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ARUP Testosterone Tests Comparison

Testosterone testing can be performed using either tandem mass spectrometry or immunoassay. Tandem mass spectrometry is more specific and accurate across a wider range of concentrations and is preferable if low testosterone concentrations are expected. Testing by immunoassay is accurate at higher testosterone concentrations and may be more cost-effective when clinically appropriate. Free or bioavailable testosterone tests may provide supportive information.

		Expected Testosterone Concentration		Method				Results Reported					Notes
Select to Compare		High (eg, as found in adult cisgender males or individuals on testosterone hormone therapy)	Low (eg, as found in children, adult cisgender females, individuals on testosterone-suppressing hormone therapy, or individuals at the initiation of some gender-affirming hormone therapies)	IA	MS	ED	Calc	Total T	Free T	% Free T	Bio T	SHBG
	Testosterone (Adult Males or Individuals on Testosterone Hormone Therapy) 0070130	High		✔				✔					Use this immunoassay to evaluate hypogonadism in cisgender males and to monitor testosterone hormone therapies. Not recommended when low testosterone concentrations, such as those found in children and cisgender females, are expected. For these individuals, testing by mass spectrometry is recommended; refer to Testosterone (Adult Females, Children, or Individuals on Testosterone-Suppressing Hormone Therapy) (0081058). Free or bioavailable testosterone measurements may provide supportive information.
	Testosterone (Adult Females, Children, or Individuals on Testosterone-Suppressing Hormone Therapy) 0081058		Low		✔			✔					Use this mass spectrometry test to measure a wide range of testosterone concentrations. Most useful when low concentrations are expected, regardless of the patient’s sex assigned at birth. Use to monitor testosterone-suppressing hormone therapies (eg, antiandrogens or estrogens). Free or bioavailable testosterone measurements may provide supportive information.
	Testosterone, Free (Adult Males or Individuals on Testosterone Hormone Therapy) 0070111	High		✔			✔		✔				Provides a calculated value for free testosterone concentration using total testosterone measured by immunoassay. Use to evaluate hypogonadism in cisgender males with a total testosterone concentration at the lower limit of normal. May be used to evaluate testosterone status in individuals with protein-binding abnormalities or to monitor testosterone hormone therapies. Not recommended when low testosterone concentrations, such as those found in children and cisgender females, are expected. For these individuals, testing by mass spectrometry is recommended; refer to Testosterone, Free (Adult Females, Children, or Individuals on Testosterone-Suppressing Hormone Therapy) (0081059).
	Testosterone, Free (Adult Females, Children, or Individuals on Testosterone-Suppressing Hormone Therapy) 0081059		Low		✔		✔		✔				Provides a calculated value for free testosterone concentration using total testosterone measured by mass spectrometry. May be used to evaluate hyperandrogenism in children and cisgender females, monitor testosterone-suppressing hormone therapies (eg, antiandrogens or estrogens), evaluate testosterone status in individuals with protein-binding abnormalities, or evaluate hypogonadism in cisgender males.
	Testosterone, Free, by Dialysis and Mass Spectrometry (Adult Males or Individuals on Testosterone Hormone Therapy) 2003246	High			✔	✔			✔				Laboratory reference method for the direct measurement of free testosterone. Not recommended when low concentrations of free testosterone, such as those found in children and cisgender females, are expected. For these individuals, the preferred test is Testosterone, Free (Adult Females, Children, or Individuals on Testosterone-Suppressing Hormone Therapy) (0081059). Calculated free testosterone is generally adequate for most evaluations of hypogonadism; refer to Testosterone, Free (Adult Males or Individuals on Testosterone Hormone Therapy) (0070111).
	Testosterone, Free and Total, Includes Sex Hormone-Binding Globulin (Adult Males or Individuals on Testosterone Hormone Therapy) 0070109	High		✔			✔	✔	✔	✔		✔	Provides a calculated value for free testosterone concentration using total testosterone measured by immunoassay. Use to evaluate hypogonadism in cisgender males with a total testosterone concentration at the lower limit of normal. May be used to evaluate testosterone status in individuals with protein-binding abnormalities or to monitor testosterone hormone therapies. Not recommended when low testosterone concentrations, such as those found in children and cisgender females, are expected. For these individuals, testing by mass spectrometry is recommended; refer to Testosterone, Free and Total, Includes Sex Hormone-Binding Globulin (Adult Females, Children, or Individuals on Testosterone-Suppressing Hormone Therapy) (0081056).
	Testosterone, Free and Total, Includes Sex Hormone-Binding Globulin (Adult Females, Children, or Individuals on Testosterone-Suppressing Hormone Therapy) 0081056		Low		✔		✔	✔	✔			✔	Provides a calculated value for free testosterone concentration using total testosterone measured by mass spectrometry. May be used to evaluate hyperandrogenism in children and cisgender females, monitor testosterone-suppressing hormone therapies (eg, antiandrogens or estrogens), evaluate testosterone status in individuals with protein-binding abnormalities, or evaluate hypogonadism in cisgender males.
	Testosterone, Free and Total, by Dialysis and Mass Spectrometry (Adult Males or Individuals on Testosterone Hormone Therapy) 2004246	High			✔	✔		✔	✔				Laboratory reference method for the direct measurement of free testosterone. Not recommended when low concentrations of free testosterone, such as those found in children and cisgender females, are expected. For these individuals, the preferred test is Testosterone, Free and Total, Includes Sex Hormone-Binding Globulin (Adult Females, Children, or Individuals on Testosterone-Suppressing Hormone Therapy) (0081056). Calculated free testosterone is generally adequate for most evaluations of hypogonadism; refer to Testosterone, Free and Total, Includes Sex Hormone-Binding Globulin (Adult Males or Individuals on Testosterone Hormone Therapy) (0070109).
	Testosterone, Bioavailable and Total, Includes Sex Hormone-Binding Globulin (Adult Males or Individuals on Testosterone Hormone Therapy) 0070102	High		✔			✔	✔	✔	✔	✔	✔	Provides a calculated value for bioavailable testosterone concentration using total testosterone measured by immunoassay. Use to evaluate hypogonadism in cisgender males with a total testosterone concentration at the lower limit of normal. May be used to evaluate testosterone status in individuals with protein-binding abnormalities or to monitor testosterone hormone therapies. Not recommended when low testosterone concentrations, such as those found in children and cisgender females, are expected. For these individuals, testing by mass spectrometry is recommended; refer to Testosterone, Bioavailable and Total, Includes Sex Hormone-Binding Globulin (Adult Females, Children, or Individuals on Testosterone-Suppressing Hormone Therapy) (0081057).
	Testosterone, Bioavailable and Total, Includes Sex Hormone-Binding Globulin (Adult Females, Children, or Individuals on Testosterone-Suppressing Hormone Therapy) 0081057		Low		✔		✔	✔	✔		✔	✔	Provides a calculated value for bioavailable testosterone concentration using total testosterone measured by mass spectrometry. May be used to evaluate hyperandrogenism in children and cisgender females, monitor testosterone-suppressing hormone therapies (eg, antiandrogens or estrogens), evaluate testosterone status in individuals with protein-binding abnormalities, or evaluate hypogonadism in cisgender males.
Bio, bioavailable; Calc, calculation; ED, equilibrium dialysis; IA, immunoassay; MS, mass spectrometry; SHBG, sex hormone-binding globulin; T, testosterone