Total Testosterone

Main male sex hormone

16/22Providers
Sex Hormones (Male)Category
Men:300-1000 ng/dL,Reference
Widely Available

16 of 22 providers

Category

Sex Hormones (Male)

Reference Range

Men:300-1000 ng/dL, Women:15-70 ng/dL

What is Total Testosterone?

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.

Why Total Testosterone Matters for Longevity

  • Muscle mass and strength:Testosterone is THE primary driver of muscle protein synthesis. Low T accelerates age-related muscle loss.
  • Bone density:Testosterone (converted to estradiol in men) maintains bone mineral density. Low T increases fracture risk.
  • Metabolic health:Low testosterone is strongly associated with insulin resistance, type 2 diabetes, visceral fat accumulation, metabolic syndrome.
  • Cardiovascular health:Contrary to old beliefs, physiologic testosterone levels are protective. Low T increases CVD risk in men.
  • Cognitive function:Testosterone supports memory, spatial ability, and may protect against cognitive decline and Alzheimer's.
  • Quality of life:Libido, energy, motivation, mood, and sense of well-being are all testosterone-dependent.

Optimal vs Standard Ranges

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: Men:300-1000 ng/dL, Women:15-70 ng/dL
Sources:PMID:21816776, PMID:34728442, PMID:20535714

Scientific Evidence

Low total testosterone in men <300 ng/dL=hypogonadism. In women, <15 ng/dL may cause fatigue and low libido.

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. (PubMed)

Primary hypogonadism (testicular failure):Klinefelter syndrome, chemotherapy, radiation, mumps orchitis, trauma, anabolic steroid abuse (suppresses natural production).|Secondary hypogonadism (pituitary/hypothalamic failure):Pituitary tumor, Kallmann syndrome, chronic opioid use, glucocorticoid excess, obesity.|Aging:Natural 1-2%/year decline after age 30.|Chronic illness:Chronic kidney disease, liver cirrhosis, HIV/AIDS, type 2 diabetes.|Medications:Opioids (most significant), glucocorticoids, ketoconazole, spironolactone, GnRH agonists.|Sleep apnea:Hypoxia suppresses testosterone production.|Obesity:Fat tissue converts testosterone to estrogen via aromatase enzyme.

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 Decline with Aging

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. (PubMed)

Low Testosterone and Mortality

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. (PubMed)

Testosterone Replacement and Cardiovascular Safety

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. (PubMed)

Which Providers Test Total Testosterone?

Superpower
Included in panel
Blueprint
Included in panel
Mito Health
Included in panel
Function
Included in panel
InsideTracker
Included in panel
Marek Comp.
Included in panel
Marek Complete
Included in panel
Marek Exec.
Included in panel
Life Ext.
Included in panel
Everlywell
Included in panel
SiPhox Health
Included in panel
Healthspan
Included in panel
Hims Base
Included in panel
Hims Adv.
Included in panel
Vitality Std
Included in panel
Vitality Elite
Included in panel

Full Provider Comparison

ProviderIncludesAnnual CostBiomarkers
SuperpowerSuperpower✓$199100+ (150 with ratios)
WHOOP Advanced LabsWHOOP Advanced Labs—$34965
Labcorp OnDemandLabcorp OnDemand—$39830+
Life ExtensionLife Extension✓$48640+
EverlywellEverlywell✓$444288
Mito HealthMito Health✓$349100+
InsideTrackerInsideTracker✓$76154
Function HealthFunction Health✓$365160+
Marek Health BaseMarek Health Base—$25065
Marek Health ComprehensiveMarek Health Comprehensive✓$49570+
Marek Health CompleteMarek Health Complete✓$895100+
Marek Health ExecutiveMarek Health Executive✓$1950150+
BlueprintBlueprint✓$37580+
Quest HealthQuest Health—$Varies75+
Empirical HealthEmpirical Health—$190100+
Oura Health PanelsOura Health Panels—$9950
SiPhox HealthSiPhox Health✓$12460
Hims Labs BaseHims Labs Base✓$19950
Hims Labs AdvancedHims Labs Advanced✓$499120+
HealthspanHealthspan✓$418870-80+
Vitality Blueprint StandardVitality Blueprint Standard✓$37585
Vitality Blueprint EliteVitality Blueprint Elite✓$700128

Related Biomarkers

Other biomarkers in the Sex Hormones (Male) category:

Free Testosterone SHBG (Sex Hormone Binding Globulin) Estradiol (E2) PSA (Prostate Specific Antigen) DHEA-S Pregnenolone

Frequently Asked Questions

What is Total Testosterone?

Main male sex hormone

What is the optimal range for Total Testosterone?

The standard reference range for Total Testosterone is Men:300-1000 ng/dL, Women:15-70 ng/dL. Optimal ranges may differ based on individual health goals and expert recommendations.

Which blood test providers include Total Testosterone?

16 out of 22 blood testing providers include Total Testosterone in their panels. This biomarker is widely available across major providers.

What category does Total Testosterone fall under?

Total Testosterone is categorized under Sex Hormones (Male). This category includes biomarkers that help assess related aspects of health and wellness.

Medical Disclaimer

This information is for educational purposes only and is not medical advice. Always consult with a qualified healthcare provider about your specific health needs.

Last reviewed:2026-02-20