Testosterone Levels Test

What is a testosterone levels test?

A testosterone levels test measures the amount of testosterone in a sample of your blood. Testosterone is known as a “male” sex hormone, but females have testosterone in smaller amounts.

Testosterone is made by:

• The testicles (or testes), the part of the male reproductive system that makes sperm
• The ovaries, the part of the female reproductive system that makes eggs
• The adrenal glands, organs on top of each kidney that make several hormones

During male puberty, testosterone causes body hair, muscle growth, and a deepening voice. In adult life, it controls sex drive, maintains muscle mass, and helps make sperm. In females, testosterone is important for the growth of bones and muscles, and healthy organs.

There are different forms of testosterone in your blood that may be measured to help diagnose certain health problems. Most of your testosterone is attached to proteins. The proteins prevent your tissues from using the testosterone right away, which helps control the amount of “active” testosterone in your body. Testosterone that’s not attached to proteins is called free testosterone. Free testosterone acts on your tissues.

Three types of blood tests measure these different forms of testosterone:

• A total testosterone test measures free testosterone and testosterone that’s attached to proteins. This is the most common type of test.
• A free testosterone test measures only the “active” form of testosterone. This test is less common, but it may be useful for diagnosing certain medical conditions.
• A bioavailable testosterone test measures free testosterone and testosterone that’s loosely attached to a blood protein called albumin. This test isn’t commonly done. But like a free testosterone test, it may help diagnose certain medical conditions.

Other names: serum testosterone, total testosterone, free testosterone, bioavailable testosterone

What is it used for?

A testosterone levels test may be used with other tests to help:

• Diagnose the cause of symptoms that could be from testosterone levels that are too high or too low
• In children and teens, to find out what’s causing:
  • Early puberty
  • Delayed puberty

Testosterone testing is also used to monitor your health if you:

• Have had an abnormal testosterone test in the past
• Are taking medicine that may affect your testosterone levels
• Are a transgender man taking testosterone for masculinizing hormone therapy (also called gender-affirming hormone therapy)

Why do I need a testosterone levels test?

You may need this test if you have symptoms of abnormal testosterone levels.

For males who have gone through puberty, the test is mostly used for symptoms of low T levels (testosterone levels which are too low). Testosterone levels tend to decrease with age. But other health issues may also cause low T, such as thyroid problems, long-lasting illness, or problems with the testicles.

The symptoms of low T may include:

• Low sex drive
• Erectile disfunction or “ED” (difficulty getting an erection)
• Infertility (difficulty getting someone pregnant)
• Enlarged breasts
• Lack of face or body hair
• Thinning bones or anemia without a known cause
• Loss of muscle mass

For females, the test is mostly used for symptoms of high T levels, such as:

• Abnormal hair growth on the body or face
• Hair loss on the head that may be like male-pattern baldness (hair loss at the temples and balding on the top of the head)
• A voice that gets lower
• Irregular or no menstrual periods
• Infertility (difficulty getting pregnant)
• Acne

What happens during a testosterone levels test?

A blood sample for a testosterone test should be taken in the morning between 7 and 10. During these hours, your testosterone levels are typically the highest.

A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

Will I need to do anything to prepare for the test?

In certain cases, you may need to fast (not eat or drink) for several hours before the test. Ask your provider how you should prepare for a testosterone levels test.

Are there any risks to the test?

There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

What do the results mean?

Your test results may mean different things depending on which test was done, your age, your symptoms, the results of other tests, and other conditions you may have. So, it’s best ask your provider to explain your test results.

A testosterone level test alone can’t diagnose any health conditions, but abnormal results with symptoms may be a sign of a health problem.

• In males, low T levels may be caused by different conditions, including:
  • Chronic (long-lasting) diseases such as liver, or kidney disease
  • A pituitary gland disorder
  • Benign tumors (not cancer)
  • Injury to the testicles
  • Alcohol use disorder
  • Certain genetic diseases such as Klinefelter syndrome
• In females low T levels are normal, but extremely low levels may be a sign of:
  • An adrenal gland disorder
  • A pituitary gland disorder
  • An ovarian disorder
• In males, high T levels may be caused by:
  • A tumor in the testicles
  • Steroid use
  • An adrenal gland disorder, such as congenital adrenal hyperplasia (CAH)
• In females, high T levels may be caused by:
  • Polycystic ovary syndrome (PCOS)
  • Ovarian cancer
  • An adrenal gland disorder, such as congenital adrenal hyperplasia (CAH)
  • A disorder of the pituitary gland

If your results are not normal, it doesn’t always mean you have a medical condition that needs treatment. It’s normal for testosterone levels to decrease with age. And certain medicines can affect your results. If you have questions about your results, talk to your health care provider.

Learn more about laboratory tests, reference ranges, and understanding results.

Is there anything else I need to know about a testosterone levels test?

At-home test kits for checking your testosterone levels are available without a prescription. The kits provide everything you need to collect a blood or saliva (spit) sample to send to a lab for testing. Talk with your provider if you think you need to be tested. If you do a home test, share the results with your provider.

Men: Eat Right, Stay Healthy

Men, are you paying attention to your health? Compared to your female counterparts, you’re more likely to smoke and drink, make unhealthy choices, and put off regular medical checkups and care. But you need to pay just as close attention to your lifestyle as women do.

One of the most important aspects of your lifestyle is what you put on your plate. Good nutrition is critical for good health. According to MyPlate.gov, eating well not only gives your body the nutrients it needs. It also helps keep weight under control and reduces your risk of chronic disease, including:

• Type 2 diabetes
• Stroke
• Metabolic syndrome
• Colon, kidney, liver and gallbladder cancers
• Osteoarthritis

Are you overweight?

Doctors use several measurements to determine whether or not your weight is in a healthy range. One is called the body mass index (BMI). Plug your height and weight into an online BMI calculator.

• If your BMI is less than 18.5, it falls within the underweight range.
• If your BMI is 18.5 to 24.9, it falls within the normal, healthy weight range.
• If your BMI is 25.0 to 29.9, it falls within the overweight range.
• If you BMI is 30.0 or higher, it falls within the obesity range.

You can also use waist and hip measurements to calculate body fat. To correctly measure waist circumference:

• Stand and place a tape measure around your middle, just above your hipbones.
• Make sure the tape is horizontal around your waist.
• Keep the tape is snug around your waist, but don’t compress the skin.
• Breathe out and take the measurement.

If your waist circumference is more than 40 inches, you could be at a higher risk for developing the health conditions mentioned above.

The easiest way to eat healthy is to follow MyPlate’s three simple steps:

• Meet nutritional needs primarily from foods and beverages.
• Choose a variety of options from each food group.
• Pay attention to portion size.

Path to improved health

You may think what you eat doesn’t matter that much. Or that whatever is lacking in your diet, you can make up with vitamin and mineral supplements. But a growing body of scientific evidence shows that nutrients work best in combination. That means it’s not one food or nutrient that prevents disease and results in a healthier life. It’s the interaction among different foods, and the cumulative effect the foods have on your body that helps.

In other words, one single nutrient isn’t the key to good health. It’s your overall eating pattern that matters.

So, what do you need to eat in order to stay healthy?

First, estimate how many calories you should eat each day. The number will vary, depending on your age, weight, activity level, and whether you’re trying to gain, maintain, or lose weight. Your doctor can help you determine this number. MyPlate has several ways to make this easy, including the Start Simple with MyPlate app, MyPlate on Alexa, and MyPlate Print Materials. These and other mobile apps have calorie intake and metabolism estimators. These can help determine your calorie requirements.

Now that you know how much you should eat, what should you be eating to fill that calorie need? Your daily diet should include:

• A variety of all vegetable subgroups.Those include dark, green (spinach, lettuce), red and orange (peppers), legumes (beans, peas), starchy (corn), and others. Eat your vegetables fresh, frozen, canned, or dried. Choose low-salt varieties when buying frozen and canned.
• Fruits, at least half of which are whole fruits. These include fresh, canned, frozen, and dried. Fruit juices are okay, but they lack fiber, so your body quickly converts them to sugar. Drinking too many can also add calories. Choose 100% fruit juice without added sugars.
• Whole grains. This includes grains by themselves, like rice, oatmeal, and popcorn. It also includes foods that contain grains like breads and cereals. At least half of your grains should come from whole grains. Limit the amount of refined grains and products made with refined grains. Foods like cookies, cakes and certain snack foods have been processed to remove the bran and germ. This also removes dietary fiber, iron, and other nutrients.
• Fat-free and low-fat dairy products.These include milk, yogurt, cheese, and fortified soy beverages. Don’t include other “milks” made from plants (like almond, rice, or coconut milk) in this group.
• Protein foods. You should eat a variety in nutrient-dense forms. Incorporate foods from both animal and plant sources. These include seafood, meats, poultry, eggs, nuts, seeds, and soy products. Legumes (beans and peas) go in this group as well as in the vegetables group.
• Health oils. They should have a high percentage of monounsaturated and polyunsaturated fats. They also should be liquid at room temperature. These include avocado, canola, corn, olive, peanut, safflower, soybean, and sunflower oils. Oils are also naturally present in nuts, seeds, seafood, olives, and avocados.

Things to consider

Your daily diet should limit:

• Added sugars, including syrups and other caloric sweeteners. These include brown sugar, corn sweetener, dextrose, fructose, high-fructose corn syrup, and honey. They should make up less than 10% of your calories per day. An added note: Replacing added sugars with high-intensity sweeteners (like saccharin or aspartame may reduce your calorie intake in the short run. However, data hasn’t proven that using these fake sugars helps in overall weight management.
• Saturated fats. Strong scientific data shows that replacing saturated fats with unsaturated, especially polyunsaturated fats, is associated with reduced blood levels of total cholesterol and of low-density lipoprotein cholesterol (LDL cholesterol). It’s also associated with a reduced risk of heart attacks and cardiovascular disease-related deaths. Foods high in saturated fats include red meat, poultry with skin, and dairy products such as cream, butter, and cheese. Saturated fats should make up no more than 10% of your calories per day.
• Trans fats. These are artificial fats created by a process that adds hydrogen to liquid vegetable oils to make them more solid. They’re found in margarines, certain snacks foods (like frozen pizza and microwave popcorn), and prepared desserts. A number of studies have shown an association between increased intake of trans fats and increased risk of cardiovascular disease. Therefore, trans fats should be limited to as few as possible. You should consume less than 2,300 mg per day. If you have high blood pressure, you might benefit from lowering your intake to 1,500 mg per day. Americans are currently averaging more than 3,400 mg per day.
• If you drink, do it in moderation. That means up to two drinks a day for men up to age 64 and one drink a day for men older than that. One drink would be 12 fluid ounces of regular beer, 5 fluid ounces of wine, or 1.5 fluid ounces of standard 80-proof liquor. The risk of various types of cancer, such as liver cancer, appears increase with the amount of alcohol you drink and the length of time you’ve been drinking.

Questions to ask your doctor

• What’s a healthy weight for me?
• Should I cut back on salt?
• Should I be taking any dietary supplements?
• How will losing weight help my condition?
• How much weight do I need to lose before I see a benefit?
• Are there any foods I should avoid because of my condition?
• Are there any foods I can add to my diet to help my condition?

Sexual health

As you age, testosterone therapy might sound promising. But there are a lot of misconceptions about what the treatment can and can’t do for you.

Testosterone therapy might seem like the ultimate anti-aging formula. Yet the health benefits of testosterone therapy for age-related decline in testosterone aren’t clear.

Find out what’s known — and not known — about testosterone therapy for normal aging.

Testosterone is a hormone produced primarily in the testicles. Testosterone helps maintain men’s:

• Bone density
• Fat distribution
• Muscle strength and mass
• Facial and body hair
• Red blood cell production
• Sex drive
• Sperm production

Testosterone levels generally peak during adolescence and early adulthood. As you age, your testosterone level gradually declines — typically about 1% a year after age 30 or 40. For older men, it’s important to determine if a low testosterone level is due to normal aging or if it is due to a disease (hypogonadism).

Hypogonadism hampers the ability to produce normal amounts of testosterone due to a problem with the testicles or with the pituitary gland that controls the testicles. Testosterone replacement therapy, in the form of injections, pellets, patches or gels, can improve the signs and symptoms of low testosterone in these men.

Not necessarily. Men can have many signs and symptoms as they age. Some that might occur as a result of lower testosterone levels can include:

• Changes in sexual function. This might include reduced sexual desire, fewer spontaneous erections — such as during sleep — and infertility.
• Physical changes. Various physical changes are possible, including increased body fat, reduced muscle bulk and strength, and decreased bone density. Swollen or tender breasts (gynecomastia) and body hair loss are possible. You might have less energy than you used to.
• Emotional changes. Low testosterone can contribute to a decrease in motivation or self-confidence. You might feel sad or depressed, or have trouble concentrating or remembering things.

Some of these signs and symptoms can be caused by other factors, including medication side effects, obstructive sleep apnea, thyroid problems, diabetes and depression. It’s also possible that these conditions cause low testosterone levels, so treatment might result in increase of testosterone levels.

A blood test is used to diagnose a low testosterone level.

Testosterone therapy can help reverse the effects of hypogonadism, but it’s unclear whether testosterone therapy would benefit older men who are otherwise healthy.

Although some men believe they feel younger and more vigorous if they take testosterone medications, there’s little evidence to support the use of testosterone in otherwise healthy men. Guidelines from the American College of Physicians indicate that testosterone therapy might improve sexual function somewhat in some men, but there’s little evidence that it improves other functions, such as vitality and energy.

Testosterone therapy has various risks, including:

• Worsening sleep apnea — a potentially serious sleep disorder in which breathing repeatedly stops and starts.
• Causing acne or other skin reactions.
• Stimulating noncancerous growth of the prostate (benign prostatic hyperplasia) and growth of existing prostate cancer.
• Enlarging breasts.
• Limiting sperm production or causing testicles to shrink.
• Stimulating too much red blood cell production, which contributes to the increased risk of forming a blood clot. A clot could break loose, travel through your bloodstream and lodge in your lungs, blocking blood flow (pulmonary embolism).

Also, some research shows that testosterone therapy can increase your risk of heart disease. More research is needed.

If you wonder whether testosterone therapy might be right for you, talk with your doctor about the risks and benefits. Your doctor will likely measure your testosterone levels at least twice before recommending testosterone therapy.

Treating normal aging with testosterone therapy is not advisable. If you don’t have a medical condition that’s contributing to your decline in testosterone levels, your doctor might suggest natural ways to boost testosterone, such as losing weight and increasing muscle mass through resistance exercise.