Enhanced Testosterone Blood Test

Thirteen markers in four groups. The testosterone picture: total testosterone, SHBG and albumin, from which free testosterone, the active fraction, is calculated. The signal from the brain: LH and FSH, which show whether a low testosterone is caused by the testes failing to respond or by the pituitary failing to signal. The hormones that interfere: prolactin, which suppresses testosterone when raised, and oestradiol, which testosterone converts into and which causes problems when too high or too low. And the safety markers relevant to treatment: PSA for the prostate, and a cholesterol profile, because testosterone therapy affects both.

Because responsible testosterone replacement needs three things a basic testosterone test does not give. First, proof that testosterone is genuinely low on a morning sample and that free testosterone, not just total, is low, since a low total with high SHBG is a different problem. Second, the cause: low LH and FSH point to a pituitary problem that needs investigating before treatment, and raised prolactin can be treated with tablets instead. Third, a baseline for safety: PSA, because testosterone can accelerate an undetected prostate cancer, and cholesterol, oestradiol and haematocrit, which treatment changes. This panel covers all of those, which is why it matches the enhanced blood test that Voy, Manual, Optimale and other online TRT providers ask you to supply.

At any of 250+ Goodbody clinics across the UK or with a nurse visiting your home, no GP referral needed. This 13-marker panel needs a venous sample and a morning appointment. If you want a simpler check first, our Testosterone Blood Test (total, free testosterone and SHBG) is available from £49 as a finger-prick kit. Your GP can also test testosterone on the NHS if you have symptoms, though usually total testosterone alone at first.

Between 7am and 10am. Testosterone follows a daily rhythm, peaking in the early morning and falling by 20 to 30 percent by late afternoon, and every reference range and every TRT clinic's threshold assumes a morning sample. An afternoon result can look low in a perfectly healthy man. Avoid strenuous exercise for 24 to 48 hours beforehand, as a hard session shifts testosterone, prolactin and SHBG. If your first result is low, guidelines require a second morning sample before a diagnosis, so book both if you know you will need them.

UK guidelines treat a morning total testosterone below 8 nmol/L, or below 12 nmol/L with symptoms and a low free testosterone, as low; 8 to 12 is a grey zone where the free level decides. Free testosterone below about 0.225 nmol/L supports the diagnosis. Around one in four men over 30 has a level in the lower range, but symptoms matter as much as numbers: low libido, erectile problems, tiredness, low mood, loss of muscle and increased body fat. Your results are analysed against the laboratory reference ranges, and the GP report flags anything outside them.

Where the problem is. If testosterone is low and LH and FSH are high, the testes are not responding to the signal, called primary hypogonadism, which can follow infection, injury, undescended testes, chemotherapy or a genetic cause such as Klinefelter syndrome. If testosterone is low and LH and FSH are low or normal, the signal itself is weak, called secondary hypogonadism, which can be caused by obesity, sleep apnoea, opioid or anabolic steroid use, raised prolactin, or a pituitary problem that needs imaging before any treatment. The distinction changes what should happen next, and a basic testosterone test cannot make it.

Oestradiol is made from testosterone; men need some for bone, mood and libido, but too much causes water retention, breast tissue and low libido, and too little causes joint pain and low libido. It matters for anyone considering or on testosterone therapy. Prolactin, when raised, switches off testosterone production and is one of the few causes of low testosterone that is directly treatable, and it can signal a pituitary growth. PSA is the safety marker: testosterone therapy should not begin without a baseline, and a raised PSA needs investigating first.

It gives you and a doctor the information to decide. Testosterone replacement is appropriate when testosterone is confirmed low on two morning samples, symptoms are present, and treatable causes such as obesity, sleep apnoea, medication or raised prolactin have been addressed or excluded. The GP report shows where your results sit against the reference ranges and what to do next, which may be a repeat test, lifestyle changes, investigation of a cause, or a conversation with your GP or a specialist about treatment. Goodbody does not prescribe testosterone.

Yes, it covers the markers most protocols check: total and free testosterone, oestradiol, PSA and lipids. Monitoring usually also includes a full blood count, because testosterone raises haematocrit, which is not in this panel; our Full Blood Count test (£69) can be added at the same appointment. Take monitoring samples at the same point in your dosing cycle each time so results are comparable, and share the report with the clinician who prescribes.

Not for the hormones. The cholesterol markers are most comparable with reference ranges after an 8 to 12 hour fast, so if those matter to you, book an early appointment before breakfast; if your priority is the testosterone picture, a morning sample with or without breakfast is fine. Take your usual medication unless your doctor has said otherwise.

The Testosterone Blood Test (from £49, finger-prick kit available) measures total and free testosterone and SHBG: the right first check. The Male Hormone and Fertility test (from £79) adds LH, FSH and prolactin for the cause of low testosterone or fertility questions. This Enhanced test (£189) adds oestradiol, PSA and a cholesterol profile, the full panel needed before or during testosterone therapy. Choose by how far along the process you are.

Results are emailed within 3 to 5 working days of your sample reaching the laboratory, with a GP report that interprets all 13 markers against the reference ranges and sets out what to do next.