Testosterone test – analysis of both free and total testosterone, SHBG and albumin
Testosterone is a central hormone for both men and women's health. It affects everything from sex drive, energy, mood and concentration to muscle mass, fat distribution and bone strength. Balanced levels of testosterone are crucial for well-being, hormonal stability and optimal body function.
This testosterone test provides a comprehensive picture of your hormonal status by analyzing both total testosterone and free testosterone – the biologically active form that is available to the body's tissues. The test also includes measurement of SHBG (Sex Hormone Binding Globulin) and albumin, which are used to calculate the percentage of free testosterone using a scientifically validated formula.
Since only a small portion of testosterone circulates freely in the blood while the rest is bound to SHBG and albumin, this analysis provides a more accurate picture of how much of the hormone is actually biologically active. This makes the test particularly useful for identifying conditions such as hypogonadism (testosterone deficiency) or hormonal imbalances caused by, for example, stress, medication, obesity or illness.
When is it appropriate to test testosterone?
A testosterone test may be appropriate if you experience symptoms such as:
- reduced sex drive or erection problems
- fatigue, depression or low energy
- increased fat mass or reduced muscle strength
- sleep difficulties or impaired recovery
- reduced motivation or cognitive acuity
- for women: irregular periods, acne or increased body hair
What does the testosterone test show?
The analysis includes four important markers that together provide a complete picture of your testosterone balance:
- Total testosterone: Measures the total amount of testosterone in the blood.
- Free testosterone: Calculated from total testosterone, SHBG and albumin – shows the active, biologically available part.
- SHBG: A transport protein that binds sex hormones in the blood. Changes in SHBG affect the availability of free testosterone.
- Albumin: A blood protein that affects how much testosterone is bound and released into the circulation.
Why analyze both free and total testosterone?
Measuring only total testosterone can give an incomplete picture. Two people with the same total level can have very different proportions of free testosterone depending on SHBG levels. By including both bound and free testosterone, you can detect hidden imbalances that would otherwise be missed. This is especially important for people with symptoms of hormonal imbalance despite “normal” total levels.
What happens after the test?
The results are compared to gender- and age-specific reference ranges to determine if the levels are within an optimal range. The doctor provides a written assessment of the results and, if necessary, recommendations for further investigation or lifestyle changes.
When ordering free testosterone, analysis of SHBG, albumin and total testosterone is also included – these are required to calculate free testosterone. Read more about the difference between free and bound testosterone.
