How to Test Testosterone Levels

December 20, 2022
Fact-checked by Dr. Avidon Appel
How to Test Testosterone Levels

Testosterone is the vital male hormone responsible for development during adolescence. As an adult, men need adequate testosterone to maintain muscle mass, sexual function, mental wellness, and overall health. While levels can fluctuate slightly each day, men require a baseline to maintain peak functioning.

Low testosterone is a medical condition that requires proper evaluation to be diagnosed. Doctors must determine the extent of the testosterone loss and its cause to plan the correct treatment.

If you have noticed changes in your body composition, sex drive, or a generalized worn-down feeling, you may be experiencing a hormonal imbalance. After reaching out to a doctor, the first step is to test your testosterone levels. The following discussion covers the types of tests, what they can tell your physician, and what to expect.

What is a Testosterone Levels Test?

A testosterone levels test is a simple blood test ordered by a doctor that assesses the amount of testosterone in your blood. Men's bodies rely on testosterone for many things, including maintaining sex drive, achieving erections, and supporting metabolism. In addition, testosterone is essential for emotional well-being and cognitive focus.

Doctors use the test to determine if your symptoms result from low testosterone. This diagnostic tool helps providers plan the best course of care and rule out abnormal testosterone levels as the symptom of a potentially serious medical condition.

Types of Testosterone Level Tests

These tests assess two types of testosterone in the blood, free and attached. Free testosterone is produced in the testes and enters your bloodstream. It is available to bind to proteins for use in several bodily processes.

Attached or bound testosterone is the hormone that is already connected to a protein. Body cells use proteins to carry out specific anatomical functions. Bound testosterone is limited to the single-use dictated by its connected protein.

A doctor orders a total testosterone test, which shows the levels of both types of testosterone in your blood, or a free testosterone test, which only shows the free testosterone.

Why Would Someone Need a Testosterone Levels Test?

You may need a testosterone test to diagnose a medical condition or identify the source of an overall change in your physical and psychological well-being. Testosterone is vital to multiple aspects of male bodily function. Hormone loss significantly changes your physical performance, mental sharpness, and overall health.

Unfortunately, testosterone loss can occur gradually, resulting in subtle changes that can be imperceptible until you take a holistic view of your health and mood.

Doctors typically order a free testosterone test for diagnostic purposes because it tells them how much usable testosterone you're producing. While it's normal for your testosterone levels to fluctuate throughout the day, these daily dips are not enough to alter how you feel and perform.

Symptoms of Low Testosterone

The following symptoms indicate low testosterone levels. If you experience one or more of these signs, it may be time to schedule a doctor's appointment for testosterone levels testing.

  • Diminished sex drive, which can lead to relationship strain and withdrawal from your partner

  • Erectile dysfunction, in which erections are not hard enough or sustained for long enough to engage in sex

  • Changes in body composition, including loss of muscle mass, increased belly fat, and the development of breast tissue

  • Fogginess, including difficulty maintaining mental focus at work, school, or home

  • Mood or emotional changes, possibly highlighted by a sense of malaise, disinterest, or depression symptoms

  • Hair loss

  • Infertility

What Happens During a Testosterone Levels Test?

A testosterone levels test is a simple blood test completed at a doctor's office or phlebotomy center. If your doctor provides any instructions before the test, be sure to comply to ensure the test results are accurate. It's best to be well-hydrated before attending the exam because this makes it easier for the phlebotomist to locate your veins.

First, the clinician will sterilize a small area on your arm, usually just below the inner aspect of your elbow, with rubbing alcohol. Once prepped, they insert a small needle into the vein. It will feel like a slight pinch or sting. Next, they attach a vacuum tube to the inserted needle and collect only enough blood to conduct the test.

The phlebotomist will then withdraw the needle, place gauze over the area, and secure it with medical tape. After that, you can leave the office. The blood sample is then sent to a lab for testing. Your doctor will contact you with the results in a few days.

What Do the Results of a Testosterone Test Mean?

Normal levels range from 300 nanograms to 1,000 nanograms of testosterone per deciliter of blood. Your age, genetics, and overall health determine your normal range. A doctor must interpret the testosterone test results to assess how testosterone loss affects you.

You may experience the symptoms and effects of low testosterone even if your levels are within the normal range. Together, you and your doctor can discuss interventions and lifestyle modifications that can elevate your testosterone, restoring lost vitality and vigor.

In general, testosterone levels fall with age after peaking in your 20s. However, once levels dip to the level that you experience lowered sex drive and other symptoms, it may be appropriate to begin treatment.

Your doctor will use the test results, your medical history, and an examination to determine the cause of low testosterone. Possible causes of low testosterone, which may require treatment or further testing, include:

  • Age, each man has a baseline testosterone level determined by their health and genetics, eventually levels peak before a man turns 30 and then decrease by about 1% year-to-year

  • Chronic illnesses, health conditions like diabetes stress the body and impact hormone production and use

  • Excess body fat and a sedentary lifestyle

  • Sleep apnea and other sleep disorders

  • Chronic physical stress from excessive training or exercise

  • Pituitary gland abnormality, infections or congenital conditions can cause the gland to underproduce some or all hormones, altering testosterone levels

  • Brain disease or injury affecting the hypothalamus, which is the part of the brain that controls hormone production

  • Thyroid disease or poor thyroid function

  • Testicular injury, cancer, infection, or auto-immune disease affecting the testes

Many of these causes are managed with testosterone replacement interventions. Doctors will also treat underlying conditions to raise testosterone levels.


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December 20, 2022

Written By
Dr. Avidon Appel

Fact-checked By
Dr. Avidon Appel

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About Author

Dr. Avidon Appel is the founder of Iron Mountain Men’s Health. He is an Internal Medicine Specialist based in Willow Grove, PA who specializes in men’s sexual health and hormone optimization and has over 19 years of experience in the medical field. He is a graduate of Philadelphia College of Osteopathic Medicine, as well as Saint Joseph’s University.

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