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HelpTest Code TESTT Testosterone, Total and Free, Serum
Reporting Name
Testosterone, Total and Free, SUseful For
Alternative, second-level test for suspected increases or decreases in physiologically active testosterone:
-Assessment of androgen status in cases with suspected or known sex hormone-binding globulin-binding abnormalities
-Assessment of functional circulating testosterone in early pubertal boys and older men
-Assessment of functional circulating testosterone in women with symptoms or signs of hyperandrogenism, but normal total testosterone levels
-Monitoring of testosterone therapy or antiandrogen therapy in older men and in females
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
Serum RedAdvisory Information
This is a second-level test for suspected increases or decreases in physiologically active testosterone. The preferred test for assessment of active testosterone is TTBS / Testosterone, Total and Bioavailable, Serum.
Necessary Information
Patient's age and sex are required.
Specimen Required
Container/Tube: Red top (serum gel/SST are not acceptable)
Specimen Volume: 2.5 mL
Specimen Minimum Volume
1 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum Red | Refrigerated (preferred) | 14 days | |
| Frozen | 60 days |
Special Instructions
Reference Values
TESTOSTERONE, FREE
Males (adult):
20-<25 years: 5.25-20.7 ng/dL
25-<30 years: 5.05-19.8 ng/dL
30-<35 years: 4.85-19.0 ng/dL
35-<40 years: 4.65-18.1 ng/dL
40-<45 years: 4.46-17.1 ng/dL
45-<50 years: 4.26-16.4 ng/dL
50-<55 years: 4.06-15.6 ng/dL
55-<60 years: 3.87-14.7 ng/dL
60-<65 years: 3.67-13.9 ng/dL
65-<70 years: 3.47-13.0 ng/dL
70-<75 years: 3.28-12.2 ng/dL
75-<80 years: 3.08-11.3 ng/dL
80-<85 years: 2.88-10.5 ng/dL
85-<90 years: 2.69-9.61 ng/dL
90-<95 years: 2.49-8.76 ng/dL
95-100+ years: 2.29-7.91 ng/dL
Males (children):
<1 year: Term infants
1-15 days: 0.20-3.10 ng/dL*
16 days-1 year: Values decrease gradually from newborn (0.20-3.10 ng/dL) to prepubertal levels
*Citation: J Clin Endocrinol Metab 1973;36(6):1132-1142
1-8 years: <0.04-0.11 ng/dL
9 years: <0.04-0.45 ng/dL
10 years: <0.04-1.26 ng/dL
11 years: <0.04-5.52 ng/dL
12 years: <0.04-9.28 ng/dL
13 years: <0.04-12.6 ng/dL
14 years: 0.48-15.3 ng/dL
15 years: 1.62-17.7 ng/dL
16 years: 2.93-19.5 ng/dL
17 years: 4.28-20.9 ng/dL
18 years: 5.40-21.8 ng/dL
19 years: 5.36-21.2 ng/dL
Females (adult):
20-<25 years: 0.06-1.08 ng/dL
25-<30 years: 0.06-1.06 ng/dL
30-<35 years: 0.06-1.03 ng/dL
35-<40 years: 0.06-1.00 ng/dL
40-<45 years: 0.06-0.98 ng/dL
45-<50 years: 0.06-0.95 ng/dL
50-<55 years: 0.06-0.92 ng/dL
55-<60 years: 0.06-0.90 ng/dL
60-<65 years: 0.06-0.87 ng/dL
65-<70 years: 0.06-0.84 ng/dL
70-<75 years: 0.06-0.82 ng/dL
75-<80 years: 0.06-0.79 ng/dL
80-<85 years: 0.06-0.76 ng/dL
85-<90 years: 0.06-0.73 ng/dL
90-<95 years: 0.06-0.71 ng/dL
95-100+ years: 0.06-0.68 ng/dL
Females (children):
<1 year: Term infants
1-15 days: 0.06-0.25 ng/dL*
16 days-1 year: Values decrease gradually from newborn (0.06-0.25 ng/dL) to prepubertal levels
*Citation: J Clin Endocrinol Metab, 36(6):1132-1142, 1973
1-4 years: <0.04 ng/dL
5 years: <0.04-0.07 ng/dL
6 years: <0.04-0.14 ng/dL
7 years: <0.04-0.23 ng/dL
8 years: <0.04-0.34 ng/dL
9 years: <0.04-0.46 ng/dL
10 years: <0.04-0.59 ng/dL
11 years: <0.04-0.72 ng/dL
12 years: <0.04-0.84 ng/dL
13 years: <0.04-0.96 ng/dL
14 years: <0.04-1.06 ng/dL
15-18 years: <0.04-1.09 ng/dL
19 years: 0.06-1.08 ng/dL
TESTOSTERONE, TOTAL
Males
0-5 months: 75-400 ng/dL
6 months-9 years: <7-20 ng/dL
10-11 years: <7-130 ng/dL
12-13 years: <7-800 ng/dL
14 years: <7-1,200 ng/dL
15-16 years: 100-1,200 ng/dL
17-18 years: 300-1,200 ng/dL
≥19 years: 240-950 ng/dL
Tanner Stages*
I (prepubertal): <7-20
II: 8-66
III: 26-800
IV: 85-1,200
V (young adult): 300-950
Females
0-5 months: 20-80 ng/dL
6 months-9 years: <7-20 ng/dL
10-11 years: <7-44 ng/dL
12-16 years: <7-75 ng/dL
17-18 years: 20-75 ng/dL
≥19 years: 8-60 ng/dL
Tanner Stages*
I (prepubertal): <7-20
II: <7-47
III: 17-75
IV: 20-75
V (young adult): 12-60
Day(s) and Time(s) Performed
Monday through Friday; 2 p.m.
Saturday, Sunday; Varies
Test Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.CPT Code Information
84402
84403
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| TGRP | Testosterone, Total and Free, S | 58952-3 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 3631 | Testosterone, Free, S | 2991-8 |
| 8533 | Testosterone, Total, S | 2986-8 |
Clinical Reference
1. Manni A, Pardridge WM, Cefalu W, et al: Bioavailability of albumin-bound testosterone. J Clin Endocrinol Metab. 1985 Oct;61(4):705-10
2. New MI, Josso N: Disorders of gonadal differentiation and congenital adrenal hyperplasia. Endocrinol Metab Clin North Am. 1988 Jun;17(2):339-366
3. Morley JE, Perry HM III: Androgen deficiency in aging men: Role of testosterone replacement therapy. J Lab Clin Med. 2000 May;135(5):370-378
4. Sizonenko PC, Paunier L: Hormonal changes in puberty III: Correlation of plasma dehydroepiandrosterone, testosterone, FSH and LH with stages of puberty and bone age in normal boys and girls and in patients with Addison's disease or hypogonadism or with premature or late adrenarche. J Clin Endocrinol Metab. 1975 Nov;41(5):894-904
5. Goudas VT, Dumesic DA: Polycystic ovary syndrome. Endocrinol Metab Clin North Am. 1997 Dec;26(4):893-912
6. Braunstein GD: Androgen insufficiency in women: Summary of critical issues. Fertil Steril. 2002 Apr;77 Suppl 4:S94-99
7. Juul A, Skakkebaek NE: Androgens and the aging male. Hum Reprod Update. 2002 Sep-Oct;8(5):423-433
8. Hackbarth JS, Hoyne JB, Grebe SK, Singh RJ: Accuracy of calculated free testosterone differs between equations and depends on gender and SHBG concentration. Steroids. 2011 Jan;76(1-2):48-55
9. Goldman AL, Bhasin S, Wu FCW, et al: A reappraisal of testosterone’s binding in circulation: Physiological and clinical implications. Endocr Rev. 2017 Aug;38(4):302-324
Method Description
Free Testosterone:
This method is based on equilibrium dialysis in which free-labeled testosterone is allowed to pass through a semipermeable membrane, whereas testosterone bound to the sex hormone-binding globulin (SHBG) remains inside the dialysis tubing. After dialysis, radioactivity is measured both inside and outside the tubing; the free testosterone results are expressed as a percentage of total testosterone. The resulting percentage is multiplied by the total testosterone concentration obtained by liquid chromatography-tandem mass spectrometry (LC-MS/MS), and an absolute free testosterone value is obtained.(Vermeulen A, Stoica T, Verdonck L: The apparent free testosterone concentration, an index of androgenicity. J Clin Endocrinol Metab. 1971;33:759-767; Bammann BL, Coulam C, Jiang NS: Total and free testosterone during pregnancy. Am J Obstet Gynecol. 1980;137:293-298)
Total Testosterone:
Deuterated stable isotope (d3-testosterone) is added to a 0.2-mL serum sample as an internal standard. Protein is precipitated from the mixture by the addition of acetonitrile. The testosterone and internal standard are extracted from the resulting supernatant by an online extraction utilizing high-throughput liquid chromatography (HTLC). This is followed by conventional liquid chromatography and analysis on a tandem mass spectrometer equipped with a heated nebulizer ion source.(Wang C, Catlin DH, Demers LM, et al: Measurement of total testosterone in adult men: comparison of current laboratory methods versus liquid chromatography-tandem mass spectrometry. J Clin Endocrinol Metab. 2004;89:534-543; Taieb J, Mathian B, Millot F, et al: Testosterone measured by 10 immunoassays and by isotope-dilution gas chromatography-mass spectrometry in sera from 116 men, women, and children. Clin Chem. 2003;49:1381-1395)
Analytic Time
3 daysReject Due To
| Gross hemolysis | Reject |
| Gross lipemia | Reject |
| Gross icterus | Reject |
Method Name
FRTST: Equilibrium Dialysis
TTST: Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)
Forms
If not ordering electronically, complete, print, and send a General Request (T239) with the specimen.
Profile Information
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| FRTST | Testosterone, Free, S | No | Yes |
| TTST | Testosterone, Total, S | Yes | Yes |