Free Testosterone
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Measures total testosterone for assessment of male hypogonadism, PCOS, and infertility.
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🧪 What is Free Testosterone?
Free testosterone refers to the biologically active portion of testosterone that is not bound to proteins in the blood.
- Total testosterone includes:
- Free testosterone (~2%)
- Testosterone bound to SHBG (sex hormone-binding globulin) (~65%)
- Testosterone bound to albumin (~33%, weakly bound)
Only free testosterone is considered bioavailable and able to exert physiological effects on target tissues.
❓ Why is the Free Testosterone Test Done?
To:
- Evaluate hypogonadism (testosterone deficiency) in men
- Investigate infertility, erectile dysfunction, decreased libido
- Assess delayed or precocious puberty
- Diagnose polycystic ovarian syndrome (PCOS) or hirsutism in women
- Differentiate between true low testosterone and low total testosterone with normal free testosterone (e.g., due to high SHBG)
📊 Normal Ranges
Group | Normal Free Testosterone Range |
|---|---|
Men (Adult) | 5 – 21 ng/dL (or 174 – 729 pmol/L) |
Women (Adult) | 0.3 – 1.9 ng/dL (or 10 – 66 pmol/L) |
Children / Adolescents | Age-dependent; lower than adults |
🔍 Values can vary by age, lab method, and SHBG levels.
Calculated free testosterone is sometimes used instead of direct measurement (via total T + SHBG + albumin).
📈 Interpretation of Results
Level | Interpretation |
|---|---|
🔻 Low Free Testosterone | - Primary hypogonadism (testicular failure) |
🔺 High Free Testosterone | - PCOS, adrenal or ovarian tumors (in women) |
🧠 Associated Organs and Conditions
Organ/System | Role |
|---|---|
Testes (Leydig cells) | Produce testosterone in males |
Ovaries & Adrenals | Contribute to testosterone in females |
Pituitary gland | Regulates testosterone via LH secretion |
Liver | Produces SHBG, affects free vs bound testosterone balance |
Hypothalamus | Controls GnRH → LH/FSH → Testosterone |
🔄 Related / Follow-Up Tests
- Total Testosterone
- SHBG (Sex Hormone-Binding Globulin)
- Albumin – Used for calculated free T
- LH and FSH – Evaluate pituitary function
- Estradiol – Especially in men with gynecomastia
- DHEA-S / Androstenedione – In hirsutism or virilization
- Prolactin – Elevated in secondary hypogonadism
- MRI Pituitary – If central cause suspected
✅ Fasting Required?
Parameter | Requirement |
|---|---|
Fasting Required? | ✅ Yes — Morning sample (7–10 AM) and 8–10 hours fasting recommended, as testosterone levels are highest in the morning and fluctuate throughout the day. |
📝 Summary
Parameter | Summary |
|---|---|
What | Measures the biologically active, unbound testosterone available in circulation |
Why Test | To evaluate hypogonadism, infertility, PCOS, or pubertal disorders |
Normal Range | Men: 5–21 ng/dL; Women: 0.3–1.9 ng/dL |
Low Levels | Suggest testosterone deficiency, aging, pituitary or testicular dysfunction |
High Levels | Seen in PCOS, tumors, steroid use |
Follow-up Tests | Total T, SHBG, LH, FSH, DHEA-S, Prolactin, Estradiol |
Fasting Required | ✅ Yes (morning sample preferred) |
How our test process works!
