Testosterone Blood Test – Everything You Need to Know

What is testosterone?

Testosterone is a hormone present in both men and women. In men, it is mainly created in the testicles. In women, it is mainly created in the ovaries. However, men have ten times higher levels of testosterone than women.1 Hence it is more commonly known as a male hormone. Testosterone is a fairly important component of a healthy life. In this post, we will explore the science behind a testosterone blood test, and highlight the importance of tracking it for an optimal life.

How does testosterone affect health and wellbeing?

Testosterone is vital for male puberty. It helps develop sexual organs, increases fertility, lowers voice, and is responsible for facial and body hair growth.1

After puberty, testosterone is still needed. This is because testosterone helps maintain muscle mass and plays a role in controlling libido1.

What does a testosterone blood test measure?

Testosterone travels in the body with the bloodstream. However, it is not always on its own. If testosterone is on its own in the blood, it is called free testosterone3. Free testosterone accounts only for just 1-3% of your body’s testosterone levels3.

So what happens to the rest of the testosterone in your body?

The rest of the testosterone combines with two proteins in the bloodstream.

  • Sex Hormone Binding Globulin (SHBG) is a protein that attaches to and carries the most testosterone in the blood3. Approximately 45% of testosterone in men and 70% testosterone in women is bound to SHBG3. SHBG-bound testosterone cannot be easily separated to be used around the body3.
  • The second protein that testosterone attaches to is albumin3. This protein-testosterone attachment is a weaker bond. Testosterone bound to albumin can free up if the body needs it3.

Thus, there are two different types of blood tests for testosterone: free testosterone blood test and total testosterone blood test.

The free testosterone blood test measures the amount of free testosterone and loosely bound testosterone from the albumin4. Whereas the total testosterone blood test will calculate all testosterone in the body.

The ElevateMe program includes a total testosterone test. For our aim of helping you live life at your optimum levels, this blood test gives a good picture of your body’s ability to create the right amount of testosterone that you require.

Causes of low testosterone levels

There are a few things that can lead to low levels of testosterone.

  • Luteinising Hormone (LH) is a hormone made in the pituitary glands that controls testosterone levels. If there are any problems with the pituitary glands or LH levels, it will impact testosterone levels1.
  • Testosterone is also developed in the testes for men. Any damage to the testes can also impact the amount of testosterone produced1. Testes damage can develop from trauma, alcoholism, or some viral diseases such as mumps1.
  • Anabolic steroid abuse by people trying to increase muscle is another common reason. The way that steroids work is that they imitate the effects of testosterone in the muscles5. Their usage has been linked with a reduced function of the testes. This causes a decrease in testosterone levels.18
  • A common question is whether masturbation affects testosterone levels. Simply put, we do not know for sure. There have only been a handful of studies carried out investigating the link. Despite this, scientists have not been able to show a confirmed link between masturbation and testosterone levels.

What are the side effects of low testosterone?

Hypogonadism is the medical term for low testosterone levels. This affects around 2 in 100 men aged 40-79 and increases to 5 in 100 men aged 70-796.

Testosterone plays a part in controlling the amount of energy we burn in our body every day6. When testosterone levels are low, the body has less energy to use than normal. Consequently, this can make you feel tired and lethargic7. Low levels of testosterone may also show low mood or depression because the hormone has an effect on your mood8.

Other side effects of low testosterone include:

  • Erectile dysfunction
  • Fertility issues
  • Loss of body hair
  • Loss of muscle mass
  • Breast tissue development
  • Bones can become weaker6

Causes of high testosterone levels

As with everything else in your body, it is possible to have high levels of testosterone which can be damaging.

High testosterone levels are quite rare. Naturally, elevated testosterone levels can only occur when there are problems with the glands and sexual organs that control testosterone production.

  • For men, having an increased testosterone level can also be caused by a tumour in the testes1. But if your levels are high before puberty, this is a sign of puberty starting1.
  • For women, high testosterone levels show that there may be ovarian tumours or a condition called Polycystic Ovary Syndrome (PCOS).
  • In both sexes, high levels can also indicate an adrenal gland tumor1.

The only other way of getting high testosterone levels is through taking testosterone as a drug9.

What are the side effects of high testosterone?

The side effects of having high levels of testosterone can be dangerous. It can affect many areas of the body. High testosterone levels can:

  • Affects sexual organs: Causing low sperm count, impotence and difficulty urinating.
  • Muscle complications, most importantly affecting the heart: Increases the chances of experiencing heart attacks and high blood pressure.
  • Mood swings: Depression and increased aggression.
  • Stunted growth: If experienced whilst in puberty, high levels of testosterone can slow and stop natural growth10.

How is a testosterone blood test carried out?

Testosterone levels are tested through a simple blood test. Testosterone levels increase during the night, therefore blood tests are taken in the morning1. There is no need to prepare or restrict your diet in any way for the blood test.

Testosterone and Age

As men get older, from the age of 30-40, their testosterone levels naturally deplete by 2% a year11. A proportion of men in this age group will experience the side effects of low testosterone.

If low testosterone levels are experienced later in life for men, it will produce similar side effects to menopause, a condition known as male menopause11. Symptoms of male menopause include tiredness, reduced libido, difficulty concentrating, and hot flushes.

How to increase testosterone levels?

Sleep

Testosterone levels in men increase naturally at night, especially during the first 3 hours of uninterrupted sleep12. Therefore, having a good bedtime routine will aid in improving sleep and your body’s ability to increase testosterone levels naturally12.

However, if testosterone levels are too low to start with, then the body cannot increase the levels naturally. In fact, low testosterone levels will interrupt your sleep.12

Exercise

Another way to increase testosterone is with aerobic exercise. Studies indicate that this will increase levels of testosterone in men13. Walking, cycling, running, and swimming are all great aerobic exercises.

Diet

Here are some foods that have been identified to improve testosterone levels:

  • Tuna
  • Low-fat milk with added vitamin D
  • Egg Yolks
  • Fortified cereals
  • Oysters
  • Shellfish
  • Beef
  • Beans13

Testosterone replacement therapy

Testosterone deficiency can be treated by a doctor with testosterone drug therapy if the deficiency is significant14. These are normally administered through an injection. However, TRT therapy can only be advised by a medical doctor.

Testosterone in Women

Women produce testosterone in their ovaries and the adrenal glands1. Testosterone in women is vital to ovary function, bone strength, and libido10.

High levels of testosterone can come from having a condition called Polycystic Ovary Syndrome (PCOS). This affects around 6-10% of women before their menopause10.

Women experience the same side effects of high testosterone levels as men. But they can also experience a reduction in breast size, and their voice can become deeper10.

However, women have a smaller range of side effects of low testosterone than men. Low testosterone levels in women can lead to low libido, weaker bones, poor concentration levels, and depression10.

What is Polycystic Ovary Syndrome (PCOS)?

To understand PCOS, let’s first briefly understand the complex hormone systems in the female reproductive system. There are four key hormones that follow a meticulous process of triggering one another.

  • Follicle Stimulating Hormone (FSH): This causes the eggs to mature in the ovaries.
  • Luteinising Hormone (LH): This triggers the body to release the matured egg.
  • Oestrogen: This ensures the womb is ready to receive an egg if fertilized.
  • Progesterone: This ensures the womb is ready to receive an egg if fertilized16.

The LH hormone controls testosterone levels. This means that if LH levels are too high, more testosterone is made. Then again, for females, too much LH will cause the body to not ovulate – the term for releasing an egg16. This can result in missing periods as the reproductive cycle has not been able to be completed. Consequently, this leads to the infertility side effect of PCOS17.

Will a testosterone blood test tell you if you have PCOS?

Although testosterone levels are high in PCOS sufferers, the high levels are not enough for a diagnosis. PCOS is a complex disease and is not easy to diagnose. Diagnosis of PCOS often only happens when all other alternatives have been ruled out16.

Summary

Testosterone is important for both women and men. Ensuring that your levels remain close to the optimal range is necessary. This will ensure that your body functions correctly and does not affect your sleep, energy levels, or mood. The ElevateMe program provides plans for regular monitoring of your biomarkers to help you ensure that your body is performing at its peak!

How’s your libido? 

Did you know 40% of men above 45 years of age and 50% of men in their 80s suffer from the diminished functional activity of testes and have testosterone deficiency?

Take an ElevateMe blood test today to capture 21 blood test insights and track your sleep, fitness, energy, metabolism, cognition, mood, and immunity.

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References

1 Labtestsonline. (2018). Testosterone Test. Last accessed 12/03/2021.

2 NHSb. (N.D.). Testosterone. Last accessed 12/03/2021.

3 Labtestonline. (2019). Sex Hormone Binding Globulin. Last accessed 19/04/2021

4 Kacker, R., Hornstein, A. & Morgentaler, A. (2013). Free testosterone by direct and calculated measurement versus equilibrium dialysis in clinical population. The aging Male. 16 (4), 164–168.

5 NHS. (2018). Anabolic Steroid Misuse. Last accessed 19/04/2021

6 Tidy, C. (2018). Testosterone Deficiency. Last accessed 12/03/2021.

7 Haren, M., Siddiqui, A., Armbrecht, H., Kevorkian, R., Kim, M., Haas,M., Mazza, A., Kumar, V., Green, M., Banks, W. & Morley, J.. (2011). Testosterone modulates gene expression pathways regulating nutrient accumulation, glucose metabolism and protein turnover in mouse skeletal muscleInternational journal of Andrology. 34 (1), 55–68.

8 Amanatkar, H., Chibnall, J., Seo, B-W., Manepalli, J. & Grossberg, G. (2014). Impact of exogenous testosterone on mood: A systematic review and meta-analysis of randomized placebo-controlled trialsAnnals of clinical physciatry. 26 (1), 19–32.

9 Jewell, T. (2019). 28 Signs of High Testosterone in Men and Women. Last accessed 17/03/2021.

10 Harvard. (2019). Testosterone — What It Does And Doesn’t Do. Last accessed 12/03/21.

11 NHS. (2019). The Male Menopause. Last accessed 12/03/2021.

12 Wittert. G. (2014). The relationship between Sleep disorders and testosterone in MenAsian Journal of Andrology. 16, 262–265.

13 Yeo, J., Cho, S., Park, S., Jo, S., Ha, J., Lee, J., Cho, S. & Park, M. (2018). Which Exercise Is Better for Increasing Serum Testosterone Levels in Patients with Erectile Dysfunction?The world’s journal of men’s health. 36 (2), 147–152.

14 Cherney, K. (2020). 8 Testosterone-Boosting Foods. Last accessed 12/03/2021.

15 Osterberg, E., Bernie, A. & Ranasamy, R. (2014). Risks of testosterone replacement therapy in menIndian Journal of Urology. 30 (1), 2–7.

16 Your Hormones. (N.D.). Hormones in Human Reproduction. Last accessed 19/04/2021

17 Lab tests online. (2019). Polycystic Ovary Syndrome. Last Accessed 19/04/2021

18 Anabolic steroid-induced hypogonadism: a challenge for clinicians. Last Accessed 24/04/2021

ElevateMe_Testosterone Blood Test

Written by Louise Taylor

After completing Clinical Technology at the University of Bradford, I am venturing into the NHS as a General Medical Engineer.

29/06/2021

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