A sophisticated clinical diagnostic technique that measures not only the total concentration of a hormone but also its various circulating forms or metabolites, known as fractions. This detailed analysis distinguishes between hormones that are free and biologically active, those bound to carrier proteins, and their breakdown products. It provides a far more accurate assessment of true hormonal status and tissue exposure than a total hormone measurement alone.
Origin
This specialized analytical approach evolved within clinical endocrinology and laboratory medicine, recognizing that the total amount of a hormone does not equate to its functional activity. The concept of hormone ‘fractions’ became essential with the discovery of binding globulins, like SHBG, which significantly influence hormone bioavailability. This technique is crucial for diagnosing subtle endocrine disorders and optimizing hormone replacement therapy.
Mechanism
The analysis relies on specific laboratory methods, such as equilibrium dialysis or mass spectrometry, to separate and quantify the different molecular forms of the hormone. For sex hormones, measuring the free fraction is paramount, as this unbound portion is available to interact with cellular receptors and elicit a biological response. Assessing metabolites, particularly for androgens and estrogens, provides insight into the body’s detoxification and elimination pathways, offering a complete picture of hormonal flux.
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