Getting your testosterone checked starts with a simple blood draw, either through your doctor or a direct-to-consumer lab service. The most common test measures total testosterone, which includes both the testosterone circulating freely in your blood and the portion bound to proteins. Results typically come back within a few days, and the process requires minimal preparation beyond scheduling your appointment at the right time of day.
Signs That Warrant Testing
Testosterone levels decline gradually with age, so not every symptom of getting older points to a hormone problem. But certain patterns are worth investigating. Low sex drive, difficulty getting or maintaining erections, unusual fatigue, loss of muscle mass, increased body fat, trouble concentrating, sleep problems, and persistent low mood are all associated with low testosterone. You don’t need all of these to justify testing. Even one or two persistent symptoms, especially low libido combined with fatigue or mood changes, give your doctor a reasonable basis to order blood work.
Some men with low testosterone have no noticeable symptoms at all. In these cases, the issue might surface during routine blood work or evaluation for another condition like infertility or bone density loss.
Where to Get Tested
The most straightforward path is through your primary care doctor or a urologist. Describe your symptoms, and they can order the lab work directly. Insurance typically covers testosterone testing when there’s a documented medical reason for it, such as symptoms of low testosterone or a related diagnosis like testicular hypofunction.
If you’d rather skip the office visit, direct-to-consumer lab services let you order the test yourself. Labcorp OnDemand, for example, offers a comprehensive testosterone panel for $159 out of pocket. You purchase the test online, then visit a local lab for the blood draw. Results go directly to you. Other companies like Quest Diagnostics offer similar services at comparable prices. These results aren’t a diagnosis on their own, but they give you concrete numbers to bring to a doctor if something looks off.
What About Home Test Kits?
Several companies sell finger-prick kits you can use at home, collecting a small blood sample on a card and mailing it to a lab. These are convenient, but accuracy is a real concern. In one study comparing finger-prick samples to standard blood draws, about a third of home-collected samples were unusable due to contamination, improper technique, or blood droplets that were too small. Among the usable samples, the correlation with standard lab results was reasonably strong (r = 0.87), but that still leaves meaningful room for error on an individual test. A standard blood draw at a lab remains the most reliable option, especially for your first test.
How to Prepare for Accurate Results
Testosterone follows a daily rhythm, peaking in the early morning and dropping through the afternoon. For this reason, blood should be drawn in the morning, ideally before 10 a.m. Testing later in the day can produce artificially low readings that don’t reflect your actual baseline.
Your doctor may ask you to fast for several hours before the test, drinking only water. Eating can temporarily lower testosterone readings, so fasting helps ensure the number you get is reliable.
One often-overlooked factor: biotin supplements. If you take biotin (commonly found in hair, skin, and nail supplements), it can interfere with the lab equipment used to measure hormones, producing falsely high or falsely low results. Stop taking biotin at least 12 hours before your blood draw, though 24 to 48 hours is safer if you’re taking high doses.
Types of Testosterone Tests
There are three versions of the test, and which one you need depends on what your doctor is looking for.
- Total testosterone is the standard first test. It measures all the testosterone in your blood, both free-floating and protein-bound. This is what most doctors order initially and what most reference ranges are based on.
- Free testosterone measures only the small fraction (roughly 2 to 3%) that isn’t attached to any protein. Your doctor might add this test if your total testosterone is borderline or if conditions like obesity, aging, or liver disease could be affecting your protein levels and skewing the total number.
- Bioavailable testosterone captures free testosterone plus the portion loosely bound to a protein called albumin. This test isn’t commonly ordered but can help clarify the picture in specific clinical situations.
For most people getting tested for the first time, total testosterone is sufficient. Your doctor will add the other tests if the initial results need more context.
Reading Your Results
The standard reference range for adult men is roughly 240 to 950 ng/dL, though exact ranges vary slightly between labs. A result below 240 ng/dL is generally considered low. A result within range but on the lower end (say, 280 or 300) might still explain symptoms in some men, which is where clinical judgment comes in.
For adult women, the normal range is much lower, typically 8 to 60 ng/dL. Levels above that range can point to conditions like polycystic ovary syndrome or adrenal gland issues.
One important detail: a single low reading isn’t enough for a diagnosis. Testosterone levels fluctuate day to day based on sleep, stress, illness, and other factors. Medical guidelines from the Endocrine Society require at least two separate morning fasting blood draws showing consistently low levels before a diagnosis of testosterone deficiency. If your first result comes back low, expect your doctor to retest on a different day to confirm.
What Happens After a Low Result
If two tests confirm low testosterone, your doctor will likely investigate the cause before jumping to treatment. Additional blood work might include tests for pituitary hormones (LH and FSH), which help determine whether the problem originates in the testes or the brain’s signaling system. Thyroid function, prolactin levels, and iron studies are sometimes checked as well, since these can all influence testosterone production.
A formal diagnosis of hypogonadism requires both consistently low lab values and symptoms that match. Having low numbers alone, without symptoms, doesn’t automatically mean you need treatment. Conversely, having symptoms but normal levels points toward a different explanation for what you’re experiencing.
If your results fall in the normal range but you’re still dealing with fatigue, low mood, or other concerns, those symptoms deserve investigation on their own. Sleep disorders, depression, thyroid dysfunction, and vitamin deficiencies can all mimic the effects of low testosterone and are worth ruling out.