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Men's hormone testing guide · 2026
Most testosterone results are misinterpreted because of when the blood was taken, not because of what the hormone was doing. Timing and the right companion markers change the answer.
A testosterone test in Bangkok normally starts with total testosterone drawn in the morning, ideally between 8am and 10am, after a normal night’s sleep. Because most circulating testosterone is bound to sex hormone binding globulin and albumin, total testosterone alone can be misleading — particularly in obesity, thyroid disease, ageing and liver disease. Guidelines recommend confirming a low reading with a second morning sample before any diagnosis is made, and adding SHBG, LH, FSH and prolactin to work out where the problem sits.
| Sample | Morning blood draw, ideally 8–10am, on two separate days if low |
|---|---|
| Fasting | Not strictly required, but a fasted morning draw improves consistency |
| First-line test | Total testosterone, with SHBG added where the picture is unclear |
| Confirmatory markers | LH, FSH, prolactin, free or calculated free testosterone |
| Collection | At home in Bangkok or at 20+ MedEx sites nationwide; nurse-at-home draw available |
| Price | Listed on the MedEx lab test catalogue — same price nationwide |
Testosterone follows a daily rhythm, peaking in the early morning and falling through the day. The size of that swing is large enough that an afternoon sample can read as low in someone whose morning level is entirely normal. Acute illness, poor sleep, heavy alcohol the night before and severe caloric restriction all push the value down temporarily.
For that reason, major endocrine guidelines advise diagnosing low testosterone only after two separate morning measurements taken on different days, both showing a low result, in someone with consistent symptoms. A single low afternoon reading is not a diagnosis and should not lead to a prescription.
If you book at-home collection through the MedEx lab test catalogue, request an early morning slot and keep the second draw at a similar time.
Roughly speaking, circulating testosterone exists in three states: tightly bound to sex hormone binding globulin (SHBG), loosely bound to albumin, and a small unbound fraction. Only the unbound and albumin-bound portions are readily available to tissue — together these are called bioavailable testosterone.
In practice, if total testosterone sits near the lower reference limit and symptoms are present, adding SHBG and albumin to the same draw resolves most ambiguity.
Book an early-morning testosterone draw at home or at a MedEx site.
Testosterone testing is most useful where the clinical picture is reasonably specific: reduced morning erections, low sexual desire, loss of body hair, small or shrinking testes, gynaecomastia, infertility or a documented fall in bone density.
Less specific symptoms — fatigue, low mood, reduced concentration, weight gain — overlap heavily with sleep apnoea, iron deficiency, thyroid disease, depression, poor sleep and uncontrolled blood sugar. Each of those is more common than genuine hypogonadism and each has a different treatment. Testing testosterone in isolation for these symptoms often produces a borderline number and no useful direction.
A more productive approach is a combined draw: testosterone with thyroid function, ferritin, HbA1c and a lipid profile, which is straightforward to arrange within a MedEx health checkup package.
If two morning samples confirm a low total testosterone, the next question is whether the problem is in the testes or in the pituitary. LH and FSH answer it.
| Low testosterone, high LH/FSH | Primary (testicular) — e.g. previous mumps orchitis, trauma, chemotherapy, Klinefelter syndrome. A karyotype may be considered. |
|---|---|
| Low testosterone, low or normal LH/FSH | Secondary (pituitary or hypothalamic) — prompts prolactin, iron studies, pituitary imaging and a review of opioids, steroids and cannabis use. |
| Low-normal testosterone, low SHBG, raised HbA1c | Frequently metabolic. Weight, sleep and glycaemic control usually move the number more than any prescription. |
Where weight and insulin resistance are driving the picture, the MedEx weight and metabolic health service addresses the cause rather than the marker.
Testosterone is measured in women for a different reason: to investigate signs of androgen excess such as hirsutism, acne, scalp hair thinning or irregular cycles, most often in the assessment of polycystic ovary syndrome.
Immunoassays perform poorly at the low concentrations found in women, so where precision matters, laboratories using liquid chromatography-mass spectrometry are preferred. A markedly elevated total testosterone — well above the typical PCOS range — warrants prompt specialist assessment to exclude an androgen-secreting tumour or congenital adrenal hyperplasia, alongside DHEA-S and 17-hydroxyprogesterone.
See the dedicated guides to SHBG and DHEA-S testing for how these fit together.
Between 8am and 10am, after a normal night’s sleep. Testosterone peaks in the early morning and falls through the day, so an afternoon sample can read low in someone with a normal morning level.
Fasting is not strictly required, but a fasted morning draw improves consistency and lets you add glucose, HbA1c and a lipid profile to the same sample.
Start with total testosterone. Add SHBG and albumin if the total sits near the lower reference limit or if you have obesity, thyroid disease or liver disease, since calculated free testosterone is more reliable than a directly measured free testosterone immunoassay.
Guidelines recommend two low morning measurements taken on separate days in someone with consistent symptoms, before any diagnosis or treatment decision is made.
Yes. Acute illness, sleep deprivation, heavy alcohol intake, severe caloric restriction and overtraining can all lower a result temporarily. Retest when you are well and rested.
Fatigue, low mood and weight gain overlap with sleep apnoea, iron deficiency, thyroid disease, depression and uncontrolled blood sugar. A broader panel is usually more informative than repeating testosterone.
Borderline result? Have it read alongside SHBG, LH and thyroid function.
Medical disclaimer: This article is general health information and does not replace medical advice, diagnosis or treatment. Laboratory reference ranges differ between laboratories and results must be interpreted alongside your symptoms, medicines and medical history. Speak with a qualified clinician before starting, stopping or changing any treatment. Service details, inclusions and prices can change — confirm them with MedEx before booking.
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