Quote:
Originally Posted by BigPoppa
This massive spread has always bothered me. I think doctors often confuse what is normal with what is optimal. Free T between 46 and 224 may be normal, but there's no ****ing way 46 is optimal if 224 is also optimal.
You're half right and half wrong. Generally the reference values just give you the range where most of the tested population falls. It has nothing to do with optimal, so in that sense you're correct.
Where you're wrong, is that you can't deduce what optimal is just from knowing the range. For example the guy with 46 may have extremely sensitive testosterone receptors and therefore only needs 46 to get the same effect as 224 for another guy. Unfortunately there's just a lot of stuff we just don't know.
Here's another example off the top of my head (and I'm oversimplifying, so there are details that could be nitpicked) where if we apply your logic, we end up tremendously wrong.
If you look at the reference values for blood platelets you'll see something like a range of 150-450. If we apply the Big Poppa logic, well if 450 is optimal, there is no way 150 is also optimal. But that would be completely wrong. The number of platelets necessary to function properly is way under 150. People walking around with 100, for example, are absolutely fine. So the optimal range is actually much wider. It's starts somewhere less than 150 and goes somewhere higher than 450 (but too high is also a problem).
The basic point is we can't figure out optimal solely from knowing what normal is. Now most of the time the two are pretty similar but you couldn't confidently state that unless you had more information. So, the bottom line is that it is possible that, in your example, 46 and 224 are both optimal. And if you're going to say they're not (and they certainly may not both be optimal), then you'll have to have more reason than "those numbers are just too different".