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Free testosterone – laboratory test
  • Registered healthcare provider, RPWDL register no. 000000229528
  • Almost 700 locations within BadamySie.pl: blood collection, diagnostic tests and specialist consultations
  • We carry out tests and consultations ourselves and through subcontractors
  • Results online, no referral needed
  • Operating since 2020 as the continuation of Poland’s first online shop for medical tests (sklep.etermed.pl, since 2013)

90,00 zł

Blood draw included in the price. How does it work?

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Free testosterone

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Description

Whereany blood collection point listed at checkout
Results turnaround timeup to 2 working days
Samplevenous blood (serum)
Preparationmorning, 7:00–10:00; no fasting required; women: days 2–5 of the cycle

Why test free testosterone

Only 1–4% of testosterone in men (1–2% in women) circulates in the blood in its free form, unbound to proteins; the rest is bound to SHBG and albumin. It is the free fraction that acts on tissues. When SHBG levels are abnormal (they rise with age, in hyperthyroidism and with oestrogen use; they fall in obesity, diabetes and hypothyroidism), total testosterone no longer reflects what reaches the cells. Measuring the free fraction then determines whether a deficiency or excess is genuine.

When to consider this test

  • men with symptoms of hypogonadism (reduced libido, erectile dysfunction, fatigue, loss of muscle mass) and total testosterone close to the lower limit of the reference range,
  • obesity, type 2 diabetes, metabolic syndrome, liver or thyroid disease, age over 60 years (altered SHBG),
  • women with hirsutism, acne, hair loss or irregular cycles despite normal total testosterone (suspected PCOS),
  • monitoring testosterone therapy or antiandrogen treatment,
  • athletes following anabolic steroid use (assessment of hormonal axis recovery).

How to prepare

  • Have your blood taken in the morning between 7:00 and 10:00, after a full night’s sleep; fasting is not required, but for a full assessment your doctor will usually also request a fasting total testosterone test at the same time.
  • Do not have the test during an infection, after a sleepless night or after strenuous training the previous day.
  • Women: days 2–5 of the cycle; hormonal contraception raises SHBG and lowers the free fraction.
  • Stop taking high-dose biotin for 2–3 days.

How to interpret your result

Results are reported in pg/ml or pmol/l (1 pg/ml = 3,47 pmol/l). Reference ranges depend on the method, sex and age; compare your result with the range on your report. As a guide, ALAB gives a range of 0,2–3,1 pg/ml for adult women.

Result What it usually means
low free testosterone, normal total testosterone high SHBG (age, hyperthyroidism, oestrogens, liver disease); a genuine deficiency is possible despite “normal” total testosterone
normal free testosterone, low total testosterone low SHBG (obesity, diabetes, hypothyroidism); apparent rather than genuine deficiency, testosterone treatment is usually not indicated
both low in a man with symptoms hypogonadism; confirmation with a second morning measurement, LH, prolactin and pituitary assessment
high free testosterone in a woman PCOS, congenital adrenal hyperplasia, rarely a tumour; the doctor adds DHEA-S, androstenedione and 17-OHP tests

The Endocrine Society recommends diagnosing deficiency based on two fasting morning measurements and using free testosterone measured by equilibrium dialysis or calculated free testosterone; it considers direct free testosterone immunoassays inaccurate.

Other tests to consider alongside this test

total testosterone, SHBG, albumin (to calculate the free fraction), LH, prolactin, TSH; in women, DHEA-S and androstenedione. Read more: article about testosterone on Badania-Medyczne.pl.

Frequently asked questions

When should free testosterone be tested instead of total testosterone?

When total testosterone is close to the lower limit of the reference range, or when something alters the level of SHBG, the protein that binds testosterone: obesity, type 2 diabetes, metabolic syndrome, thyroid and liver disease, older age or certain medicines. In these situations, total testosterone is misleading, while free testosterone shows the fraction that is actually active.

What time should the blood sample be taken?

In the morning, between 7:00 and 10:00; testosterone levels in men are highest at this time. Keep to the same time when repeating the test. Women: days 2–5 of the cycle.

Why does the method matter?

Direct free testosterone immunoassays are inaccurate; the Endocrine Society recommends equilibrium dialysis or calculation using total testosterone, SHBG and albumin. Ask at the collection point or check your report to find out which method was used; if the result is questionable, the doctor requests total testosterone + SHBG and calculates the free fraction.

Sources: ALAB laboratoria, Free testosterone (sample collection time, free fraction 1–4%, role of SHBG, causes of low and high levels); Bhasin S. et al., Testosterone Therapy in Men with Hypogonadism: Endocrine Society Clinical Practice Guideline, J Clin Endocrinol Metab 2018 (two fasting morning measurements, free testosterone when SHBG is altered, equilibrium dialysis or calculation, not direct immunoassays). This information does not replace a medical consultation.

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Where you can have this test

You choose the collection point when you order. Addresses, opening hours and preparation tips are in our city guide:

How to prepare for a blood test (fasting, medication, exercise), in Polish

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