Complete Testing & Optimization Guide
Optimal ranges, provider comparison, and strategies to improve your Total Testosterone levels
Included in 8 of 10 major testing providers
Sex Hormones (Male)
bone density
Abnormal Total Testosterone levels can indicate underlying health issues that may go undetected without proper testing. Regular monitoring helps catch problems early when they're most treatable.
Understanding your Total Testosterone levels enables targeted interventions, tracks treatment effectiveness, and helps optimize your overall health and performance.
Total testosterone measures the combined amount of free (unbound) and protein-bound testosterone in your blood. Testosterone is the primary male sex hormone, but it's critically important for both men and women. In men, it's produced primarily in the testes, while women produce smaller amounts in the ovaries and adrenal glands. Testosterone is essential for muscle mass, bone density, libido, energy, mood, cognitive function, and metabolic health.
Here's what many people don't understand:testosterone levels naturally decline with age—about 1-2% per year after age 30 in men. This gradual decline contributes to sarcopenia (muscle loss), increased body fat, reduced bone density, lower libido, fatigue, and cognitive decline. However, "age-appropriate"levels are often suboptimal for longevity and quality of life. Many functional medicine practitioners target higher levels within the normal range to optimize healthspan.
Total testosterone includes both free testosterone (2-3% of total, biologically active) and bound testosterone (bound to SHBG and albumin, less active). If total testosterone is low-normal but SHBG is high, free testosterone may be inadequate. This is why checking free testosterone or calculating the free androgen index is important alongside total testosterone.
Bottom line: TSH and Free T4 alone miss people with conversion problems. Free T3 is the only way to know if you have enough active thyroid hormone at the tissue level.
| Range Type | Level | Clinical Significance |
|---|---|---|
| Optimal (Men) | 500-900 ng/dL | Optimal range for men. Higher end associated with better muscle mass, energy, libido. Functional medicine often targets 600-800 ng/dL. |
| Optimal (Women) | 30-70 ng/dL | Optimal range for women. Too low causes fatigue, low libido, muscle loss. Too high can cause virilization (facial hair, acne, voice changes). |
| Low (Men) | <300 ng/dL | Hypogonadism in men. Requires treatment with testosterone replacement therapy (TRT). Causes fatigue, low libido, muscle loss, depression. |
| Low (Women) | <15 ng/dL | Low testosterone in women. Causes fatigue, low libido, difficulty building muscle. Consider DHEA supplementation or low-dose testosterone. |
Standard lab range:bone density
>1000 ng/dL
High (Women)
High testosterone in women. May indicate PCOS, adrenal hyperplasia, or tumor. Causes acne, hirsutism, irregular periods, infertility.
Testosterone cypionate or enanthate injections:100-200 mg every 7-10 days (most effective). Maintains stable levels.
Testosterone cream/gel:Daily application to shoulders/upper arms. Convenient but variable absorption. Risk of transfer to partners/children.
Testosterone pellets:Implanted subcutaneously every 3-6 months. Stable levels but requires minor surgery.
Goal:Bring total T to 600-900 ng/dL, free T to upper-normal range, and resolve symptoms. Monitor hematocrit, PSA, estradiol.
Resistance training:THE most powerful natural testosterone booster. Heavy compound lifts (squats, deadlifts, bench press) 3-4x/week.
Adequate sleep:7-9 hours nightly. Sleep deprivation drops testosterone by 10-15%.
Maintain healthy body fat:Obesity suppresses testosterone (fat tissue converts T to estrogen via aromatase). Target <20% body fat for men, <30% for women.
Reduce stress:Chronic stress elevates cortisol, which suppresses testosterone production.
Optimize micronutrients:Zinc (15-30 mg/day), magnesium (400 mg/day), vitamin D (>40 ng/mL) are critical cofactors for testosterone synthesis.
Note: Obesity:Lose weight through calorie deficit + resistance training. Every 10 lb fat loss increases T by ~50 ng/dL in obese men. | Testicular dysfunction (primary hypogonadism):Varicocele repair, discontinue damaging medications (opioids, glucocorticoids). | Pituitary dysfunction (secondary hypogonadism):Check LH, FSH, prolactin. May need MRI brain if pituitary tumor suspected. | Medications:Opioids, glucocorticoids, statins (modest effect) can suppress T. Discuss alternatives with doctor.
Note: PCOS (most common cause in women):Metformin, inositol, low-carb diet, weight loss improve insulin sensitivity and reduce testosterone. | Adrenal hyperplasia:May need glucocorticoid replacement if 17-hydroxyprogesterone elevated. | Ovarian/adrenal tumors:Rare but require imaging if testosterone >150 ng/dL in women.
Acne, oily skin|Increased facial/body hair (women)|Male-pattern baldness (women with high T)|Aggressive or irritable mood|Irregular menstrual periods (women)|Infertility in women|Deep voice (women, irreversible)|Increased red blood cell count (high hematocrit)|Testicular atrophy (if using exogenous testosterone without HCG)
Source:High testosterone in men >1000 ng/dL may indicate exogenous use or tumor. In women >100 ng/dL, evaluate for PCOS or adrenal disorder.
Exogenous testosterone use (TRT, anabolic steroids).|Testicular tumors:Leydig cell tumors produce excess testosterone.|Adrenal tumors:Androgen-secreting adrenal carcinomas (rare).|PCOS in women:Insulin resistance drives ovarian androgen production.|Congenital adrenal hyperplasia:Enzyme deficiency causes androgen excess.|Ovarian tumors in women:Rare androgen-secreting tumors.
Source:If low T confirmed:Retest along with LH, FSH, prolactin, estradiol to determine if primary vs secondary hypogonadism.|If starting TRT:Retest total and free testosterone, hematocrit, PSA (men >40) after 6-8 weeks, then every 3-6 months.|If optimizing lifestyle:Retest 3-6 months after weight loss, exercise program, sleep improvement.|Routine screening:Consider checking testosterone in men >35 with fatigue, low libido, or difficulty building muscle. Women with similar symptoms may benefit from testing.|Morning collection:Testosterone peaks in the morning (7-10 AM). Always test in the morning for accurate baseline.
Testosterone declines ~1-2%/year after age 30 in men. By age 70, 30-50% of men have total testosterone <300 ng/dL (hypogonadism range). This decline contributes to sarcopenia, osteoporosis, insulin resistance, and cognitive decline. Testosterone replacement can reverse many age-related changes.
Source:Travison TG, et al. A population-level decline in serum testosterone levels in American men. J Clin Endocrinol Metab. 2007;92(1):196-202.
Multiple studies show low testosterone (<300 ng/dL) is associated with 35-40% increased all-cause mortality in men, independent of age and comorbidities. Low T is linked to increased cardiovascular disease, diabetes, and frailty.
Source:Shores MM, et al. Low serum testosterone and mortality in male veterans. Arch Intern Med. 2006;166(15):1660-1665.
Recent large trials (TRAVERSE, 2023) show testosterone replacement in hypogonadal men does NOT increase cardiovascular events and may be protective when levels are optimized to physiologic range (400-800 ng/dL). Supraphysiologic doses (>1000 ng/dL) may increase risk.
Source:Lincoff AM, et al. Cardiovascular safety of testosterone-replacement therapy. N Engl J Med. 2023;389(2):107-117.
| Provider | Includes Test | Annual Cost | Total Biomarkers |
|---|---|---|---|
 Superpower | ✓ | $199 | 100+ |
 WHOOP Advanced Labs | — | $349 | 65 |
 Labcorp OnDemand | — | $398 | 30+ |
| ✓ | $486 | 40+ | |
| ✓ | $468 | 83 | |
| ✓ | $798 | 100+ | |
 InsideTracker | ✓ | $680 | 48 |
 Function Health | ✓ | $499 | 100+ |
| ✓ | $900 | 70+ | |
| ✓ | $1150 | 110 | |
| — | $Varies | 75+ |
Choose from 8 providers that include this biomarker in their panels
Total Testosterone is a sex hormones (male) biomarker that Main male sex hormone The normal reference range is bone density. Regular testing helps track changes and identify potential health issues early.
8 out of 10 major blood testing providers include Total Testosterone in their standard panels. These include Superpower, Blueprint, Mito Health and others.
For most people, testing Total Testosterone 2-4 times per year is recommended to establish baseline levels and track trends. If you have abnormal results or are actively working to optimize this biomarker, more frequent testing (quarterly) may be beneficial. Always consult with your healthcare provider for personalized testing frequency recommendations.
The standard laboratory reference range for Total Testosterone is bone density. However, many functional medicine practitioners recommend tighter "optimal" ranges for peak health and performance. Your ideal range may vary based on your age, sex, health goals, and other individual factors. Work with a healthcare provider familiar with optimal ranges to determine your target levels.
Most direct-to-consumer blood testing services that include Total Testosterone provide the physician order as part of their service. However, some states have restrictions on direct-to-consumer testing. Check with your chosen provider about availability in your state and whether they provide the necessary physician authorization.
Essential for muscle mass
This information is for educational purposes only and is not medical advice. Always consult with a qualified healthcare provider about your specific health needs and before making decisions about blood testing.
