Testosterone, Free, Direct With Total Testosterone Blood Test, LC/MS-MS

Quick Facts

• Sample: Blood (venous draw)
• Fasting: Not required
• Turn-around: 4–6 business days. May take longer based on weather, holiday, or lab delays.

Benefits

•  Comprehensive hormone assessment measuring both active and total testosterone levels
• Advanced LC/MS-MS technology provides superior accuracy compared to standard immunoassays
• No doctor visit required for confidential, direct-access hormone testing
• Monitor treatment effectiveness for testosterone replacement therapy patients
• Early detection of hormone imbalances affecting energy, libido, and overall health

Who Is This Test For?

•  Men experiencing fatigue, decreased libido, or erectile dysfunction
• Individuals monitoring testosterone replacement therapy effectiveness
• Men investigating unexplained infertility or reproductive health concerns
• Those evaluating early or delayed puberty in adolescents
• Transgender men receiving gender-affirming hormone therapy
• Health-conscious individuals seeking baseline hormone measurements

How It Works – Just 3 Steps

• Order online and visit any convenient lab location nationwide
• Simple blood draw with no fasting or special preparation required
• Secure results delivered online within 4-6 business days

FAQ

What does this test measure? Both free testosterone (bioactive form) and total testosterone (bound + unbound) for comprehensive hormone evaluation.

Do I need to fast before this test? No fasting required, though morning collection is preferred when possible for optimal accuracy.

How accurate is this test? LC/MS-MS methodology provides 91% sensitivity and superior specificity compared to standard immunoassays (Journal of Clinical Endocrinology & Metabolism 2012).

Can women take this test? Yes, though normal ranges differ significantly as women produce much smaller amounts of testosterone.

Will my insurance cover this test? Walk-In Lab offers transparent pricing without insurance requirements for direct-pay convenience.

What if my results are abnormal? Professional consultation is recommended for result interpretation and potential follow-up testing or treatment options.

More Details

What is the purpose of this test?
This comprehensive test measures both free and total testosterone to detect hormone imbalances, diagnose hypogonadism, and monitor treatment effectiveness. Free testosterone represents the bioactive form that directly affects cellular receptors, comprising only 1-3% of total testosterone (Cleveland Clinic 2025). Total testosterone includes both bound and unbound forms, providing a complete hormonal picture essential for accurate diagnosis.

The dual measurement approach offers superior diagnostic accuracy compared to single-parameter testing, particularly important for detecting testosterone deficiency that affects up to 20% of young adult males aged 15-39 (AUA News 2024).

Who would benefit from this test?
Men experiencing symptoms of testosterone deficiency including fatigue, erectile dysfunction, decreased libido, muscle weakness, or infertility benefit most from this comprehensive assessment. The test is particularly valuable for individuals with conditions affecting hormone-binding proteins, such as obesity, diabetes, or thyroid disorders.

Healthcare providers recommend this test for monitoring testosterone replacement therapy effectiveness and evaluating transgender men receiving gender-affirming hormone therapy. Additionally, individuals with risk factors including chronic illness, pituitary dysfunction, or those taking medications like opioids or corticosteroids should consider regular monitoring (Endocrine Society 2018).

When should I order this test?
Order this test when experiencing symptoms like loss of sex drive, muscle weakness, erectile dysfunction, infertility, or brittle bones without known cause. The test is recommended for confirming suspected hypogonadism and establishing baseline measurements before starting hormone therapy.

Recent evidence suggests that testosterone levels below 400 ng/dL may warrant evaluation in men aged 20-44, compared to the traditional 300 ng/dL threshold used for older adults. Morning collection is preferred as testosterone levels naturally peak in early morning hours (Mayo Clinic Laboratories 2019).

How do I interpret the results?
Understanding your testosterone results requires considering both free and total levels within age-appropriate reference ranges. Professional interpretation is recommended for optimal clinical decision-making.

Free testosterone below lab reference

• What it means: Possible hypogonadism
• Typical action: Confirmatory testing, specialist consultation

Total testosterone < 280–300 ng/dL

• What it means: Likely testosterone deficiency
• Typical action: Further evaluation, consider treatment

Total testosterone 300–400 ng/dL

• What it means: Borderline/gray zone
• Typical action: Repeat testing, symptom assessment

Total testosterone > 400 ng/dL

• What it means: Generally normal
• Typical action: Monitor if symptomatic

Advanced LC/MS-MS methodology demonstrates superior diagnostic accuracy with 89% sensitivity and 83% specificity in clinical applications.

Disclaimer: Reference ranges may vary by laboratory. Listed ranges are general guidelines and may differ from those used by the performing lab. Always consult your healthcare provider for interpretation.

Pre-test preparation
No special preparation is required for this test, including no fasting requirements. However, discontinue biotin supplementation at least 72 hours before collection for optimal accuracy. Morning collection between 7-10 AM is preferred when possible, as testosterone levels naturally peak during early morning hours.

Avoid excessive alcohol consumption and ensure adequate sleep before testing, as these factors can temporarily affect hormone levels. Continue regular medications unless specifically instructed otherwise by your healthcare provider.

How often should I get tested?
Testing frequency depends on your specific circumstances and health status. Regular monitoring helps track hormonal changes and treatment effectiveness.

• Initial evaluation of symptoms: One-time or repeat in 2–4 weeks
• Testosterone replacement therapy: Every 3–6 months initially, then annually
• Monitoring chronic conditions: Every 6–12 months
• Preventive health screening: Every 2–3 years after age 40
• Post-treatment follow-up: As directed by healthcare provider

Why early detection matters

Early detection of testosterone deficiency can prevent long-term health complications including osteoporosis, cardiovascular disease, metabolic syndrome, and decreased quality of life. The economic burden of untreated testosterone deficiency is substantial, with estimated 20-year costs between $190-525 billion for US men aged 45-74.

Timely intervention through lifestyle modifications or appropriate treatment can restore energy levels, improve sexual function, maintain muscle mass, and support overall well-being. Regular monitoring allows for proactive health management and optimization of hormonal balance throughout aging.

Related tests you may consider

Sex Hormone-Binding Globulin (SHBG) Test  evaluates whether a person has an excess or deficiency of testosterone.

Luteinizing Hormone (LH) and Follicle-Stimulating Hormone (FSH) Tests screens for issues with fertility or reporductive organs, ovulation, or pituitary function by measuring FSH and LH levels.

Comprehensive Metabolic Panel (CMP-14) with eGFR Blood is commonly used to evaluate nutrient levels, liver, and kidney function.