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Free Testosterone

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Fasting Required

Details

Measures total testosterone for assessment of male hypogonadism, PCOS, and infertility.

₹499₹1,485

66% OFF

Free Testosterone Test Information Guide

  • Why is it done?
    • Measures the biologically active form of testosterone that is not bound to proteins in the bloodstream
    • Evaluates sexual dysfunction, erectile dysfunction, and low libido in men
    • Assesses symptoms of hypogonadism including fatigue, muscle weakness, and mood changes
    • Investigates infertility issues in men by evaluating testosterone production
    • Evaluates hormonal imbalances in women related to polycystic ovary syndrome (PCOS) and virilization
    • Monitors testosterone replacement therapy effectiveness and dosing
    • Assists in evaluating pituitary and testicular function disorders
    • Performed in early morning hours when testosterone levels are typically highest
  • Normal Range
    • Men: 7.0-24.0 pg/mL (24-83 pmol/L)
    • Women: 0.0-4.0 pg/mL (0-14 pmol/L) - varies based on menstrual cycle phase
    • Unit of Measurement: picograms per milliliter (pg/mL) or picomoles per liter (pmol/L)
    • Normal Results: Free testosterone levels within the reference range indicate normal hormonal function and adequate testosterone availability for biological activity
    • Low Results: Levels below the normal range may indicate hypogonadism, pituitary disorders, or reduced testosterone production
    • High Results: Levels above the normal range may indicate PCOS in women, androgen-secreting tumors, or inappropriate testosterone supplementation
    • Reference Range Variation: Ranges vary between laboratories due to different assay methods; always compare results to the specific laboratory's reference range
  • Interpretation
    • Low Free Testosterone (<7.0 pg/mL in men): May indicate primary hypogonadism (testicular failure), secondary hypogonadism (pituitary/hypothalamic dysfunction), aging-related decline, chronic illness, obesity, liver disease, or inadequate testosterone supplementation
    • Borderline Low Results (4-7 pg/mL): May warrant repeat testing, evaluation of total testosterone, and assessment of hormone-binding globulin (SHBG) levels to determine clinical significance
    • High Free Testosterone in Women (>4.0 pg/mL): May suggest PCOS, adrenal hyperplasia, ovarian tumors, or other androgen-secreting conditions causing virilization, irregular menstruation, or infertility
    • Clinical Context Importance: Results must be interpreted with symptoms, physical examination findings, and other hormone levels (total testosterone, SHBG, LH, FSH) for accurate diagnosis
    • Factors Affecting Results: Time of day (morning levels higher), age, medications (steroids, anticonvulsants), stress, sleep quality, body weight, liver function, and estrogen/SHBG levels
    • Assay Method Considerations: Direct immunoassay methods are less accurate at low levels; dialysis or ultrafiltration methods are considered more reliable but less available
    • Testosterone Replacement Effects: During therapy, free testosterone should be monitored to ensure levels are within therapeutic range and to adjust dosing appropriately
  • Associated Organs
    • Primary Organs: Testes (in males - produce 95% of testosterone), adrenal glands (produce 5%), ovaries (in females - produce testosterone), hypothalamus, and pituitary gland
    • Hypothalamic-Pituitary-Gonadal (HPG) Axis: Controls testosterone production through GnRH, LH, and FSH signaling
    • Liver: Produces SHBG (sex hormone-binding globulin) that binds testosterone; liver dysfunction affects free testosterone levels
    • Associated Conditions - Low Testosterone: Klinefelter syndrome, testicular atrophy, orchitis, hypogonadism, Kallmann syndrome, hypopituitarism, erectile dysfunction, infertility, osteoporosis, delayed puberty
    • Associated Conditions - High Testosterone (Women): Polycystic ovary syndrome (PCOS), adrenocortical tumors, ovarian tumors, congenital adrenal hyperplasia, virilization, hirsutism, acne, male-pattern baldness, irregular menstruation
    • Associated Systemic Conditions: Obesity, type 2 diabetes, metabolic syndrome, chronic kidney disease, liver cirrhosis, HIV/AIDS, depression, cardiovascular disease
    • Potential Complications of Abnormal Results: Low testosterone: decreased bone density, muscle loss, sexual dysfunction, mood disturbances; High testosterone in women: reproductive dysfunction, virilization, increased cardiovascular risk
  • Follow-up Tests
    • Total Testosterone: Measures bound and free testosterone combined; helps confirm low free testosterone findings
    • Sex Hormone-Binding Globulin (SHBG): Determines how much testosterone is bound versus free; elevated SHBG can lower free testosterone despite normal total levels
    • Luteinizing Hormone (LH): Evaluates pituitary function and testicular response; helps distinguish primary from secondary hypogonadism
    • Follicle-Stimulating Hormone (FSH): Assesses male fertility and spermatogenesis; elevated levels may indicate testicular failure
    • Estradiol: Measures estrogen levels; testosterone can convert to estradiol; relevant in evaluating hormone imbalance
    • Prolactin: Elevated prolactin can suppress testosterone production; assess if LH/FSH abnormalities present
    • Thyroid Function Tests (TSH, Free T4): Thyroid disorders can affect testosterone metabolism and SHBG production
    • Semen Analysis: For evaluation of male infertility; assesses sperm count, motility, and morphology
    • Dehydroepiandrosterone Sulfate (DHEA-S): Evaluates adrenal androgen production, particularly if elevated testosterone suspected from adrenal source
    • Imaging Studies: MRI of pituitary if secondary hypogonadism suspected; ultrasound of testes for primary hypogonadism evaluation
    • Repeat Testing: Repeat measurement in 2-4 weeks for borderline results; performed in morning for consistency
    • Ongoing Monitoring: During testosterone replacement therapy: monitor at 6-8 weeks after starting, then annually; adjust based on symptoms and free testosterone levels
  • Fasting Required?
    • Fasting Required: No - fasting is not required for free testosterone testing
    • Timing Requirements: Test should be performed in the morning between 7:00 AM and 10:00 AM when testosterone levels are naturally highest; critical for accurate results and consistency
    • Medications to Report: Inform healthcare provider of testosterone replacement therapy, anabolic steroids, corticosteroids, anticonvulsants, ketoconazole, spironolactone, estrogens, oral contraceptives, and any other medications that may affect testosterone levels
    • Do Not Avoid: Normal breakfast and fluids are typically allowed unless part of a comprehensive metabolic panel requiring fasting
    • Additional Preparation: Avoid strenuous exercise the day before testing; get adequate sleep (7-9 hours); avoid alcohol consumption 24 hours before test; minimize stress if possible
    • Menstrual Cycle Timing (Women): If possible, testing should be performed during the follicular phase (days 3-5 of menstrual cycle) for consistent results, or healthcare provider may specify timing
    • Room Temperature Tolerance: Sample should be transported to laboratory promptly; blood samples are typically stable at room temperature for testing

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