Men with low testosterone levels may feel low on energy and lack of sex drive. High testosterone levels can actually cause men to feel similar symptoms. Testosterone is important for women’s health too, and women can experience a variety of symptoms from having low or high testosterone levels.
If you’re experiencing symptoms that might indicate an imbalance in testosterone, then you might be wondering, “How can I check my testosterone level?” It’s important to measure testosterone levels before you start any type of treatment for low or high testosterone. What’s the best way to test testosterone levels? How can you know whether you have low or high testosterone?
Why is it important to test testosterone levels?
Many people are tempted to simply start taking supplemental testosterone when they have symptoms of low testosterone. However, this is often ineffective and can even be dangerous. Many of the symptoms of low testosterone can actually also be caused by high testosterone. If you start taking extra testosterone when your levels were already high, this will make the problem worse. In addition, many of the symptoms of testosterone imbalance can also be caused by other types of conditions, such as high or low thyroid hormone levels.
For all of these reasons, it’s important that you get testosterone tested before you start to take any extra testosterone.
How to test testosterone levels
Testosterone levels are usually tested using a blood test. Although saliva tests are also available, they’re generally not considered to be as reliable as a blood test for testosterone levels. Despite promising results in some studies, the results of studies on saliva tests have not consistently shown that they give an accurate measurement of your blood testosterone levels. If you’ve had an abnormal result on a saliva test for testosterone, it’s a good idea to follow it up with a blood test to be sure.
To get a blood test for testosterone, one way is to go to your doctor and talk to them about your concerns. If they agree that it’s necessary to test your testosterone, then they’ll order blood work for testosterone levels. You’ll then need to visit a lab to have your blood drawn for the test. Because the sample for hormonal blood tests is usually taken first thing in the morning, you’ll need to find a way to get to the lab very early.
For those who prefer a more convenient way to test their hormone levels, home testing is also an option. For this method, you order a test kit, which is delivered to your home. You take your blood samples via a small fingerprick, and send them back to the lab. They’ll be tested, and you’ll get your results online a few days later.
In premenopausal women, there is variation in testosterone levels over the course of the menstrual cycle. While levels of estrogen and progesterone vary significantly during different phases of the cycle, the variations in testosterone levels are far smaller, and the day-to-day variation is actually larger than the variation in different phases of the cycle. Still, it’s important for a woman to keep track of where she is in her cycle at the time the sample is taken for her testosterone test, so that the results can be interpreted properly. If levels of other sex hormones are also being tested, then it may be necessary to take the sample at a particular phase of the menstrual cycle.
What’s the difference between free and total testosterone levels?
When you’re getting your testosterone levels checked, it’s important to know whether your test is measuring total testosterone or free testosterone. In some cases, both of these measurements will be reported.
Testosterone and other sex hormones are generally carried in the blood on a carrier protein known as sex hormone binding globulin, or SHBG. When testosterone is bound to SHBG, it’s not available to bind to testosterone receptors and cause effects on your body. A test for free testosterone measures only testosterone that’s not bound to SHBG, meaning that it’s available to bind to testosterone receptors. By contrast, total testosterone measures the total amount of the hormone that’s present in your blood, whether it’s bound to SHBG or not.
Many experts believe that free testosterone is a more useful measurement, because it’s only looking at the testosterone that’s actually available to your body. However, it’s more difficult to measure free testosterone. This means that the accuracy of the test may be lower, and there may be more variation from lab to lab.
Sources
Bui HN, Sluss PM, et al. Dynamics of serum testosterone during the menstrual cycle evaluated by daily measurements with an ID-LC-MS/MS method and a 2nd generation automated immunoassay. Steroids. 2013 Jan;78(1):96-101. doi: 10.1016/j.steroids.2012.10.010.
De Wit AE, Bosker FJ, et al.
Testosterone in human studies: Modest associations between plasma and salivary measurements. Andrologia 2018 Feb;50(1). doi: 10.1111/and.12779.
Keevil BG, Adaway J. Assessment of free testosterone concentration.
J Steroid Biochem Mol Biol 2019 Jun;190:207-211. doi: 10.1016/j.jsbmb.2019.04.008.
Keevil BG, MacDonald P, et al. Salivary testosterone measurement by liquid chromatography tandem mass spectrometry in adult males and females. Ann Clin Biochem 2014 May;51(Pt 3):368-78. doi: 10.1177/0004563213506412.
Testosterone, Total, Bioavailable, and Free, Serum. Mayo Clinic Laboratories. https://www.mayocliniclabs.com/test-catalog/Overview/83686#Clinical-and-Interpretive. Accessed 19 August 2022.
