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
Hematocrit is the share of your blood that is made up of red blood cells. Red blood cells carry oxygen from your lungs to the rest of your body.
Lifestyle Tips
Drink normally on the day of the draw. Do you snore loudly and stop breathing during sleep? Mention it to your GP.
Hormones
6What It Measures
Testosterone is the main male sex hormone. It supports muscles, sex drive and energy. Women make it too, in much smaller amounts, in the ovaries and the adrenal glands (small glands on top of the kidneys).
Lifestyle Tips
Test before 10 am after a good night's sleep, and not while you are ill. Testosterone is highest in the morning, so compare only morning results.
What It Measures
Most testosterone in your blood is bound to proteins. Free testosterone is the small part that is not bound, and that part does the work in your body.
When Levels Are Low
This often has a cause you can change.
The most common ones:
- Overweight, poor sleep or a recent illness.
- Getting older.
- Medicines such as strong painkillers (opioids).
What should you do?
- You feel well: you don't need to do anything.
- You are tired or have little desire for sex: have it tested again in the morning. Still low: make an appointment with your GP.
Lifestyle Tips
Have your blood taken before 10 in the morning. Testosterone is highest then.
What It Measures
SHBG is a protein from your liver that carries sex hormones, such as testosterone, through your blood. Hormone that is bound to SHBG does not work. Only the free part does.
When Levels Are High
This usually has a harmless cause, but it changes how you read your testosterone.
The most common ones:
- The contraceptive pill or hormone tablets that contain oestrogen.
- Getting older, especially in men.
- A low body weight, or eating very little for a long time.
Less common:
- An overactive thyroid, a gland in your neck that sets your energy use.
- Liver disease.
What should you do?
- You use the pill or hormone tablets: this is an expected effect. You don't need to do anything.
- Your testosterone is normal but you have complaints such as low sex drive or tiredness: discuss it with your GP. Less testosterone is free when SHBG is high.
- You have palpitations, lose weight or sweat a lot: make an appointment with your GP.
Lifestyle Tips
Losing weight and moving more raise a low SHBG. The pill and hormone tablets raise it too, so mention them when you compare results.
What It Measures
LH is a hormone from the pituitary gland, a small gland under your brain. In women it triggers ovulation. In men it tells the testicles to make testosterone.
Lifestyle Tips
If you have periods, have your blood taken on day 2 to 5 of your cycle. In the middle of the cycle LH peaks for a day.
What It Measures
FSH is a hormone from the pituitary gland, a small gland under your brain. It tells the ovaries to ripen eggs and the testes to make sperm.
Lifestyle Tips
Do you have periods? Test on day 2 to 5 of your cycle. The pill makes the result unreliable.
What It Measures
Estradiol is the main female sex hormone. It is made in the ovaries and controls the menstrual cycle. Men also make a small amount.
Lifestyle Tips
If you have periods, the result depends on the day of your cycle. Write down the first day of your last period, so you can compare results.
Tumor Markers
1What It Measures
PSA is a protein made by the prostate, a gland below the bladder in men. It can rise when the prostate grows, is inflamed, or has cancer.
Lifestyle Tips
Don't ejaculate or cycle a long distance in the 48 hours before the test. Finasteride and dutasteride halve your PSA, so tell your GP if you use them.
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.