Total testosterone

What it measures, and what changes the number.

Total testosterone measures all the testosterone in the blood, both the large share bound to SHBG and albumin and the small unbound share. Testosterone is produced mainly by the testes in males and in smaller amounts by the ovaries and adrenal glands.

It is often read with SHBG and albumin so that free or bioavailable testosterone can be calculated, and with LH and FSH, which reflect pituitary signalling. Estradiol and prolactin are frequently ordered in the same panel.

Levels vary over the day and are usually highest in the morning, so labs often request an early sample. The assay method matters: immunoassays (IA) and mass spectrometry (MS) can give different results, especially at lower concentrations, and results are reported in nmol/L or ng/dL. Labs may print it as TESTOSTERONE, TOTAL, MALES (ADULT), IA, TESTOSTERONE, TOTAL, MS or Testosterona total.

Reference ranges labs publish

Each lab states an interval for its own method and the population it measured. They differ, they are not interchangeable, and none of them is a verdict on a single result.

Usually reported in nmol/L or ng/dL.

Often read alongside: SHBG, Free testosterone (calculated), LH, FSH, Estradiol (E2)

Calculators that use it: Free testosterone calculator, Testosterone to estradiol ratio, Free androgen index (FAI)

Blood test glossary