Testosterone is a vital hormone that plays multiple roles in the human body. Known primarily as a male sex hormone (also called an androgen), testosterone supports the development and function of the reproductive system and helps strengthen muscle and bone tissue. Overall, testosterone has a major impact on health, mood, and well-being.
What Happens When Testosterone Is Deficient?
Testosterone deficiency (also called hypogonadism) can cause a variety of symptoms, including:
Rapid weight gain, primarily through increased fat mass rather than muscle
Reduced sexual function and libido
Chronic fatigue and daytime sleepiness
Difficulty concentrating
Low testosterone levels can also be associated with:
Cardiovascular risk
Insulin resistance
Decreased bone mass
Symptoms of Testosterone Deficiency:
In Men:
Sexual dysfunction
Hair loss (especially body hair)
Sparse facial hair
Loss of muscle mass
Chronic obesity and weight gain
Decreased energy, stamina, and strength
Poor memory and attention
Difficulty expressing thoughts
In Women:
Thinning hair
Dry skin
Decreased sexual desire
Loss of muscle mass
Weight gain with associated fat accumulation
Mood changes (e.g., anxiety, stress)
Decreased bone density
General weakness
Can High Testosterone Cause Problems?
Yes. Excessive testosterone levels may lead to:
Reduced sperm count
Testicular shrinkage
Sexual dysfunction
Acne outbreaks
Though it may be genetic, high testosterone can also result from:
Use of anabolic steroids
Rare adrenal gland tumors
How to Check Testosterone Levels?
Maintaining normal testosterone levels is crucial for both men and women, as testosterone plays a key role in healthy metabolism. For example, optimal testosterone helps burn fat and build muscle.
Testosterone testing involves measuring the levels in the blood and determining whether they are appropriate for the person’s age and health status. There are two types of testosterone measurements:
Total testosterone
Free testosterone
Free vs. Total Testosterone: What’s the Difference?
Total Testosterone
Most testosterone in men is produced in the testicles, where cholesterol is converted into testosterone through complex biochemical reactions. A smaller portion is secreted by the adrenal glands.
In the bloodstream, testosterone binds to two main proteins:
Sex Hormone Binding Globulin (SHBG)
Albumin
Free Testosterone
A small percentage of testosterone remains unbound to proteins — this is called free testosterone, which is biologically active and can enter cells directly to regulate metabolism and other cellular functions.
Free testosterone is the usable form of the hormone. In contrast, testosterone bound to proteins like SHBG cannot enter most cells.
Why Measure Free Testosterone?
Total testosterone includes both protein-bound and free forms. Since SHBG levels can vary (especially in individuals with obesity or insulin resistance), free testosterone may decrease even if total levels appear normal — or vice versa.
Therefore, if symptoms of hypogonadism are present but total testosterone appears normal, it is essential to check free testosterone levels. Many symptoms may be caused by imbalances in free testosterone, even when total levels are within range.
For example, in overweight individuals with insulin resistance, SHBG may decrease, resulting in a lower total testosterone level — yet free testosterone may still be within the normal range.
At Sağlam Ailə Medical Center, both total and free testosterone can be tested.
Please arrive for testing in the morning, on an empty stomach.
For more information about testosterone total and free tests, or to book an online appointment, contact our Call Center at (012) 910 or reach us on WhatsApp at (055) 4000 910.