Bioavailable Hormone Metrics are a set of clinical measurements used to quantify the portion of a hormone that is unbound or loosely bound to carrier proteins, thus representing the fraction immediately available to exert biological effects on target tissues. These metrics include free hormone concentrations and the calculated bioavailable fraction, which typically includes the free hormone plus the albumin-bound fraction. They offer a superior clinical assessment of functional hormone status compared to total hormone levels, which can be misleading due to variations in carrier protein concentrations.
Origin
This concept originated in clinical endocrinology as a refinement of hormone testing, acknowledging the profound influence of plasma binding proteins, particularly Sex Hormone-Binding Globulin (SHBG), on hormone action. The development of reliable laboratory assays and calculation models allowed clinicians to move beyond total levels for a more accurate reflection of tissue exposure. These metrics are now essential for the precise diagnosis and management of hormonal imbalances.
Mechanism
The metrics function by quantifying the hormone not tightly bound to SHBG, which acts as a storage and transport reservoir. The free and albumin-bound hormones are in rapid equilibrium with the tightly bound fraction, allowing them to dissociate and diffuse into target cells. By measuring these bioavailable fractions, the clinician gains direct insight into the effective hormonal signal reaching the cell receptors, providing the necessary data for fine-tuning personalized hormone replacement and modulation strategies.
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