How much does it cost to get testosterone levels checked

Testing by CLIA approved lab: LabCorp or Quest Diagnostics

What are free and total testosterone?

Testosterone is a primary sex hormone that is found in both men and women's systems. While being in charge of developing male traits, this protein has many other functions as well, such as the ability to control our sex drive, regulating the production of sperm, increasing energy, and promoting the development of muscle mass. Testosterone concentrations decline naturally with age, which may lead to physiological changes such as low sex drive.

Testosterone can be either free testosterone or bound testosterone, and the cumulative total of both is the total testosterone in the body.

Bound testosterone - Around 98% of the testosterone that our body produces is bound to SHBG (sex hormone binding globulin) and albumin. SHBG carries testosterone in the blood This is referred to as bound proteins.

Free testosterone - The remaining 2% are free and unbound, circulating in the bloodstream and ready to be used by the system as needed. Free testosterone is responsible for numerous functions including the development of male characteristics, cell replication in bones and muscles and others.

Total testosterone - The total testosterone level is the sum of both free and bound testosterone. It is important to measure the levels of total and free testosterone since the free levels can offer a better indication of the proper functions carried on by these unbound hormones.

The role of testosterone in development

Testosterone plays a very important role and the normal development of the fetus during pregnancy, as well as the proper development of the male reproductive system. A 2018 study published in the Journal of Psychoneuroendocrinology explored the effect of prenatal and pubertal testosterone on brain lateralization. The lateralization of pain refers to how some functions, like the neural functions and the cognitive processes, tend to be more dominant in one side of the brain (the hemisphere). According to the study, both levels of testosterone (free and bound) affect how the brain processes several cognitive tasks. Testosterone levels need to be within the normal ranges for the baby to develop healthy brain functions. Babies who have high levels of fetal testosterone are more prone to autism.

Testosterone levels are at their highest during adolescence. Luteinizing hormone (LH), a hormone produced in the pituitary gland, stimulates the production and release of testosterone. Boys develop the first outward signs of testosterone during puberty. These signs include new hair growth (pubic hair and facial hair), testicular growth stimulated by follicle-stimulating hormone (FSH), the testicles descending, changes in the voice, broadening of the shoulders, and the face taking on more masculine features.

Testosterone plays a lifelong role in both women's and men's health. By the time a man reaches the age of thirty, testosterone levels start declining at a very low rate: approximately one percent per year. For women who have not reached menopause, testosterone is produced in the ovaries; and, its levels start declining by the time a woman reaches menopause.

This testosterone test is appropriate for men and women measuring both levels of free and total testosterone in the blood.

What causes low levels of free and total testosterone?

Several factors and health conditions may decrease the normal levels of testosterone in the body.

1. Alcoholism and liver disease lower testosterone levels in men.
2. Some drugs, such as androgens and steroids, can result in depressed testosterone levels, leading to hypogonadism.
3. Men who have prostate cancer and are being treated with the use of androgens may show lower testosterone levels, caused by the medicines they are taking.
4. Elevated prolactin levels can suppress serum testosterone levels.
5. Since SHBG produces bound testosterone, high SHBG levels reduce the amount of free testosterone in the body by binding more free testosterone to the blood.

What causes high levels of free a total testosterone?

1. Drugs and hormone therapies are the most common causes of high levels of testosterone.
2. Anticonvulsants, barbiturates, and clomiphene can result in elevated testosterone levels.
3. Estrogen therapy often leads to abnormally high testosterone levels in women.

Why measure your free and total testosterone?

Testosterone testing is essential for both men and women, and anybody who demonstrates symptoms of abnormal testosterone levels should seek out a testosterone test as soon as possible. The symptoms of low testosterone include:

• Erectile dysfunction
• Infertility
• Reduced sex drive
• Hirsutism, or abnormal/excessive hair growth
• Abnormal sleep patterns
• Trouble focusing
• Lack of motivation
• Low bone density
• Loss of muscle mass and strength
• Depression
• Fatigue
• Swelling of the breasts in men

High testosterone levels are typically only symptomatic in women. The symptoms of high testosterone levels include:

• Development of masculine physical features in women
• Infertility in women
• Polycystic ovary syndrome (PCOS)
• Hair loss in women
• Acne
• Growth of facial hair
• Irregular or absent menstrual periods

Any of the above symptoms can indicate abnormal testosterone levels, which can be related to more serious conditions. As such, anybody displaying any of these symptoms should get their testosterone levels tested.

What do your free and total testosterone test results mean?

Reference ranges of testosterone are different for men and women, and these levels change according to age.

For men, total testosterone levels are:

• Less than 3 ng/dL around 9 or 10 years old
• Between 0 and 432 ng/dL starting around 11 years old
• Between 65 and 778 ng/dL starting around 13 years old
• Between 180 and 763 ng/dL starting around 14 years old
• Between 188 and 882 ng/dL starting around 15 years old
• Between 264 and 916 ng/dL from 18 years old onward

For women, total testosterone levels are:

• Less than 3-6 ng/dL around 8 years old
• Between 0 and 10 ng/dL around 9 - 11 years old
• Between 0 and 24 ng/dL around 12 years old
• Between 0 and 27 ng/dL around 13 years old
• Between 5 and 38 ng/dL around 15 years old
• Between 8 and 48 ng/dL for women between 20 and 49 years old
• Between 3 and 41 ng/dL for women who are older than 49

Normal free testosterone levels differ with age and gender. The following are the normal values of free testosterone:

• Boys and girls up to 19 years old - No established normal levels of free testosterone
• Women over 19 years old - Levels should be between 0 and 4.2 pg/mL
• Men between the ages of 20 and 29 - Levels should be between 9.3 and 26.5 pg/mL
• Men between the ages of 30 and 39 - Levels should be between 8.7 and 25.1 pg/mL
• Men between the ages of 40 and 49 - Levels should be between 6.8 and 21.5 pg/mL
• Men between the ages of 50 and 59 - Levels should be between 7.2 and 24.0 pg/mL
• Men above 59 years old - Levels should be between 6.6 and 18.1 pg/mL

Higher than normal levels of testosterone can indicate testicular tumors, adrenal tumors, early puberty, or congenital adrenal hyperplasia. Women typically display low testosterone levels. High levels can indicate PCOS, ovarian or adrenal gland tumors or congenital adrenal hyperplasia.

What happens if your testosterone levels are irregular?

Men who have low testosterone levels have a number of testosterone therapy options for raising their testosterone levels back to the normal ranges. Testosterone replacement therapy options typically show no negative side effects, and more common side effects tend to be mild (such as rashes or irritation at the site of treatment). There is some evidence linking testosterone therapy to more serious side effects such as cardiac complications and stroke. Research into the long-term side effects of testosterone therapy are ongoing. Be sure to follow all medical advice from your doctor if you elect to receive testosterone replacement therapy.

Where can I get a free and total testosterone test near me?

Please use our Lab Locator to find find a convenient testosterone testing location.

Reviewed By: Dr. Kurt Kloss, MD
Last Reviewed Date: Mar 01, 2021

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