How to Measure Your Testosterone Level?

When you go to get tested for testosterone, the lab will often show you what’s considered the “normal” range among patients who have tested with that particular lab. It’s called the “reference range.”

For example, LabCorp (the lab I used to test my T levels here in Tulsa, OK) shows a reference range of 348 – 1197 ng/dl (nanograms per decilitre) for total testosterone levels. According to this reference range, my total testosterone level of 383 ng/dl at the beginning of my experiment would mean my total T levels were — barely — within the normal range.

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Here’s the problem.

That reference range consists of a wide variety of men who tested with LabCorp: 80-year-old men and 20-year-old men; obese men and super fit men; men with pituitary gland problems and men with glands that work like champs.

Sure, my 383 ng/dl was considered normal, but normal compared to whom? An 80-year-old man with Type 2 diabetes?

The fact that reference ranges don’t break patients down by age or health status explains why a 30-year-old man can go to his doctor with the symptoms of low T, only to be told that his T levels are fine because they’re within the “normal” range. If you’re 30 (or even 50), but have the same testosterone level as an 8o-year-old, diabetic man, your doc may say you’re okay, but you’re still not going to feel good. Plain and simple.

What’s interesting is that for many years, the bottom number of the reference range for T levels at many medical labs was much lower. For example, up until last year, LabCorp’s reference range for testosterone was 249-836 ng/dl. You could have had a testosterone level of 250 (which is super low) and still be told by your doctor that you were normal.

All this is to say that the “normal” levels put out there by doctors and labs aren’t all that useful.

Average Testosterone Levels by Age

When determining what’s considered a normal testosterone level, it’s best to look at what the reference range is for men your age. Researchers have known for years that T levels typically drop by about 1% every year after you hit your mid-30s. So if you’re 35, comparing yourself to a bunch of 80-year-old men isn’t very useful because they likely have really low T levels.

Unfortunately, many labs don’t break down reference ranges by age. However, studies have been done in which researchers do just that. Below, I include the results from two such studies.

How to Measure Your Testosterone Level
There are three ways to test your testosterone levels: saliva sample, urine sample, and blood sample. Each method has its pros and cons.

Saliva and urine tests are relatively inexpensive and fast. You can even buy a saliva test kit on Amazon for about $30. Just spit in the cup, put it in the mail, and a week later you’ll get a total testosterone measurement. The problem is that saliva and urine tests aren’t very accurate, which is why endocrinologists typically don’t use saliva or urine samples when diagnosing low testosterone levels. Instead they use blood serum tests.

While blood tests are much more accurate and sensitive than saliva or urine tests, they’re also much more expensive — blood tests for total and free testosterone can set you back $130. Because I wanted the most accurate results, I went with the blood serum testing.

What I didn’t know before I got tested was that there are different kinds of testosterone blood tests, some more accurate than others. As I mentioned at the beginning of the post, there isn’t much standardization amongst labs when it comes to testing. Some labs use one method, while another lab will use another test.

I later learned that the blood test I used to measure my total testosterone for my experiment wasn’t the most accurate on the market and wasn’t what the CDC is recommending labs use in their goal to standardize hormone testing. (I tested myself a month after my 90-day experiment with the blood test the CDC recommends. I’ll share my results in a bit.) I also learned that measuring free testosterone is pretty dang hard and that most free T measurements that labs give are typically just estimates.

Below I share what I learned about the confusing world of testosterone blood tests.

Blood Tests for Total Testosterone

ECLIA Method. When I tested myself for total testosterone for my experiment, the method the lab used was ECLIA, short for Electrochemiluminescent Immunoassay. It’s a fast and affordable method to measure total testosterone in your blood. Many labs use this method because it’s automatic and doesn’t require too much work on a lab technician’s part. However, some studies have shown that values obtained with ECLIA are significantly higher compared to the more reliable LC/MS method. Which brings me to…

LC/MS Method. LC/MS is short for liquid chromatography-mass spectrometry. It’s considered the gold standard method by many researchers in measuring small molecules. Its accuracy and consistency is why the CDC is recommending LC/MS to be the standard method used when testing total testosterone. Because LC/MS is more sensitive than ECLIA, doctors typically use this method when testing patients with really low testosterone levels, such as women and children. While it’s more accurate and sensitive, the LC/MS method is more expensive than ECLIA. And it takes a bit longer to get your results.

A month after my 90-day experiment, I got tested again, but this time using the LC/MS method. My total testosterone level using this method was 826.9 ng/dl. Meaning my T levels increased even more since starting my testosterone changes.

You’ll have to make the call on which method you go with. If you don’t think you have extremely low T, ECLIA will work just fine. Just know that most researchers see LC/MS as the method that produces the most accurate and consistent results. Labs often offer both ECLIA and LC/MS tests. Later on, I’ll share where you can get tested using either method.

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