Cut From Steel

This week's hero is the man reading this right now

I have spent these letters handing you other men's stories. Those men had records, film footage, and a documented second act. You have none of that, and you are the harder case.

You are the man who opened this at six in the morning instead of going back to sleep. Nobody gave you a crowd for it. No writer filed a report.

You booked the blood test. Then came the harder part, which was walking past the vending machine on the fourth floor every afternoon for a month. Last Friday you went to bed at half ten, because you had already decided that Saturday morning belonged to you.

Theodore Roosevelt gave the line at the top of this letter in Paris in April 1910, in a speech called Citizenship in a Republic. He described the man in the arena, the one whose face is marred by dust and sweat and blood, who errs and comes short again and again. Roosevelt was not describing a champion. He was describing a man who showed up, took the hits, and came back.

You are in that arena this morning, and the critics in your case are living inside your own head. Your total testosterone is a number on a page. What you did at half ten on Friday night is the part that moves it. Nobody will hand you a belt for this. That is exactly why it counts.

The number they measured was the wrong one

You went to the doctor because the afternoons had gone flat and the gym had stopped paying you back. He ordered a testosterone test. The result came back inside the range, so the conversation ended there, and you went home with nothing to work on.

I want to give you the part he skipped. Testosterone travels in your blood in three forms. Roughly 44 percent of it is bound tightly to a protein called sex hormone binding globulin, about 50 percent rides loosely on albumin, and only 2 to 3 percent floats free. Your tissues can only use the free portion and the loosely held portion. The total on your report counts all three, including the part that is locked up and unavailable.

Three things your panel did not tell you

So what happens to that split as a man gets older? I count three findings worth knowing, and your doctor had seven minutes.

01 / The Binding Protein Climbs

You make more of that protein every decade. The Institute of Medicine's review of testosterone and aging notes that sex hormone binding globulin rises with age in men, and the shift becomes clearer after fifty. In the Massachusetts Male Aging Study, free testosterone fell about 1.2 percent per year of age while total testosterone fell about 0.4 percent. Put plainly, the number your doctor read out is the one that drops slowest.

02 / A Normal Total Can Hide a Low Free

You may need a second measurement, and there is guidance for asking. The Endocrine Society's clinical practice guideline says clinicians should measure free testosterone when the total sits in a borderline zone near the lower limit, for example 200 to 400 nanograms per decilitre, or when something has altered the binding protein. That same guideline says the cheap direct free-testosterone immunoassays are inaccurate, so ask for equilibrium dialysis or a calculation from total testosterone, SHBG, and albumin.

03 / Your Waist Moves the Protein Too

You can push that protein the other way, and weight is the lever. The Endocrine Society lists obesity and diabetes among the conditions that lower SHBG, which is why Cleveland Clinic notes that a low total testosterone in a heavier man may simply reflect low binding protein while his free testosterone reads normal. So one panel can mislead in both directions, depending on the man holding it.

What to do with this on Monday

You can start by getting the draw done properly. Cleveland Clinic advises measuring total testosterone between seven and eleven in the morning, and confirming a low result with a second test two to three weeks later. Ask for SHBG and albumin on the same requisition, so a free testosterone can be calculated rather than guessed at.

You should work the levers that cost nothing while you wait for the appointment. A small controlled study of ten healthy young men found that eight nights of under five hours of sleep lowered their daytime testosterone by 10 to 15 percent. Harvard Health reports that resistance training with large muscle groups, such as squats and bench presses, can raise testosterone, and that weight loss may support production by up to about 30 percent in some research. None of that is a cure, and all of it is available tonight.

One last thing. The number on the page is not the number in your body. Go and ask for the other one.

— Travis

Insider Member's Corner

6 free habits that protect the testosterone you still make:

You didn't put in 45 years to settle for beige.

01 / Watch · Grand Seiko “Snowflake” SBGA211

Grand Seiko builds this one in Nagano, running the Spring Drive calibre 9R65, with a seconds hand that glides instead of ticking. The dial is not painted. Grand Seiko says the whiteness comes from a silver plating process meant to copy the texture of the snow on the mountains outside the Shinshu studio. Accuracy is quoted at about a second a day, with a 72-hour reserve, in a 41mm titanium case. Retail sits somewhere between $6,200 and $6,900 depending on the boutique.

02 / Bourbon · Blanton’s Original Single Barrel

Elmer T. Lee created this in 1984, near the end of his run at Buffalo Trace, and it is credited as the world’s first single barrel bourbon. Every bottle carries a horse-and-jockey stopper, and there are eight of them, each stamped with a letter of BLANTON’S and each showing a different stage of a race. The barrels still come from Warehouse H, the metal warehouse Colonel Blanton put up after Prohibition, where the temperature swings harder than it does in brick. Bottled at 93 proof. Sticker prices sit in the sixties and shelves rarely agree, so expect nearer a hundred if you find one.

03 / Licence · Learning to Fly

You could hold a private pilot certificate a year from now. The FAA minimum is 40 hours under Part 61 or 35 under Part 141, and AOPA is honest that most people finish somewhere between 50 and 70 hours. Cost has moved a long way, and current schools quote about $18,000 at the floor with $21,000 to $26,000 as typical. Nobody needs to own a plane. Renting one on a Saturday morning is the entire point.