Health Assessment Report
ExampleTestosterone & hormone panel · 8 biomarkers
Patient details
- Name
- Mark Bakker
- Gender
- Male
- Age
- 41 years
- Date of birth
- 04-09-1984
Test details
- Test Date
- 11-06-2026
- Report date
- 14-06-2026
- Location
- Rotterdam Centrum
- Laboratory
- Star-SHL
8
Total Markers
6
In Range
2
Needs Attention
Overall Assessment
Your total testosterone of 16.8 nmol/L sits in the middle of the reference range. On that number alone you would have no abnormality at all. Your free testosterone, however, is low (0.21 nmol/L) and your SHBG is raised (62 nmol/L) — and those two belong together.
SHBG binds testosterone in the blood. What is bound is not available to your tissues. With a raised SHBG the total can therefore look normal while the working fraction falls short. That is exactly the pattern here, and it is why this panel measures both.
Key Findings
Free testosterone low (0.21 nmol/L)
AttentionBelow the 0.25 lower limit. This is the fraction actually available to muscle, bone and the central nervous system. Reduced energy, loss of libido and difficulty maintaining muscle are the symptoms that fit.
SHBG raised (62 nmol/L)
AttentionAbove the 54 upper limit. This explains the gap between your normal total and your low free testosterone. SHBG rises with thyroid overactivity, liver disease, markedly low body weight and with age.
LH and FSH normal — the signalling works
GoodLH 4.2 U/L and FSH 3.8 U/L are within range, so the pituitary is driving the testes normally. That rules out a primary pituitary problem and makes the picture more benign.
Hematocrit and PSA are fine
GoodHematocrit 0.46 L/L and PSA 0.8 µg/L. These are the standard safety checks before any testosterone treatment, and both are normal.
Detailed Analysis
Hormones
AttentionThe core picture is a normal total testosterone (16.8 nmol/L) alongside a low free testosterone (0.21 nmol/L) and a raised SHBG (62 nmol/L).
Roughly two per cent of the testosterone in your blood circulates freely; the rest is bound to SHBG and albumin. Only the free and weakly albumin-bound fractions are biologically active. A raised SHBG shifts that balance, which makes the total read more favourably than the situation warrants.
LH and FSH are normal, meaning the signal from the pituitary is intact. Your estradiol of 98 pmol/L is likewise normal and consistent with these testosterone values.
Hematology
NormalYour hematocrit is 0.46 L/L, within range. This is the most important safety value in testosterone therapy, which can raise it and thicken the blood. The starting point here is favourable.
Tumor Markers
NormalYour PSA is 0.8 µg/L, well below the 3.0 limit. PSA is checked before and during testosterone treatment. This value calls for no further investigation.
Recommendations
Find the cause of the raised SHBG first
A raised SHBG is a finding, not a diagnosis. Have thyroid function (TSH and free T4) and liver values measured before treatment is discussed. Where a cause is identifiable, addressing it often resolves the free testosterone on its own.
Repeat the test fasting and before 10am
Testosterone follows a clear daily rhythm, peaking in the early morning. A single abnormal reading is never enough to base treatment on. Repeat the measurement on a second morning, fasting, before 10am.
Discuss the result with your GP or an andrologist
Testosterone therapy is a long-term treatment with its own risks and with consequences for fertility. This result is a reason for a conversation, not for starting on your own.
Next Steps
Have the test repeated on a second morning, together with TSH, free T4 and liver values. With those results in hand it will be clear whether the raised SHBG has an identifiable cause.
Then contact your GP. This report does not replace a consultation and is not on its own an indication for treatment.
Your Test Results
Hematology
1What It Measures
Haematocrit indicates what proportion of your blood consists of red blood cells. Blood is broadly made up of fluid (plasma) and cells; haematocrit is the share taken up by the red cells, often reported as l/l or as a percentage. The value is measured as standard in the complete blood count and tracks closely with your haemoglobin and red cell count. Because haematocrit is a ratio rather than an absolute amount, it is strongly influenced by your fluid balance. Dehydration shrinks the plasma fraction and therefore raises the haematocrit, without you having produced any more red blood cells.
Lifestyle Tips
Drink enough, certainly on the day of the blood draw. Dehydration is by far the most common reason for an apparently raised haematocrit. Stopping smoking lowers a structurally raised haematocrit, because your body then needs to make fewer red cells to achieve the same oxygen transport. If you use testosterone, have your haematocrit checked as agreed. A persistently high value calls for a discussion with your doctor about dosing or other measures; do not experiment with this yourself.
Hormones
6What It Measures
This test measures the total amount of testosterone in your blood, reported in nmol/l. It includes both testosterone bound to proteins like SHBG and albumin, and the small fraction of free, unbound testosterone available for immediate use.
Lifestyle Tips
Regular resistance training, adequate sleep, stress management, and a balanced diet with sufficient zinc and vitamin D may support healthy testosterone levels. Limiting alcohol consumption could also be beneficial. Consult your healthcare provider for personalized guidance.
What It Measures
This test measures the fraction of testosterone not bound to proteins like SHBG or albumin. Free testosterone represents roughly 1-3% of total testosterone but is the most biologically active form. Your healthcare provider may compare this with total testosterone for a complete picture.
When Levels Are Low
Some people may experience persistent fatigue, decreased muscle mass, low mood, reduced libido, or difficulty concentrating when free testosterone is low. Weight gain and decreased bone density could also suggest insufficient bioavailable testosterone. A healthcare provider can help assess your symptoms.
Lifestyle Tips
Regular resistance training, adequate sleep, stress management, and maintaining a healthy body weight may support healthy testosterone levels. Ensuring sufficient zinc and vitamin D intake could also contribute positively. Always discuss supplementation or significant lifestyle changes with your healthcare provider.
What It Measures
This test measures the level of SHBG in your blood, reported in nmol/l. SHBG binds to sex hormones and influences how much testosterone and estrogen is freely available for your body to use. Higher SHBG means less free hormone.
When Levels Are High
Some people with elevated SHBG levels may experience fatigue, reduced libido, or mood changes, as more hormones are bound and less are freely available. High SHBG could potentially mask adequate total hormone production.
Lifestyle Tips
Maintaining a healthy body weight, regular exercise, and balanced nutrition may support healthy SHBG levels. Excessive alcohol consumption and certain medications could influence SHBG. Discuss any concerns with your healthcare provider before making changes.
What It Measures
This test measures the concentration of luteinizing hormone in your blood. LH is produced by the anterior pituitary gland and works together with FSH to regulate the reproductive system, including gonadal steroid production and gamete maturation.
Lifestyle Tips
Maintaining a healthy weight, managing stress, and ensuring adequate sleep may support balanced LH levels. Extreme exercise or very low body fat can sometimes disrupt pituitary hormone production. Consult your healthcare provider for guidance.
What It Measures
This test measures the concentration of follicle-stimulating hormone in your blood. FSH is released by the pituitary gland and stimulates the ovaries to produce eggs or the testes to produce sperm. Your healthcare provider may interpret FSH alongside LH and sex hormones for context.
Lifestyle Tips
Maintaining a healthy weight, managing stress, and ensuring adequate nutrition may support healthy pituitary function and FSH regulation. Avoiding excessive exercise that could disrupt hormonal balance is also important. Always discuss concerns about your reproductive health with your healthcare provider.
What It Measures
This test measures the concentration of estradiol (E2) in your blood. Estradiol is produced primarily by the ovaries in women and in smaller amounts by the testes and adrenal glands in men. Your healthcare provider may use this result alongside other hormone levels.
Lifestyle Tips
Maintaining a healthy weight, regular physical activity, and a balanced diet rich in fibre and cruciferous vegetables may support healthy estrogen metabolism. Limiting alcohol intake and managing stress could also contribute to hormonal balance. Always discuss lifestyle changes with your healthcare provider.
Tumor Markers
1What It Measures
PSA measures the total blood concentration of prostate-specific antigen, a serine protease enzyme produced almost exclusively by prostate cells. Elevated blood PSA may reflect a larger prostate volume, inflammation, or increased cellular permeability.
Lifestyle Tips
Maintaining a healthy weight, regular physical activity, a diet rich in vegetables and fruit (particularly lycopene-containing tomatoes), and limiting red and processed meat may support prostate health. Always discuss prostate health concerns with your healthcare provider.
Assessed by a BIG-registered doctor
This report was prepared by a BIG-registered doctor. It does not replace a personal medical consultation. Always consult your general practitioner if you have questions.