Fertility Test for Women

Fertility Testing for Women and health information

Fertility Tests for Women start with relevant blood tests to assess the hormone levels that cause infertility. These include Follicle-stimulating hormone (or FSH)Luteinizing hormone (or LH)Free and Total TestosteroneProlactin (or PRL) and Sex Hormone-Binding globulin (or SHBG) 

SEE BELOW THE LIST OF TESTS FOR MORE INFORMATION ABOUT  Lab Testing for Infertility


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Description: The AMH test is a blood test that checks for Anti Mullerian Hormone in your blood’s serum.

Also Known As: AMH Test, AMH Hormone Test, Mullerian-inhibiting hormone Test, MIH Test, Mullerian Inhibiting Factor Test, MIF Test, Mullerian Inhibiting Substance Test, MUS Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is an Anti-Mullerian Hormone test ordered?

When a woman's ovarian function, reproductive concerns, especially when considering assisted reproduction techniques like in vitro fertilization, or when a health practitioner wishes to evaluate her chances of entering menopause, an AMH test may be recommended.

When a woman shows indications and symptoms of polycystic ovarian syndrome, AMH may be ordered.

AMH may be ordered on a regular basis for a woman with AMH-producing ovarian cancer to check therapy effectiveness and recurrence.

When an infant's genitalia is ambiguous or when a male child's testicles have not descended properly, an AMH test may be ordered.

What does an Anti-Mullerian Hormone blood test check for?

Anti-Müllerian hormone is a hormone generated by male and female reproductive tissues, including the testicles and ovaries. The role of AMH, as well as the amount generally present, varies by gender and age. This test detects the presence of AMH in the blood.

AMH is produced by the testicles early in the development of a baby boy, limiting the development of female reproductive organs while boosting the development of other male reproductive organs. AMH levels in boys stay high until adolescence, when they begin to decline.

AMH levels are low in girls, allowing for the development of female reproductive structures. Young females' AMH levels remain low until adolescence, when the ovaries begin to manufacture it and levels rise. AMH will then gradually decrease in women during their reproductive years, eventually becoming undetectable after menopause.

AMH is essential for a woman during her reproductive years. A female contains roughly one million eggs at birth, which normally decline to about 500,000 during infancy. Only a small percentage of these leftover eggs will mature into follicles, one at a time throughout a woman's monthly menstrual cycle. During the process of egg maturation and release, AMH exerts a balancing influence on the monthly cyclical actions of follicle-stimulating hormone and luteinizing hormone. This follicular expansion is reflected in the amount of AMH present.

The AMH level has been demonstrated in studies to be effective in assessing a woman's remaining egg maturation potential and her chances of conceiving. During the childbearing years, AMH decreases gradually, reduces considerably as menopause approaches, and is essentially undetectable after menopause. The level of AMH can be used to assess a woman's current reproductive status and anticipate the beginning of menopause.

Polycystic ovarian syndrome, a disorder affecting the ovaries, has been linked to elevated AMH levels. This syndrome causes unusually excessive levels of AMH to be produced by the extra follicles.

In the fetus, AMH is also important for sexual distinction. A developing fetus might develop either male or female reproductive organs throughout the first several weeks of pregnancy. The two testicles present in a baby boy produce AMH and androgens, which limit the development of female reproductive organs while promoting the growth of other male reproductive organs. Both male and basic female organs may develop if a significant amount of AMH is not accessible or lacking during this process. A baby with ambiguous genitalia may not be recognized as male or female right away.

Some ovarian cancers have high levels of AMH. If the hormone is produced by a tumor, the AMH test can be used as a tumor marker to track therapy effectiveness and check for recurrence.

Lab tests often ordered with an Anti-Mullerian Hormone test:

  • FSH
  • LH
  • Estrogen
  • Estradiol
  • Testosterone Free and Total
  • Progesterone
  • Sex Hormone Binding Globulin

Conditions where an Anti-Mullerian Hormone test is recommended:

  • PCOS
  • Infertility
  • Menopause

How does my health care provider use an Anti-Mullerian test?

Anti-Müllerian hormone is not a commonly requested test, but it can be helpful in some situations.

AMH is a hormone made by the reproductive organs. Its function and the amount that is generally present varies by gender and age.

An AMH test, along with other hormone tests like estradiol and FSH, may be ordered for women of reproductive age to determine how much time they have left to conceive. These tests can also be used to assess ovarian function and possibly forecast when menopause will occur.

AMH may be ordered for a woman who will be having assisted reproduction techniques such as in vitro fertilization; the amount of AMH present is linked to her potential treatment response. A low amount of AMH indicates a poor ovarian response, implying that fewer eggs will be recovered following ovarian stimulation. It's usually ordered in conjunction with additional hormone lab tests and a transvaginal ultrasound scan for this purpose.

Polycystic ovarian syndrome can be diagnosed with an AMH test. Because there are more follicles present, AMH may be raised.

AMH levels are elevated in several ovarian malignancies. If the hormone is initially increased, the test can be used as a tumor marker to assess therapy response and track recurrence.

An AMH test, together with chromosome testing, hormone testing, and sometimes imaging scans, may be requested to help establish the sex of an infant with external genitals that are not distinctly male or female.

What do my Anti Mullerian Hormone test results mean?

A low quantity and quality of eggs with diminishing fertility during a woman's reproductive years may suggest a poor number and quality of eggs, resulting in minimal or less responsiveness to IVF treatment. It could also mean that the ovaries aren't working properly.

A decrease in AMH level and/or a severe fall in AMH could indicate the start of menopause. AMH levels that are negative to low in a female are normal during childhood and after menopause.

Although an elevated level of AMH is frequently associated with PCOS, it is not diagnostic of the illness. Increased AMH may potentially signal a greater or even excessive reactivity to IVF, necessitating a modification of the treatment.

When AMH is used to track the progress of an AMH-producing ovarian cancer, a decrease in AMH suggests a positive response to treatment, whereas an increase could indicate cancer recurrence.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.


DHEA is a weakly androgenic steroid that is useful when congenital adrenal hyperplasia is suspected. It is also useful in determining the source of androgens in hyperandrogenic conditions, such as polycystic ovarian syndrome and adrenal tumors.

Brief Description: DHEA Sulfate is a blood test that is measuring the levels of Dehydroepiandrosterone Sulfate in the blood. It is often used to diagnose any problems in the adrenal glands such as cancer or a tumor. It can also be used to evaluate the cause of early puberty in young boys and male characteristics or appearance in women.

Also Known As: DHEA-SO4 Test, DHEAS Test, DHES1 Test, Dehydroepiandrosterone Sulfate Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a DHEA Sulfate test ordered?

When excess androgen production is suspected and/or a health practitioner wants to analyze a person's adrenal gland function, a DHEAS test, along with other hormone testing, may be requested.

It can be assessed when a woman exhibits signs and symptoms of amenorrhea, infertility, and/or virilization. The intensity of these alterations varies, but they may include:

  • A huskier voice
  • Hair on the face or on the body that is excessive
  • Baldness in men
  • Muscularity
  • Acne
  • The Adam's apple has been enlarged
  • Breast size has shrunk

It may also be ordered if a young girl exhibits evidence of virilization or if a female infant's external genitalia are not clearly male or female.

When young males show indicators of premature puberty, such as a deeper voice, pubic hair, muscularity, and an enlarged penis before the age of typical puberty, DHEAS may be evaluated.

What does a DHEA Sulfate blood test check for?

Male sex hormone dehydroepiandrosterone sulfate is found in both men and women. This test determines the amount of DHEAS in your blood.

DHEAS:

  • At puberty, it aids in the development of male secondary sexual traits.
  • Can be transformed into more strong androgens like testosterone and androstenedione by the body.
  • It has the ability to transform into estrogen.

DHEAS is almost entirely produced by the adrenal glands, with minor contributions from a woman's ovaries and a man's testicles.

It's a good indicator of how well the adrenal glands are working. Overproduction of DHEAS can be caused by malignant and non-cancerous adrenal tumors, as well as adrenal hyperplasia. DHEAS can be produced by an ovarian tumor in rare cases.

DHEAS excess:

  • In adult men, it may go unnoticed.
  • In young boys, it can cause early puberty.
  • Menstrual irregularities and the development of masculine physical traits in girls and women, such as excess body and facial hair
  • Can result in a female infant being born with genitals that aren't clearly male or female

Lab tests often ordered with a DHEA Sulfate test:

  • Testosterone
  • ACTH
  • FSH
  • LH
  • Prolactin
  • Estrogen
  • Estradiol
  • Sex Hormone Binding Globulin
  • 17-Hydroxyprogesterone
  • Androstenedione

Conditions where a DHEA Sulfate test is recommended:

  • PCOS
  • Infertility
  • Endocrine Syndromes
  • Adrenal Insufficiency
  • Congenital Adrenal Hyperplasia

How does my health care provider use a DHEA Sulfate test?

The dehydroepiandrosterone sulfate test is ordered in conjunction with testosterone and other male hormones assays to:

  • Examine the adrenal glands' performance.
  • Differentiate DHEAS-secreting disorders produced by the adrenal glands from those caused by the testicles or, in rare cases, the ovaries
  • Adrenocortical tumors and adrenal malignancies can be diagnosed with this test.
  • Assist in the diagnosis of congenital and adult-onset adrenal hyperplasia.

DHEAS levels are frequently examined in women, along with other hormones like FSH, LH, prolactin, estrogen, and testosterone, to help diagnose polycystic ovarian syndrome and rule out other reasons of infertility, lack of monthly cycle, and excess facial and body hair.

DHEAS levels, along with other hormones, may be requested to examine and diagnose the cause of young females developing masculine physical traits and young boys developing early puberty.

What do my DHEA-S test results mean?

A normal DHEAS level, together with other normal male hormone levels, suggests that the adrenal gland is working properly. When an adrenal tumor or cancer is present but not secreting hormones, DHEAS may be normal.

A high DHEAS blood level could indicate that the person's symptoms are caused or exacerbated by excessive DHEAS production. An elevated level of DHEAS, on the other hand, is not used to make a diagnosis of any particular condition; rather, it usually signals that further testing is required to determine the source of the hormone imbalance. An adrenocortical tumor, Cushing illness, adrenal cancer, or adrenal hyperplasia, as well as a DHEAS-producing ovarian tumor, can all cause high DHEAS.

DHEAS levels may be high in polycystic ovary syndrome, but they may also be normal, as PCOS is usually associated with ovarian androgen production.

Adrenal insufficiency, adrenal dysfunction, Addison disease, or hypopituitarism, a disorder characterized by low levels of pituitary hormones that govern the generation and secretion of adrenal hormones, can all produce low DHEAS levels.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.


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Description: Estradiol is a blood test that is used to measure the levels of Estradiol in the blood's serum. Estradiol is one of the Estrogen hormones in the body.  Estradiol, Ultrasensitive LC/MS/MS #30289 is a more appropriate test for children that have not yet started a menstrual cycle.

Also Known As: E2 Test, Estrogen 2 Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is an Estradiol test ordered?

Tests for estradiol for women may be ordered if:

  • After menopause, a woman may experience symptoms such as abnormal vaginal bleeding or irregular or absent menstrual cycles.
  • When a woman is unable to conceive, a series of estradiol readings taken over the course of her menstrual cycle may be used to track follicle development before using in vitro fertilization procedures
  • A woman is experiencing menopause symptoms such as hot flashes, night sweats, sleeplessness, and/or irregular or absent menstrual cycles.
  • If a menopausal woman is on hormone replacement therapy, her doctor may order estrone levels on a regular basis to check her progress.

Men and young boys may be subjected to estradiol testing if:

  • A boy's puberty is delayed, as evidenced by slow or delayed growth of testicles and penis, as well as a lack of deepening of voice or growth of body hair.
  • Signs of feminization, such as larger breasts.

What does an Estradiol blood test check for?

Estradiol, or E2, is a component of Estrogen that is present in the blood. For women, Estradiol is something that should be produced naturally, and the body produces larger amounts of Estradiol during puberty and it fluctuates throughout the menstrual cycle. Estradiol is most prominent in women of reproductive age. Low levels are common in girls who have not yet had their first menstrual cycle and in women after their reproductive age.

Lab tests often ordered with an Estradiol test:

  • Estrogen, Total, Serum
  • Estriol
  • Estrone
  • Testosterone Free and Total
  • Sex Hormone Binding Globulin
  • FSH
  • LH
  • Progesterone

Conditions where an Estradiol test is recommended:

  • Infertility
  • Menopause
  • Polycystic Ovarian Syndrome
  • Hormone Imbalance
  • Premature, delayed, or abnormal development of sex organs

Commonly Asked Questions:

How does my health care provider use an Estradiol test?

Estrogen tests are used to detect a deficit or excess of estrogen in a woman, as well as to aid in the diagnosis of a range of illnesses linked to this imbalance. They may also be ordered to monitor the health of the growing fetus and placenta during pregnancy, as well as to help predict the timing of a woman's ovulation. Estrogen testing can be used to detect a hormone excess and its origin in men.

In the case of girls and women

Estradiol testing may be requested for the following reasons:

  • Diagnose early-onset puberty, which occurs when a girl develops secondary sex traits much earlier than anticipated, or late puberty, which occurs when a female develops secondary sex characteristics or begins menstruation later than predicted.
  • Examine menstrual irregularities such as the absence of menstrual periods, infertility, and unusual vaginal bleeding.
  • Evaluate ovary function and look for signs of ovarian failure.
  • Serial measurements of estradiol can be used to track follicle development in the ovary in the days leading up to in vitro fertilization.
  • Keep track of any hormone replacement therapy you're getting to help with your fertility.
  • Keep track of menopausal hormone replacement medication, which is used to treat symptoms caused by estrogen insufficiency.
  • Identify cancers that produce estrogen.
  • As with breast cancer, keep an eye on anti-estrogen therapy.

Boys and men may be subjected to estradiol testing in order to:

  • Assist in the diagnosis of delayed puberty
  • Assist in determining the cause of larger breasts or other feminization indications.
  • Detect an excess of relative estrogen due to a testosterone or androgen deficit.
  • Identify cancers that produce estrogen.

What do my Estradiol test results mean?

Estradiol is one of the three Estrogens that have a large impact on the women's body throughout the menstrual cycle. When these hormones are too high or too low, it could cause irregular bleeding, infertility, complications with menopause, and delayed or premature puberty. Out of range levels can also be indicative of an ovarian condition such as PCOS. It is important to note that these values will fluctuate throughout a woman's cycle. The Estrogen hormones work together and if one is out of range, the others may also be out of range. It is recommended to follow up with a licensed healthcare professional to determine the best treatment if need.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

IMPORTANT - Note this Estradiol test is not for children that have yet to start their menstrual cycle.  If this test is ordered for a child that has yet to begin their menstrual cycle Quest Diagnostics labs will substitute in Estradiol, Ultrasensitive LC/MS/MS - #30289 at an additional charge of $34


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Description: Estrogen is a blood test that will measure the amount of estrogen in the blood's serum. It is used in fertility treatment, hormone treatment, and can be used to help diagnose a problem with the endocrine system.

Also Known As: Estrogen Estrogenic Hormones Test, Estrogen Test, Total Estrogen Test, Estrogen Serum Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is an Estrogen Total test ordered?

Testing for estrogen for girls and women may be ordered if:

  • The development of a girl's sex organs occurs sooner or later than predicted.
  • After menopause, a woman may experience symptoms such as abnormal vaginal bleeding or irregular or absent menstrual cycles.
  • When a woman is unable to conceive, a series of estradiol readings taken over the course of her menstrual cycle may be used to track follicle development before using in vitro fertilization procedures.
  • A woman is experiencing menopause symptoms such as hot flashes, night sweats, sleeplessness, and/or irregular or absent menstrual cycles.
  • If a menopausal woman is on hormone replacement therapy, her doctor may order estrone levels on a regular basis to check her progress.

Boys and men may be subjected to estrogen testing if:

  • A boy's puberty is delayed, as evidenced by slow or delayed growth of testicles and penis, as well as a lack of deepening of voice or growth of body hair.
  • Signs of feminization, such as larger breasts, can be seen in a guy.

What does an Estrogen Total blood test check for?

Estrogens are a class of steroids that have a role in the development and operation of female reproductive organs, as well as the generation of secondary sex characteristics. They help regulate the menstrual cycle, are essential in the growth of breasts and the uterus, and aid in the maintenance of a healthy pregnancy, together with another hormone, progesterone. Though they are primarily associated with women, they are also prevalent in men and play a role in bone metabolism and growth in both genders.

The amount of estrogen in a man's blood varies, but it does so much less over time and is much lower than in a woman's.

Lab tests often ordered with an Estrogen Total test:

  • Estradiol
  • Estriol
  • Estrone
  • Testosterone Free and Total
  • Sex Hormone Binding Globulin
  • FSH
  • LH
  • Progesterone

Conditions where an Estrogen Total test is recommended:

  • Infertility
  • Menopause
  • Polycystic Ovarian Syndrome (PCOS)
  • Hormone Imbalance
  • Premature, delayed, or abnormal development of sex organs

How does my health care provider use an Estrogen Total test?

Estrogen tests are used to detect a deficit or excess of estrogen in a woman, as well as to aid in the diagnosis of a range of illnesses linked to this imbalance. They may also be ordered to monitor the health of the growing fetus and placenta during pregnancy, as well as to help predict the timing of a woman's ovulation. Estrogen testing can be used to detect a hormone excess and its origin in men.

What do my Estrogen test results mean?

The sex and age of the person being tested determine the normal estrogen levels. It also depends on a woman's menstrual cycle or whether she is pregnant. The normal values indicated and the units used in reference ranges will differ slightly between laboratories.

Estrogen levels can be elevated or lowered in a variety of metabolic disorders. Because the levels of estrone, estradiol, and estriol change from day to day and throughout a woman's menstrual cycle, care must be used when interpreting the results.

Rather than examining single numbers, a health practitioner monitoring a woman's hormones will look at trends in the levels, rising or falling over time in connection with the menstrual cycle or pregnancy.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.


Description: A Follicle Stimulating Hormone, or FSH, test is a blood test that measures the levels of FSH in the blood. This can be used to diagnose conditions related to the sex organs, early or late puberty, or a condition affecting the pituitary or hypothalamus. It is also used to predict ovulation, evaluate infertility and monitor during infertility treatment. Levels that are out of range can help, along with several other hormone test, to evaluate the cause of irregular menstrual cycles.

Also Known As: Follicle Stimulating Hormone Test, Follitropin Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a FSH test ordered?

An FSH test may be recommended for a woman if she is having trouble conceiving or has irregular or absent menstrual periods.

When a woman's menstrual cycle has ended or grown erratic, FSH may be ordered to see if she has entered menopause.

When a man's spouse is unable to conceive, when he has a low sperm count, or when he has low muscle mass or diminished sex drive, for example, the test may be ordered.

When a health care provider detects a pituitary issue in a woman or a man, testing may be ordered. Because a pituitary problem can disrupt the production of a variety of hormones, other signs and symptoms may appear in addition to those described above. Fatigue, weakness, unexpected weight loss, and decreased appetite are just a few examples.

When a boy or girl does not seem to be entering puberty at the proper age, FSH and LH may be prescribed. Puberty symptoms include:

  • Breast enlargement in young women
  • Pubic hair development
  • In boys, the testicles and penis grow.
  • In girls, menstruation begins.

What does a FSH blood test check for?

FSH is a hormone linked to production and the development of eggs and sperm in both men and women. FSH is measured in the blood.

The pituitary gland, a grape-sized structure near the base of the brain, produces FSH. The hypothalamus in the brain, the pituitary gland, and hormones generated by the ovaries or testicles all work together to control FSH production. The hypothalamus secretes gonadotropin-releasing hormone, which causes the pituitary to secrete FSH and luteinizing hormone, a hormone that is closely related to FSH and is also important in reproduction.

During the follicular phase of the menstrual cycle, FSH increases the growth and maturation of eggs in the ovaries in women. The menstrual cycle is divided into two phases: follicular and luteal, each lasting approximately 14 days. During this follicular phase, FSH triggers the follicle's synthesis of estradiol, and the two hormones collaborate to help the egg follicle develop further. A surge of FSH and luteinizing hormone occurs near the end of the follicular period. Shortly after this burst of hormones, the egg is released from the ovary. The hormones inhibin, estradiol, and progesterone all help the pituitary gland regulate the quantity of FSH released. FSH also improves the ovary's ability to respond to LH.

Ovarian function declines and eventually quits as a woman matures and approaches menopause. FSH and LH levels rise as a result of this.

FSH induces the development of mature sperm in men's testicles, as well as the production of androgen binding proteins. After adolescence, men's FSH levels remain rather steady.

FSH levels rise early after birth in infants and children, then fall to very low levels by 6 months in boys and 1-2 years in girls. Prior to the onset of puberty and the development of secondary sexual characteristics, concentrations begin to rise again.

The production of too much or too little FSH can be caused by disorders affecting the brain, pituitary, ovaries, or testicles, resulting in infertility, irregular menstrual cycles, or early or delayed sexual development.

Lab tests often ordered with a FSH test:

  • Estrogen
  • Estradiol
  • LH
  • Testosterone
  • Progesterone
  • Androstenedione
  • Sperm Analysis
  • Anti-Mullerian Hormone
  • Prolactin
  • Sex Hormone Binding Globulin

Conditions where a FSH test is recommended:

  • Infertility
  • Menopause
  • Pituitary Disorders
  • Endocrine Syndromes
  • PCOS

How does my health care provider use a FSH test?

There are various applications for the follicle-stimulating hormone test, which is a hormone linked to reproduction and the development of eggs in women and sperm in men.

The test can be used with additional hormone assays including luteinizing hormone, testosterone, estradiol, and/or progesterone in both women and men to help:

  • Find out what's causing infertility.
  • Diagnose conditions involving ovarian or testicular dysfunction.
  • Aid in the diagnosis of diseases of the pituitary or hypothalamus, which can impact FSH production.

FSH levels are also relevant in women for:

  • Menstrual irregularities are being investigated.
  • Menopause start or confirmation prediction

FSH levels in males are used to determine the cause of a low sperm count.

FSH and LH are used to diagnose delayed or precocious puberty in children. Puberty timing irregularities could indicate a more significant disease involving the hypothalamus, pituitary gland, ovaries, testicles, or other systems. LH and FSH levels can help distinguish between benign symptoms and real disease. Once it's been determined that the symptoms are due to an actual condition, more testing can be done to figure out what's causing them.

What do my FSH test results mean?

FSH test findings are frequently combined with those from other hormone testing, such as LH, estrogens, and/or testosterone.

A high or low FSH level as part of an infertility workup is not diagnostic, but it does provide some insight into the cause. A hormone imbalance, for example, can influence a woman's menstrual cycle and/or ovulation. To make a diagnosis, a doctor will take into account all of the information gathered during the examination.

Women's Health

FSH and LH levels can assist distinguish between primary ovarian failure and secondary ovarian failure.

Primary ovarian failure is associated with high levels of FSH and LH.

Low FSH and LH levels are indicative of secondary ovarian failure caused by a pituitary or hypothalamic issue. Low FSH levels in the blood have been linked to an increased risk of ovarian cancer.

Men's Health

Primary testicular failure causes high FSH levels. As shown below, this can be the result of developmental problems in testicular growth or testicular damage.

Low levels are indicative of pituitary or hypothalamic dysfunction.

Children's Health

Precocious puberty is defined by high levels of FSH and LH, as well as the development of secondary sexual traits at an extremely young age. This occurs far more frequently in girls than in boys. This abnormal development is usually caused by a problem with the central nervous system, which can have a variety of causes.

Normal prepubescent LH and FSH levels in children who are showing signs of pubertal alterations could suggest a syndrome known as "precocious pseudopuberty." Elevated levels of the hormones estrogen or testosterone cause the signs and symptoms.

LH and FSH levels can be normal or below what is expected for a child of this age range in delayed puberty.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.


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Description: A Follicle Stimulating Hormone, or FSH, test is a blood test that measures the levels of FSH in the blood. This can be used to diagnose conditions related to the sex organs, early or late puberty, or a condition affecting the pituitary or hypothalamus. It is also used to predict ovulation, evaluate infertility and monitor during infertility treatment. Levels that are out of range can help, along with several other hormone test, to evaluate the cause of irregular menstrual cycles.

A Luteinizing Hormone, or LH, Test is a test that measures the level of the LH in the blood. It is used to predict ovulation, evaluate infertility and monitor during infertility treatment, or identify a pituitary disorder. It can also help along with several other hormone test to evaluate the cause of irregular menstrual cycles.

Also Known As: Follicle Stimulating Hormone test, Follitropin Test, Luteinizing Hormone Test, Lutropin Test, Interstitial Cell Stimulating Hormone Test, ICSH Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a FSH and LH test ordered?

An FSH and LH test may be recommended for a woman if she is having trouble conceiving or has irregular or absent menstrual periods.

When a woman's menstrual cycle has ended or grown erratic, FSH and LH may be ordered to see if she has entered menopause.

When a man's spouse is unable to conceive, when he has a low sperm count, or when he has low muscle mass or diminished sex drive, for example, the test may be ordered.

When a health care provider detects a pituitary issue in a woman or a man, testing may be ordered. Because a pituitary problem can disrupt the production of a variety of hormones, other signs and symptoms may appear in addition to those described above. Fatigue, weakness, unexpected weight loss, and decreased appetite are just a few examples.

What does a FSH and LH blood test check for?

FSH and LH are hormones linked to production and the development of eggs and sperm in both men and women. FSH and LH is measured in the blood.

The pituitary gland produces FSH and LH. The hypothalamus in the brain, the pituitary gland, and hormones generated by the ovaries or testicles all work together to control FSH and LH production. The hypothalamus secretes gonadotropin-releasing hormone, which causes the pituitary to secrete FSH and luteinizing hormone.

During the follicular phase of the menstrual cycle, FSH and LH increases the growth and maturation of eggs in the ovaries in women. The menstrual cycle is divided into two phases: follicular and luteal, each lasting approximately 14 days. During this follicular phase, FSH triggers the follicle's synthesis of estradiol, and the two hormones collaborate to help the egg follicle develop further. A surge of FSH and luteinizing hormone occurs near the end of the follicular period. Shortly after this burst of hormones, the egg is released from the ovary. The hormones inhibin, estradiol, and progesterone all help the pituitary gland regulate the quantity of FSH released. FSH also improves the ovary's ability to respond to LH.

Ovarian function declines and eventually quits as a woman matures and approaches menopause. FSH and LH levels rise as a result of this.

FSH induces the development of mature sperm in men's testicles, as well as the production of androgen binding proteins. After adolescence, men's FSH levels remain rather steady.

FSH levels rise early after birth in infants and children, and then quickly fall to low levels by 6 months of age in boys and  around 1 and half years of age in girls. Before puberty and the development of secondary sexual characteristics, FSH levels begin to rise again.

The production of too much or too little FSH and LH can be caused by disorders affecting the brain, pituitary, ovaries, or testicles, resulting in infertility, irregular menstrual cycles, or early or delayed sexual development.

Lab tests often ordered with a FSH and LH test:

  • Estrogen
  • Estradiol
  • Testosterone
  • Progesterone
  • Androstenedione
  • Sperm Analysis
  • Anti-Mullerian Hormone
  • Prolactin
  • Sex Hormone Binding Globulin

Conditions where a FSH and LH test is recommended:

  • Infertility
  • Menopause
  • Pituitary Disorders
  • Endocrine Syndromes
  • PCOS

How does my health care provider use a FSH and LH test?

There are various applications for the follicle-stimulating hormone and luteinizing hormone test, which are hormones linked to reproduction and the development of eggs in women and sperm in men.

The test can be used with additional hormone assays including luteinizing hormone, testosterone, estradiol, and/or progesterone in both women and men to help:

  • Find out what's causing infertility.
  • Diagnose conditions involving ovarian or testicular dysfunction.
  • Aid in the diagnosis of diseases of the pituitary or hypothalamus, which can impact FSH production.

FSH and LH levels are also relevant in women for:

  • Menstrual irregularities are being investigated.
  • Menopause start or confirmation prediction

FSH and LH levels in males are used to determine the cause of a low sperm count.

FSH and LH are used to identify delayed or early puberty in children. Puberty timing irregularities could indicate a more significant disease involving the hypothalamus, pituitary gland, ovaries, testicles, or other systems. LH and FSH levels can help distinguish between benign symptoms and real disease. Once it's been determined that the symptoms are due to an actual condition, more testing can be done to figure out what's causing them.

What do my FSH and LH test results mean?

FSH and LH test findings are frequently combined with those from other hormone testing estrogens, and/or testosterone.

A high or low FSH level as part of an infertility workup is not diagnostic, but it does provide some insight into the cause. A hormone imbalance, for example, can influence a woman's menstrual cycle and/or ovulation. To make a diagnosis, a doctor will take into account all of the information gathered during the examination.

Women's Health

  • FSH and LH levels can assist distinguish between primary ovarian failure and secondary ovarian failure.
  • Primary ovarian failure is associated with high levels of FSH and LH.
  • Low FSH and LH levels are indicative of secondary ovarian failure caused by a pituitary or hypothalamic issue. Low FSH levels in the blood have been linked to an increased risk of ovarian cancer.

Men's Health

  • Primary testicular failure causes high FSH levels. As shown below, this can be the result of developmental problems in testicular growth or testicular damage.
  • Low levels are indicative of pituitary or hypothalamic dysfunction.

Children's Health

  • Precocious puberty is defined by high levels of FSH and LH, as well as the development of secondary sexual traits at an extremely young age. This occurs far more frequently in girls than in boys. This abnormal development is usually caused by a problem with the central nervous system, which can have a variety of causes.
  • Normal prepubescent LH and FSH levels in children who are showing signs of pubertal alterations could suggest a syndrome known as "precocious pseudopuberty."
  • For children with delayed puberty, LH and FSH levels can be normal or below what is expected for children of their age.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.


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Description: A Luteinizing Hormone, or LH, Test is a test that measures the level of the LH in the blood. It is used to predict ovulation, evaluate infertility and monitor during infertility treatment, or identify a pituitary disorder. It can also help along with several other hormone test to evaluate the cause of irregular menstrual cycles.

Also Known As: Luteinizing Hormone Test, Lutropin Test, Interstitial Cell Stimulating Hormone Test, ICSH Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is an LH test ordered?

LH testing may be ordered in adults when:

  • A woman is having trouble conceiving or has irregular or non-existent menstrual cycles.
  • When a woman's menstrual cycle has stopped or grown irregular, or it is suspected that she has entered menopause.
  • When a man's partner is unable to conceive, when he has low testosterone levels, or when he has poor muscular mass or decreased sex drive.
  • Unexplained weight loss, exhaustion and weakness, and decreased appetite are just a few examples of signs and symptoms that may be present when a health professional suspects a pituitary issue.

When a boy or girl does not appear to be entering puberty at the appropriate age, LH may be ordered. Puberty symptoms include:

  • Breast enlargement in young women
  • Pubic hair development
  • Boys' testicles and penis grow.
  • In girls, menstruation begins.

What does an LH blood test check for?

Luteinizing hormone is a hormone linked to reproduction and the stimulation of ovarian egg release in women, as well as testosterone production in males. This test determines how much luteinizing hormone is present in the blood.

The pituitary gland, a grape-sized structure near the base of the brain, produces LH. The hypothalamus in the brain, the pituitary gland, and the hormones generated by the ovaries and testicles all work together to control LH production.

Several hormones rise and fall in a certain order in premenopausal women's bodies during each menstrual cycle. LH increases ovulation and the generation of other hormones such as estradiol and progesterone during the menstrual cycle.

Each phase of a woman's menstrual cycle lasts roughly 14 days and is separated into follicular and luteal stages. A mid-cycle surge of follicle-stimulating hormone and LH occurs near the end of the follicular phase. Ovulation is triggered by this surge, which results in the rupture of the egg follicle on the ovary and the release of the egg.

The place where the egg follicle ruptured becomes a "corpus luteum" during the luteal phase. The corpus luteum is stimulated to begin generating progesterone by LH release. While FSH and LH levels decrease, progesterone and estradiol levels rise. If the egg is not fertilized, these hormone levels will drop after a few days. Menstruation begins, and then the cycle repeats itself.

Ovarian function declines and eventually quits as a woman matures and approaches menopause. FSH and LH levels rise as a result of this.

LH stimulates the testicles' Leydig cells to create testosterone in men. After adolescence, men's LH levels remain generally steady. A high level of testosterone sends negative feedback to the pituitary gland and hypothalamus, reducing the amount of LH released.

LH levels in newborns and youngsters peak shortly after delivery and then drop to extremely low levels. Levels begin to rise again at the age of 6-8 years, just before puberty and the development of secondary sexual traits.

Lab tests often ordered with an LH test:

  • FSH
  • Testosterone
  • Progesterone
  • Estrogen
  • Estradiol
  • Androstenedione
  • Sperm Analysis
  • Prolactin
  • Anti-Mullerian Hormone
  • Sex Hormone Binding Globulin

Conditions where an LH test is recommended:

  • Infertility
  • Menopause
  • Pituitary Disorders
  • Endocrine Disorders
  • PCOS

How does my health care provider use an LH test?

There are various applications for the luteinizing hormone test, which is a hormone linked to production and the stimulation of the release of an egg from the ovary in women and testosterone synthesis in males.

LH is frequently used in conjunction with other tests in both women and men:

  • In the investigation of infertility,
  • To help with the diagnosis of pituitary diseases that impact LH production.
  • To aid in the diagnosis of diseases involving the ovaries or testicles

FSH and LH are used to diagnose delayed and precocious puberty in children. Puberty timing irregularities could indicate a more significant disease involving the hypothalamus, pituitary gland, ovaries, testicles, or other systems. LH and FSH levels can help distinguish between benign symptoms and real disease. Once it's been determined that the symptoms are due to an actual condition, more testing can be done to figure out what's causing them.

LH is occasionally evaluated in response to gonadotropin releasing hormone treatment in those with evidence of impaired ovarian or testicular function to distinguish between problems involving the brain or pituitary gland. The hypothalamus produces GnRH, which stimulates the pituitary gland to release LH and FSH. A baseline blood sample is taken for this test, and then the subject is given a GnRH injection. Following that, blood samples are collected at predetermined intervals and the level of LH is monitored. This test can assist distinguish between a pituitary disorder, in which LH does not respond to GnRH, and a hypothalamic disorder, in which LH does respond to GnRH. It's also useful for determining if a child is precocious or delayed in puberty.

What do my LH test results mean?

Women's Health

Primary ovarian failure and secondary ovarian failure can be distinguished using LH and FSH levels.

Primary ovarian failure is characterized by elevated levels of LH and FSH.

Multiple LH tests can be done to detect the surge that precedes ovulation in women who are attempting to conceive. Ovulation has happened when LH levels rise.

Because a woman's ovaries stop working during menopause, her LH levels rise.

Secondary ovarian failure is characterized by low levels of LH and FSH, which indicate a problem with the pituitary or hypothalamus.

Men's Health

LH levels that are too high could suggest primary testicular failure. This can be caused by testicular injury or developmental problems in testicular growth.

Low levels of LH and FSH are detected in secondary testicular failure and reflect a pituitary or hypothalamic issue.

For both men and women

The LH response to GnRH can assist distinguish between secondary and tertiary dysfunction. After determining the baseline level of LH, a dosage of GnRH is administered through injection. The fact that the pituitary responded to the GnRH and that the level of LH increased afterward suggests a hypothalamic problem. A low amount of LH indicates that the pituitary did not respond to GnRH and points to a pituitary illness.

Children's

Precocious puberty is defined as high levels of LH and FSH together with the development of secondary sexual characteristics at an unusually young age in young children. This occurs far more frequently in girls than in boys. This abnormal development is usually caused by a problem with the central nervous system, which can have a variety of causes.

Normal FSH and LH levels with a few indications of puberty could indicate a benign form of precocious puberty with no underlying or discernible reason, or it could simply be a normal variation of puberty. LH and FSH levels can be normal or below what is expected for a child of this age range in delayed puberty. In addition to other tests, the LH response to GnRH test may aid in determining the cause of delayed puberty. Delay in puberty can be caused by a variety of factors.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.


Description: A Progesterone test is a blood test that measures the Progesterone levels in your blood's serum, and it is useful for tracking hormones or identifying hormone imbalances.

Also Known As: PGSN Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a Progesterone test ordered?

The test may be ordered a few times during a woman's menstrual cycle to monitor the change in progesterone concentrations during an infertility assessment, when she is having problems getting pregnant and her health care provider wants to make sure she is ovulating normally. Situations include:

  • Determining ovulation timing to follow up pharmacological therapy to promote ovulation
  • When signs like stomach pain and spotting point to an ectopic pregnancy or a threatening miscarriage, call your doctor.
  • When a woman needs progesterone replacement medication on a regular basis to keep her pregnancy going
  • During a high-risk pregnancy, the placenta and fetal health should be monitored on a regular basis.
  • When a non-pregnant lady has abnormal uterine bleeding, it's a sign that she's pregnant.

For men, progesterone may be ordered for fertility and sperm production testing.

What does a Progesterone blood test check for?

Progesterone is a steroid hormone that aids a woman's body in preparing for pregnancy. It interacts with a number of other female hormones. The level of progesterone in the blood is measured with this test.

The hormone estrogen causes the endometrium, the uterine lining, to grow and renew itself on a monthly basis, while a surge in luteinizing hormone causes an egg to be released from one of two ovaries. At the place where the egg was released, a corpus luteum forms in the ovary and begins to generate progesterone. Endometrial growth is halted by this progesterone, which is supplemented by modest amounts produced by the adrenal glands, and the uterus is prepared for the probable implantation of a fertilized egg.

The corpus luteum deteriorates, progesterone levels decline, and menstrual bleeding begins if fertilization does not occur. The corpus luteum continues to produce progesterone after a fertilized egg is placed in the uterus, and the egg forms a trophoblast that produces human chorionic gonadotropin. After a few weeks, the placenta takes over as the main source of progesterone from the corpus luteum, producing rather significant amounts of the hormone for the duration of the pregnancy.

Males produce progesterone as well, although at a considerably lesser level. Its role is to aid in the formation of sperm.

Lab tests often ordered with a Progesterone test:

  • Estrogen
  • Estradiol
  • Estriol
  • Estrone
  • hCG
  • FSH
  • LH
  • Testosterone

Conditions where a Progesterone test is recommended:

  • Pregnancy
  • Infertility
  • Menopause

Commonly Asked Questions:

How does my health care provider use a Progesterone test?

A progesterone test can be used in the following situations:

  • To aid in the recognition and management of various infertility issues. Multiple measurements can be employed because progesterone levels vary throughout the menstrual cycle.
  • To assess whether a woman has ovulated, when she ovulated, or to track the success of induced ovulation
  • Early in pregnancy, combined with human chorionic gonadotropin tests, to help determine an ectopic or failing pregnancy.
  • To keep track of a high-risk pregnancy
  • To evaluate effectiveness of progesterone injection therapy that is administered to help support pregnancy

Other tests used to diagnose the source of irregular uterine bleeding in non-pregnant women include FSH, LH, hCG, thyroid tests, coagulation tests, and a complete blood count.

What do my Progesterone test results mean?

The interpretation of progesterone test results is dependent on the purpose of the test and requires information of a woman's menstrual cycle or pregnancy stage. When an egg is released from the ovary, progesterone levels rise for several days, then either continue to rise with early pregnancy or fall to initiate menstruation.

A woman may not be ovulating or having regular menstrual periods if her progesterone levels do not rise and fall on a monthly basis. This could be a factor in infertility.

The pregnancy may be ectopic and/or failing if levels do not rise properly throughout the first trimester. If successive assessments show no increase in progesterone levels over time, the placenta and fetus' viability may be jeopardized.

Progesterone levels can occasionally rise as a result of:

  • Ovarian cysts can be found in some women.
  • Molar pregnancies are non-viable pregnancies.
  • Ovarian cancer is an uncommon type of cancer that affects the ovaries.
  • The adrenal glands produce too much progesterone.
  • Cancer of the adrenal gland
  • Adrenal hyperplasia is a condition that occurs at birth

Low progesterone levels have been linked to:

  • Toxemia in the third trimester of pregnancy
  • Ovary function is impaired.
  • Menstrual irregularities
  • Ectopic pregnancy is a term used to describe a pregnancy
  • Miscarriage or fetal death

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.


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Description: A prolactin test is a blood test that measures the Prolactin levels in your blood's serum, and it is useful in identifying unexplained problems with breastfeeding, menstrual cycles, and infertility.

Also Known As: PRL Test, Prolactin Blood test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a Prolactin test ordered?

Prolactin testing may be requested in the following situations:

  • If someone is experiencing prolactinoma symptoms such as inexplicable headaches, breast nipple discharge, and or vision impairment.
  • Infertility or irregular menstrual periods in a woman.
  • A male that has low testosterone or has signs such as diminished sex drive, nipple discharge, or infertility.

When a person has a prolactinoma, prolactin levels may be requested on a regular basis to track the tumor's progress and response to treatment. They may also be ordered at regular intervals to check for the return of prolactinoma.

When a doctor suspects a person has a pituitary condition such hypopituitarism, prolactin levels, as well as other hormone levels like growth hormone, may be requested.

Prolactin concentrations are sometimes measured when a person has an illness or is receiving medication that may impair dopamine production.

What does a Prolactin blood test check for?

The anterior region of the pituitary gland, a grape-sized structure located at the base of the brain, produces prolactin. Prolactin is a hormone that promotes lactation and is found in low concentrations in men and non-pregnant women. This test determines how much prolactin is present in the blood.

Dopamine, a brain neurotransmitter, regulates and inhibits prolactin release. Prolactin levels are typically high throughout pregnancy and shortly after childbirth. The hormones prolactin, estrogen, and progesterone enhance the production of breast milk during pregnancy. Prolactin aids in the initiation and maintenance of breast milk supply after childbirth. If a woman does not breastfeed, her prolactin level quickly returns to pre-pregnancy levels if she does not nurse. Suckling by the infant has a vital function in the release of prolactin if she does nurse. The amount of prolactin emitted by the pituitary, as well as the amount of milk produced, have a feedback system.

A prolactinoma, a pituitary gland tumor that generates excessive prolactin production, is a common cause of an unusually raised prolactin level. The most frequent type of pituitary tumor is prolactinoma, which is usually benign. They are more common in women, but they can also be found in men. The size and location of the tumor, as well as the unintended effects of excess prolactin, such as milk production in a woman who is not pregnant or nursing and, occasionally, in a man, can cause problems.

When the anterior pituitary gland and/or tumor grow large enough, they can put pressure on the optic nerve, causing headaches and visual abnormalities, as well as interfering with the pituitary gland's other hormones. Prolactinomas in women can induce infertility and menstrual abnormalities, while in men, they might cause a gradual loss of sexual function and libido. Prolactinomas can cause damage to the surrounding tissues if they are not treated.

Lab tests often ordered with a Prolactin test:

  • FSH
  • LH
  • Testosterone
  • DHEA-S
  • Estrogen
  • Estradiol
  • Estrone
  • Estriol
  • Progesterone
  • Androstenedione

Conditions where a Prolactin test is recommended:

  • Pituitary Disorders
  • Infertility
  • Pregnancy
  • PCOS
  • Thyroid Diseases

Commonly Asked Questions:

How does my health care provider use a Prolactin test?

Prolactin levels can be used for a variety of purposes. Prolactin is a hormone generated by the pituitary gland, and its major function is to assist pregnant and nursing women in initiating and maintaining breast milk production.

Prolactin testing, in combination with other hormone tests, may be used to:

  • Determine what is causing the production of breast milk that isn't related to pregnancy or breastfeeding
  • Find out what's causing men's infertility and erectile problems.
  • Determine the reason of a woman's menstrual irregularity and/or infertility.
  • Detect and diagnose prolactinomas, track their therapy, and look for recurrences.
  • Examine anterior pituitary function or any other pituitary problems.

What do my prolactin test results mean?

Prolactin levels in the blood of men and nonpregnant women are usually very low. Prolactin levels must be analyzed according to the time of day they are taken. Over the course of a 24-hour period, the levels will rise during sleep and peak in the morning. A person's blood should be drawn 3 to 4 hours after they wake up.

During pregnancy and while the mother is nursing, a high amount of prolactin is typical.

High prolactin levels can also be noticed in the following:

  • Prolactin-producing and -releasing tumors
  • Eating disorders such as  anorexia nervosa
  • Hypothalamic diseases
  • Hypothyroidism
  • Kidney disease
  • Liver disease
  • Polycystic ovarian syndrome
  • Other tumors and disorders of the pituitary gland

Low levels of prolactin are not normally treated, but they could indicate a general decline in pituitary hormones caused by a pituitary condition such hypopituitarism.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.


Description: Sex Hormone Binding Globulin test is a blood test that is often paired in testosterone testing for men suspected to have low testosterone and women with elevated testosterone.

Also Known As: SHBG Test, TeBG Test, Testosterone-Estrogen Binding Globulin Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a Sex Hormone Binding Globulin test ordered?

Sex Hormone Binding Globulin may be ordered by a healthcare provider to investigate infertility, diminished sex drive, and erectile dysfunction in males, or irregular cycles, infertility, and excess body and face hair in women, when total testosterone values do not appear to be consistent with the mentioned signs and symptoms.

What does a Sex Hormone Binding Globulin blood test check for?

SHBG is a liver-produced protein that strongly binds to the hormones testosterone, dihydrotestosterone, and estradiol. SHBG distributes these hormones in the blood as physiologically inactive versions when they are bound. This test examines the amount of SHBG in the blood and is most commonly used to determine whether a person has too much or too little testosterone.

In men, SHBG binds roughly 45 percent to 65 percent of testosterone in the blood, with the rest weakly and reversibly linked to albumin. Only around 2% to 3% of testosterone is accessible to tissues as free testosterone, but testosterone that is weakly linked to albumin is also bioavailable and can be rapidly absorbed by the body's tissues.

In women, a somewhat higher percentage of testosterone is bound to SHBG in the blood than in men. SHBG is important in controlling the quantities of bioavailable male sex hormones and estrogens circulating throughout the body in women. Because SHBG has a stronger affinity for the androgens testosterone and DHT, women with low SHBG may experience signs and symptoms of androgen excess.

A total testosterone test does not differentiate between bound and unbound testosterone; instead, it determines the total amount of testosterone present. In many circumstances, this is sufficient to determine if testosterone production is excessive or inadequate. However, if a person's SHBG level is abnormal, the total testosterone level may not accurately reflect the amount of testosterone available to the person's tissues. When a person's indications and symptoms do not match the results of a total testosterone test, a SHBG test may be conducted.

Lab tests often ordered with a Sex Hormone Binding Globulin test:

  • Testosterone
  • Estradiol
  • Dihydrotestosterone
  • FSH
  • LH
  • Estriol
  • Estrone
  • Albumin
  • Prolactin

Conditions where a Sex Hormone Binding Globulin test is recommended:

  • Polycystic Ovary Syndrome
  • Infertility
  • Liver disease
  • Hyperthyroidism
  • Eating disorders
  • Pregnancy
  • Cushing Syndrome
  • Hypothyroidism

How does my health care provider use a Sex Hormone Binding Globulin test?

The sex hormone binding globulin test can be performed to determine whether a man has low testosterone or if a woman has too much testosterone. It can be used in conjunction with other tests to assess a person's sex hormone status.

SHBG is a protein that binds to testosterone, dihydrotestosterone, and estradiol, among other hormones. SHBG distributes these hormones in the blood as physiologically inactive versions when they are bound. Changes in SHBG levels can have an impact on the amount of hormone accessible to the body's tissues.

To assess a person's current hormonal balance, tests for albumin and one or more additional sex hormones, such as prolactin, estradiol, and LH may be conducted.

In men

In order to diagnose the cause of infertility, diminished sex drive, or erectile dysfunction in an adult male, SHBG and total testosterone levels may be ordered. When total testosterone findings are contradictory with clinical symptoms, measuring SHBG in addition to testosterone is extremely beneficial.

Total testosterone in the blood is measured without distinguishing between bound and unbound testosterone; rather, it determines the total amount of testosterone in the blood. In many circumstances, this is sufficient to determine if testosterone production is excessive or inadequate. However, if a person's SHBG level is abnormal, the total testosterone level may not accurately reflect the amount of testosterone available to the body's tissues.

With a simple total testosterone assessment, health practitioners can estimate bioavailable testosterone by measuring SHBG. Because less testosterone is accessible to the body's tissues, increased SHBG in males may be linked to symptoms of low testosterone levels.

Total testosterone should be measured in the initial screening for testosterone deficiency, according to the Endocrine Society's professional standards. If the results are abnormal, the test is repeated the next day. They propose one of the following if repeat readings are low-normal and/or SHBG is abnormal:

In women

The ovaries and adrenal glands produce modest amounts of testosterone in women. Even little increases in testosterone production can throw off the hormone balance, resulting in symptoms including irregular or missed periods, infertility, acne, and excessive face and body hair. These and other signs and symptoms are common in polycystic ovarian syndrome, a disorder marked by an overproduction of male sex hormones. SHBG and testosterone testing may be helpful in detecting and evaluating excess testosterone production and/or decreasing SHBG concentrations, as well as in evaluating women with PCOS.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results


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Description: A T3 Total test is a blood test that measures triiodothyronine levels in your blood’s serum to evaluate your thyroid’s health and to screen for, diagnose, and monitor thyroid disorders such as hyperthyroidism.

Also Known As: Total T3 Test, Triiodothyronine Test, T3 Test, Bound T3

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a T3 Total test ordered?

When a person's TSH test results are abnormal, a total T3 test may be recommended. When a person has symptoms that imply hyperthyroidism, it may be requested as part of the investigational workup, especially if the free T4 level is not elevated.

The following are possible signs and symptoms:

  • Heart rate has increased.
  • Anxiety
  • Loss of weight
  • Sleeping problems
  • Hand tremors
  • Weakness
  • Diarrhea
  • Visual disturbances, light sensitivity
  • Puffiness around the eyes, dryness, discomfort, and, in some cases, bulging of the eyes are all possible side effects.

Total T3 may be ordered at regular intervals to monitor a known thyroid disease or to assess the efficacy of hyperthyroidism treatment.

What does a T3 Total blood test check for?

T3 is one of two key hormones produced by the thyroid gland, a small butterfly-shaped organ near the base of the throat that sits flat across the windpipe. Thyroxine is the other primary thyroid hormone, and together they help govern the rate at which the body utilizes energy. T3 in the blood is almost entirely linked to protein. The remaining portion is free and is the hormone's physiologically active form. Tests can determine the amount of free T3 or total T3 in the blood.

A feedback system controls T3 and T4 production. The hypothalamus releases thyrotropin releasing hormone when thyroid hormone levels in the blood drop, which prompts the pituitary gland to create and release thyroid-stimulating hormone. The thyroid gland is thus stimulated to create and/or release more thyroid hormones as a result of TSH. T4 is the most common thyroid hormone produced. This hormone is generally inactive, but in the liver and other tissues, it is transformed into the considerably more active T3.

If the thyroid gland produces too much T4 and T3, the person may have symptoms like uneasiness, hand tremors, weight loss, sleeplessness, and puffiness around dry, itchy eyes. The person's eyes may be unable to move normally and appear to be glaring in some circumstances. The eyeballs may also appear to bulge in some circumstances.

If the thyroid gland does not produce enough thyroid hormones, the person may experience weight gain, dry skin, lethargy, and constipation, which are all signs and symptoms of hypothyroidism and a slower metabolism. Thyroid hormone levels in the blood might be low or high due to thyroid malfunction, or in rare cases, insufficient or excessive TSH production due to a pituitary issue.

Autoimmune illnesses are the most common causes of thyroid dysfunction. Hyperthyroidism is caused by Graves disease, but it can also be caused by thyroiditis, thyroid malignancy, or high TSH production. Total T3 can be used to diagnose and monitor the impact of certain disorders on thyroid hormone production.

Lab tests often ordered with a T3 Total test:

  • TSH
  • T3 Free
  • T4 Free
  • T4 Total
  • T3 Reverse
  • T3 Uptake
  • Thyroid Peroxidase
  • Thyroglobulin Antibodies

Conditions where a T3 Total test is recommended:

  • Hyperthyroidism
  • Hypothyroidism
  • Hashimotos
  • Graves’ Disease
  • Autoimmune Diseases
  • Thyroid Cancer

How does my health care provider use a T3 Total test?

Thyroid function is measured with a total triiodothyronine test. It's usually ordered to assist identify hyperthyroidism, but it can also be used to track a person's therapy for a thyroid problem.

Thyroid hormones T3 and T4 are generated by the thyroid gland. They aid in the regulation of the rate at which the body expends energy and are governed by a feedback system. Thyroid-stimulating hormone boosts T4 and T3 synthesis and release. The liver and other tissues convert T4 into T3 as needed.

The majority of T4 and T3 in the blood is attached to protein, while just a small amount is free. Total T4, free T4, total T3, and free T3 can all be measured in blood tests.

Because the majority of T3 is coupled to protein, total T3 can be influenced by protein levels and binding ability, but free T3 is unaffected. Some professional standards, however, advocate total T3, thus either test can be used to evaluate thyroid function. To assist diagnose Graves disease, an autoimmune illness that is the most prevalent cause of hyperthyroidism, free T3 or total T3 may be ordered together with thyroid antibodies.

Following an abnormal TSH, a total T3 test is generally done, especially if the free T4 test is not high.

What does my T3 Total Test result mean?

Thyroid hormone levels that are high or low suggest a mismatch between the body's needs and supplies, but they don't inform the doctor what's causing the excess or deficiency.

If someone is being treated for hyperthyroidism with anti-thyroid medication and their free or total T3 levels are normal, the medicine is likely beneficial in treating the illness. If the free or total T3 or free T4 levels are high, the medication isn't working to address the problem, and the person may be having hyperthyroidism symptoms.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results


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Description: A T3 Free test is a blood test that measures unbound triiodothyronine levels in your blood’s serum to evaluate your thyroid’s health and to screen for, diagnose, and monitor thyroid disorders such as hyperthyroidism.

Also Known As: Free T3 Test, Free Triiodothyronine Test, FT3 Test, T3F Test, Unbound T3 Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a T3 Free test ordered?

When a person's TSH test results are abnormal, a free T3 test may be recommended. When a person has symptoms that imply hyperthyroidism, it may be requested as part of the investigational workup, especially if the free T4 level is not elevated.

The following are possible signs and symptoms:

  • Heart rate has increased.
  • Anxiety
  • Loss of weight
  • Sleeping problems
  • Hand tremors
  • Weakness
  • Diarrhea
  • Visual disturbances, light sensitivity
  • Puffiness around the eyes, dryness, discomfort, and, in some cases, bulging of the eyes are all possible side effects.

Free T3 may be ordered at regular intervals to monitor a known thyroid disease or to assess the efficacy of hyperthyroidism treatment.

What does a T3 Free test check for?

T3 is one of two key hormones produced by the thyroid gland, a small butterfly-shaped organ near the base of the throat that sits flat across the windpipe. Thyroxine is the other primary thyroid hormone, and together they help govern the rate at which the body utilizes energy. T3 in the blood is almost entirely linked to protein. The remaining portion is free and is the hormone's physiologically active form. Tests can determine the amount of free T3 or total T3 in the blood.

A feedback system controls T3 and T4 production. The hypothalamus releases thyrotropin releasing hormone when thyroid hormone levels in the blood drop, which prompts the pituitary gland to create and release thyroid-stimulating hormone. The thyroid gland is thus stimulated to create and/or release more thyroid hormones as a result of TSH. T4 is the most common thyroid hormone produced. This hormone is generally inactive, but in the liver and other tissues, it is transformed into the considerably more active T3.

If the thyroid gland produces too much T4 and T3, the person may have symptoms like uneasiness, hand tremors, weight loss, sleeplessness, and puffiness around dry, itchy eyes. The person's eyes may be unable to move normally and appear to be glaring in some circumstances. The eyeballs may also appear to bulge in some circumstances.

If the thyroid gland does not produce enough thyroid hormones, the person may experience weight gain, dry skin, lethargy, and constipation, which are all signs and symptoms of hypothyroidism and a slower metabolism. Thyroid hormone levels in the blood might be low or high due to thyroid malfunction, or in rare cases, insufficient or excessive TSH production due to a pituitary issue.

Autoimmune illnesses are the most common causes of thyroid dysfunction. Hyperthyroidism is caused by Graves disease, but it can also be caused by thyroiditis, thyroid malignancy, or high TSH production. Total T3 can be used to diagnose and monitor the impact of certain disorders on thyroid hormone production.

Lab tests often ordered with a T3 Free test:

  • TSH
  • T3 Total
  • T4 Free
  • T4 Total
  • T3 Reverse
  • T3 Uptake
  • Thyroid Peroxidase
  • Thyroglobulin Antibodies

Conditions where a T3 Free test is recommended:

  • Hyperthyroidism
  • Hypothyroidism
  • Hashimotos
  • Graves’ Disease
  • Autoimmune Diseases
  • Thyroid Cancer

How does my health care provider use a T3 Free test?

Thyroid function is measured with a free triiodothyronine test. It's usually ordered to assist identify hyperthyroidism, but it can also be used to track a person's therapy for a thyroid problem.

Thyroid hormones T3 and T4 are generated by the thyroid gland. They aid in the regulation of the rate at which the body expends energy and are governed by a feedback system. Thyroid-stimulating hormone boosts T4 and T3 synthesis and release. The liver and other tissues convert T4 into T3 as needed.

The majority of T4 and T3 in the blood is attached to protein, while just a small amount is free. Total T4, free T4, total T3, and free T3 can all be measured in blood tests.

Because the majority of T3 is coupled to protein, total T3 can be influenced by protein levels and binding ability, but free T3 is unaffected. Some professional standards, however, advocate total T3, thus either test can be used to evaluate thyroid function. To assist in diagnosing Graves disease, an autoimmune illness that is the most prevalent cause of hyperthyroidism, free T3 or total T3 may be ordered together with thyroid antibodies.

Following an abnormal TSH, a free T3 test is generally done, especially if the free T4 test is not high.

What does my T3 Free result mean?

Thyroid hormone levels that are high or low suggest a mismatch between the body's needs and supplies, but they don't inform the doctor what's causing the excess or deficiency.

If someone is being treated for hyperthyroidism with anti-thyroid medication and their free or total T3 levels are normal, the medicine is likely beneficial in treating the illness. If the free or total T3 or free T4 levels are high, the medication isn't working to address the problem, and the person may be having hyperthyroidism symptoms.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results


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Description: A T4 Total test is a blood test that measures thyroxine free levels in your blood’s serum to evaluate your thyroid’s health and to screen for, diagnose, and monitor thyroid disorders such as hypothyroidism.

Also Known As: Total T4 Test, Total Thyroxine Test, T4 Test, T4, T4 Total Test, Bound T4 Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a T4 Total test ordered?

When a person exhibits symptoms of hyperthyroidism or hypothyroidism, a Total T4 test may be administered, especially if a TSH test result is abnormal.

Hyperthyroidism can cause the following signs and symptoms:

  • Heart rate has increased.
  • Anxiety
  • Loss of weight
  • Sleeping problems
  • Hand tremors
  • Weakness
  • Diarrhea
  • Visual disturbances, light sensitivity
  • Puffiness around the eyes, dryness, discomfort, and, in some cases, bulging of the eyes are all possible side effects.

Hypothyroidism can cause the following symptoms:

  • gaining weight
  • Skin that is dry
  • Constipation
  • Intolerance to the cold
  • Skin that is puffy
  • Hair loss
  • Fatigue
  • Women's menstrual irregularities

When a person is being treated for a thyroid problem, Total T4 testing, along with other thyroid tests, may be requested on a regular basis.

Thyroid testing will most likely be ordered early and late in the pregnancy, as well as for a period after delivery, to monitor the mother and baby in pregnant women with thyroid abnormalities.

In the United States, thyroid hormone screening is routinely performed on babies as part of newborn screening programs.

What does a T4 Total blood test check for?

The thyroid gland, a small butterfly-shaped structure that lays on the windpipe towards the bottom of the throat, produces one of two primary hormones: thyroxine. Triiodothyronine is the other primary thyroid hormone, and together they help govern the rate at which the body utilizes energy. T4 in the blood is almost entirely linked to protein. The remaining portion is free and is the hormone's biologically active form. This test determines how much Bound T4 is present in the blood.

A feedback loop controls T4 production. The hypothalamus releases thyrotropin releasing hormone, which encourages the pituitary gland to generate and release thyroid-stimulating hormone when the amount of T4 in the blood drops. The thyroid gland is thus stimulated to produce and/or release more T4 as a result of TSH. TSH release is blocked as T4 content in the blood rises.

T4 accounts for over 90% of thyroid hormones. The thyroid gland releases accumulated T4 into circulation when the body requires it. T4 is either free or bound to protein in the blood. The amount of free T4 in the body is just about 0.1 percent of total T4. In the liver or other tissues, T4 is converted to T3. T3, like T4, is mainly attached to protein, however the physiologically active forms of T3 and T4 are the free versions. Free T3 in circulation is 4 to 5 times more active than free T4.

Dry skin, weight gain, cold intolerance, weariness, and irregular menstruation are among signs of hypothyroidism that occur when the thyroid gland does not produce enough T4 due to thyroid malfunction or insufficient TSH. Myxedema, or severe untreated hypothyroidism, can cause heart failure, convulsions, and coma. Hypothyroidism in children can slow growth and sexual development.

When the thyroid gland generates too much T4, the rate of a person's body functions increases, resulting in hyperthyroidism symptoms such as anxiety, increased heart rate, difficulty sleeping, weight loss, puffiness and dry itchy eyes, and hand tremors.

The most prevalent causes of thyroid dysfunction are connected to autoimmune illnesses. Hyperthyroidism is caused by Graves disease, while hypothyroidism is caused by Hashimoto thyroiditis. Thyroiditis, thyroid malignancy, and excessive or insufficient TSH production can all induce hyperthyroidism or hypothyroidism. By measuring Total T4, the influence of these variables on thyroid hormone synthesis can be recognized and monitored.

Note: Free T4 Index (T7) will only be calculated and reported if test code code 861 (T3 Uptake) is ordered as well.

Lab tests often ordered with a T4 Total test:

  • TSH
  • T3 Total
  • T3 Free
  • T4 Free
  • T3 Reverse
  • T3 Uptake
  • Thyroid Peroxidase
  • Thyroglobulin Antibodies

Conditions where a T4 Total test is recommended:

  • Hyperthyroidism
  • Hypothyroidism
  • Hashimotos
  • Graves’ Disease
  • Autoimmune Diseases
  • Thyroid Cancer

How does my health care provider use a T4 Total test?

Total thyroxine tests are used to assess thyroid function and detect thyroid disorders, such as hyperthyroidism and hypothyroidism, after the thyroid stimulating hormone level has been found to be abnormal.

The thyroid gland produces T4 and another hormone called triiodothyronine. They aid in the regulation of the rate at which the body expends energy and are governed by a feedback system. TSH promotes the thyroid gland's synthesis and release of T4 and T3.

The majority of T4 and T3 in the blood is attached to protein, while just a small amount is free. Total T4, free T4, total T3, and free T3 can all be measured in blood testing. The total T4 test has been around for a long time, but it is influenced by the quantity of protein in the blood that can bind to the hormone. The active form of thyroxine, free T4, is unaffected by protein levels. Many people believe that the free T4 test is a more accurate reflection of thyroid hormone activity, and it has largely supplanted the total T4 test.

A Total T4 test can be used in conjunction with or after a TSH test, and occasionally with a free T3 test to:

  • Help diagnose the cause of hyperthyroidism and hypothyroidism by detecting too much or too little thyroid hormone.
  • Differentiate between thyroid disorders.
  • Assist in the diagnosis of pituitary diseases
  • Assist in the diagnosis of infertility in women
  • In an individual with a known thyroid condition, track the effectiveness of treatment.
  • Monitor patients with pituitary disease to ensure that their thyroid is still operating, and thyroid hormone medication should be monitored if it isn't.
  • Monitor patients with thyroid cancer whose tumors respond to TSH. TSH and T4 levels will be monitored on a regular basis to ensure that adequate thyroid hormone is being administered to maintain TSH low while keeping T4 high.

In the United States, babies are routinely tested for T4 and TSH levels to rule out congenital hypothyroidism, which can lead to mental retardation if left untreated.

Thyroid abnormalities can sometimes be detected using Total T4 and TSH, however professional opinions differ on who should be screened and when they should start.

Thyroid antibodies, as well as a Total T4 test, may be ordered if a health practitioner suspects someone has an autoimmune-related thyroid problem.

What does my T4 Total result mean?

In general, high total T4 levels suggest an overactive thyroid gland, while low total T4 levels suggest an underactive thyroid gland. The test results are not diagnostic in and of themselves, but they will urge the health care provider to conduct additional testing to determine the reason of the excess or deficiency.

A range of temporary and chronic thyroid disorders are linked to both decreased and increased total T4 levels. A pituitary gland issue could be indicated by low total T4 levels along with a low TSH level, or by high total T4 levels combined with a high TSH.

When thyroid tests are done to monitor treatment for thyroid or pituitary diseases, the results will tell the doctor whether the treatment is working and/or if a dose adjustment is required. People with hyperthyroidism, for example, have their total T4, total T3, and TSH levels examined on a regular basis while taking anti-thyroid medicines to ensure that the drugs are effective and to reduce doses if thyroid hormone levels fall too low. TSH and total T4 levels are monitored on a frequent basis in hypothyroid patients to ensure that the correct dose of thyroid hormone is being given to bring TSH levels back to normal.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.


Most Popular

Description: A T4 Free test is a blood test that measures thyroxine free levels in your blood’s serum to evaluate your thyroid’s health and to screen for, diagnose, and monitor thyroid disorders such as hypothyroidism.

Also Known As: Free T4 Test, Free Thyroxine Test, FT4 Test, T4F Test, T4 Free Test, Unbound T4 Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a T4 Free test ordered?

When a person exhibits symptoms of hyperthyroidism or hypothyroidism, a free T4 test may be administered, especially if the TSH test is abnormal.

Hyperthyroidism can cause the following signs and symptoms:

  • Heart rate has increased.
  • Anxiety
  • Loss of weight
  • Sleeping problems
  • Hand tremors
  • Weakness
  • Diarrhea
  • Visual disturbances, light sensitivity
  • Puffiness around the eyes, dryness, discomfort, and, in some cases, bulging of the eyes are all possible side effects.

Hypothyroidism can cause the following symptoms:

  • gaining weight
  • Skin that is dry
  • Constipation
  • Intolerance to the cold
  • Skin that is puffy
  • Hair loss
  • Fatigue
  • Women's menstrual irregularities

When a person is being treated for a thyroid problem, free T4 testing, along with other thyroid tests, may be requested on a regular basis.

Thyroid testing will most likely be ordered early and late in the pregnancy, as well as for a period after delivery, to monitor the mother and baby in pregnant women with thyroid abnormalities.

In the United States, thyroid hormone screening is routinely performed on babies as part of newborn screening programs.

What does a T4 Free blood test check for?

The thyroid gland, a small butterfly-shaped structure that lays on the windpipe towards the bottom of the throat, produces one of two primary hormones: thyroxine. Triiodothyronine is the other primary thyroid hormone, and together they help govern the rate at which the body utilizes energy. T4 in the blood is almost entirely linked to protein. The remaining portion is free and is the hormone's biologically active form. This test determines how much free T4 is present in the blood.

A feedback loop controls T4 production. The hypothalamus releases thyrotropin releasing hormone, which encourages the pituitary gland to generate and release thyroid-stimulating hormone when the amount of T4 in the blood drops. The thyroid gland is thus stimulated to produce and/or release more T4 as a result of TSH. TSH release is blocked as T4 content in the blood rises.

T4 accounts for over 90% of thyroid hormones. The thyroid gland releases accumulated T4 into circulation when the body requires it. T4 is either free or bound to protein in the blood. The amount of free T4 in the body is just about 0.1 percent of total T4. In the liver or other tissues, T4 is converted to T3. T3, like T4, is mainly attached to protein, however the physiologically active forms of T3 and T4 are the free versions. Free T3 in circulation is 4 to 5 times more active than free T4.

Dry skin, weight gain, cold intolerance, weariness, and irregular menstruation are among signs of hypothyroidism that occur when the thyroid gland does not produce enough T4 due to thyroid malfunction or insufficient TSH. Myxedema, or severe untreated hypothyroidism, can cause heart failure, convulsions, and coma. Hypothyroidism in children can slow growth and sexual development.

When the thyroid gland generates too much T4, the rate of a person's body functions increases, resulting in hyperthyroidism symptoms such as anxiety, increased heart rate, difficulty sleeping, weight loss, puffiness and dry itchy eyes, and hand tremors.

The most prevalent causes of thyroid dysfunction are connected to autoimmune illnesses. Hyperthyroidism is caused by Graves disease, while hypothyroidism is caused by Hashimoto thyroiditis. Thyroiditis, thyroid malignancy, and excessive or insufficient TSH production can all induce hyperthyroidism or hypothyroidism. By measuring free T4, the influence of these variables on thyroid hormone synthesis can be recognized and monitored.

Lab tests often ordered with a T4 Free test:

  • TSH
  • T3 Total
  • T3 Free
  • T4 Total
  • T3 Reverse
  • T3 Uptake
  • Thyroid Peroxidase
  • Thyroglobulin Antibodies

Conditions where a T4 Free test is recommended:

  • Hyperthyroidism
  • Hypothyroidism
  • Hashimotos
  • Graves’ Disease
  • Autoimmune Diseases
  • Thyroid Cancer

How does my health care provider use a T4 Free test?

Free thyroxine tests are used to assess thyroid function and detect thyroid disorders, such as hyperthyroidism and hypothyroidism, after the thyroid stimulating hormone level has been found to be abnormal.

The thyroid gland produces T4 and another hormone called triiodothyronine. They aid in the regulation of the rate at which the body expends energy and are governed by a feedback system. TSH promotes the thyroid gland's synthesis and release of T4 and T3.

The majority of T4 and T3 in the blood is attached to protein, while just a small amount is free. Total T4, free T4, total T3, and free T3 can all be measured in blood testing. The total T4 test has been around for a long time, but it is influenced by the quantity of protein in the blood that can bind to the hormone. The active form of thyroxine, free T4, is unaffected by protein levels. Many people believe that the free T4 test is a more accurate reflection of thyroid hormone activity, and it has largely supplanted the total T4 test.

A free T4 test can be used in conjunction with or after a TSH test, and occasionally with a free T3 test to:

  • Help diagnose the cause of hyperthyroidism and hypothyroidism by detecting too much or too little thyroid hormone.
  • Differentiate between thyroid disorders.
  • Assist in the diagnosis of pituitary diseases
  • Assist in the diagnosis of infertility in women
  • In an individual with a known thyroid condition, track the effectiveness of treatment.
  • Monitor patients with pituitary disease to ensure that their thyroid is still operating, and thyroid hormone medication should be monitored if it isn't.
  • Monitor patients with thyroid cancer whose tumors respond to TSH. TSH and T4 levels will be monitored on a regular basis to ensure that adequate thyroid hormone is being administered to maintain TSH low while keeping T4 high.

In the United States, babies are routinely tested for T4 and TSH levels to rule out congenital hypothyroidism, which can lead to mental retardation if left untreated.

Thyroid abnormalities can sometimes be detected using free T4 and TSH, however professional opinions differ on who should be screened and when they should start.

Thyroid antibodies, as well as a free T4 test, may be ordered if a health practitioner suspects someone has an autoimmune-related thyroid problem.

What does my T4 Free result mean?

In general, high free T4 levels suggest an overactive thyroid gland, while low free T4 levels suggest an underactive thyroid gland. The test results are not diagnostic in and of themselves, but they will urge the health care provider to conduct additional testing to determine the reason of the excess or deficiency.

A range of temporary and chronic thyroid disorders are linked to both decreased and increased free T4 levels. A pituitary gland issue could be indicated by low free T4 levels along with a low TSH level, or by high free T4 levels combined with a high TSH.

When thyroid tests are done to monitor treatment for thyroid or pituitary diseases, the results will tell the doctor whether the treatment is working and/or if a dose adjustment is required. People with hyperthyroidism, for example, have their free T4, free T3, and TSH levels examined on a regular basis while taking anti-thyroid medicines to ensure that the drugs are effective and to reduce doses if thyroid hormone levels fall too low. TSH and free T4 levels are monitored on a frequent basis in hypothyroid patients to ensure that the correct dose of thyroid hormone is being given to bring TSH levels back to normal.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.


Brief Description: Testosterone, Free (Dialysis) and Total, MS is a blood test used to detect abnormal levels of testosterone in both male and female patients, and diagnose causes of erectile dysfunction, infertility, virilization, polycystic ovary syndrome, and delayed or early puberty in children.

Also Known As: Total Testosterone, Free Testosterone, Testosterone Free and Total

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a Free and Total Testosterone test ordered?

When infertility is suspected, or when a man has decreased sex drive or erectile difficulties, a testosterone test may be ordered. Other signs include a lack of beard and body hair, a loss of muscle mass, and the formation of breast tissue. Low total and bioavailable testosterone levels have also been linked to, or caused by, increased visceral fat, insulin resistance, and an increased risk of coronary artery disease.

The test is frequently ordered in conjunction with the FSH and LH tests in males who are experiencing delayed or slow puberty. Although the age at which puberty begins varies from person to person, it usually begins around the age of ten. The following are some of the signs and symptoms of delayed puberty:

  • Muscle mass development is delayed.
  • Voice not getting lower or a lack of body hair growth
  • Growth of the testicles and penis is slowed or delayed.

When a young boy appears to be going through an early puberty with clear secondary sex traits, the test can be ordered. Various malignancies and congenital adrenal hyperplasia can cause early puberty in boys due to elevated testosterone.

When a woman has irregular or no menstrual cycles, is having trouble getting pregnant, or displays masculine traits such as abundant facial and body hair, male pattern baldness, and/or a low voice, testosterone testing may be done. Testosterone levels can rise as a result of malignancies in the ovary or adrenal gland, as well as other illnesses including polycystic ovarian syndrome.

What does a Testosterone Total and Free blood test check for?

In men, testosterone is the primary sex hormone. It's in charge of a man's physical appearance. Although it is thought to be a "masculine" sex hormone, it is found in both men and women's blood. This test determines the amount of testosterone in a person's blood.

Testosterone is primarily produced in the male testicles by unique endocrine tissue called Leydig cells. It's also made by the adrenal glands in both males and females, as well as the ovaries in females in modest amounts.

In males, testosterone promotes the formation of secondary sex characteristics such as penis size, body hair growth, muscle development, and a deeper voice. It is abundant in males during adolescence and adulthood in order to regulate sex drive and preserve muscle mass. Estradiol is the major sex hormone in females, and testosterone is converted to it in women.

The pituitary gland produces luteinizing hormone, which stimulates and regulates testosterone synthesis. Testosterone functions in a negative feedback loop: when testosterone levels rise, LH production falls, slowing testosterone production; lower testosterone levels cause higher LH production, which promotes testosterone production.

Testosterone levels fluctuate throughout the day, increasing in the early morning hours and dropping in the evening. Levels rise after activity and fall as people get older.

About two-thirds of testosterone is attached to sex-hormone binding globulin in the bloodstream, with the remaining one-third bound to albumin. Only a small percentage of testosterone is released into the bloodstream as free testosterone. The bioavailable fraction is the free plus albumin-bound testosterone, which can act on target tissues.

Lab tests often ordered with a Testosterone Free and Total test:

  • Estradiol
  • Dihydrotestosterone
  • FSH
  • LH
  • Estrogens
  • Estriol
  • Estrone
  • Albumin
  • Prolactin
  • Anti-mullerian Hormone
  • Androstenedione
  • Sex Hormone Binding Globulin

Conditions where a Testosterone Free and Total test is recommended:

  • Polycystic Ovary Syndrome
  • Alcoholism
  • Mumps
  • Hypothalamic disease
  • Pituitary disease
  • Infertility
  • Liver disease
  • Hyperthyroidism
  • Eating disorders
  • Pregnancy
  • Cushing Syndrome
  • Hypothyroidism
  • Testicular cancer
  • Adrenal insufficiency
  • Congenital Adrenal Hyperplasia

Commonly Asked Questions:

How does my health care provider use a Testosterone Free and Total test?

In men, women, girls, and boys, testosterone testing is used to identify a variety of problems. Testosterone is the major sex hormone in males, and it is responsible for masculine physical traits. It is produced mostly by the testicles. Although it is thought to be a "male" sex hormone, it is found in both males and females.

The testosterone test can be used to determine whether or not you're experiencing:

  • Delayed or early puberty in boys
  • In both men and women, sex drive has decreased.
  • Men's erectile dysfunction
  • Male and female infertility
  • Tumors of the testicles in men
  • Disorders of the hypothalamus or pituitary gland
  • Virilization and hirsutism in girls and women

A testosterone total test is usually used to diagnose a condition. The free and total testosterone test distinguishes between testosterone that is bound to proteins in the blood and testosterone that is not attached to proteins.

About two-thirds of testosterone is tied to SHBG in the blood, with the remaining one-third attached to albumin. Free testosterone circulates in a tiny percentage. Bioavailable testosterone is made up of free testosterone and testosterone bound to albumin, and it can operate on target tissues.

A test for free or bioavailable testosterone may be performed in some circumstances, such as when the level of SHBG is abnormal, as it may more accurately indicate the presence of a medical issue.

Other tests and hormone levels may be performed in conjunction with testosterone testing, depending on the reason for testing. Here are a few examples:

  • FSH
  • LH
  • Estrogen
  • Estradiol
  • SHBG
  • DHEA-S
  • Prolactin
  • Androstenedione
  • 17-Hydroxyprogesterone

What does my testosterone test result mean?

Males: 

Testosterone levels often begin to fall after the age of 30. Testosterone levels may drop more in obese or chronically unwell men, as well as with the use of certain drugs.

Hypogonadism can be caused by a variety of factors, including:

  • Pituitary or hypothalamic illness
  • Reduced testosterone production in young males can be caused by genetic disorders
  • Possible infertility or testicular failure
  • Acquired damage to the testes, such as from drinking, physical injury, or viral infections like mumps, reduces testosterone production.
  • Diabetes

Healthcare practitioners may recommend testosterone replacement therapy to men who have consistently low testosterone levels and associated signs and symptoms. The Food and Drug Administration has not approved testosterone supplements to improve strength, sports performance, or avoid aging disorders. It's possible that using it for these purposes is dangerous.

Increased testosterone levels in men can mean one of several things:

  • Tumors of the testicles
  • Testosterone-producing tumors in the adrenal glands
  • Use of anabolic steroids
  • Early puberty in males due to an unknown cause
  • Adrenal hyperplasia in toddlers and babies

Females:

Testosterone levels in women are typically low. Increased testosterone levels can mean one of the following things:

  • Ovarian or adrenal gland tumor
  • PCOS
  • Adrenal hyperplasia that occurs at birth.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.


Helpful in assessing testicular function in males and managing hirsutism, virilization in females.

Description: Testosterone Free and Total with Sex Hormone Binding Globulin is a blood test used to detect abnormal levels of testosterone in both male and female patients, and diagnose causes of erectile dysfunction, infertility, virilization, polycystic ovary syndrome, and delayed or early puberty in children.

Also Known As: Total Testosterone Test, Free Testosterone Test, Testosterone Free and Total Test, Sex Hormone Binding Globulin Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a Testosterone Free and Total with Sex Hormone Binding Globulin test ordered?

When infertility is suspected, or when a man has decreased sex drive or erectile difficulties, a testosterone test may be ordered. Other signs include a lack of beard and body hair, a loss of muscle mass, and the formation of breast tissue. Low total and bioavailable testosterone levels have also been linked to, or caused by, increased visceral fat, insulin resistance, and an increased risk of coronary artery disease.

The test is frequently ordered in conjunction with the FSH and LH tests in males who are experiencing delayed or slow puberty. Although the age at which puberty begins varies from person to person, it usually begins around the age of ten. The following are some of the signs and symptoms of delayed puberty:

  • Muscle mass development is delayed.
  • Voice not getting lower or a lack of body hair growth
  • Growth of the testicles and penis is slowed or delayed.

When a young boy appears to be going through an early puberty with clear secondary sex traits, the test can be ordered. Various malignancies and congenital adrenal hyperplasia can cause early puberty in boys due to elevated testosterone.

When a woman has irregular or no menstrual cycles, is having trouble getting pregnant, or displays masculine traits such as abundant facial and body hair, male pattern baldness, and/or a low voice, testosterone testing may be done. Testosterone levels can rise as a result of malignancies in the ovary or adrenal gland, as well as other illnesses including polycystic ovarian syndrome.

What does a Testosterone Total and Free with Sex Hormone Binding Globulin blood test check for?

In men, testosterone is the primary sex hormone. It's in charge of a man's physical appearance. Although it is thought to be a "masculine" sex hormone, it is found in both men and women's blood. This test determines the amount of testosterone in a person's blood.

Testosterone is primarily produced in the male testicles by unique endocrine tissue called Leydig cells. It's also made by the adrenal glands in both males and females, as well as the ovaries in females in modest amounts.

In males, testosterone promotes the formation of secondary sex characteristics such as penis size, body hair growth, muscle development, and a deeper voice. It is abundant in males during adolescence and adulthood in order to regulate sex drive and preserve muscle mass. Estradiol is the major sex hormone in females, and testosterone is converted to it in women.

The pituitary gland produces luteinizing hormone, which stimulates and regulates testosterone synthesis. Testosterone functions in a negative feedback loop: when testosterone levels rise, LH production falls, slowing testosterone production; lower testosterone levels cause higher LH production, which promotes testosterone production.

Testosterone levels fluctuate throughout the day, increasing in the early morning hours and dropping in the evening. Levels rise after activity and fall as people get older.

About two-thirds of testosterone is attached to sex-hormone binding globulin in the bloodstream, with the remaining one-third bound to albumin. Only a small percentage of testosterone is released into the bloodstream as free testosterone. The bioavailable fraction is the free plus albumin-bound testosterone, which can act on target tissues.

In many circumstances, measuring total testosterone is sufficient information for a healthcare provider. A test for free or bioavailable testosterone may be performed in some circumstances, such as when the level of SHBG is abnormal, as it may more accurately indicate the presence of a medical issue.

SHBG is a liver-produced protein that strongly binds to the hormones testosterone, dihydrotestosterone, and estradiol. SHBG distributes these hormones in the blood as physiologically inactive versions when they are bound. This test examines the amount of SHBG in the blood and is most commonly used to determine whether a person has too much or too little testosterone.

In men, SHBG binds roughly 45 percent to 65 percent of testosterone in the blood, with the rest weakly and reversibly linked to albumin. Only around 2% to 3% of testosterone is accessible to tissues as free testosterone, but testosterone that is weakly linked to albumin is also bioavailable and can be rapidly absorbed by the body's tissues.

In women, a somewhat higher percentage of testosterone is bound to SHBG in the blood than in men. SHBG is important in controlling the quantities of bioavailable male sex hormones and estrogens circulating throughout the body in women. Because SHBG has a stronger affinity for the androgens testosterone and DHT, women with low SHBG may experience signs and symptoms of androgen excess.

A total testosterone test does not differentiate between bound and unbound testosterone; instead, it determines the total amount of testosterone present. In many circumstances, this is sufficient to determine if testosterone production is excessive or inadequate. However, if a person's SHBG level is abnormal, the total testosterone level may not accurately reflect the amount of testosterone available to the person's tissues. When a person's indications and symptoms do not match the results of a total testosterone test, a SHBG test may be conducted.

Lab tests often ordered with a Testosterone Free and Total with Sex Hormone Binding Globulin test:

  • Estradiol
  • Dihydrotestosterone
  • FSH
  • LH
  • Estrogens
  • Estriol
  • Estrone
  • Albumin
  • Prolactin
  • Anti-mullerian Hormone
  • Androstenedione

Conditions where a Testosterone Free and Total with Sex Hormone Binding Globulin test is recommended:

  • Polycystic Ovary Syndrome
  • Alcoholism
  • Mumps
  • Hypothalamic disease
  • Pituitary disease
  • Infertility
  • Liver disease
  • Hyperthyroidism
  • Eating disorders
  • Pregnancy
  • Cushing Syndrome
  • Hypothyroidism
  • Testicular cancer
  • Adrenal insufficiency
  • Congenital Adrenal Hyperplasia

Commonly Asked Questions:

How does my health care provider use a Testosterone Free and Total with Sex Hormone Binding Globulin test?

In men, women, girls, and boys, testosterone testing is used to identify a variety of problems. Testosterone is the major sex hormone in males, and it is responsible for masculine physical traits. It is produced mostly by the testicles. Although it is thought to be a "male" sex hormone, it is found in both males and females.

The testosterone test can be used to determine whether or not you're experiencing:

  • Delayed or early puberty in boys
  • In both men and women, sex drive has decreased.
  • Men's erectile dysfunction
  • Male and female infertility
  • Tumors of the testicles in men
  • Disorders of the hypothalamus or pituitary gland
  • Virilization and hirsutism in girls and women

A testosterone total test is usually used to diagnose a condition. The free and total testosterone test distinguishes between testosterone that is bound to proteins in the blood and testosterone that is not attached to proteins.

About two-thirds of testosterone is tied to SHBG in the blood, with the remaining one-third attached to albumin. Free testosterone circulates in a tiny percentage. Bioavailable testosterone is made up of free testosterone and testosterone bound to albumin, and it can operate on target tissues.

A test for free or bioavailable testosterone may be performed in some circumstances, such as when the level of SHBG is abnormal, as it may more accurately indicate the presence of a medical issue.

Other tests and hormone levels may be performed in conjunction with testosterone testing, depending on the reason for testing. Here are a few examples:

  • FSH
  • LH
  • Estrogen
  • Estradiol
  • SHBG
  • DHEA-S
  • Prolactin
  • Androstenedione
  • 17-Hydroxyprogesterone
  • The sex hormone binding globulin test can be performed to determine whether a man has low testosterone or if a woman has too much testosterone. It can be used in conjunction with other tests to assess a person's sex hormone status.

SHBG is a protein that binds to testosterone, dihydrotestosterone, and estradiol, among other hormones. SHBG distributes these hormones in the blood as physiologically inactive versions when they are bound. Changes in SHBG levels can have an impact on the amount of hormone accessible to the body's tissues.

To assess a person's current hormonal balance, tests for albumin and one or more additional sex hormones, such as prolactin, estradiol, and LH may be conducted.

In men

In order to diagnose the cause of infertility, diminished sex drive, or erectile dysfunction in an adult male, SHBG and total testosterone levels may be ordered. When total testosterone findings are contradictory with clinical symptoms, measuring SHBG in addition to testosterone is extremely beneficial.

Total testosterone in the blood is measured without distinguishing between bound and unbound testosterone; rather, it determines the total amount of testosterone in the blood. In many circumstances, this is sufficient to determine if testosterone production is excessive or inadequate. However, if a person's SHBG level is abnormal, the total testosterone level may not accurately reflect the amount of testosterone available to the body's tissues.

With a simple total testosterone assessment, health practitioners can estimate bioavailable testosterone by measuring SHBG. Because less testosterone is accessible to the body's tissues, increased SHBG in males may be linked to symptoms of low testosterone levels.

Total testosterone should be measured in the initial screening for testosterone deficiency, according to the Endocrine Society's professional standards. If the results are abnormal, the test is repeated the next day. They propose one of the following if repeat readings are low-normal and/or SHBG is abnormal:

In women

The ovaries and adrenal glands produce modest amounts of testosterone in women. Even little increases in testosterone production can throw off the hormone balance, resulting in symptoms including irregular or missed periods, infertility, acne, and excessive face and body hair. These and other signs and symptoms are common in polycystic ovarian syndrome, a disorder marked by an overproduction of male sex hormones. SHBG and testosterone testing may be helpful in detecting and evaluating excess testosterone production and/or decreasing SHBG concentrations, as well as in evaluating women with PCOS.

What does my testosterone test result mean?

Males: 

Testosterone levels often begin to fall after the age of 30. Testosterone levels may drop more in obese or chronically unwell men, as well as with the use of certain drugs.

Hypogonadism can be caused by a variety of factors, including:

  • Pituitary or hypothalamic illness
  • Reduced testosterone production in young males can be caused by genetic disorders
  • Possible infertility or testicular failure
  • Acquired damage to the testes, such as from drinking, physical injury, or viral infections like mumps, reduces testosterone production.
  • Diabetes

Healthcare practitioners may recommend testosterone replacement therapy to men who have consistently low testosterone levels and associated signs and symptoms. The Food and Drug Administration has not approved testosterone supplements to improve strength, sports performance, or avoid aging disorders. It's possible that using it for these purposes is dangerous.

Increased testosterone levels in men can mean one of several things:

  • Tumors of the testicles
  • Testosterone-producing tumors in the adrenal glands
  • Use of anabolic steroids
  • Early puberty in males due to an unknown cause
  • Adrenal hyperplasia in toddlers and babies

Females:

Testosterone levels in women are typically low. Increased testosterone levels can mean one of the following things:

  • Ovarian or adrenal gland tumor
  • PCOS
  • Adrenal hyperplasia that occurs at birth.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.


Description: Testosterone, Total, MS is a blood test used to detect abnormal levels of testosterone in both male and female patients, and diagnose causes of erectile dysfunction, infertility, virilization, polycystic ovary syndrome, and delayed or early puberty in children.

Also Known As: Total Testosterone Test, Testosterone Total Test, Female Testosterone Test, Pediatric Testosterone Test, Ultrasensitive Testosterone Test, Uncapped Testosterone Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a Testosterone Total test ordered?

When infertility is suspected, or when a man has decreased sex drive or erectile difficulties, a testosterone test may be ordered. Other signs include a lack of beard and body hair, a loss of muscle mass, and the formation of breast tissue. Low total and bioavailable testosterone levels have also been linked to, or caused by, increased visceral fat, insulin resistance, and an increased risk of coronary artery disease.

The test is frequently ordered in conjunction with the FSH and LH tests in males who are experiencing delayed or slow puberty. Although the age at which puberty begins varies from person to person, it usually begins around the age of ten. The following are some of the signs and symptoms of delayed puberty:

  • Muscle mass development is delayed.
  • Voice not getting lower or a lack of body hair growth
  • Growth of the testicles and penis is slowed or delayed.

When a young boy appears to be going through an early puberty with clear secondary sex traits, the test can be ordered. Various malignancies and congenital adrenal hyperplasia can cause early puberty in boys due to elevated testosterone.

When a woman has irregular or no menstrual cycles, is having trouble getting pregnant, or displays masculine traits such as abundant facial and body hair, male pattern baldness, and/or a low voice, testosterone testing may be done. Testosterone levels can rise as a result of malignancies in the ovary or adrenal gland, as well as other illnesses including polycystic ovarian syndrome.

What does a Testosterone Total blood test check for?

In men, testosterone is the primary sex hormone. It's in charge of a man's physical appearance. Although it is thought to be a "masculine" sex hormone, it is found in both men and women's blood. This test determines the amount of testosterone in a person's blood.

Testosterone is primarily produced in the male testicles by unique endocrine tissue called Leydig cells. It's also made by the adrenal glands in both males and females, as well as the ovaries in females in modest amounts.

In males, testosterone promotes the formation of secondary sex characteristics such as penis size, body hair growth, muscle development, and a deeper voice. It is abundant in males during adolescence and adulthood in order to regulate sex drive and preserve muscle mass. Estradiol is the major sex hormone in females, and testosterone is converted to it in women.

The pituitary gland produces luteinizing hormone, which stimulates and regulates testosterone synthesis. Testosterone functions in a negative feedback loop: when testosterone levels rise, LH production falls, slowing testosterone production; lower testosterone levels cause higher LH production, which promotes testosterone production.

Testosterone levels fluctuate throughout the day, increasing in the early morning hours and dropping in the evening. Levels rise after activity and fall as people get older.

About two-thirds of testosterone is attached to sex-hormone binding globulin in the bloodstream, with the remaining one-third bound to albumin. Only a small percentage of testosterone is released into the bloodstream as free testosterone. The bioavailable fraction is the free plus albumin-bound testosterone, which can act on target tissues.

In many circumstances, measuring total testosterone is sufficient information for a healthcare provider. A test for free or bioavailable testosterone may be performed in some circumstances, such as when the level of SHBG is abnormal, as it may more accurately indicate the presence of a medical issue.

Lab tests often ordered with a Testosterone Total test:

  • Estradiol
  • Dihydrotestosterone
  • FSH
  • LH
  • Estrogens
  • Estriol
  • Estrone
  • Albumin
  • Prolactin
  • Anti-mullerian Hormone
  • Androstenedione
  • Sex Hormone Binding Globulin

Conditions where a Testosterone Total test is recommended:

  • Polycystic Ovary Syndrome
  • Alcoholism
  • Mumps
  • Hypothalamic disease
  • Pituitary disease
  • Infertility
  • Liver disease
  • Hyperthyroidism
  • Eating disorders
  • Pregnancy
  • Cushing Syndrome
  • Hypothyroidism
  • Testicular cancer
  • Adrenal insufficiency
  • Congenital Adrenal Hyperplasia

Commonly Asked Questions:

How does my health care provider use a Testosterone Total test?

In men, women, girls, and boys, testosterone testing is used to identify a variety of problems. Testosterone is the major sex hormone in males, and it is responsible for masculine physical traits. It is produced mostly by the testicles. Although it is thought to be a "male" sex hormone, it is found in both males and females.

The testosterone test can be used to determine whether or not you're experiencing:

  • Delayed or early puberty in boys
  • In both men and women, sex drive has decreased.
  • Men's erectile dysfunction
  • Male and female infertility
  • Tumors of the testicles in men
  • Disorders of the hypothalamus or pituitary gland
  • Virilization and hirsutism in girls and women

A testosterone total test is usually used to diagnose a condition. The free and total testosterone test distinguishes between testosterone that is bound to proteins in the blood and testosterone that is not attached to proteins.

About two-thirds of testosterone is tied to SHBG in the blood, with the remaining one-third attached to albumin. Free testosterone circulates in a tiny percentage. Bioavailable testosterone is made up of free testosterone and testosterone bound to albumin, and it can operate on target tissues.

A test for free or bioavailable testosterone may be performed in some circumstances, such as when the level of SHBG is abnormal, as it may more accurately indicate the presence of a medical issue.

Other tests and hormone levels may be performed in conjunction with testosterone testing, depending on the reason for testing. Here are a few examples:

  • FSH
  • LH
  • Estrogen
  • Estradiol
  • SHBG
  • DHEA-S
  • Prolactin
  • Androstenedione
  • 17-Hydroxyprogesterone

What does my testosterone test result mean?

Males: 

Testosterone levels often begin to fall after the age of 30. Testosterone levels may drop more in obese or chronically unwell men, as well as with the use of certain drugs.

Hypogonadism can be caused by a variety of factors, including:

  • Pituitary or hypothalamic illness
  • Reduced testosterone production in young males can be caused by genetic disorders
  • Possible infertility or testicular failure
  • Acquired damage to the testes, such as from drinking, physical injury, or viral infections like mumps, reduces testosterone production.
  • Diabetes

Healthcare practitioners may recommend testosterone replacement therapy to men who have consistently low testosterone levels and associated signs and symptoms. The Food and Drug Administration has not approved testosterone supplements to improve strength, sports performance, or avoid aging disorders. It's possible that using it for these purposes is dangerous.

Increased testosterone levels in men can mean one of several things:

  • Tumors of the testicles
  • Testosterone-producing tumors in the adrenal glands
  • Use of anabolic steroids
  • Early puberty in males due to an unknown cause
  • Adrenal hyperplasia in toddlers and babies

Females:

Testosterone levels in women are typically low. Increased testosterone levels can mean one of the following things:

  • Ovarian or adrenal gland tumor
  • PCOS
  • Adrenal hyperplasia that occurs at birth.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.


Most Popular

Description: A TSH test is a blood test that measures thyroid stimulating hormone levels in your blood’s serum and is used to screen for and monitor treatment of thyroid disorders such as hypothyroidism and hyperthyroidism.

Also Known As: Thyroid Stimulating Hormone Test, Thyrotropin Test, TSH test, Thyroid Test, TSH Screen Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a TSH test ordered?

When a person has symptoms of hyperthyroidism or hypothyroidism, or an enlarged thyroid gland, a doctor may order a TSH test.

Hyperthyroidism can cause the following signs and symptoms:

  • Heart rate has increased.
  • Anxiety
  • Loss of weight
  • Sleeping problems
  • Hand tremors.
  • Weakness
  • Diarrhea
  • Visual disturbances, light sensitivity
  • Puffiness around the eyes, dryness, discomfort, and, in some cases, bulging of the eyes are all possible side effects.

Hypothyroidism can cause the following signs and symptoms:

  • gaining weight
  • Skin that is dry
  • Constipation
  • Intolerance to the cold
  • Skin that is puffy
  • Hair loss is a common problem.
  • Fatigue
  • Women's menstrual irregularities

When a person is being treated for a thyroid disease, TSH may be ordered at regular intervals. The American Thyroid Association suggests waiting 6-8 weeks after changing a person's thyroid medication dose before testing their TSH level again.

In the United States, TSH screening is routinely performed on newborns shortly after birth as part of each state's newborn screening program.

What does a TSH blood test check for?

The pituitary gland, a small structure beneath the brain and beyond the sinus cavities, produces thyroid-stimulating hormone. TSH causes thyroxine and triiodothyronine to be released into the bloodstream by the thyroid gland. These thyroid hormones aid in the regulation of the body's energy usage. This test determines how much TSH is present in the blood.

The feedback mechanism that the body utilizes to maintain consistent quantities of thyroid hormones in the blood includes TSH and its regulatory hormone, thyrotropin releasing hormone, which comes from the hypothalamus. TSH synthesis by the pituitary gland increases as thyroid hormone concentrations fall. TSH stimulates the thyroid gland, a small butterfly-shaped gland that lays flat against the windpipe at the base of the throat, to produce and release T4 and T3. Thyroid production turns on and off to maintain generally steady levels of thyroid hormones in the blood when all three organs are operating regularly.

When the thyroid produces excessive amounts of T4 and T3, the affected person may have hyperthyroidism symptoms such as high heart rate, weight loss, agitation, hand tremors, itchy eyes, and difficulty sleeping. The most prevalent cause of hyperthyroidism is Graves disease. It is a chronic autoimmune condition in which the immune system creates antibodies that mimic TSH, causing the thyroid hormone to be produced in excessive levels. As a result, the pituitary gland may produce less TSH, resulting in a low blood level.

Weight gain, dry skin, constipation, cold intolerance, and weariness are all symptoms of hypothyroidism, a condition in which the thyroid produces fewer thyroid hormones. In the United States, Hashimoto thyroiditis is the most prevalent cause of hypothyroidism. It's an autoimmune disease in which the immune system attacks the thyroid, causing inflammation and destruction as well as the generation of autoantibodies. The thyroid generates low levels of thyroid hormone in Hashimoto thyroiditis. The pituitary gland may create more TSH, resulting in a high blood level.

TSH values, on the other hand, do not necessarily indicate or predict thyroid hormone levels. TSH is produced abnormally in some persons and does not work properly. Despite having normal or modestly increased TSH values, they frequently develop hypothyroidism. Thyroid hormone levels can be high or low in a variety of thyroid illnesses, regardless of the amount of TSH in the blood.

TSH levels may be elevated or lowered in rare cases due to pituitary dysfunction. In addition to pituitary dysfunction, an issue with the hypothalamus can cause hyperthyroidism or hypothyroidism.

Lab tests often ordered with a TSH test:

  • T3 Free
  • T3 Total
  • T4 Free
  • T4 Total
  • T3 Reverse
  • T3 Uptake
  • Thyroid Peroxidase
  • Thyroglobulin Antibodies
  • Thyroid Panel

Conditions where a test TSH is recommended:

  • Hyperthyroidism
  • Hypothyroidism
  • Hashimotos
  • Graves’ Disease
  • Autoimmune Diseases
  • Thyroid Cancer

Commonly Asked Questions:

How does my health care provider use a TSH test?

Thyroid function and/or symptoms of a thyroid problem, such as hyperthyroidism or hypothyroidism, are frequently assessed with the thyroid-stimulating hormone test.

The pituitary gland, a small structure beneath the brain and beyond the sinus cavities, produces TSH. It's a part of the body's feedback system that keeps the thyroid hormones thyroxine and triiodothyronine in check and helps regulate the pace at which the body burns calories.

TSH tests are typically ordered in conjunction with or before a free T4 test. A free T3 test and thyroid antibodies are two further thyroid tests that can be ordered. TSH, free T4, and free T3 are sometimes ordered as part of a thyroid panel.

TSH is used to:

  • Diagnose a thyroid issue in a patient who is experiencing symptoms.
  • Check newborns for an underactive thyroid.
  • Monitor thyroid replacement therapy.
  • Monitor treatment of hyperthyroidism that involves medication.
  • Assist women in diagnosing and monitoring infertility issues.
  • Assist in determining the pituitary gland's function
  • Screen adults for thyroid issues and diseases.

What does my TSH blood test result mean?

A high TSH level could indicate that:

  • The person being examined has an underactive thyroid gland that isn't responding well to TSH stimulation owing to acute or chronic thyroid dysfunction.
  • If a person has hypothyroidism or has had their thyroid gland removed, the dose of thyroid hormone replacement medicine may need to be changed.
  • A patient with hyperthyroidism is taking too much anti-thyroid medication, and the dosage needs to be reduced.
  • There is a problem with the pituitary gland, such as a tumor that causes TSH levels to be out of control.

A low TSH level could imply the following:

  • An overactive thyroid gland
  • Thyroid hormone prescription taken in excess by patients being treated for an underactive thyroid gland.
  • Inadequate medication in an individual being treated for hyperthyroidism; nevertheless, after successful anti-thyroid treatment, TSH production may take a time to recover. This is why the American Thyroid Association recommends testing for thyroid hormones as well as TSH levels throughout treatment.
  • The pituitary gland has been damaged, preventing it from releasing enough TSH.

An abnormal TSH result, whether high or low, suggests an excess or deficiency in the quantity of thyroid hormone available to the body, but does not pinpoint the cause for the abnormal result. Additional testing is frequently performed after an abnormal TSH test result to determine the reason of the increase or decrease.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.


This test is useful in the differential diagnosis of pituitary and gonadal insufficiency and in children with precocious puberty.

This test is useful in the differential diagnosis of pituitary and gonadal insufficiency and in children with precocious puberty.

This test is useful in the differential diagnosis of pituitary and gonadal insufficiency and in children with precocious puberty.

This test is useful in the differential diagnosis of pituitary and gonadal insufficiency and in children with precocious puberty.

This test is useful in the differential diagnosis of pituitary and gonadal insufficiency and in children with precocious puberty.


Infertility refers to being unable to get pregnant. The average diagnosis comes after a period of assessment (1 year or more) with the couple trying to get pregnant. In some cases, a woman may get pregnant but won’t be able to carry the fetus to term (miscarriage), and this is also noted under the same diagnosis of infertility. 

According to modern research, 10-15% of all US couples deal with this concern. Approximately 33% of these cases involve women-related problems concerning fertility. While another 33% includes men-related issues. The remaining 33% consists of a combination of men and women-related problems. 

Timing and interaction of many factors come into play when looking at fertility.  Hormones, both men’s and women’s, constitute a big part of this equation.  These hormones include those produced by a man’s testicles, a woman’s ovaries, and glands like the pituitary, hypothalamus, and thyroid. 

When it comes to pregnancies, a woman has to develop an egg in one of the ovaries and then release it. Women are born with a set number of eggs (or oocytes), and each one has its own spot in the ovaries, nesting in a cavity filled with fluid, called a follicle. When a healthy female is born, she will have approximately 1-2 million follicles, but most of these degenerate once puberty hits. As a result, there are about 200,000-400,000 viable follicles left. When a woman starts entering the all-important reproductive years, the numbers dwindle further so much that only about 400 mature eggs are ever released. Most women release about one mature egg per month. 

A woman’s menstrual cycle kickstarts the follicle-stimulating hormone (FSH) that causes the follicles to mature a few at a time. During this stage, typically, only one follicle tends to dominate over the rest. This is when estradiol production begins to rise and hits top gear around day 14 out of the cycle. The estradiol causes the uterine lining to thicken and acts as a catalyst for hormone production of gonadotropin-releasing hormone, FSH, and luteinizing hormone. When these hormones come into effect, the mature egg is released, and that’s what begins the ovulation process. 

The mature egg begins to move through the fallopian tube and, if sperm are present, eventually gets fertilized. If fertilized successfully, the embryo begins to form and move into the uterus before finally settling into the endometrium (or the lining of the uterine). When the embryo starts to develop, the newly formed placenta supplies nourishment and other support during the gestation period. A hitch in any of these processes could spur problems with infertility. In the end, deciphering the things that cause infertility may be complicated, while other times, it may be relatively easy to identify and address the cause. 

Main Causes of Infertility 

It starts with something as simple as age. Couples that are trying to conceive during their 30s or 40s see a rise in these issues. 

The best time for a woman to conceive is during her early 20s before fertility substantially declines by age 35 and even more after 40. When a woman reaches menopause, she doesn’t have many functioning eggs available. 

When it comes to men, their number and motility of sperm decreases, which reduces the likelihood of pregnancy. There are other relevant age-related concerns for men, such as low testosterone levels, erectile issues, ejaculation trouble, and prostate concerns. 

Along with age, other relevant factors to keep in mind for men and women include: 

  • Too Much Exercise 
  • Unhealthy Habits (i.e., Smoking, Alcoholism, Drugs) 
  • Significant Medical Conditions (i.e., Diabetes) 
  • Exposure to Chemicals/Toxins 
  • Exceedingly Overweight/Underweight 

While each of these may play a role in causing infertility, there are times when the root cause is unknown. These conditions may restrict sperm movement, affect ovulation, or affect fertilization or implantation of the egg. 

For women, here are some of the leading conditions that can cause infertility: 

  • Polycystic Ovary Syndrome (or PCOS) – Impedes the Releasing of Mature Eggs 
  • Pelvic Inflammatory Disease (or PID) – Blocks Fallopian Tubes Due to STDs 
  • Primary Ovary Insufficiency (or POI) 
  • Endometriosis 
  • Fibroids in the Uterus 
  • Irregular Hormone Levels (FSH, LH, Estrogens) 
  • Eating Disorders 
  • Autoimmune Disorders (i.e., Antiphospholipid Syndrome) 
  • Hypothyroidism 
  • Gluten Intolerance 

For men, the following conditions can impact their fertility: 

  • Irregular Hormone Levels (Testosterone, FSH, LH) 
  • Erectile Dysfunction 
  • Low Sperm Count, Clumped Sperm, Abnormally-Shaped Sperm, Poor Sperm Movement (Motility) 
  • Obstructions Preventing Ejaculation 
  • Enlarged Veins Near the Testicles (Varicoceles) 
  • Prolonged Fever 
  • Injured Testicle(s) 
  • Mumps Infection (Inflamed Testicles) 
  • Excessive Heat Near the Testicles 
  • Klinefelter Syndrome 

Lab Testing for Women 

It’s best to start with relevant blood tests to assess the hormone levels that cause infertility.

These can include: 

In some cases, changes in thyroid and/or pituitary function can impact the menstrual cycle and ovulation process. Blood tests may help spot irregularities when it comes to thyroid function (Free T4 and/or TSH) along with steroids (DHEA-STestosterone) and while also shedding light on androgen levels. 

Imaging Procedures 

There are specific imaging techniques that can be deployed to spot physical concerns that impede fertilization or healthy pregnancies. These imaging procedures include ultrasound sonograms, x-rays, and fiber-optic endoscopies, all to help locate abnormalities such as abscesses, tumors, fibroids, and/or polyps.   

Lab Testing for Men 

For men, the diagnostic process involves a thorough look through their medical history and a physical exam to spot any abnormalities. Depending on what’s observed, the examination may also involve the use of a trans-rectal ultrasound (TRUS) to find abnormalities that can include blockages affecting the release of sperm during ejaculation. Note: an absence of sperm (azoospermia) may be due to a lack of seminal vesicles or vas deferens.   

Semen Analysis is a foundational test used to aid in diagnosing infertility in men. The semen is collected and evaluated to spot potential defects in the shape, number, or movement (motility) of sperm. 

Blood tests can be used to assess hormone levels. These include: