Total testosterone is a direct blood measure of free plus protein-bound testosterone in nmol/L. Practitioners use it for men with low libido, low energy or poor recovery, for women with signs of androgen excess, and to track change as weight and sleep improve. Afternoon collection in men can read falsely low, so confirm a low male result on a second early morning sample.
| Test type | Measured in a blood sample |
|---|---|
| Measurements required | Total testosterone only |
| Sample and collection | Blood draw at a collection centre |
| Preparation | Men: book your collection before 10am, ideally after an overnight fast (water only), as testosterone is highest in the morning. |
| Turnaround | About 3 to 5 business days |
| Available through | Hormone Studies. Available in: Full Body Health Check, Weight Management Test, Male Hormone Health Test, Testosterone Panel. |
| Pricing | Price on sign-up |
| Results | Returned in the Vively practitioner platform, beside your client's other markers |
What are the Total testosterone reference and optimal ranges?
| Typical lab reference | Vively optimal | |
|---|---|---|
| Men | 11 to 40 nmol/L | 12 to 40 nmol/L |
| Women, day 2 to 5 of cycle | 0.5 to 3.2 nmol/L | 1.5 nmol/L up to the top of the lab range |
Labs differ, and female ranges depend heavily on method (mass spectrometry reads lower than immunoassay), so read results against the range printed on the client's report (RCPA guidance). Optimal ranges guide follow-up; they are not diagnostic cut-offs.
Check a client's Total testosterone result
Enter the value from your client's lab report to see where it sits against the typical lab range and the Vively optimal range.
A guide only, not a diagnosis. One result is a starting point: read it with symptoms, history and a repeat test. Labs differ, so check the result against the range on your client's report. Nothing you enter is stored or sent.
How do you arrange Total testosterone testing through Vively?
- Get verified. Practitioners with a recognised qualification or membership (ATMS, NHAA, ANTA, Dietitians Australia, NSA, CMA or Ahpra registration) can request free practitioner access.
- Choose a panel. Log in to the practitioner platform and pick a panel that includes Total testosterone, or build your own. Add-on pricing shows when you sign up.
- Client collects. Your client collects at a partner collection centre, with their request on their phone or printed.
- Review results. Results come back to you in the practitioner platform, beside your client's other markers, ready for the follow-up consult.
Which Vively panels include Total testosterone?
Log in to the practitioner platform to view a panel in full, or build and save your own from 100+ tests and panels.
- Log in to view this panelTestosterone Panel5 markers · HormonesPrice on sign-up
- Log in to view this panelMale Hormone Health Test6 markers · HormonesPrice on sign-up
- Weight Management Test27 markers · Heart & metabolicPrice on sign-upTotal testosteroneTotal CholesterolLDL CholesterolHDL CholesterolNon-HDL CholesterolTriglyceridesFree testosteroneSHBG+19 moreLog in to view this panel
Why does the optimal range sit there?
For men, our 12 nmol/L floor follows the Endocrine Society of Australia; for women, 1.5 nmol/L is a Vively working target read with symptoms.
The Endocrine Society of Australia position statement (Yeap et al., 2016) treats morning total testosterone above 12 nmol/L as consistent with normal function, and below 8 nmol/L on repeat testing as supporting androgen deficiency.
Results here need SHBG, free testosterone and LH. Borderline low results often reflect sleep, weight, alcohol, illness or training load rather than true deficiency.
The 2019 Global Consensus Position Statement on testosterone in women notes that no blood level defines androgen insufficiency, so read the result as context with SHBG and FAI.
What should Total testosterone be read with?
- LowLow total, low SHBG, normal free testosterone (men)
Often seen with excess weight and insulin resistance; the free fraction may be adequate.
- LowLow total on two morning samples, high LH
Points to a testicular (primary) cause; GP review.
- LowLow total, low or normal LH
Secondary pattern, often from obesity, opioids, illness or energy deficit; a pituitary cause needs GP exclusion.
- HighHigh testosterone in a woman, low SHBG, high fasting insulin
Pattern often seen in PCOS with insulin resistance.
- HighHigh testosterone in a man, low LH and FSH
Suggests external testosterone or anabolic steroid use; check haemoglobin and discuss with the GP.
What can affect a Total testosterone result?
- Afternoon collection in men, especially under 45 (reads falsely low)
- A meal or glucose drink before collection (temporary fall)
- Acute illness, sleep deprivation, a heavy training block or energy deficit
- Opioids, glucocorticoids, and testosterone, anabolic steroid or DHEA use
- In women, the combined pill (raises SHBG, lowers free testosterone) and Implanon (may lower androgens)
- Immunoassay methods, which can read high at the low concentrations seen in women
When should you refer the client to their GP?
- Men: total testosterone below 8 nmol/L on two morning samples, or low with high or inappropriately normal LH and symptoms
- Men: headaches, visual change, small or changed testes, breast enlargement or infertility
- Women: rapid-onset hirsutism, deepening voice or other virilisation, or total testosterone above about 5 nmol/L
- Any client using testosterone or anabolic steroids without medical supervision
How should a client prepare for a Total testosterone test?
Copy or print this to send to your client.
Preparing for your Total testosterone test
- Men: book your collection before 10am, ideally after an overnight fast (water only), as testosterone is highest in the morning.
- If your result comes back low, expect to repeat it on another morning, as one low reading isn't enough to confirm it.
- Women: if you have periods, book for day 2 to 5 of your cycle. Day 1 is the first day of full bleeding.
- Tell your practitioner if you use hormonal contraception, such as the pill or an implant, as it can change your result.
- Take your pathology request to any of 4,000+ collection centres. Bring it printed or on your phone.
- Keep taking prescribed medicines as usual unless your doctor tells you otherwise.
- Results usually take about 3 to 5 business days and come to your practitioner. Book your results appointment for after that.
How do practitioners use Total testosterone with clients?
Read testosterone with sleep, stress, alcohol, training load, body composition, medicines, liver health and insulin resistance in view, and confirm a low male result on a second early morning sample before acting. In men with obesity, weight loss and better sleep can lift total testosterone, so retest after lifestyle change.
Total testosterone FAQs
Can a naturopath, nutritionist or dietitian order testosterone through Vively?
Yes. Add it to any client panel on the Vively practitioner platform. It sits in Hormone Studies and is also in Full Body Health Check, Weight Management Test and Male Hormone Health Test. Add-on pricing shows when you sign up. No account yet? Request free access.
Should I order SHBG with total testosterone?
Yes, in most cases. SHBG sets how much testosterone is available, so a total of 10 nmol/L means something different at an SHBG of 20 than at 60 nmol/L. Ordering both lets the lab calculate free testosterone, which matters most in the 8 to 12 nmol/L grey zone, in older men and in clients with insulin resistance.
Why do men need two morning samples?
Because testosterone varies by time of day and from day to day. Levels peak in the early morning and can fall after a meal, a poor night's sleep or illness. The Endocrine Society of Australia recommends confirming a low result with a second fasting morning sample before calling it low.
What does a total testosterone of 10 nmol/L mean in a male client?
It sits in the 8 to 12 nmol/L grey zone, so it neither confirms nor excludes androgen deficiency. Confirm it on a second early morning sample, then add SHBG, free testosterone and LH. Sleep, weight, alcohol, illness and training load often explain borderline results. Persistent results below 8 nmol/L, or symptoms with high LH, need GP review.
How do I read a high testosterone result in a female client?
Read it with SHBG, free androgen index, fasting insulin and cycle history rather than on its own. A high result with low SHBG and high fasting insulin often fits PCOS with insulin resistance. Immunoassays can also read high at the low concentrations seen in women. Rapid-onset hirsutism, voice change or a level above about 5 nmol/L needs GP review.
References
- Yeap BB, et al. Endocrine Society of Australia position statement on male hypogonadism (part 1): assessment and indications for testosterone therapy. Medical Journal of Australia. 2016.
- Davis SR, et al. Global Consensus Position Statement on the Use of Testosterone Therapy for Women. Journal of Clinical Endocrinology and Metabolism. 2019.
- Royal College of Pathologists of Australasia. RCPA Manual: Testosterone. Source
- Pathology Tests Explained. Testosterone.