This refers to the dynamic study of the absorption, distribution, metabolism, and excretion of the fraction of hormones that are unbound and capable of exerting physiological effects on target tissues. It is crucial in assessing true endocrine status, as total hormone levels alone may not reflect the active concentration available for receptor binding. We focus on this fraction because it directly correlates with clinical symptomatology and tissue response.
Origin
The term combines “bioavailable,” signifying biological accessibility, with “kinetics,” derived from the Greek kinetikos meaning “of motion,” describing the rates of change. Within endocrinology, this concept originated from the need to move beyond static total hormone assays toward a functional measure of hormonal action. This understanding underpins precision in replacement therapies.
Mechanism
The kinetics involve the equilibrium between bound hormones, primarily to Sex Hormone Binding Globulin or albumin, and free hormones. Changes in carrier protein concentration or affinity directly alter the rate at which active hormones reach cellular targets to initiate transcription or other signaling cascades. Analyzing these kinetic parameters helps clinicians optimize dosing schedules for therapeutic efficacy while minimizing peripheral effects.
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