.png)
Take-home points
- Testosterone home test kits have become increasingly popular due to their convenience and privacy, but they may not provide the most reliable results.
- The NHS and other national health services offer free testosterone testing and your doctor can give you tailored expert advice based on your specific circumstances.
- We recommend everyone get tested by a trained healthcare professional, rather than via an at-home testosterone test kit.
What is a testosterone test kit?
As per its name, a testosterone test kit is a kit that tests for the hormone testosterone. But what's inside and how does it work? While there are testosterone tests that use samples of urine and saliva, by far the most common method is the trusted blood test, which can be carried out in two different ways.
Needle blood test
- The first of which requires a healthcare professional, like a nurse, doctor or phlebotomist, to find a vein, and fill a small tube (vacutainer) with blood from your vein. This type is similar to most other blood tests, involving the use of a small needle and requires between 5–10 ml of blood.
Finger prick blood test
- The other type of testosterone test kit doesn't contain a needle. Instead, they contain a finger-pricking device (lancet), like the ones people with diabetes use, to prick the tip of a finger and cause it to bleed from the capillaries. Only a few drops are needed to fill the included container, known as a microtainer. Perhaps this kit is better for those that don't like needles, or have a fear of them. However, be aware that some people find these finger-pricking devices hurt more than needles.
Both kits require a blood sample but they differ in the volume of blood collected, and the skill required to use them. The first type of test, the traditional kind, is generally more suited for the healthcare setting. It's the type your doctor would use and particularly useful when multiple tests are to be run, as the sample collected is bigger.
The second type is more suited for home testing and more than likely is the type you'd receive if you were to order an online testosterone test. Both kits require the collected sample to be sent to a lab, where the analysis will be done, and a report of the results will be generated.1,2,3
Are at-home testosterone tests accurate?
What are these kits for?
The purpose of testosterone test kits is to determine the levels of testosterone in the blood. The reasons as to why individuals may opt for these tests are varied. Perhaps out of curiosity, but usually to confirm whether or not someone's testosterone levels are within the normal range. In any case, knowing your testosterone levels can give you insight into your overall health and well-being.
Learn more about low testosterone, and how it can impact your health
Besides, for men, testosterone deficiency (TD) is not just limited to sexual symptoms. A deficiency in testosterone has a strong impact on overall health and wellbeing including muscle mass, bone density, energy levels, mood, motor response and cognitive function.4 So it's a good idea to test for it, especially when it's reported that testosterone deficiency is underestimated by specialist physicians.4
Comparing at-home testosterone test kits vs. clinical testosterone tests
Clinical testosterone tests in professional settings utilise validated methods and trained professionals, typically offering results deviating less than 20% from gold-standard methods.5 And, to further bolster trust in clinical tests, the American Center for Disease Control and Prevention (CDC) has implemented a hormone standardisation scheme which requires labs to match results within 6.4% of CDC samples.6
In contrast, the question of "how accurate are at-home testosterone tests" reveals a more varied picture. Their accuracy is inconsistent, with some studies showing that saliva-based testosterone tests demonstrate considerable variability in results, particularly for women.7,8 One study also showed variations of 26.3–40.8% in men and 57%–115% in women comparing 6 different home test kits.8 When compared with clinical tests, home kit results diverged by an average of 194% in men and 67% in women.8
In practice > online: Why are home testosterone tests not as accurate?
When it comes to any test, they are only as good as the sample, the analysis and the overall reliability of the test. Although at-home testosterone test kits may seem convenient, they do have their limitations.
Varied laboratory techniques, user error, and transportation mishaps are only some of the many factors that contribute to discrepancies in accuracy between clinical and at-home testosterone kits.8 One of the major drawbacks of at-home tests depends on the provider you've selected: they may not be regulated to the same standard as the labs your doctor or hospital would use, not hold a UKAS accreditation (United Kingdom Accreditation Service), and if that's the case, the results they give may be misleading.
If the lab you’re acquiring the test from is not accredited, who's to say their testing process is established? Is the equipment they are using being appropriately maintained? What are they doing to avoid, or minimise, the risk of contaminating the sample(s)? These are just a few of the alarm bells that should be ringing whenever you send a sample for testing.
Discrepancies in collecting samples
At-home testing kits require you to collect the sample, and that too may have some unintended consequences. Since the collected sample has to be sent to a lab for analysis, there is always room for error during transportation or processing. The results may not be accurate, depending on how the sample is collected and the conditions in which it is later stored and shipped to the lab. Those last two points are out of your control, and for those reasons, it's often best to have a medical professional collect, package and distribute the sample for you.
It's always advisable to consult your doctor
The most prominent benefit of undergoing a clinical testosterone test is that healthcare professionals can carry out all steps under more controlled conditions, following established processes that work and can be relied upon.
Testosterone levels are best measured in the morning, on an empty stomach and before 11 a.m. Glucose has been shown to influence testosterone and samples taken outside of these conditions may be up to 30% lower, and so sticking as closely as possible to these parameters is paramount to getting accurate results.4 You may also need to have at least two tests, preferably 4 weeks apart, to confirm any results.4
It's also important to consider that it costs nothing to get a testosterone test on the NHS in the United Kingdom, and in many other countries as well. The British Society for Sexual Medicine recently published some guidelines which encourage physicians to test for testosterone deficiency in all men with consistent and multiple signs of testosterone deficiency.4
Learn more about hypogonadism and testosterone deficiency diagnosis
Finally, testosterone tests aren't intepreted based on a single reading. To get a complete picture, your healthcare professional will measure total testosterone, free testosterone and levels of sex hormone binding globulin (SHBG) – parameters which some at-home testosterone kits cannot measure.10
Why take the risk?
Taking an at-home testosterone test with potentially skewed or inaccurate results can lead to unnecessary health concerns. Getting your testosterone levels checked with your doctor on the other hand means they'll be able to take into consideration your age, overall health and any other conditions or medications when interpreting your results. The NHS offers support for low testosterone, as does many other international health services. You'll receive expert interpretation of the results and leave the doctor's office more informed. So why take the risk when you can get tested at your general practice?
References
- Simmonds MJ, et al. Clin Hemorheol Microcirc 2011;47(2):111-9. doi: 10.3233/CH-2010-1372.
- Maroto-García J, et al. Diagnosis 2023;10(3): 281-297.
- Vein vs Cap Study. Available from: https://clinicorelabs.com/wp-content/uploads/2021/06/Vein-vs-Cap-Study.pdf [Accessed 20-OCT-2023].
- Hackett G, et al. World J Mens Health 2023 Jul;41(3):508-537.
- Vesper HW, et al. Steroids 2009; 74: 498–503.
- Trost LW, Mulhall JP. J Sex Med 2016; 13: 1029–1046.
- Welker KM, et al. Psychoneuroendocrinology 2016; 71: 180–188.
- Adebero T, et al. Pediatr Exerc Sci 2020; 32: 65–72.
- Boots LR, et al. Fertil Steril 1998; 69: 286–292.
- Anawalt BD, et al. AM. J Urol 2012; 187: 1369–1373.
