Testosterone Test and Interpreting Results

A testosterone test measures the amount of the male hormone, testosterone, in the blood. Both men and women produce this hormone.

The test described in this article measures the total amount of testosterone in the blood. Much of the testosterone in the blood is bound to a protein called sex hormone binding globulin (SHBG). Another blood test can measure the "free" testosterone. However, this type of test is often not very accurate.

Alternative Names: Serum testosterone

How the Test is Performed

A blood sample is taken from a vein. The best time for the blood sample to be taken is between 7 a.m. and 10 a.m. A second sample is often needed to confirm a result that is lower than expected.

How to Prepare for the Test

The health care provider may advise you to stop taking medicines that may affect the test.

How the Test will Feel

You may feel a slight prick or sting when the needle is inserted. There may be some throbbing afterward.

Why the Test is Performed

This test may be done if you have symptoms of abnormal male hormone (androgen) production.

In males, the testicles produce most of the testosterone in the body. Levels are most often checked to evaluate signs of abnormal testosterone such as:

• Early or late puberty (in boys)
• Infertility, erectile dysfunction,
• low level of sexual interest
• thinning of the bones, infertility, (in men)

In females, the ovaries produce most of the testosterone. The adrenal glands can also produce too much of other androgens that are converted to testosterone. Levels are most often checked to evaluate signs of higher testosterone levels, such as:

• Acne, oily skin
• Change in voice
• Decreased breast size
• Excess hair growth (thick, dark hair in the area of the moustache, beard, sideburns, chest, buttocks, inner thighs)
• Increased size of the clitoris
• Irregular or absent menstrual periods
• Male-pattern baldness or hair thinning

Normal Results

Normal measurements for these tests:

• Male: 300 to 1,000 ng/dL
• Female: 15 to 70 ng/dL

Note: ng/dL = nanograms per deciliter

The examples above are common measurements for results for these tests. Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different specimens. Talk to your provider about the meaning of your specific test results.

What Abnormal Results Mean

Certain health conditions, medicines, or injury can lead to low testosterone. Testosterone level also naturally drops with age. Low testosterone can affect sex drive, mood, and the body in men.

Decreased total testosterone may be due to:

• Chronic illness
• The pituitary gland does not produce normal amounts of some or all of its hormones
• Problem with areas of the brain that control hormones
• Low thyroid function
• Delayed puberty
• Diseases of the testicles (trauma, cancer, infection, immune)
• Benign tumor of the pituitary cells that produce too much of the hormone prolactin
• Too much body fat (obesity)

Increased total testosterone level may be due to:

• Resistance to the action of male hormones (androgen resistance)
• Tumor of the ovaries
• Cancer of the testes
• Congenital adrenal hyperplasia
• Taking medications or drugs that increase testosterone level

References

Rosenfield RL, Barnes RB, Ehrmann DA. Hyperandrogenism, hirsuitism, and polycystic ovary syndrome. In: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Adult and Pediatric. 7th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 133.

Swerdloff RS, Wang C. The testis and male sexual function. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 234.

TRT Update, 9 Week Blood Test

They call is "cruising" for a reason - I've just been cruising along, doing my test injections 1x per week and the hCG 2x. My initial prescription was for 10 weeks; at 9 weeks I had a Doctor consult scheduled and a blood test taken. Let's do the blood first, since that's probably what you're most interested in. These were my before-therapy levels:

Test	Result	Reference
Serum Testosterone	239 ng/dL	348 - 1197
Free Testosterone	8.0 pg/mL	6.8 - 21.5

And after 9 weeks of therapy (that would be 9 testosterone injections and 18 hCG injections):

Test	Result	Reference
Serum Testosterone	1,128 ng/dL	348 - 1197
Free Testosterone	29.4 pg/mL	6.8 - 21.5

So you can see that's a significant difference from my start numbers.

Serum Testosterone increased 889
Free Testosterone increased 21.4

My weight went from 184 to 196. They have an impedance body tester for body fat, not the most accurate I know, which showed me going from 14.9 to 13.7 percent.

I gotten stronger in bench (from 180x10 first set to 225x7), and the elbow and shoulder discomfort I had is mostly gone now. Unfortunately my back still bothers me, so I haven't been pushing on the squats and deadlifts. I did go from 275x6 on deadlift to 310x6, but that not really going all out.

So physically, there's been a very noticeable change. The more esoteric "mental" benefits have yet to manifest.

I still don't sleep well and frequently suffer from insomnia
No burst of mental clarity or increased motivation or focus
My energy levels do seem a bit higher during my workouts, but not increased overall.

The doctor didn't really have much to say when I pointed this out. She suggested a sleep aid supplement, which I declined.

I'm pretty happy as far as the gains go though, and I've decided to stick with it. So I continued the prescription with only one alteration, that being I decided (after consulting with the doc) to inject 2x a week, .5ml each time (for the same 1ml a week). I'd read this can provide more even test levels, plus it makes the shots a bit quicker and easier.

I'm still doing the shots myself using a 5/8 inch 28g needle in alternating quads on Mondays and Thursdays. No issues there. And the hCG in the stomach on Sundays and Wednesdays.

I did discover something interesting. With insurance, I was paying $78 a month for the testosterone cypionate and hCG, plus an additional $75 for the clinic fee, for a total $158 a month. So three months comes in at $474. If I use insurance, I can ONLY fill my prescription 1 month at a time.

If I "bulk" order from the clinics preferred prescription provider, I can get 3 months of testosterone cypionate and hCG for $425, a savings of about $50. So there you go....

Blood Test Results for Testosterone Levels

My second visit to the clinic was on another Friday, a week after my first visit. It was at this appointment I would go over my lab results with the doctor and get recommendations (if any) for a course of treatment.

I'd done plenty of research in the meantime on testosterone and testosterone levels, so I had a preconception going in. From my research, it seemed that "normal" testosterone levels encompassed a pretty wide range. It was commonly accepted that testosterone declined as one aged, and that your age influenced your levels, in that a 20-year old should have higher levels than a 40-year old.

A "soft" lower limit to serum testosterone of 300 ng/dL was mentioned in more than one place.

The blood test was for a full panel, the most pertinent of course (in this case) are the testosterone (both serum and free), my LH (luteinizing hormone) and FSH (follicle stimulating hormone) and IGF-1 (insulin-like growth factor 1) and a bunch of other stuff I'm not going to cover.

First up the testosterone:

Test	Result	Reference
Serum Testosterone	239 ng/dL	348 - 1197
Free Testosterone	8.0 pg/mL	6.8 - 21.5

I was surprised at the results. As I mentioned, I kind of considered the whole TRT replacement/anti-aging clinic thing to be sort of a wink-wink-nudge-nudge-here's-your-prescription-steroids sort of thing. They had hinted that even if my testosterone levels came back in the "normal" range, if I was experiencing the mere symptoms of low testosterone, I would still be a candidate for therapy. I read that as: pay the money, get the goods.

But surprise, surprise, my serum testosterone was actually low. Considerably low in fact, being more than 100 points under the bottom of the "normal" range, a range not established by the clinic whose job it was to sell testosterone, but by the medical society at large. Ditto for my free testosterone, which, while not under the bottom of normal, was pretty close to it.

Wow.

Given my lifestyle of exercise and healthy eating, I was shocked. I mean, I honestly never expected my testosterone to be actually be low. I maintained a muscular appearance, I picked up heavy things and put them down, and although my recovery time was longer and gaining strength and mass (without fat to go along with it) was tough, I figured that was the normal price of being 47 years old.

To see that low number staring right at me was a harsh and tangible confirmation of my physical decline and ultimate mortality.

Ouch.

While I wrapped my head around that realization, the doc went on to talk about some of the other results:

Test	Result	Reference
IGF-1:	146 ng/dL	59 - 201
Estradiol:	7.4 pg/mL	7.6 - 42.6
Total Estrogens:	62 pg/mL	40 - 115
LH (luteinizing hormone):	2.2 mIU/mL	1.7 - 8.6
FSH:	2.8 mIU/mL	1.5 - 12.4

No issues with IGF-1, so I've got that going for me, which is nice....

My estradiol was low, probably as counterpoint to my testosterone being low, as they tend to be somewhat synched. Higher testosterone = higher estradiol. It's this increase that, for stronger androgens like steroids, makes Post Cycle Therapy a good idea.

'Cause it works like this: you take steroids, the steroids artificially raise your testosterone, your body reacts by 1) reducing its natural production of testosterone (because it sees there's plenty) and 2) increasing estradiol (to balance out what it sees as higher testosterone). Then,  when you stop taking the steroids, your testosterone drops rapidly (as your body isn't producing as much, or any, and your no longer artificially raising it) leaving you with excess estradiol.

It takes your body a while to realize this and get everything in balance again. Too much estradiol and not enough testosterone and suddenly your nipples get puffy and aching and maybe even leaking fluid. Welcome to gynecomastia my swole friend.

In any case, mine being low isn't an issue since my test is low too. One potential long term effect of low estradiol could be reduced bone density (osteoporosis). Hopefully all the weight training I do keeps my bone density up.

My LH (luteinizing hormone) is in the normal range. I'm giving a very top level summary here, but LH is released by the pituitary to stimulate the testes to produce testosterone. Low LH can be another effect of steroid use, as in your pituitary won't be making it if it sees enough testosterone there already. My LH being normal could be seen as anecdotal evidence that everything is working as it should and I just have naturally low test.

FSH (follicle stimulating hormone) luteinizing hormone (LH) act together reproduction, so it's also involved in the process your body uses to decide if it needs to make more testosterone. It's particularly related to telling your testes to make sperm.

So there you have. According to widely accepted standards, I have medically low testosterone, and the clinic was going to help me do something about it.