Androgens . Patient guide
Total Testosterone Blood Test
What is Total Testosterone
Total testosterone measures the total amount of testosterone circulating in the blood, including both protein-bound and free (active) fractions, and it is the standard first-line test of male androgen status. According to BSSM (British Society for Sexual Medicine) 2017 UK guidelines, the testosterone deficiency diagnostic pathway in men requires at least two morning fasted samples drawn between 7 and 11 AM, with thresholds of below 8 nmol/L supporting a diagnosis, 8 to 12 nmol/L the grey zone, and above 12 nmol/L typically normal. Total testosterone is also used in women to investigate raised androgen symptoms (hirsutism, acne, scalp thinning, suspected PCOS / PMOS).
This biomarker entry is being clinically reviewed by our team. The factual content draws on UK guidance (NICE, NHS, Royal Colleges and the relevant speciality society where cited).
Reference range
Reported in nmol/L. Final reports always carry the issuing laboratory's range, which is what your clinician will interpret against.
| Group | Range | Note |
|---|---|---|
| Adult men | 8.6 to 29.0 | nmol/L; many UK clinicians consider levels under 12 nmol/L as low if symptoms are present (BSSM) |
| Adult women | 0.3 to 2.4 |
What it is
In men, testosterone is produced mainly by the testes under signal from the pituitary (LH and FSH). It is responsible for libido, muscle mass, bone density, mood, and red blood cell production. In women, smaller amounts come from the ovaries and adrenal glands.
Why a clinician would order it
In men: persistent fatigue, low libido, erectile changes, reduced morning erections, mood changes, loss of muscle. In women: hirsutism, acne, scalp thinning, irregular periods, suspected PCOS / PMOS.
If your level is outside the range
Symptoms of low Total Testosterone
- Reduced libido
- Erectile changes
- Loss of morning erections
- Fatigue
- Reduced muscle bulk
- Mood changes, low motivation
- Reduced body or facial hair
What low can indicate. Primary hypogonadism (testicular failure), secondary hypogonadism (pituitary or hypothalamic cause), age-related decline, obesity, opioid use, post anabolic-steroid use, untreated sleep apnoea.
Symptoms of high Total Testosterone
- In women: hirsutism, acne, scalp thinning, irregular periods. In men: usually due to exogenous supplementation.
What high can indicate. In women: PCOS / PMOS, congenital adrenal hyperplasia, androgen-secreting tumour (rare). In men: exogenous testosterone or anabolic-steroid use, rarely a pituitary or adrenal cause.
Testing tips
Morning sample (ideally before 11am) is essential, because testosterone follows a strong diurnal rhythm and an afternoon sample may read 30 percent lower. Repeat on two separate days before any treatment decision.
Where you can get this tested
Total Testosterone is included in the following WMG Health panels. Same-day appointments at our Harley Street clinic, with results clinician-reviewed.
Want a specific combination of markers we do not have a panel for? Build a custom panel and our clinicians will design one for you.
Symptoms often investigated with Total Testosterone
Total Testosterone is commonly tested when patients present with the following symptoms. If any of these resonate with you, the linked guides explain what to look for and which test pathway is appropriate.
Read this marker alongside another
Total Testosterone is most useful when interpreted together with the markers below. Each guide walks through the 4-quadrant matrix our clinicians use when both come back at once.
Sources
UK guidance our clinicians use when interpreting this marker.
This page is general patient information, not personal medical advice. A GMC-registered clinician will review your results and tailor any interpretation to you. See our Editorial Policy for how we write and review content.
Common questions about Total Testosterone
What is a normal Total Testosterone range?
Adult men: 8.6 to 29.0 (nmol/L; many UK clinicians consider levels under 12 nmol/L as low if symptoms are present (BSSM)). Adult women: 0.3 to 2.4. Always interpret your own results against the laboratory range printed on your report, since assay-specific reference ranges vary.
What does a low Total Testosterone result mean?
Primary hypogonadism (testicular failure), secondary hypogonadism (pituitary or hypothalamic cause), age-related decline, obesity, opioid use, post anabolic-steroid use, untreated sleep apnoea.
What does a high Total Testosterone result mean?
In women: PCOS / PMOS, congenital adrenal hyperplasia, androgen-secreting tumour (rare). In men: exogenous testosterone or anabolic-steroid use, rarely a pituitary or adrenal cause.
Do I need to fast or prepare for the Total Testosterone blood test?
Morning sample (ideally before 11am) is essential, because testosterone follows a strong diurnal rhythm and an afternoon sample may read 30 percent lower. Repeat on two separate days before any treatment decision.
Can I order a Total Testosterone blood test privately in London?
Yes. WMG Health offers Total Testosterone as part of bespoke panels and several pre-built panels at our 134 Harley Street clinic. Results are clinician-reviewed by a GMC-registered doctor within 4 hours for the most common assays. All panels are custom-built around your specific question; bookings via /contact/ or 020 3239 3378.