@liltoomuchlifts TRT claims need some context

What did @liltoomuchlifts actually say?

She got bloodwork done after a year without hormone testing, found her female hormones "in range," but flagged her free testosterone at "9 nanograms per deciliter," which she called low for a female. She cited a normal female range of "15 to 70" ng/dL, and noted this was measured after three months of eating in a caloric surplus. Her conclusion: if she maintained muscle at that level, everyone else has no excuse.

That's a reasonable summary of her situation, and she's not making wild therapeutic claims. But there are some real measurement and reference-range issues worth unpacking before this becomes a template for self-diagnosis.

Does the science back this up?

Partially, but the unit confusion here is doing a lot of heavy lifting. Free testosterone in women is almost always reported in picograms per milliliter (pg/mL) in clinical lab settings, not nanograms per deciliter (ng/dL). Those are different units, and mixing them up produces numbers that sound alarming but may not mean what they appear to mean.

For context: the Endocrine Society's clinical practice guideline (Bhasin et al., 2018, Journal of Clinical Endocrinology and Metabolism) reports normal free testosterone in premenopausal women as approximately 0.3 to 1.9 ng/dL when calculated using total testosterone and SHBG, or roughly 1 to 8.5 pg/mL by direct immunoassay. A value of 9 ng/dL by standard assay would actually be elevated, not low. If her lab used pg/mL and she's reading it as ng/dL, the interpretation flips entirely. The reference range she cited, 15 to 70, also doesn't match widely published female free testosterone norms in any unit cleanly, which raises questions about which lab panel she's reading.

What did they get wrong (or right)?

Credit where it's due: she's right that testosterone plays a role in muscle maintenance for women, and that low levels can impair body composition. That's supported by evidence. Davison et al. (2005, Journal of Clinical Endocrinology and Metabolism) confirmed that free testosterone declines with age in women and correlates with lean mass. She's also right that caloric restriction suppresses testosterone, so measuring during a deficit would likely show lower values than a surplus period.

What she got wrong, or at least muddled, is the unit and reference range situation. Saying "9 nanograms per deciliter" and calling it low based on a 15 to 70 range doesn't match standard clinical reporting for female free testosterone. It's possible she's reading a total testosterone result, a different assay format, or a lab that uses non-standard units. Without seeing the actual lab report, this is unverifiable. But the confident delivery of specific numbers in a TikTok context, without clarifying units, is exactly the kind of thing that sends thousands of women to clinics convinced they have a deficiency they may not have.

What should you actually know?

Free testosterone measurement in women is genuinely complicated. There is no universally standardized reference range, and the assay method matters enormously. Direct immunoassay tests are considered less accurate than calculated free testosterone derived from total testosterone and sex hormone-binding globulin (SHBG). The Endocrine Society explicitly warns against diagnosing androgen deficiency in women based on testosterone levels alone, because symptoms and context matter as much as the number.

If you're a woman who lifts, eats well, and is concerned about hormones, a single free testosterone result without SHBG, total testosterone, LH, and FSH context is incomplete data. Low testosterone in women is a real clinical entity, but it's diagnosed by a clinician reviewing the full picture, not a single number from a panel. If you're concerned, get a proper workup through a licensed provider who can interpret your specific lab format and reference ranges.

• Caloric restriction does suppress testosterone in women, so her point about surplus improving levels is biologically sound.
• But unit accuracy matters. A number without the right unit is just a number.
• Self-diagnosis from a single biomarker on TikTok, even well-intentioned, can lead to unnecessary supplementation or treatment.