Clinical vs home Testosterone test

Take-home points

• A well sourced home testosterone tests can provide a good indication of testosterone levels, but many home tests vary in accuracy
• Clinical testosterone tests are generally more accurate and reliable, particularly when measuring low testosterone levels
• Consult a healthcare professional if you are unsure whether a home testing kit suits your needs

What is testosterone?

Testosterone is a hormone that is mostly produced in the testes. Among many crucial functions, testosterone plays a role in developing certain physical characteristics (such as muscle and bone development) and improving mood, energy levels, sexual function, and fertility.

However, testosterone levels fluctuate at different stages in life. Whether due to a health condition, age, or even a change in lifestyle or medication, your testosterone levels can decline to a clinically low level. As such, an increasing number of men are interested in monitoring their testosterone levels to ensure there is no cause for concern.  

What is a home testosterone blood test?

A home testosterone test is a medical test that allows you to measure your testosterone levels in the comfort of your own home.  These tests typically involve collecting a sample of saliva, urine, or blood, which is then sent to a laboratory for analysis. Home testosterone tests are designed to be easy and convenient, with most tests providing clear instructions and results that can be obtained within a week.

What is a clinical testosterone blood test?

A clinical testosterone test on the other hand, is a type of blood test that is conducted in a healthcare setting, such as a hospital, clinic, or doctor's office. These tests are typically more comprehensive than home testosterone tests, as they can measure a broader range of testosterone levels and other hormones (read more on taking a clinical testosterone test). Clinical testosterone tests are performed by a trained medical professional, who will typically take a blood sample from your arm and send it to a laboratory for analysis.

What is the difference between a home and clinical testosterone blood test?

There are five key differences between a home and clinical testosterone test:

• The test setting. Home testosterone tests are designed for home use, while clinical testosterone tests are conducted in a healthcare setting

• The person performing the test. Home testosterone tests require you to extract blood or urine; trained medical professionals perform clinical tests.  
• The type of testosterone test. Home testosterone tests are generally less comprehensive than clinical tests and usually measure only total testosterone (not free testosterone, SHBG, LH, FSH, hCG, etc.)
• The test accuracy. Clinical testosterone tests are generally considered more accurate than home testosterone tests (to be discussed in the next section)
• The test price. Home test kits cost in the region of £25 - £100. Depending on location and benefits, you may be able to receive a clinical testosterone test as part of a national health service or private health insurance

Click here to view our article on understanding testosterone test results

How accurate is a clinical testosterone test?

As clinical testosterone tests use validated methods, controlled environments, and trained professionals, they are generally considered to be highly accurate. There is still significant variability between clinical laboratories, but several studies have found most clinical tests do not deviate more than 20% compared to gold-standard methods (rarely used in clinical practice due to cost and accessibility).^1,2

To further increase confidence in clinical test results, the Centers for Disease Control (CDC) in the United States of America have initiated a hormone standardization program, with laboratories needing to meet strict criteria (report testosterone values within 6.4% of CDC-tested samples) to receive certification.³

Repeat testosterone testing is still advised. Due to natural fluctuations in testosterone levels, alongside possible measurement error, the same clinical test on two separate occasions can vary from 10–30% in the same individual.^4,5 One study in 16 men found that 50% of the men reported as hypogonadal (defined as testosterone <300 ng/dl [10.4 nmol/L]) on their first clinical measurement were within normal ranges on repeat testing.⁶

How accurate is a home testosterone test?

The accuracy of a home testosterone test can vary depending on the specific test used and the quality of the laboratory conducting the analysis. Unfortunately, many researchers claim that all home kits have limited utility, however, some can provide more accurate results than others.  

In one study, testosterone results from six different home testing kits varied between 26.3–40.8% in men and 57%–115% in women.⁷ Moreover, when the home test kit results were compared to an established clinical method, the results deviated by an average of 194% in men and 67% in women.  

Why are home testosterone tests less accurate?

Differences different home test kit results could be explained by:

• Different laboratory techniques
• User error

• Less likely to adhere to the pre-test protocols (fasted-state, morning test)
• Laboratory error
• Mishandling during transport.

It is also important to note that most home testosterone kits use an immunoassay method (a method of measuring concentrations of hormones and other compounds within bodily fluids), which is less accurate in low testosterone ranges. If you are concerned with low testosterone levels or conditions such as hypogonadism, it is best to seek a clinical test from a trained healthcare professional.

Should I get a clinical or home testosterone test?

If you have a general health interest without symptoms of abnormal testosterone levels, then a home test kit may suit your needs. Seek a more accurate and reliable clinical testosterone test if your symptoms or home test kit indicates high or low testosterone levels.  

^{Last updated: 27th July 2023}

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References

1. Wang C, et al. J Clin Endocrinol Metab 2004;89(2):534-43.

2. Vesper HW, et al. Steroid 2009;74(6):498-503.

3. Vesper HW, et al. Am J Clin Nutr 2016;104 Suppl 3(Suppl 3):907S-12S.

4. Brambilla DJ, et al. Clin Endocrinol (Oxf) 2007; 67(6):853-62.

5. Valero-Politi, Fuentes-Anderiu X. Clin Chem 1993;39(8)1723–5.

6. Morley, et al. Metabolism 2002;51(5):554-9.

7. Boots LR, et al. Fertil Steril 1998;69(2):286-92.