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Blood v Urinary Testosterone Test
Hi B. and Daniel,
The endocrinologist has requested blood tests for the following testosterone markers:
1. Testosterone
2. Free Testosterone
Should I ask him to add SHBG (Sex Hormone-Binding Globulin) and Estradiol? Are there any other testosterone markers we should consider?
Additionally, I came across in formation about urinary testosterone testing and I’m a bit confused. Which method is generally considered more accurate, sensitive, or reliable? What are the reasons for preferring one test over the other?
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2 Replies
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Hi @naslam1603 – great questions.
If they’ve already ordered total and free testosterone, then yes, it’s smart to add SHBG (to better interpret free versus bound levels) and also Estradiol (to see how much testosterone converts to estrogen). You could also consider albumin, LH, and FSH for a more comprehensive picture.
When it comes to blood vs urine testing for testosterone, blood (serum) tests are the gold standard. They are standardized and give a clear snapshot of circulating testosterone at the time of the draw. This makes blood testing more reliable for diagnosing and monitoring levels over time.
Urine tests on the other hand measure testosterone and its metabolites excreted over time so it’s helpful to look at hormone metabolism and function. But results can vary depending on hydration level, kidney function and how accurately the sample is collected. So because of these variables, urinary testing can be less precise for determining actual circulating testosterone levels and is used more for looking at hormone metabolism than for diagnosis. Serum is usually the way to go for actual levels.
And timing is key. First morning is always best to reduce variables when tracking levels over time.
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Thank you B. I’ve requested these additional markers.
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