Question About Ranges

[NEFLRick]

So, been hanging out here, getting good advice/info and I always see, "post your bw with ranges." Now, the stuff I've read shows the ranges really don't mean much of anything. I've read the ranges are established by the testing lab based on the average range of results they've gotten from the people they've tested. This explains why each lab has a different range. Here is a link to an article explaining this.

So my question is, why does everyone ask for the ranges when posting bw? Seems to me the ranges really tell us nothing about what's going on with the person who was tested.

Obviously, I could be totally missing something.

Thanks.

[jomamma007]

as you said different labs use different ranges.

For example if I said my free testosterone was 20, well
On labcorp, who usually uses a range for free testosterone around 9-26, that would be an excellent score.

But Quest Labs usually uses numbers around 46-224, or 35-155 for their ranges.

So you see if one doesn't specify the ranges we can't really tell if there levels are off.

Obviously the ranges and numbers are just guidelines, as HRT is about treating symptoms, but they do usually help people find their sweet spots.

[bass]

so we don't have to look it up. its your job to make it easy for member to read your post so they can give you an answer right there and then.

[NEFLRick]

I think you guys are missing my point. Since the ranges are just (essentially) arbitrary ranges set by the different labs, why is that information important when someone is asking for help. I'm not trying to be a jerk, I'm just really curious. Seems like the ranges don't mean anything. It's the actual levels which matter.

If I have a free test level of 10, I'd still be low regardless of what range was set by the lab. At least that's what I'm thinking.

Now, this is all assuming (of course) that, while the ranges aren't the same, the actual testing procedures/scoring is the same. If we're comparing the same units for the level, it should be the same regardless of what any range is set by a given lab. Or am I missing something?

[bullshark99]

Ranges are NOT irrelevant, many times here members indicate that but it's not truly the case. The "spirit" behind that statement is that say LabCorp has a range of 348-1146 ( I believe) for total Tes. If one came in at 1800 I hardly think one would say this person has Low T based on them feeling like shit. Now if they came in at 439 and felt like shit, even though they are in " clinical" range it is very possible they are suffering symptoms of Low T. Bottom line is, A Dr may/ prob would look at a number and if it was in range, would dismiss a persons concerns, this in my opinion is wrong and why the situation should be evaluated further.

[kelkel]

Ranges, symptoms and feelings all help to paint a picture of what's going on and help with a proper evaluation.

[Bonaparte]

While they all set their ranges a bit differently, they don't vary all that much. You can't get too caught up and base a diagnosis purely on "within or outside of range", but you still need to have an idea of what is considered acceptable by the medical community.

And because if someone just says their test level is 20...WTF am I supposed to do with that??!! 20 what? 20 with a range of 10-30 would be average and no cause for concern, but 20 on a scale of 300-1100 would be abysmal.

[phaedo]

Good question, really, given how we all encourage to treat the patient and not the numbers. What should really be asked is what units of measure are you using? Is your serum testosterone measured in miligrams per deciliter? Or picograms per liter? or molar concentration? et cetera

Range is purely a statistically average based on a certain sample size and representative of the whole population. Obviously, each lab is privy to different samples, and therefore, different means and different standard deviations. The bell curves from each lab lie roughly within the same approximate values, where physicians can generally rely on the ranges as a probability of the upper and lower extremes. Ranges of any blood test allow for a quick snapshot in relation to the rest of the population. A single test is not an absolute relation to themselves or their symptomatology, though on average, delineates between low, normal, or high. This is why a prudent physician will check and re-check abnormalities.

So to your question: why does everybody ask for ranges? Because a range accounts for the units of the number provided -- it's simply easier. Ranges allow for a quick, relative assessment. Ranges are guidelines for quick evaluation of salient ailments, albeit should always be considered in context with the patient's anatomy, physiology, pathology, and psychology.

[NEFLRick]

So to your question: why does everybody ask for ranges? Because a range accounts for the units of the number provided -- it's simply easier. Ranges allow for a quick, relative assessment. Ranges are guidelines for quick evaluation of salient ailments, albeit should always be considered in context with the patient's anatomy, physiology, pathology, and psychology.

Ok, this makes the most sense. This is sort of what I thought. If everyone is using the same units of measure, ranges wouldn't be needed. You would be at an acceptable level, higher than or lower than an acceptable level. But, if you're not using the same units, you aren't comparing apples to apples.

I just wanted to make sure I wasn't missing anything. Thanks.

[no0ne23]

This is pure speculation from a relative newbie, but I also think the ranges are dependent on the type of test run. When my clinic switched labs, I saw the ranges change significantly for Free T: 35.0-155.0 pg/mL (Quest) and 8.7-25.1 pg/mL (LabCorp). From what I was told, the testing methods are different and the nurse said I have to push the decimal over one spot for LabCorp -- so my 13.8 from LabCorp is comparable to a 138 from Quest. My jaw dropped when I originally saw the report and thought I went from 111.2 down to 13.8.

[thisAngelBites]

Reference ranges are about more than units.

Reference ranges are empirical determinations of the distribution of amounts of certain chemicals within a human population. This makes sense, of course, because there is no way to theorise about how much testosterone that men of a certain age should have - instead we develop a reference group of people, usually ones that are healthy (or at least without any symptoms known to be related to the chemical in question) and take their bloods for analysis in order to learn about what the normal values are. From this, the mean of the results is calculated, and the boundaries of the reference range (if presuming a normal distribution - there is also a logarithmic normal distribution which is done differently) are at two standard deviations from the mean. This means that of all the values they get from the reference group, the 95% in the middle will be considered the "normal" range, and the top and bottom 2.5% will be outside.

Of that group, it will be possible that some people in the middle 95% will actually have a condition associated with the chemical being tested, and that some of the people outside the interval will be healthy. There is also the statistical possibility that some results fall outside the reference range purely by chance.

You can start to see some of the reasons different labs have different ranges - their ranges were developed using different groups of people as the reference group. Additionally, lab equipment varies, and this is a reason that each lab has to empirically determine its own range using its own equipment.

This is not to say that reference ranges are exact things. Most of these ranges are only very loosely done with regards to age, which is why you sometimes see people complaining on the board that their physician says their T is normal, when the reference group consisted of men between the ages of 19-80. So it doesn't tell you a lot about what a 40 year old man's levels should be. Typically doctors do something similar but more informal where in order to determine what the guideline should be for a 40yo, they look at the levels of 40 year old men who seem to not be suffering the symptoms known to be associated with low or high T. So this are all really just forms of pattern recognition.

Also, reference ranges can't account for things like diet, exercise, and as I mentioned, age (and usually, sex). And that alludes to another reason why international reference ranges are not desirable. Groups of people eating a similar diet in Micronesia might well have different values for some things than people consuming a Standard American Diet. We are better off comparing Micronesians to other Micronesians rather than to Americans.

I agree with Phaedo that lab values should be understood in the context of the patient and are just part of the picture. Statistically, it doesn't take much for a test to be slightly outside a reference range, and so often people on the board ask for more test results in order to try and determine whether there is a pattern consistent with a particular pathology, or whether the result might be an aberration. But it indeed useful to know how your results loosely compare with a group of people near you who appear to be healthy, all tested on your lab's same equipment. The more you deviate from the reference group's values, the greater the statistical likelihood that there is a problem.

I hope that helps.