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Preparing for your testosterone test: Do's and Don'ts

MD Niklas Marizy

MD Niklas Marizy

Physician and Head of Medical at Adon Health
Testosteron-Hacks Testosteronwert

Inhaltsverzeichnis

    We'll show you how to best prepare for a testosterone test to get the most accurate and reliable results. When it comes to determining your testosterone levels, proper preparation is crucial for accurate and reliable results. In this article, we offer a simple guide to help you prepare optimally for your testosterone test.

    It's important that you take certain precautions and avoid certain activities to ensure your test results are as accurate as possible. Here are the essential do's and don'ts to follow to get the best insight into your hormone levels.

    Testosterone plays a central role in many physiological processes in the body, including muscle mass, bone strength, energy levels, and libido ( Harvard Health, 2023 ). Whether you are experiencing actual symptoms of low testosterone or simply want to monitor your health, it is important to perform the test correctly. Preparation for the test begins several days beforehand and involves various aspects of your lifestyle and daily routine.

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    What is a testosterone blood test?

    A testosterone blood test is used to measure the concentration of testosterone in the bloodstream. Testosterone is produced in significantly smaller amounts by the testes in men and by the ovaries in women ( Vierhapper et al., 1997 ) when the brain sends them a signal to produce it ( Acevedo-Rodriguez et al., 2018 ). It is then released into the bloodstream and travels to various organs and tissues, where it exerts its effects.

    Testosterone exists in the blood in two forms:

    • Bound testosterone: The portion of testosterone bound to sex hormone-binding globulin (SHBG), albumin, and other blood proteins .
    • Free testosterone: Testosterone not bound to serum proteins.

    Both free testosterone and testosterone bound to the blood protein albumin are collectively referred to as bioavailable testosterone ( Krakowsky & Grober, 2015 ). The bond between testosterone and albumin is relatively weak, allowing it to dissociate easily. SHBG-bound testosterone is inactive, while bioavailable testosterone is considered active because it is the portion of testosterone that can be used by tissues as needed ( Goldman et al., 2017 ).

    The classic testosterone blood test measures the amount of free testosterone, bound testosterone, and bioavailable testosterone, also collectively referred to as total testosterone . However, a direct measurement of free testosterone alone is often unnecessary, as a relatively accurate estimate can be achieved using a formula. For this estimate, it is sufficient to determine total testosterone as well as the two blood proteins SHBG and albumin ( Vermeulen et al., 1999 ).

    It is primarily total testosterone and free testosterone that are medically checked. This can help to identify a possible cause of erectile dysfunction, low libido, and other sexual problems ( Hintikka et al., 2009 ).

    Infographic from Adon Health showing the distribution of testosterone fractions in the blood, with proportions of free, SHBG-bound and albumin-bound testosterone.

    When you should consider a testosterone test

    In men, normal testosterone levels range from 300 to 1,000 nanograms per deciliter (ng/dL) ( Zhu et al., 2022 ), while in women, healthy testosterone levels range from 15 to 70 ng/dL. Testosterone levels are known to decrease over the course of a person's life, but they can also fluctuate, particularly due to underlying health problems ( Kelly & Jones, 2015 ).

    Symptoms that men with low testosterone may experience include:

    If you notice these symptoms, a test may be useful to clarify the cause and, if necessary, initiate appropriate treatment.

    Infographic from Adon Health about symptoms of testosterone deficiency, including hair loss, fat gain, muscle wasting, metabolic disorders and decreased libido.

    What you should do before your test


    Choosing the right time

    Testosterone levels are typically highest in the morning. Therefore, it is important to schedule the test early in the day, ideally between 7 and 10 a.m. ( Brambilla et al., 2009 ). This ensures that your testosterone levels are at their highest and that the results are as accurate as possible. Furthermore, subsequent tests should always be performed at the same time to guarantee the best possible comparability ( Collier et al., 2010 ).

    If you would like to learn more about testosterone fluctuations and the so-called circadian rhythm, please read our article " Hormonal Fluctuations: Understanding the Highs and Lows of Testosterone Levels ".

    Communicate with your doctor

    Inform your doctor about all medications and supplements you are taking. Some substances can affect your testosterone levels and lead to inaccurate results ( Coluzzi et al., 2018 ). These include prescription medications, over-the-counter drugs, herbal supplements, and vitamins. Clear communication with your doctor will help minimize potential interference and ensure your test results are as accurate as possible. Your doctor can also give you specific instructions on whether you should discontinue certain medications or supplements before the test.

    Stay hydrated

    Drink plenty of water before the test to ensure you are well hydrated. Good hydration can help obtain more accurate blood test results. Dehydration can affect blood composition and distort test results.

    Make sure you get enough sleep.

    Make sure you get at least 7-8 hours of sleep the night before the test. Lack of sleep can negatively affect your testosterone levels, as the body regulates and renews hormones during sleep. A good night's rest is therefore important to ensure your test results are as accurate as possible. Try developing a relaxing evening routine to help you sleep better ( Ukraintseva et al., 2018 ).

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    What you should avoid before your test


    Avoid excessive stress

    Try to minimize stress before the test, as high stress levels can affect your hormone levels, including testosterone. Stress can increase cortisol levels, which in turn can inhibit testosterone production ( Xiong et al., 2021 ). Relaxation techniques such as meditation, deep breathing, or yoga can be helpful to calm you and lower your stress levels ( Gothe et al., 2016 ). Ideally, plan relaxing activities the evening before the test to ensure you are in the calmest and most balanced state possible.

    Avoid strenuous training

    Avoid strenuous exercise the day before your test. Intense physical activity can temporarily alter your testosterone levels and lead to inaccurate results. Intense exercise can cause testosterone levels to rise or fall in the short term, which can distort the measurement. Stick to light activities such as walking or gentle stretching to ensure your testosterone levels are within the normal range during the test ( Riachy et al., 2020 ).

    Avoid alcohol and caffeine

    Avoid alcohol and caffeine for 24 hours before your test. Both substances can affect your hormone levels and should be avoided to ensure accurate test results. Alcohol can suppress testosterone production and disrupt hormone balance ( SJ Smith et al., 2023 ), while caffeine can increase cortisol levels ( Lovallo et al., 2005 ), which in turn can affect testosterone levels. By avoiding alcohol and caffeinated beverages such as coffee, tea, and certain soft drinks, you will help ensure your testosterone levels are measured as accurately as possible. Drink water or decaffeinated beverages instead to stay hydrated and keep your hormone levels stable.

    Avoid smoking

    Smoking can affect your testosterone levels. It is advisable to refrain from smoking before the test to obtain the most accurate results. The chemicals in tobacco can disrupt the hormonal balance and distort your testosterone levels ( Zhao et al., 2016 ).

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    Our conclusion, your knowledge

    By following these recommendations, you can ensure that your testosterone levels are measured as accurately as possible. A well-prepared testing procedure allows for a more precise diagnosis and therefore the best possible treatment. By following these tips, you actively contribute to your doctor gaining a clear picture of your hormonal status and being able to offer you the best possible support. Remember that small changes in your preparation can make a big difference in the accuracy of your test results.

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    Testosterone and self-confidence: How hormones influence our social behavior

    Testosterone, a key hormone for male health, profoundly influences self-confidence and social behavior. It not only has physical effects but also psychological and emotional ones. In today's healthcare landscape, research into men's health is gaining increasing importance. A key element in this complex system is the hormone testosterone, which influences far more than just physical characteristics (Hintikka et al., 2009) . Our current focus is on the profound impact of testosterone on the psychological and social aspects of a man's life. By concentrating on the multifaceted relationship between testosterone, self-confidence, and social interactions, we open a window to a better understanding of how hormones can influence men's daily lives and well-being. Our comprehensive perspective on men's health allows us to develop approaches that extend far beyond physical health. These approaches aim to promote and strengthen both mental well-being and social interaction. ‍ Testosterone: A key hormone for physical, mental and social health Testosterone, commonly known as the "male hormone," is essential for the development of traits such as muscle mass, bone structure, and body hair. However, its role extends far beyond physical development. In a psychological context, testosterone is a key element influencing mood, energy levels, and even cognitive performance. Normal testosterone levels are crucial for a man's mental balance and emotional well-being. It influences self-confidence, risk-taking, and motivation (Tajima-Pozo et al., 2015) . On an emotional level, balanced testosterone levels can contribute to stable mood and improved stress management strategies (Tyborowska et al., 2023) . Testosterone also affects cognitive functions, including memory and concentration ( Sternbach, 1998 ; Smith et al., 2018 ). It is also known to influence sexual health, including libido and reproductive function (Hintikka et al., 2009) . On a social level, testosterone plays a role in how men interact with others. It influences social dynamics and can shape behavior in relationships, both romantic and professional (Knight et al., 2022) . In conclusion, testosterone is a central component of a man's health and well-being, with effects that extend far beyond physical development. It is a key hormone that influences and connects the body, mind, and social aspects of life. ‍ Influence of testosterone on mental well-being Testosterone plays a crucial role in men's mental well-being and psychological health. Studies show that an imbalance in testosterone levels is associated with a range of psychological symptoms such as fatigue, depression, and a generally reduced quality of life (Hintikka et al., 2009) . These findings underscore the importance of balanced testosterone levels for boosting self-confidence and promoting overall well-being. Low testosterone levels can negatively impact mood and energy levels, leading to reduced self-confidence and impaired self-esteem. Those affected may feel tired, demotivated, and less productive, posing challenges in both their personal and professional lives (Zitzmann, 2020) . Furthermore, testosterone has a significant influence on the body's stress response. This is partly due to its interaction with the hypothalamic-pituitary-gonadal (HPP) axis, a central element of the hormonal system. The hypothalamus, a region of the brain responsible for regulating numerous bodily functions, responds to stress by stimulating the release of corticotropin-releasing hormone (CRH). This causes the pituitary gland to release adrenocorticotropic hormone (ACTH), which in turn stimulates the adrenal glands to produce cortisol, the so-called "stress hormone." An imbalance in this hormonal axis, particularly excessive cortisol production during chronic stress, can impair testosterone production. High cortisol levels can disrupt signaling in the hypothalamic-pituitary-adrenal (HPA) axis, leading to reduced secretion of gonadotropin-releasing hormone (GnRH) by the hypothalamus and, consequently, decreased testosterone production. Chronic stress can therefore lead to an imbalance in testosterone levels, which in turn makes stress management more difficult (Xiong et al., 2021) . A balanced testosterone level, on the other hand, supports the body's ability to cope with stress and contributes to greater stress resilience. This is particularly important because effective stress management significantly contributes to preventing burnout and increasing self-confidence in men. To boost self-confidence and mental health, it is therefore essential to maintain a balanced hormonal system. In addition to a healthy diet and regular physical activity, targeted relaxation exercises and stress reduction techniques can also help regulate testosterone levels and thus support mental well-being. ‍ The role of testosterone in a social context Testosterone plays a crucial role in social behavior and interaction. Varying levels of this hormone are central not only to physical development but also to mental and social skills. Optimized testosterone levels can significantly influence a man's self-esteem and confidence (Dalton & Ghosal, 2018) . It promotes assertiveness and strengthens leadership qualities, which can be of great importance, especially in the professional environment. Men with balanced testosterone levels tend to appear more self-confident and decisive in social situations (Jockenhövel et al., 2009) . Furthermore, a balanced testosterone level supports the development of positive social interactions. It contributes to improved risk-taking behavior, enabling men to better weigh options and make more rational decisions in challenging situations. This leads to a healthier lifestyle and strengthens social networks (Booth et al., 2006) . Testosterone also has a positive influence on emotional intelligence. Appropriate testosterone levels improve the ability to recognize emotions in oneself and others and to respond appropriately. This promotes emotional connectedness and relationship skills, which in turn are essential for a fulfilling and balanced social life (Tyborowska et al., 2023) . Overall, testosterone is far more than just a hormone. It is a critical factor for men's self-confidence, social skills, and emotional well-being. A balanced testosterone level contributes significantly to improving quality of life and promoting a healthy, confident demeanor. ‍ Debunking Myths: Testosterone and Aggression A study by the University of Zurich and Royal Holloway London has debunked the widespread myth that testosterone directly leads to aggressive behavior. In fact, the study showed that testosterone can lead to fairer behavior when it comes to securing one's status. The results of this study thus challenge the common assumption that testosterone generally promotes aggression and egocentric behavior. Instead, it appears to increase sensitivity to social status and can promote prosocial behavior in complex social situations (Eisenegger et al., 2009) . ‍ Dominance behavior instead of aggression Testosterone plays a more complex role than often assumed and is more readily associated with dominance behavior than with aggression. Dominance behavior, understood as the drive to achieve or maintain high social status, is often displayed in non-aggressive ways, as observed in primates. In rhesus monkeys with high testosterone levels, for example, staring and threatening gestures, rather than direct aggression, lead to high social status (Higley et al., 1996) . In humans, status can also be expressed through subtle means such as prolonged staring or dominant body language in social interactions. Testosterone also responds to social contexts, as demonstrated by the increased testosterone levels in men when exposed to the scent of ovulating women (Miller & Maner, 2009) . Testosterone also rises before physical and non-physical competitions and responds to competition results (Mehta & Josephs, 2006) . It influences psychological and neurochemical processes important for maintaining high social status, promoting high motivation, low fearfulness, and stress resilience. In animals, testosterone enhances reward-based behavior (Nyby, 2008) . Low testosterone levels in humans lead to apathy, while in healthy individuals, testosterone promotes motivation to act. ‍ Practical approaches to strengthening self-confidence Practical methods for boosting self-confidence include regulating testosterone levels through a healthy diet and regular exercise. These natural approaches can enhance well-being and self-confidence. Additionally, there are medical options such as testosterone replacement therapy, which should be used under careful medical supervision and after an accurate diagnosis of testosterone deficiency. Such treatments can be used to specifically correct hormonal imbalances and thereby boost self-confidence (Lašaitė et al., 2016) . It is important to carefully consider both natural and medical approaches to boosting testosterone levels. Some practical methods besides testosterone replacement therapy include: Nutrition: A balanced diet rich in vitamins and minerals can positively influence testosterone levels. Zinc and vitamin D, in particular, play an important role (Nimptsch et al., 2012) . Regular exercise: Strength training and intense physical activity can stimulate natural testosterone production (Riachy et al., 2020) . Stress management: Since stress can affect testosterone levels, it is important to practice stress reduction techniques such as meditation, yoga or deep breathing exercises (Gothe et al., 2016) . Sufficient sleep: A healthy sleep cycle supports hormonal balance, including testosterone levels (Patel et al., 2018) . Avoiding alcohol and other harmful substances: Excessive alcohol consumption and smoking can lower testosterone levels (Jensen et al., 2014) . Our conclusion, your knowledge The connection between testosterone and social behavior is complex and multifaceted. A deep understanding of this dynamic enables men to take a proactive approach to their health. By balancing testosterone levels, men can improve their self-confidence and social skills, which in turn leads to overall well-being. This holistic approach to health care opens new avenues to optimize not only physical, but also mental and social health, thereby enhancing overall well-being.

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