The free androgen index is a measure of the biologically active testosterone in the blood. It is a ratio of the total testosterone to the level of sex hormone-binding globulin (SHBG). About half of all testosterone in the blood is tightly bound to SHBG and the rest is either free or loosely bound to albumin. Only the portion that is free or bound to albumin is considered biologically active. The portion bound to SHBG is considered biologically inert. Thus, by calculating the ratio of total testosterone to SHBG, one can get a measurement of physiologically active testosterone in the blood. The free androgen index is expressed in the same units and multiplied by 100 to provide a number similar to the free testosterone concentration in blood. Normal free androgen index results are slightly higher than free testosterone levels, however. As a ratio, there are no units. The free androgen index may be a more accurate assessment of free testosterone in women than in men.
More about the relationship between Free Androgen Index and SHBG:
Sex hormone-binding globulin (SHBG) and the free androgen index (FAI) are closely related measures that provide insight into androgen status and metabolic health. Here is a summary of their relationship:
SHBG is a protein that binds to sex hormones like testosterone, regulating their bioavailability. Lower SHBG levels lead to higher levels of unbound or "free" testosterone. The FAI is calculated as (total testosterone / SHBG) x 100 and represents the percentage of total testosterone that is unbound and biologically active.[1]
An elevated FAI, resulting from low SHBG and/or high testosterone, is associated with adverse cardiometabolic risk factors such as insulin resistance, dyslipidemia, and systemic inflammation in both men and women.[2][4][5] In women, a high FAI is a key feature of polycystic ovary syndrome (PCOS) and is linked to reproductive issues like menstrual irregularities and hirsutism.[4]
Conversely, higher SHBG levels lead to lower FAI and are associated with a more favorable cardiometabolic profile.[2][5] Factors like obesity, insulin resistance, and certain medications can suppress SHBG production, raising FAI.[1][3] Age, genetics, and ethnicity also influence SHBG and FAI levels.[3][5]
In summary, SHBG and FAI are inversely related measures that reflect androgen bioavailability. Their levels are influenced by metabolic factors and have implications for reproductive and cardiometabolic health in both sexes.[1][2][3][4][5]
Normal Ranges for Free Androgen Index:
• Male:
− 20 to 29 years: 30.0−128.0
− 30 to 39 years: 24.0−122.0
− 40 to 49 years: 14.0−126.0
− Older than 49 years: 18.0−82.0
• Female:
− 20 to 49 years: 0.4−8.4
− Older than 49 years: 0.4−6.6
Sources:
https://www.labcorp.com/test-menu/25691/free-androgen-index-fai
https://www.labcorp.com/test-menu/35496/testosterone-free-direct
https://www.uptodate.com/contents/overview-of-androgen-deficiency-and-therapy-in-women
Citations:
[1] https://www.ahajournals.org/doi/10.1161/01.cir.0000157697.54255.ce
[2] https://www.sciencedirect.com/topics/biochemistry-genetics-and-molecular-biology/free-androgen-index
[3] https://www.endocrinologiapediatrica.org/modules.php?idarticulo=364&idlangart=EN&name=articulos
[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8279613/
[5] https://pubmed.ncbi.nlm.nih.gov/15769764/
Keeping track of your medical data and laboratory results while understanding what they mean empowers positive health outcomes.
Keeping track of your medical data and lab results while understanding what they mean empowers positive health outcomes.
Save 10% off any plan with promo-code:
HEALTH10
Elevated Free Androgen Index (FAI) in Men
Elevated FAI levels in men can signify various underlying conditions and metabolic disturbances.
Conditions Associated with Elevated FAI
- Hypogonadism (low testosterone production) can paradoxically lead to increased FAI due to decreased sex hormone-binding globulin (SHBG) levels.
- Obesity and insulin resistance are linked to lower SHBG, resulting in higher FAI despite normal total testosterone.
- Androgen-secreting tumors of the testes or adrenal glands can increase androgen levels and FAI.
Possible Reasons for Elevation
- Certain medications like glucocorticoids can suppress SHBG production, raising FAI.
- Chronic conditions like HIV/AIDS, hepatitis C, and liver disease can affect SHBG and androgen levels.
- Genetic factors and race (e.g., higher FAI in African American men) may play a role.
Potential Treatment Considerations
- Lifestyle modifications like weight loss and exercise can improve insulin sensitivity and SHBG levels.
- Medications to lower androgen levels or block their effects may be used for androgen-secreting tumors.
- Surgical removal of tumors may be necessary in some cases.
Other Biomarkers and Associations
- Insulin resistance markers like HOMA-IR and oral glucose tolerance test (OGTT) are inversely associated with total testosterone and SHBG.
- Obesity, as measured by body mass index (BMI), is inversely associated with total testosterone and SHBG.
- Age is inversely associated with total testosterone but positively associated with SHBG.
Nutrient Associations
- Zinc and vitamin D deficiencies have been linked to lower testosterone levels.
- A diet high in processed foods and refined carbohydrates may contribute to insulin resistance and lower SHBG.
Elevated Free Androgen Index (FAI) in Women
Elevated FAI levels in women can signify underlying conditions related to androgen excess or imbalance.
Conditions Associated with Elevated FAI
- Polycystic ovary syndrome (PCOS) is strongly associated with elevated FAI levels. PCOS is characterized by high androgen levels, irregular menstrual cycles, and polycystic ovaries.
- Androgen-secreting tumors of the ovaries or adrenal glands can lead to excessive androgen production and elevated FAI.
- Congenital adrenal hyperplasia and other adrenal disorders that disrupt steroidogenesis can result in high androgen levels and FAI.
Clinical Manifestations of High FAI
- Hirsutism (excessive hair growth in a male pattern)
- Acne
- Irregular or absent menstrual cycles
- Infertility or difficulty conceiving
- Male pattern baldness or hair thinning
Impact on Quality of Life
- Higher FAI levels were associated with poorer quality of life in women with PCOS, particularly in domains related to hirsutism, menstrual irregularity, depression, and weight concerns.
Diagnosis and Evaluation
- FAI is calculated as: (total testosterone / SHBG) x 100%
- FAI levels >5 are considered indicative of PCOS in women.
- Additional tests like prolactin, 17-hydroxyprogesterone, and pelvic ultrasound may be ordered to identify the underlying cause.
In summary, elevated FAI in both men and women often signifies underlying conditions related to androgen imbalance or excess. Proper evaluation and management are crucial to address the underlying cause and associated symptoms.
Sign up
Sign up now and create your account. Use code HEALTH10 for a 10% discount on any plan. Don't miss out!
Organize
Bring all results from any laboratories to your account. You can enter your tests yourself, or we'll be happy to organize your files—whether in PDF, JPEG, CSV, or even screenshots.
Learn and improve
Once your information is stored in your account, dive into a wealth of insights about your results. If you have any more questions, we are here to answer them.
Adult men with too little testosterone may lose lean muscle mass, become fatigued, feel weak, and develop depression. Low testosterone can reduce libido and contribute to erectile dysfunction. Gynecomastia—the development of breast tissue in men—is another symptom of low testosterone. Boys with low testosterone may fail to develop secondary sex characteristics such as deepened voice, pubic hair, and facial hair. Low testosterone is less problematic for women, but it can interfere with sexual function.
Some specific causes of low free androgen index are:
- Hypogonadism
- Testicular injury
- Testicular cancer
- Testicular cancer treatment
- Type 2 diabetes mellitus
- Obesity
- Chronic liver disease
- Chronic kidney disease
Guiding our user for 10 years to promptly understand, track, and act on their laboratory results.
$15/month
for personal lab results
Cancel your subscription at any time.
$250/once
full premium version
$45/month
track your clients’ labs
Cancel your subscription at any time.
Guiding our user for 10 years to promptly understand, track, and act on their laboratory results.
Personal plans
track personal results
Professional Plan
track multiple client's results
$15/month
for personal lab results
$250/once
own it for life
$45/month
for health professionals
Complete Plan
Unlimited Plan
$15 per month
$250 full version
Are you a health professional?
Level up your lab report analysis with our Pro plan, built for health practitioners like you.
Health Business Account
$45/month
Cancel your subscription at any time.
Unlock additional Pro plans when you sign up.
Unlock Your Health Journey with Healthmatters.io! Ever wished for a one-stop digital health haven for all your lab tests? Look no further! Healthmatters.io is your personalized health dashboard, bringing together test reports from any lab. Say goodbye to scattered results—organize and centralize your lab data effortlessly. Dive into the details of each biomarker and gain insights into the meaning behind your medical test data.
Join the community of thousands who've transformed the way they understand their lab results. Experience the joy of having all your lab data neatly organized, regardless of where or when the tests were done.
For our professional users, Healthmatters.io is a game-changer. Revel in the intuitive tools that not only streamline analysis but also save valuable time when delving into your client's lab report history. It's not just a dashboard; it's your gateway to a smarter, more informed health journey!
Healthmatters.io personal account provides in-depth research on 4000+ biomarkers, including information and suggestions for test panels such as, but not limited to:
You can combine all test reports inside your Healthmatters account and keep them in one place. It gives you an excellent overview of all your health data. Once you retest, you can add new results and compare them.
If you are still determining whether Healthmatters support your lab results, the rule is that if you can test it, you can upload it to Healthmatters.
While we do talk about popular labs, we welcome reports from lots of other places too. It's as simple as this: if you can get a test done, you can upload it to Healthmatters. We can interpret results from any lab out there. If laboratories can analyze it, we can interpret it.
Still on the hunt for a specific biomarker? Just tell us, and we'll add it to our database. Anything from blood, urine, saliva, or stool can be uploaded, understood, and tracked with your Healthmatters account!
There are two ways to add your test reports to your healthmatters.io account. One option is to input the data using the data entry forms. The other method is to utilize our "Data entry service."
Our data entry forms offer an easy, fast, and free way for you to input the reports yourself. Self-entry allows you to add an unlimited number of reports at no cost. We make the self-entry process user-friendly, providing dozens of templates that pre-populate the most popular laboratory panels and offering instant feedback on entered values.
For those who prefer assistance, we offer a "Data entry service" to help you input your data. Simply attach an image or file of your lab test results, and a qualified team member from our data entry team will add the results for you. We support various file types, including PDFs, JPGs, or Excel. This service is particularly useful if you have many reports to upload or if you're too busy to handle the data entry yourself.
Our special data entry service makes it easy to add your results to your private dashboard. Just attach an image or a file of your lab test results, and our skilled data entry team will do the work for you. It's all done by humans, ensuring that your data is entered accurately and with personal care for each client.
Depending on your account, the data entry service can be included for free or come at an additional cost of $15 per report.
For users on the Complete monthly plan, the first report is entered free of charge, and each additional report incurs a fee of $15.
Unlimited account holders enjoy the entry of ten reports without charge. Subsequent reports are subject to a $15 fee per report.
Additionally, users on the Complete plan can upgrade to a yearly subscription from the account settings. The annual subscription includes a data entry service for five reports.
The Unlimited plan is a one-time purchase for $250, and it covers your account for a lifetime with no additional payments.
For the Complete plan, the cost is $15 per month. You have the flexibility to cancel it anytime through your account settings, ensuring no further payments. To avoid charges, remember to cancel at least a day before the renewal date. Once canceled, the subscription remains active until the end of the current billing cycle.
Additionally, you can upgrade to the yearly Advanced plan from within your account. The annual cost is $79, and it comes with a data entry service for five reports.
You can always upgrade to a lifetime version with a prorated price from a monthly or yearly subscription.
Simply log in and navigate to your account settings to cancel your subscription. Scroll down to locate the 'Cancel' button at the bottom of the page. Ensure you cancel at least one day before the renewal date to prevent any charges. Once cancellation is requested, the subscription remains active until the conclusion of the current billing cycle.
Unlocking the insights from your lab tests has never been this intuitive! We've crafted multiple ways for you to navigate your data, whether you're glancing at a single report or delving into a treasure trove of testing data.
1. Graph View:Dive into a visual journey with our biomarker graphs, showcasing over 40 data points. Combining years of results unveils trends, empowering you to make informed decisions. Our visualization tools make it a breeze to compare and understand changes over time, even if your results are from different labs. A search function and filters simplify the exploration of extensive data, allowing you to focus on what needs attention.
2. All Tests ViewGet a quick grasp of your test reports in minutes! Explore neatly organized reports on a timeline, highlighting crucial details like dates, critical results, and lab/panel names. Each report opens up to reveal in-depth descriptions and additional recommendations for each biomarker. The history of previous results is just a click away, and you can download a comprehensive report for deeper insights. Color-coded and user-friendly, it's designed for easy reading, understanding, and navigation.
3. Table View:For a holistic view of all biomarkers side by side, our table view is your go-to. Results are neatly displayed in a categorized and dated table, ideal for those with an extensive test history. Utilize sorting, filters, and color-coding to enhance your analysis and gain extra insights.
Experience the power of clear, organized data visualization with Healthmatters.io — your key to understanding and taking charge of your health journey!
Yes, you can download information from your account. We can compile your labs into a CSV file. To download all your labs, you can go to Account Settings, and at the bottom of the page, you will find a link to download your information.
Yes, you can print your report. To do so, navigate to "All tests" and open the report you wish to print. You'll find a print button in the right corner of the report. Click on it, and your browser's print window will open. If you prefer to print in a bigger typeface, adjust the scale using the print window settings.
A personal account is all about keeping your own lab test results in check. It's just for you and your personal use.
The professional or business account is designed for health professionals who wish to track and organize their clients' laboratory results.
To learn more about Healthmatters Pro, please refer to the professional page.
At HealthMatters, we're committed to maintaining the security and confidentiality of your personal information. We've put industry-leading security standards in place to help protect against the loss, misuse, or alteration of the information under our control. We use procedural, physical, and electronic security methods designed to prevent unauthorized people from getting access to this information. Our internal code of conduct adds additional privacy protection. All data is backed up multiple times a day and encrypted using SSL certificates. See our Privacy Policy for more details.
1,5-Anhydroglucitol (1,5-AG), Intermediate Glycemic Control, 5-Methyltetrahydrofolate, AC/FC, Acylcarnitine, Adiponectin, Adiponectin (Boston Heart), Albumin/Creatinine Ratio, Random Urine, Anti-Thyroglobulin ab. (0-39), Anti-Thyroglobulin Antibody (Boston Heart), C-Peptide, LC/MS/MS, C-Peptide, Serum, C-Peptide, Ultrasensitive (Endocrine Sciences), Ceruloplasmin, Choline, CoQ10, Creatinine, Random Urine, Cyclic AMP, Plasma, Dihydrotestosterone (female), Dihydrotestosterone (male), Estimated Average Glucose (eAG), Free Androgen Index, Free testosterone, Free Testosterone (Male) in pmol/L, Free Testosterone (Male/Serum) in ng/ml, Free Testosterone, Direct (Female), Free Testosterone, Direct (Male), Free Testosterone, Percent (Female), Fructosamine, Glutamic Acid Decarboxylase, Glycated Hb (HbA1c), Glycated Serum Protein (GSP), Hemoglobin A1c (HbA1c), HOMA-B, HOMA-IR, HOMA-S, Homocysteine, Insulin (Fasting), Insulin Antibody, Insulin Resistance Score, Insulin, Free (Bioactive), Insulin, Intact, LC/MS/MS, Insulin-Like Growth Factor I (IGF-1), Iodine, Serum/Plasma, Nonesterified Fatty Acids (Free Fatty Acids), Pregnenolone, Proinsulin, Sex Horm Binding Glob, Serum (Male), Sex Hormone-Binding Globulin (SHBG), T7 Index, Testost., % Free+Weakly Bound, Testost., % Free+Weakly Bound (female), Testost., F+W Bound (female), Testost., Free, Calc (Female), Testosterone, Testosterone (Female/Child), Testosterone, bioavailable, Testosterone, bioavailable (male), Testosterone, Serum (Female), Thyroglobulin, Thyroglobulin Antibodies (0 - 1 IU/L), Thyrotropin Receptor Ab, Serum, Thyroxine-binding globulin, TBG, TMA, TMAO, TMAO (Trimethylamine N-oxide), Triiodothyronine, Serum, TSH Receptor Antibody (TBII), Zinc Transporter 8 (ZnT8) Antibody
