Androgen Profile (Testosterone-Total, Testosterone-Free, SHBG, DHT, FAI, Androstenedione)

Androgen Profile (Testosterone-Total, Testosterone-Free, SHBG, DHT, FAI, Androstenedione) is a comprehensive blood test used to evaluate the production, transport, availability, and metabolism of androgen hormones. Androgens are hormones involved in sexual development, reproductive function, muscle and bone health, hair growth, skin changes, and several metabolic processes in both males and females.

This profile measures total testosterone, free testosterone, sex hormone-binding globulin (SHBG), dihydrotestosterone (DHT), Free Androgen Index (FAI), and androstenedione. Evaluating these markers together provides a broader assessment than measuring total testosterone alone, particularly when SHBG levels are abnormal or symptoms do not match the total testosterone result.

Benefits of the Test

• Provides a comprehensive assessment of androgen status.
• Measures total and biologically available testosterone indicators.
• Evaluates SHBG and its effect on testosterone availability.
• Assesses DHT, a potent metabolite of testosterone.
• Includes FAI to estimate circulating androgen activity.
• Measures androstenedione from adrenal and gonadal sources.
• Supports evaluation of androgen excess or deficiency.
• Helps guide endocrine, fertility, and reproductive management.

Why Doctors Recommend This Test

Doctors may recommend this profile for men with reduced libido, erectile difficulties, infertility, reduced muscle mass, low energy, delayed puberty, or suspected testosterone deficiency. In women, it may be advised for irregular periods, excessive facial or body hair, acne, scalp hair thinning, infertility, virilization, or suspected polycystic ovary syndrome. The profile may also support evaluation of adrenal, ovarian, testicular, pituitary, or androgen-metabolism disorders.

Preparation Before Test

• A serum blood sample is required for testing.
• Morning collection is generally preferred, particularly when assessing testosterone in males.
• Fasting requirements depend on laboratory protocol and any additional tests ordered.
• Inform the doctor about hormone therapy, testosterone treatment, steroids, contraceptive pills, and fertility medicines.
• Provide details of supplements, including biotin-containing hair, skin, or nail products.
• Do not stop prescribed medicines or hormone therapy without medical advice.
• Women should provide menstrual-cycle and pregnancy information when relevant.
• Patients receiving testosterone treatment should follow the doctor's instructions regarding collection timing.
• Repeat morning testing may be required when an abnormal testosterone result is identified.

Normal Reporting Time

Most Androgen Profile reports at Focus Diagnostics are initiated within 2–3 hours of sample receipt for processing and hormone-testing workflow preparation. Final analysis of total testosterone, free testosterone, SHBG, DHT, FAI, and androstenedione, followed by validation and quality review, is generally completed within several working days. Reporting time may vary because specialized components such as DHT and androstenedione may be processed on scheduled testing days.

Who Should Take This Test?

This profile may be recommended for:

• Men with suspected testosterone deficiency.
• Men with reduced libido, erectile difficulties, or infertility.
• Women with hirsutism, persistent acne, or scalp hair thinning.
• Women with irregular periods or suspected polycystic ovary syndrome.
• Individuals with signs of androgen excess or virilization.
• Children or adolescents with early or delayed puberty.
• Patients with suspected adrenal, ovarian, or testicular disorders.
• Individuals undergoing monitoring of prescribed androgen-related treatment.

Detailed Information

Testosterone is the principal androgen hormone. In males, it is produced mainly by the testes, while smaller quantities are produced by the adrenal glands. In females, testosterone is produced in lower quantities by the ovaries and adrenal glands and through the conversion of other steroid hormones.

Total testosterone represents both protein-bound and unbound testosterone circulating in the blood. Most testosterone is bound to SHBG or albumin, while only a small fraction circulates as free testosterone. Changes in SHBG can alter free testosterone availability even when total testosterone appears normal.

Free testosterone represents the unbound fraction of testosterone. It may be especially useful when symptoms suggest androgen deficiency or excess but total testosterone is inconclusive, or when SHBG is affected by age, obesity, thyroid disorders, liver disease, pregnancy, medicines, or hormone therapy.

SHBG is a protein produced mainly by the liver that transports testosterone and other sex hormones. Increased SHBG can reduce the proportion of free testosterone, while decreased SHBG can increase the free fraction. Oral contraceptives and estrogen exposure may increase SHBG, whereas obesity and insulin resistance may lower it.

The Free Androgen Index is a calculated estimate derived from total testosterone and SHBG values. It is commonly calculated using the ratio of total testosterone to SHBG, multiplied by 100 when compatible units are used. FAI may help assess androgen activity, particularly in women, but it must be interpreted using the laboratory's method and reference intervals.

Dihydrotestosterone is a potent androgen formed when testosterone is converted by the enzyme 5-alpha-reductase. DHT contributes to the development of male external genitalia, facial and body hair, prostate growth, and certain androgen-related skin and hair effects.

DHT testing may support the evaluation of selected androgen-metabolism disorders, 5-alpha-reductase abnormalities, disorders of sexual development, and treatment involving medicines that modify DHT production. The result should not be used alone to diagnose hair loss or prostate disease.

Androstenedione is produced by the adrenal glands and gonads and serves as a precursor for testosterone and estrogens. Increased androstenedione may occur in polycystic ovary syndrome, congenital adrenal hyperplasia, certain adrenal or ovarian disorders, and some hormone-producing tumours.

In women, androgen excess may cause hirsutism, persistent acne, irregular or absent periods, infertility, scalp hair thinning, deepening of the voice, or increased muscle development. Polycystic ovary syndrome is a common cause, but thyroid disorders, congenital adrenal hyperplasia, medicines, and adrenal or ovarian tumours may also require consideration.

In men, low androgen activity may be associated with reduced libido, erectile difficulties, infertility, decreased muscle mass, reduced body hair, fatigue, low mood, and reduced bone density. Possible causes include testicular disease, pituitary or hypothalamic disorders, obesity, chronic illness, medicines, or ageing.

Testosterone levels vary during the day and between different days. Morning levels in younger males may be considerably higher than afternoon levels. Consequently, an unexpected or low result may require confirmation with another morning sample before diagnosing androgen deficiency.

Hormone results must be interpreted using age-specific and sex-specific reference intervals. Menstrual-cycle stage, pregnancy, menopause, puberty, medicines, supplements, body weight, and underlying illness may also influence the results.

Depending on the findings, additional tests may include LH, FSH, prolactin, estradiol, DHEA-S, 17-hydroxyprogesterone, thyroid-function tests, cortisol, semen analysis, pelvic ultrasound, testicular ultrasound, pituitary imaging, or genetic testing.

At Focus Diagnostics, Androgen Profile testing is performed using advanced immunoassay and specialized hormone-analysis technologies, validated methodologies, and stringent quality-assurance standards to provide accurate, reliable, and clinically meaningful results.