
In our experience, most men in their 20's and 30's have the Free Androgen Index of a 50-year old that fought in World War II.

Medical Abstract: Scientific Information About S.H.B.G.
Sex Hormone Binding Globulin in Endocrinol Nutr. 2009 Apr;56(4):209-12. doi: 10.1016/S1575-0922(09)70987-8. Epub 2009 Jun 11.[Article in Spanish] [Variations in the concentration of the sex hormone binding globulin is a major factor causing a variation in total testosterone values]. Authors: Pinés Corrales PJ1, Louhibi Rubio L, Aznar Rodríguez S, Lomas Meneses MA.

13.Effects of drug administration of gonadotropins [danazol], sex steroid hormones and binding proteins in humans; Pugeat M. "in males as well as females, the long-term adminstration of danazol decreases also the biding capacity of SHBG, and consequently increased the free fraction of sex steroid hormones."

Abstract:
Measurement of total testosterone concentrations is the initial test for the diagnosis of androgen deficiency or excess in men. However, total testosterone concentrations may be affected by alterations in sex hormone binding globulin (SHBG) concentrations. Most circulating testosterone is bound to SHBG and to albumin and only 0.5-3% of circulating testosterone is unbound or free. The free fraction can be measured by equilibrium dialysis or calculated using published algorithms. The term bioavailable testosterone refers to unbound testosterone plus albumin-bound testosterone; this term reflects the view that, in addition to unbound testosterone, albumin-bound testosterone is readily dissociable and thus bioavailable. Bioavailable testosterone can be measured by precipitation methods or calculated from total testosterone, SHBG, albumin concentrations and their affinity constants. Free testosterone measurements by analog methods are frequently available, but these measurements are affected by alterations in SHBG and are inaccurate."

Copyrighted 2014