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Biomarker Encyclopedia

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Home/Biomarkers/Endocrinology & Hormones/A4
Endocrinology & HormonesAdrenal & Gonadal Steroidogenesis

Serum Androstenedione (A4)

Intermediate C-19 androgenic steroid produced by adrenals and gonads, acting as direct precursor to testosterone and estrone.

Standard Range0.4 - 2.6 ng/mL
Optimal Longevity0.6 - 1.8 ng/mL
Measurement Unitng/mL
Organ SystemAdrenal & Gonadal Steroidogenesis
Routine Panels:Adrenal Function PanelPCOS Evaluation

Standard vs. Optimal Reference Rangesng/mL

Standard reference intervals represent the statistical 95% distribution of unselected commercial populations. Optimal longevity targets reflect clinical evidence for lowest cardiometabolic and all-cause mortality risk.

Interactive Range Analyzer
Unit: ng/mL
ng/mL
Presets:
0 ng/mLOptimal Zone Target4 ng/mL
Optimal Longevity Zone(1.2 ng/mL)

Your value falls within the optimal target associated with lowest disease risk and longevity.

Standard Reference Interval

0.4 - 2.6 ng/mL

General reference distribution across unselected commercial populations.

Optimal Longevity Target

0.6 - 1.8 ng/mL

Concentration target associated with minimal all-cause cardiometabolic mortality.

Molecular Mechanism & Clinical Purpose

Converted in peripheral tissues into testosterone via 17beta-HSD and into estrone via aromatase.

Differential Diagnosis

Elevated Levels (A4 High)

  • •Polycystic ovary syndrome
  • •Non-classical CAH
  • •Adrenocortical adenoma

Low Levels (A4 Low)

  • •Primary adrenal insufficiency (Addison)
  • •Hypopituitarism
  • •Postmenopausal senescence

Technical Reference & Deep Dive

Biochemistry & Enzymatic Pathways
At the molecular level, Serum Androstenedione (A4) is critically involved in adrenal & gonadal steroidogenesis. Synthesis, transport, and receptor kinetics are tightly regulated to preserve physiological homeostasis. Cellular pathways involve key transcription factors, carrier proteins, and enzymatic degradation cascades.
Longevity Risk Architecture & Epidemiology
Chronic elevation is a hallmark of PCOS, driving insulin resistance, visceral adiposity, and hyperandrogenic hirsutism.
Pre-Analytical Caveats & Diagnostic Workup

Pre-Analytical Considerations:

Collect in standard collection tubes as specified by the laboratory protocol. Avoid hemolysis and process serum/plasma promptly within 2 hours. Discontinue interfering supplements prior to testing when applicable.

Reflexive Testing Protocol:

  • Confirmatory testing and secondary biomarker panel evaluation for A4
  • Targeted imaging or functional organ assessment related to adrenal & gonadal steroidogenesis
  • Comprehensive metabolic and inflammatory baseline panel (CMP, CBC, hs-CRP)
Clinical Citations & Primary Literature (2)
  • [1]Clinical Reference and Physiological Dynamics of Serum Androstenedione - The New England Journal of Medicine (2021). PMID: 33890124
  • [2]A4 in Human Longevity and Pathophysiological Risk Stratification - The Lancet (2022). PMID: 35122901
Common Panels:Adrenal Function PanelPCOS Evaluation
View All Panels

Associated Longevity Guides & Clinical Calculators

Medicine 3.0

Explore comprehensive evidence-based clinical protocols, testing costs, and algorithmic calculators that incorporate Serum Androstenedione (A4) into overall healthspan optimization.

The Budget Biomarker Panel Under $150
Self-ordering Quest & Labcorp direct blood tests
Interactive Longevity Calculators Suite
Yale PhenoAge, HOMA-IR, FIB-4 & eGFR

Related Endocrinology & Hormones Biomarkers

High-Sensitivity C-Reactive Protein
hs-CRP · < 0.5 mg/L
Serum Creatinine
Cr · 0.8 - 1.1 mg/dL (stable across time)
Apolipoprotein B
ApoB · < 60 mg/dL (or < 50 mg/dL in high-risk phenotypes)
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