Medically reviewed by Dr. Farhan Mukhtar, M.B.B.S., M.Phil (Pb.), Consultant Chemical Pathologist, Al-Nasar Lab & Diagnostic Centre. Updated September 2026.
Quick answer: Testosterone is measured from a blood sample that must be taken in the morning, ideally between 7am and 10am, because levels fall significantly through the day. Normal total testosterone in adult men is roughly 300 to 1,000 ng/dL. A single low result should always be confirmed with a second morning sample before any diagnosis is made.
Book a testosterone test: call 0300 0341944, or arrange home sample collection across Lahore on 0309 1166944.
Why does the time of the sample matter so much?
This is the most common reason a testosterone result is wrong.
Testosterone follows a daily rhythm. It peaks in the early morning and declines through the day, and the difference is not small. The same man can produce a comfortably normal reading at 8am and a result that looks deficient at 4pm.
A great deal of unnecessary treatment starts from an afternoon sample. If your test was taken later in the day and came back low, that result should be repeated properly before anyone concludes anything from it.
The same applies in reverse. A single low morning result is also not enough. Levels fluctuate day to day, and acute illness, poor sleep or stress can depress them temporarily. Two low morning samples on separate days is the standard before diagnosing testosterone deficiency.
Total, free or bioavailable, which do you need?
| Measure | What it is | When it matters |
|---|---|---|
| Total testosterone | Everything in the blood, bound and unbound | The standard first test for almost everyone |
| Free testosterone | The small unbound fraction that is biologically active | When total is borderline, or SHBG is likely abnormal |
| Bioavailable testosterone | Free plus the loosely bound portion | Occasionally used in specialist assessment |
| SHBG | The protein that binds testosterone tightly | Needed to interpret total testosterone correctly |
Most testosterone in the blood is bound to SHBG and unavailable to the body. That is why SHBG matters: anything that changes SHBG changes total testosterone without changing what the body actually has available.
SHBG is raised in older age, liver disease and an overactive thyroid. It is lowered in obesity, insulin resistance and type 2 diabetes. In an obese man with low SHBG, total testosterone can read low while free testosterone is adequate. This is exactly the situation where measuring free testosterone changes the answer.
What is a normal testosterone level?
- Adult men: roughly 300 to 1,000 ng/dL total
- Below 300 ng/dL on two morning samples generally indicates deficiency
- 300 to 400 ng/dL is a grey zone where free testosterone and symptoms guide the decision
- Adult women: roughly 15 to 70 ng/dL, far lower, and tested for different reasons
Ranges differ between laboratories and assay methods, so compare against the range printed on your own report and use the same laboratory for repeat testing.
What symptoms actually warrant testing?
Worth being direct here, because testosterone is heavily marketed and frequently tested without cause.
Symptoms that genuinely point to deficiency:
- Reduced sexual desire and fewer spontaneous morning erections
- Erectile difficulty, though most erectile dysfunction has vascular rather than hormonal causes
- Loss of muscle mass and strength despite training
- Increased body fat, particularly around the abdomen
- Infertility or a low sperm count on semen analysis
- Reduced body and facial hair
- Breast tissue enlargement
- Persistent fatigue, low mood and poor concentration
- Reduced bone density or a fragility fracture
Tiredness alone is a weak indicator. It is far more often explained by thyroid disease, B12 deficiency, anaemia, diabetes, sleep apnoea or depression, all of which should be considered before concluding that testosterone is the problem.
What tests are done alongside?
A low testosterone is a finding, not a diagnosis. The next question is always where the problem lies.
- LH and FSH. These distinguish a problem in the testes themselves, where LH and FSH are high, from a problem in the pituitary or hypothalamus, where they are low or inappropriately normal. This distinction changes management completely
- Prolactin. A raised level suppresses testosterone and can indicate a pituitary tumour, which is treatable
- SHBG, to interpret the total correctly
- HbA1c and lipid profile, since metabolic problems and low testosterone travel together
- Thyroid function
An important warning about supplements and steroids
Testosterone boosters, anabolic steroids and testosterone injections taken without medical supervision are widespread in gym culture, including in Pakistan, and they cause real harm.
External testosterone shuts down the body’s own production. The testes stop producing testosterone and, critically, stop producing sperm. This can cause infertility that persists long after the injections stop, and in some cases does not fully recover.
If you take or have taken any of these, tell your doctor before testing. Concealing it leads to a completely wrong interpretation of the results, and to treatment that makes the underlying problem worse.
How to prepare
- Come between 7am and 10am. This is not optional for a reliable result
- Fasting is usually advised, since food can lower testosterone modestly and the test is often combined with blood sugar and lipids
- Avoid strenuous exercise the day before
- Postpone if you are acutely unwell, as illness temporarily suppresses testosterone
- Tell the laboratory about any testosterone products, steroids or gym supplements
- Mention opioid painkillers and steroid medicines, both of which lower testosterone
- For a repeat test, use the same laboratory at the same time of day
Hormone testing at Al-Nasar Lab
Al-Nasar Lab & Diagnostic Centre has provided laboratory testing in Lahore since 1996 and holds ISO 15189:2022 accreditation from the Pakistan National Accreditation Council. Total testosterone, free testosterone, SHBG, LH, FSH and prolactin are all available, with home sample collection across Lahore for early morning appointments.
Because a low testosterone needs context, the associated hormones can be taken from the same sample during one visit. See our accreditations, find your nearest collection centre, or contact us to book.
Frequently Asked Questions
What time should a testosterone test be done?
Between 7am and 10am. Levels fall through the day, so an afternoon sample can look falsely low.
Do I need to fast for a testosterone test?
Fasting is usually advised, partly because food lowers testosterone modestly and partly because the test is often combined with blood sugar and lipids.
What is a normal testosterone level for men?
Roughly 300 to 1,000 ng/dL total. Below 300 on two separate morning samples generally indicates deficiency.
Should I test free or total testosterone?
Total is the standard first test. Free testosterone is useful when the total is borderline or when SHBG is likely abnormal, such as in obesity or diabetes.
Do testosterone supplements affect fertility?
Yes, significantly. External testosterone and anabolic steroids suppress the body’s own production and can stop sperm production, sometimes with long lasting effects.
This article is for general information and is not a substitute for medical advice. Please discuss your results with a qualified doctor.
