The best blood test for testosterone: total, free, SHBG and LH as one baseline
The best way to check testosterone is a morning blood test for total testosterone, taken with SHBG and albumin so your free testosterone can be calculated, plus LH. Together they show how much testosterone you make, how much your body can use, and the signal your brain is sending.
Here's why one number isn't enough. Almost all testosterone travels bound to proteins, tightly to SHBG and loosely to albumin. SHBG differs a lot between men and tends to rise with age, so two men with the same total can have quite different free testosterone. Numia's Male Hormone Panel reports all of these from one draw.
What does each marker tell you?
| Marker | What it tells you |
|---|---|
| Total testosterone | All testosterone, bound and unbound |
| SHBG | The main carrier protein; how much is tightly held |
| Albumin | A looser carrier; needed to calculate free testosterone |
| Free testosterone | The unbound, usable share; calculated, not measured |
| LH | The brain's signal to the testes; helps show where a low result starts |
| DHEAS | A hormone from the adrenal glands that also declines with age |
Why track free testosterone and SHBG over time?
Because they can shift even when your total looks steady. In the Massachusetts Male Aging Study, each extra year of age went with about 2% less free testosterone, more than double the drop in total, and about 1.6% more SHBG. Total alone can miss that.
Weight matters too. In the European Male Ageing Study, men who gained weight saw testosterone and SHBG fall; men who lost weight saw both rise. A baseline with SHBG helps you see what changed and why.
How is free testosterone worked out in BC?
BC labs calculate it from total testosterone, SHBG and albumin, usually with a formula called Vermeulen's equation. Older "direct" tests were dropped in BC because they performed poorly. That's why Numia's panel includes albumin: it lets the lab make the calculation.
When do BC's public labs add SHBG?
BC's public system runs tests in a clinical order. Total testosterone comes first, and for adult men SHBG is added when the total is borderline low, roughly 3–8 nmol/L. That's a sensible sequence for a publicly funded system. For a full baseline from the start, Numia reports SHBG with every total.
Where does Numia fit?
Testing usually runs in steps: an appointment for a requisition, a lab visit, a wait, then another appointment for results. Numia brings them together. A licensed Canadian physician approves your requisition online within 24 hours, a clinician draws your blood at home in the morning, and you get results in 7 days, in plain English in the Numia app. The Numia Companion, an AI that has read your results, answers questions and cites the panel. Out-of-range results are physician-reviewed with next steps, and an optional wellness consultation lets you talk them through.
Numia's Male Hormone Panel is an HSA-eligible service. PSA and hematocrit, safety checks before any treatment, aren't included; a prescriber adds them.
Frequently asked questions
What bloodwork should I get before starting TRT?
Guidelines call for total testosterone on two separate mornings, free testosterone and SHBG when the total is borderline, LH, and baseline hematocrit and PSA, among other checks. Numia's panel covers the hormones; your prescriber orders the safety tests.
Which markers should I retest when raising testosterone naturally?
Total testosterone, SHBG and free testosterone, since SHBG shifts with weight, plus LH. Retest at the same lab and time of day. Numia's morning home draws make that easy to repeat.
Is free testosterone more accurate than total?
No, it answers a different question. Total is measured; free is calculated from total, SHBG and albumin. Free matters most when the total is borderline or SHBG is unusual, so Numia reports both.
Sources11 references
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Last updated October 6, 2026
