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Andropause
Laboratory

Which blood values show whether a testosterone deficiency is present

A single blood value is not enough. Anyone who really wants to understand testosterone deficiency and treat it safely needs the whole picture — a complete hormone panel that captures all the relevant adjusting screws. That's exactly what the AndroKlinik Andropause Laboratory is. On this page, we explain which values are measured, what they mean — and why many men with 'normal testosterone' may nevertheless need treatment.

Ready for your hormone check?

Book an initial consultation now — including an individual laboratory order and evaluation of findings by the specialist.

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Why a single testosterone value can be deceptive

Many men know this: The GP measures testosterone, the value is 'within the normal range', and yet they feel weak, listless, no longer like themselves.

The reason: Testosterone is not the same as testosterone. In the blood, it exists in three forms:

  • Bound to SHBG (sex hormone-binding globulin) — biologically inactive, not usable
  • Loosely bound to albumin — partially available
  • Free testosterone — the directly effective, biologically active portion

Anyone who only measures the total value may only see the bound, unusable amount. That's why you need a panel that captures all the relevant values — and a specialist who interprets them in context.

Example from practice

  • A 48-year-old man has total testosterone: 14 nmol/l — formally within the normal range.
  • However, his SHBG is greatly elevated (68 nmol/l), and free testosterone correspondingly low: 0.18 nmol/l.
  • Clinically: relevant testosterone deficiency despite a 'normal' total value.
  • Without the complete panel, this finding would have been overlooked.

The AndroKlinik laboratory panel:
All values at a glance

Our standard panel covers all clinically relevant hormone levels and accompanying parameters. It is taken once before the first therapy consultation — and repeated regularly over the course of treatment.

Laboratory value

What is measured?

Normal range*

Typical in andropause

Why it matters

Total testosterone

Total amount of the hormone in the blood

12–35 nmol/l

Often reduced, but not always meaningful on its own

Baseline value – starting point of the classification

Free testosterone

Biologically active, directly effective portion

0.17–0.6 nmol/l

Frequently low, even with normal total testosterone

The decisive value for the symptoms

SHBG

Transport protein – binds and inactivates testosterone

10–70 nmol/l

Often elevated – thereby lowers free testosterone

Explains 'normal' testosterone despite complaints

LH

Signal from the brain (pituitary gland) to the testes

1.5–9.3 IU/l

Low: central problem; high: testicular problem

Shows where the hormone system fails

FSH

Controls sperm production and testicular health

1.5–12.4 IU/l

Elevated in case of testicular damage

Important for the desire to have children & testicular assessment

PSA

Prostate-specific antigen

< 4.0 ng/ml

No direct connection with TRT

Mandatory safety check before any hormone therapy

Hematocrit / Blood count

Proportion of red blood cells, blood health in general

42–52 %

Can increase under TRT – monitoring necessary

Safety marker during therapy

Estradiol (E2)

Female hormone – also produced in men from testosterone

< 40 pg/ml

Often elevated in case of overweight – inhibits testosterone effect

Explains symptoms despite sufficient testosterone

TSH (Thyroid)

Controls energy metabolism

0.4–4.0 mIU/l

Disorders often mimic andropause symptoms exactly

Important differential diagnosis

Glucose / HbA1c

Blood sugar and long-term blood sugar

< 100 mg/dl / < 5.7 %

Diabetes correlates strongly with testosterone decline

Influences the therapy decision

Cholesterol / Lipids

Blood lipid values

LDL < 115 mg/dl

Dyslipidemia common in andropause

Overall health and cardiovascular risk

* All normal ranges are guideline values. The actual interpretation is always carried out individually by the specialist — depending on age, symptoms and accompanying findings.

Have your personal laboratory panel determined

After the initial consultation, the doctor creates your individual laboratory order — including blood collection close to your home.
Start your hormone check now

Where is the blood collection carried out?

You don't have to come to us at the clinic to have blood drawn. AndroKlinik cooperates with a nationwide network of certified partner laboratories — including Synlab and Labor MVZ.

Here's how it works:

  • After your first video consultation, you receive the laboratory order directly from the doctor — digitally, as a PDF.
  • You visit the nearest partner laboratory — at an appointment of your choice, in the morning while fasting.
  • The blood collection takes a few minutes. No long journey, no queue.
  • The results are transmitted via you to AndroKlinik.
  • Within 48 hours, the specialist evaluates your values and discusses them with you in the second video consultation.

How to find your partner laboratory

  • If needed, we will name the laboratory near you during the consultation, where you can present our document and have blood drawn.
  • Partner network: Synlab, Labor MVZ and other certified institutions nationwide.
  • No health insurance certificate necessary — the doctor's laboratory order is sufficient.

How do I prepare for the blood collection?

For your laboratory values to be meaningful, the right preparation is important. Testosterone is subject to a distinct daily rhythm — small errors during collection can strongly distort the result.
  • Blood collection in the morning while fasting — ideally between 7:00 and 10:00 (testosterone is highest in the morning)
  • Eat nothing for at least 8 hours beforehand — water and unsweetened tea are allowed
  • No intense exercise and no sex on the day before the collection
  • No alcohol in the 24 hours before the collection
  • Take medications as usual — unless your doctor gives other instructions
  • Go to the laboratory calm and relaxed — stress can lower testosterone in the short term

Why the time of day is so important

  • Testosterone follows a circadian rhythm: in the morning, the values are up to 25 % higher than in the evening.
  • A collection at 3 p.m. can make a borderline finding appear normal — and vice versa.
  • In the case of unclear initial findings, the doctor therefore always recommends a repeat measurement at the same time of day.

Laboratory over time

Why regular check-ups are so important

After 6–8 weeks (initial check)

What is checked?
Testosterone, free testosterone, hematocrit – first efficacy check and safety check

After 3 months

What is checked?
Complete panel – adjustment of the dosage or therapy form if necessary

Every six months (long-term course)

What is checked?
All laboratory values incl. PSA, blood count, metabolism – overall assessment of health

In case of symptom change (at any time)

What is checked?
Targeted control check – if something has changed or new complaints occur
You can conveniently attend all follow-up check-ups via telemedicine: fill out the medical history form digitally, blood collection close to home, discussion via video — without travel, without a waiting room.

Frequently asked questions about the Andropause Laboratory

Do I have to be fasting for the blood collection?
Yes — for meaningful hormone levels, a fasting collection in the morning (7–10 a.m.) is important. Water and unsweetened tea are allowed. Food, coffee and alcohol should be avoided for at least 8 hours beforehand.
How long does it take until I get my laboratory results?
Most values are available 24–48 hours after the blood collection. The specialist then evaluates the results and discusses them with you in a second video consultation — including a concrete therapy proposal if there is a need for action.
What does the laboratory cost?
The laboratory costs are billed directly through the partner laboratory and depend on the scope of the panel. Your doctor creates a laboratory order tailored to your situation — you only pay for what you really need. You can find guideline prices on our services page.
Can my GP also order the laboratory?
Yes — if you already have laboratory values from your GP, you are welcome to bring them to the initial consultation. The andrologist checks whether the panel is complete, or whether supplementary values would be useful. Often SHBG, free testosterone or estradiol are missing in the GP laboratory.
What happens if my values are abnormal?
Abnormal values are no reason to panic — they are the starting point for a good treatment. In the evaluation consultation, the specialist explains to you exactly what the values mean, which therapy options come into consideration and which next steps make sense. Nothing happens without your consent.
Does the health insurance cover the laboratory costs?
Our offer is aimed at self-payers. Statutory health insurance (GKV) reimbursements for extended hormone panels are generally not provided — unless the GP refers with a justified suspicion. In this case, please first speak with your insurance fund. We are happy to advise you on the cost options.

Start your hormone check now

Book an initial consultation → receive laboratory order → blood collection near you → findings & therapy plan in 48 hours.

About the author

Dr. med. Timo A. Spanholtz
Specialist in Plastic and Aesthetic Surgery - Specialist for Men's Health and Intimate Surgery

Dr. med. Timo A. Spanholtz
Dr. Spanholtz is the founder and chief physician of AndroKlinik. With many years of clinical experience in men's health, andrology and reconstructive urology, he supports patients from the entire German-speaking region.
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