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Protein S deficiency is a blood clotting disorder that increases the risk of developing abnormal blood clots, particularly deep vein thrombosis and pulmonary embolism. It is caused by insufficient production of protein S, a natural anticoagulant protein that regulates the blood clotting cascade. The Protein S Antigen, Free test is the most important test for diagnosing this condition.
Protein S deficiency is caused by either genetic mutations inherited from one or both parents or acquired factors that reduce protein S levels. Inherited protein S deficiency results from mutations in the PROS1 gene, which provides instructions for making protein S. Acquired causes include pregnancy, oral contraceptive use, hormone replacement therapy, liver disease, vitamin K deficiency, and certain autoimmune conditions like lupus. Blood clots can form when protein S levels drop below normal because the body loses its natural ability to prevent excessive clotting.
The Protein S Antigen, Free test is the most important test for Protein S deficiency because it measures the amount of free, active protein S circulating in your blood. This test specifically detects the functional form of protein S that actually prevents blood clots, making it the gold standard for diagnosis. Low levels of free protein S antigen directly indicate a deficiency and explain why someone might be experiencing abnormal clotting. Your doctor may also order protein S activity tests and total protein S levels to confirm the diagnosis and determine the type of deficiency.
You should get tested if you have experienced unexplained blood clots, especially at a young age (under 50), have recurrent clotting episodes, or have a family history of blood clots or clotting disorders. Testing is also recommended if you develop deep vein thrombosis or pulmonary embolism without obvious risk factors like surgery or prolonged immobility. Women with recurrent pregnancy losses or clotting complications during pregnancy should also consider testing, as protein S deficiency can affect pregnancy outcomes.
What this means
Your testosterone levels are slightly below the optimal range. While this is not necessarily cause for concern, it may contribute to occasional fatigue, reduced motivation, or lower muscle mass over time.
Recommended actions
Increase resistance or strength training
Prioritize 7–8 hours of quality sleep per night, try to reduce stress
Include more zinc- and magnesium-rich foods (like shellfish, beef, pumpkin seeds, spinach)
Consider retesting in 3–6 months
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