Testosterone therapy monitoring
- For follow-up
Blood test to monitor testosterone therapy with total testosterone, SHBG, albumin, calculated free testosterone, full blood count and cholesterol profile. It checks hormone exposure and monitors any rise in haematocrit, one of the most important adverse effects of treatment.
No prescription or appointment needed
Results in 1-2 working days
Includes: Total testosterone · SHBG · Albumin · Calculated free testosterone · Full blood count · Lipid profile and ratios. See what each one measures
What it is for
It is used to check whether treatment reaches suitable levels at the right point in the dosing interval and to monitor the haematocrit. It also makes it possible to compare the cholesterol profile with the value before treatment.
It is designed for monitoring a treatment that has already been prescribed, not for deciding a dose change on your own. How often checks are done and the exact timing of the sample depend on the formulation and the clinical situation.
When it is recommended
- The first months after starting treatment, as your doctor has planned
- Regular monitoring on a stable dose
- After changing the dose or formulation
- New symptoms that make it necessary to check the haematocrit or testosterone level
Clinical comment
The haematocrit is one of the main safety measures during testosterone therapy. If it rises above the established limits, the doctor must review the dose, the formulation, other causes of erythrocytosis and whether treatment should be temporarily stopped.
Free testosterone is calculated from total testosterone, SHBG and albumin to avoid the direct immunoassay. The value is only useful if the timing of the sample relative to the gel application or injection is known, because the concentration can vary a great deal over the interval.
Oestradiol and DHEA-S are not included routinely, because they are not part of usual monitoring without a specific indication. PSA is considered separately, according to age, history and shared decision-making about prostate screening.
Dr. Antonio Mas
What is tested
- Total testosterone
- Assesses the level reached with treatment, taking into account when the sample is taken relative to the dose.
- SHBG
- Helps interpret total testosterone when the carrier protein changes.
- Albumin
- Used together with total testosterone and SHBG to calculate the free fraction.
- Calculated free testosterone
- Estimates the available fraction using a validated formula.
- Full blood count (with haematocrit and haemoglobin)
- Lipid profile (total cholesterol, HDL, LDL, triglycerides) and ratios
These tests are used to calculate Testosterona libre calculada. They are not separate tests.
How to prepare
Have the sample taken in the morning, after 8 hours of fasting. Check with whoever prescribed your treatment when you should have it done relative to your dose. This varies depending on whether you use a gel, a short-acting injection or a long-acting formulation. Do not change your treatment schedule on your own before the test.
You can add
Without another needle. It is offered when you order, so you do not have to decide now.
- General blood testA general blood test with full blood count, glucose, cholesterol and kidney and liver function: the basic parameters included in any general check-up.+€59.00
- PSA and prostate healthAssesses the prostate with total and free PSA; it is usually considered from the age of 50, or earlier if there is a family history.+€29.00
Related blood tests
We have other profiles in Men with more or fewer tests:
- Total testosterone, free testosterone and SHBG test€59.00
- Low testosterone assessment€129.00
- Gynaecomastia assessment€129.00
- Full male hormone blood test€169.00
The most comprehensive is not always the most useful. If you are not sure, the one we recommend to start with is Low testosterone assessment.
What it is based on
Endocrine Society · J Clin Endocrinol Metab 103(5):1715-1744
Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline
Advises against the direct immunoassay for free testosterone, because it is inaccurate, and recommends obtaining it by equilibrium dialysis or calculating it from total testosterone, SHBG and albumin. It also sets the haematocrit as what must be monitored during treatment, with checks at 3 and 6 months and then once a year.
Protocol designed by Dr. Antonio Mas, specialist in Endocrinology and Nutrition, Spanish medical licence no. 080846289, and reviewed in September 2026.
This blood test is a standardised protocol and does not replace a medical consultation. If you have symptoms, a known condition or a complex clinical situation, speak to your doctor.