Testosterone Blood Test

What is a testosterone test?

A testosterone blood test measures the level of testosterone circulating in your blood. Total testosterone measures both bound (attached to proteins) and free testosterone. Free testosterone is the biologically active portion. Testing is done in the morning (7-10am) when levels peak. In men, testosterone is primarily produced by the testes. In women, it is produced in smaller amounts by the ovaries and adrenal glands.

Testosterone normal range

Other tests done with testosterone

Questions to ask your doctor

• Is my testosterone result truly low or within normal for my age?
• Do I need LH, FSH and prolactin tested too?
• Am I a candidate for testosterone replacement therapy?
• Could my medication (opioids, steroids, antidepressants) be lowering my testosterone?
• If I am a woman with high testosterone, do I need an ultrasound for PCOS?

Testosterone and the tests ordered with it

Total testosterone is rarely interpreted alone. Here is how the usual companions compare:

Reading your testosterone report: what your doctor actually looks at

Before the number, doctors check the circumstances. Run through the same checklist:

1. What time was the blood drawn? Testosterone peaks in the early morning and can be a third lower by afternoon. A late-day sample is the commonest reason for a falsely low result — a morning repeat (around 7–10 am) comes before any conclusions.
2. What did SHBG look like? Roughly half of testosterone is tightly bound and inactive. When SHBG is raised (ageing, liver disease) or lowered (obesity, insulin resistance), total testosterone misleads — the free fraction tells the truer story.
3. What was happening in your life? Illness, poor sleep, severe stress and crash dieting all push testosterone down temporarily. A low result during such a period deserves a recheck after recovery, not a diagnosis.
4. Do symptoms match the number? Reduced libido, fatigue and low mood alongside a low morning result mean something different from a low number in someone who feels entirely well.
5. Is it the right reference range? Women are measured at much lower levels with sex-specific ranges, and a high result in a woman usually prompts a PCOS workup — a completely different interpretation.

Testosterone test price in India: typical bands across major lab chains

Total testosterone typically costs ₹900–₹1,800, with free-testosterone or SHBG add-ons priced separately. Typical list-price bands:

These are approximate bands, not quotes: prices change often and vary by city, and home collection can add a small fee. Where possible, choose a NABL-accredited lab, and remember the range printed on your own report is the one that counts.

Frequently Asked Questions

Pharmacist's practical notes

Timing is the single biggest practical factor in this test. Testosterone peaks in the early morning and can be a third lower by the afternoon, so an afternoon sample is the commonest reason for a falsely low result. If your result came from a late-day draw, ask your doctor whether a morning repeat (around 7–10 am) is worth doing before any conclusions.

Total testosterone is not the whole story. Roughly half is tightly bound to SHBG and biologically inactive, and only a small fraction circulates free and active. When SHBG is altered — raised with ageing or liver disease, lowered with obesity or insulin resistance — total testosterone can mislead, which is why doctors often interpret it alongside SHBG or a calculated free testosterone.

Illness, stress, poor sleep and excess weight can all push testosterone down temporarily. A single low result during a period of sickness, crash dieting or severe stress deserves a recheck after recovery rather than a diagnosis. Body weight in particular matters: obesity is one of the commonest reversible contributors to low readings.

Symptoms carry as much weight as the number. Reduced libido, fatigue, loss of muscle and low mood alongside a low morning result mean something different from a low number in someone who feels entirely well. If you are a woman with a high result, the interpretation is different again — usually a workup for PCOS — so make sure the result is read against the correct sex-specific range.

References

Sources cited on this page. PubMed links open the original abstract.

1. Bhasin S, Cunningham GR, Hayes FJ, et al. Testosterone therapy in men with androgen deficiency syndromes: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2010;95(6):2536–2559. PMID 20525905 · doi:10.1210/jc.2009-2354
2. Bhasin S, Brito JP, Cunningham GR, et al. Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2018;103(5):1715–1744. PMID 29562364 · doi:10.1210/jc.2018-00229
3. Heidelbaugh JJ. Testosterone Replacement Therapy for Male Hypogonadism. Am Fam Physician. 2024;109(6):543–549. PMID 38905552

Why a single testosterone result is not enough

Testosterone has a pronounced diurnal rhythm in men: levels peak in the early morning (7–9 am) and decline throughout the day, with afternoon values up to 30–35% lower than morning levels. NICE and the British Society for Sexual Medicine guidelines require that low testosterone be confirmed on at least two separate morning fasting samples before a diagnosis of hypogonadism is made, a single low afternoon result is not diagnostic.

Additionally, approximately 40–60% of circulating testosterone is tightly bound to sex hormone-binding globulin (SHBG) and is biologically inactive. Another 40–50% is loosely bound to albumin (bioavailable). Only 1–3% is free testosterone, the pharmacologically active fraction. When SHBG is altered, raised in hyperthyroidism, liver disease, and ageing; lowered in obesity, hypothyroidism, and insulin resistance, total testosterone may not reflect androgen bioavailability. In these cases, free testosterone calculation (using a validated formula from total testosterone, SHBG, and albumin) or direct free testosterone measurement is needed.

The ADAM questionnaire and symptom assessment

Biochemical testosterone deficiency without symptoms should generally not be treated. The Androgen Deficiency in Aging Males (ADAM) questionnaire and the Aging Males' Symptoms (AMS) scale are standardised tools used to assess symptom burden before and during testosterone replacement therapy (TRT). Key symptoms of testosterone deficiency include: reduced libido, erectile dysfunction, fatigue, depressed mood, poor concentration, reduced muscle mass and strength, increased abdominal fat, and, with severe or prolonged deficiency, osteoporosis and anaemia. The decision to treat is based on the combination of low biochemical levels and clinically significant symptoms.²

Testosterone in women, a growing clinical role

Testosterone is often thought of as purely a male hormone, but women produce testosterone in the ovaries and adrenal glands, and it plays an important role in libido, energy, and bone density. In postmenopausal women, testosterone levels decline alongside oestrogen. NICE guideline NG23 recommends offering testosterone supplementation to postmenopausal women with reduced sexual desire that is not improved by HRT alone. Testing in women uses lower reference ranges, female testosterone levels are approximately 10–20-fold lower than male, and must be interpreted with sex-specific reference intervals.