Arrive With Data

The reference range

“Within range” tells you you’re average. It doesn’t tell you you’re healthy.

The bracket printed next to your result is not a health standard. It’s a description of a group of men a laboratory measured at some point in the past, and those men have been getting worse.

An analysis of CDC survey data covering more than four thousand young men found average total testosterone fell from roughly 605 ng/dL in 1999–2000 to roughly 451 ng/dL by 2015–16. The authors flagged the consequence themselves: young men’s levels are the benchmark from which “normal” gets defined, so a decline in young men drags the accepted range down behind it.

That already happened. From 2011 through June 2017, one of the two large American reference labs reported an adult male range of roughly 348 to 1,197 ng/dL. In July 2017 it replaced that with 264 to 916.

Consider what that did to a real man. In June 2017 he measured 1,100 and was told he was normal. In August, the same man with the same blood was reading above the top of the range. Nothing about him changed. The paperwork changed.

The guide is about ordering the measurements that carry more information than the bracket does.

What’s in it

Why total testosterone is the wrong headline number, and what a 3,334-man study found instead
The free testosterone problem — three methods sold under one name, and why the cheapest is the one to avoid
The exact tests to order, and the two on the same menu that look almost identical
The complete panel, marker by marker, and why each one is on the list
How to prepare so the draw measures your physiology instead of your week
Where to order it, and where to take it — six services and clinics, none of which pay me anything

Where should I send it?

Educational content only. Not medical advice, diagnosis, or interpretation. Bespoke Physique is not a medical provider and does not interpret laboratory results. No commercial relationship exists between Bespoke Physique and any laboratory or clinic named in the guide.