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Testosterone, Bioavailable Test

Testosterone, Bioavailable Test

January 21, 2026
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Do I need a Testosterone, Bioavailable test?

Feeling fatigued, losing muscle, struggling with low libido, or noticing brain fog? Could your bioavailable testosterone be the missing piece?

Bioavailable testosterone measures the hormone actually available for your body to use, not just what's floating in your blood. It reveals whether you have enough active testosterone to support energy, strength, mood, and sexual health.

Testing your bioavailable testosterone gives you a precise snapshot of your hormonal health, helping you understand if low levels are driving your symptoms. It's the essential first step to getting answers and personalizing your treatment plan so you can reclaim your vitality.

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If you’ve been postponing blood testing for years or feel frustrated by doctor appointments and limited lab panels, you are not alone. Standard healthcare is often reactive, focusing on testing only after symptoms appear or leaving patients in the dark.

Superpower flips that approach. We give you full insight into your body with over 100 biomarkers, personalized action plans, long-term tracking, and answers to your questions, so you can stay ahead of any health issues.

With physician-reviewed results, CLIA-certified labs, and the option for at-home blood draws, Superpower is designed for people who want clarity, convenience, and real accountability - all in one place.

Key benefits of Testosterone, Bioavailable testing

  • Measures testosterone your body can actually use, not just total hormone levels.
  • Spots hormonal imbalance when total testosterone appears normal but symptoms persist.
  • Clarifies fatigue, low libido, mood changes, and muscle loss in men and women.
  • Guides treatment decisions for testosterone replacement or other hormone therapies.
  • Tracks response to therapy by showing how much active hormone reaches tissues.
  • Flags conditions like PCOS, metabolic syndrome, or age-related hormonal decline early.
  • Best interpreted with total testosterone, SHBG, and your clinical symptoms together.

What is Testosterone, Bioavailable?

Bioavailable testosterone is the portion of testosterone in your blood that is free to enter cells and activate biological effects. Testosterone circulates in three forms: tightly bound to sex hormone-binding globulin (SHBG), loosely bound to albumin, and completely unbound (free). Only the free and albumin-bound fractions can move into tissues to do their work.

The testosterone your tissues can actually use

Because albumin releases testosterone easily, the combination of free and albumin-bound testosterone represents the hormone that is biologically active. This fraction is what drives muscle growth, bone density, libido, energy, and mood.

Why binding matters

SHBG acts like a tight handcuff, holding testosterone out of reach. When SHBG levels rise, total testosterone may look normal, but bioavailable testosterone drops. This explains why some people with "normal" total testosterone still experience low-testosterone symptoms.

A clearer window into hormone function

Bioavailable testosterone offers a more accurate picture of hormonal activity than total testosterone alone, especially when SHBG or albumin levels are abnormal.

Why is Testosterone, Bioavailable important?

Bioavailable testosterone measures the portion of testosterone that's free to enter cells and activate receptors throughout your body. It includes both unbound testosterone and testosterone loosely attached to albumin, excluding the tightly bound fraction that can't be used by tissues. This marker reveals how much hormone is actually available to fuel muscle growth, bone density, libido, mood regulation, and metabolic health in both men and women.

When levels drop below the typical range

Low bioavailable testosterone often signals reduced production by the testes or ovaries, or increased binding by proteins that lock the hormone away. Men may experience fatigue, loss of muscle mass, reduced sexual desire, and difficulty concentrating. Women can notice similar energy and mood shifts, along with decreased bone strength and changes in body composition. In both sexes, low levels are linked to insulin resistance, increased body fat, and cardiovascular risk over time.

When levels climb above the expected range

Elevated bioavailable testosterone in men is uncommon without supplementation, but in women it may reflect polycystic ovary syndrome, adrenal disorders, or other hormonal imbalances. Symptoms can include acne, irregular periods, excess body hair, and metabolic disturbances. High levels may also increase cardiovascular strain and affect cholesterol profiles.

The bigger metabolic and aging picture

Bioavailable testosterone connects deeply to bone health, muscle maintenance, cognitive function, and metabolic resilience. Tracking it helps clarify whether symptoms stem from true hormone deficiency or from binding protein shifts, guiding more precise evaluation of endocrine and overall vitality.

What do my Testosterone, Bioavailable results mean?

Low bioavailable testosterone

Low values usually reflect reduced production by the testes or ovaries, increased binding by carrier proteins, or age-related decline. In men, this often manifests as reduced energy, muscle mass, libido, and mood stability. In women, low bioavailable testosterone can contribute to fatigue, diminished sexual interest, and loss of lean tissue, particularly after menopause when ovarian production drops. The bioavailable fraction represents testosterone loosely bound to albumin plus free testosterone, both of which can enter cells and exert hormonal effects.

Optimal bioavailable testosterone

Being in range suggests adequate androgen activity to support muscle maintenance, bone density, sexual function, and metabolic health. Optimal levels vary by sex and age, with men typically requiring higher concentrations than women. For most adults, mid-range values correlate with stable energy and body composition, though individual needs differ.

High bioavailable testosterone

High values usually reflect excess endogenous production, exogenous supplementation, or reduced binding protein levels. In men, this is often intentional or linked to certain tumors. In women, elevated bioavailable testosterone may indicate polycystic ovary syndrome, adrenal disorders, or androgen-secreting tumors, and can cause acne, hirsutism, and menstrual irregularities.

Factors that influence bioavailable testosterone

Bioavailable testosterone changes with age, sex hormone-binding globulin levels, obesity, liver disease, and medications including hormonal contraceptives and corticosteroids. Interpretation requires context from total testosterone and SHBG.

Method: Laboratory-developed test (LDT) validated under CLIA; not cleared or approved by the FDA. Results are interpreted by clinicians in context and are not a stand-alone diagnosis.

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Frequently Asked Questions

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How it works
What should I expect during a blood draw?
  • A trained phlebotomist will guide you through the process.
  • A tourniquet is placed on your arm, the site is cleaned, and a small needle is used to collect blood into one or more tubes.
  • Results are usually ready in about a week.
  • Most people feel only a quick pinch.
  • The needle is removed, gentle pressure is applied, and a bandage is placed.
How do I prepare for a blood draw?
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  • Follow any fasting instructions you’ve been given.
  • Let us know if you’re on medications, have fainted before, or have needle anxiety.
What should I do after my blood draw?
  • Press gently on the site for a few minutes.
  • Keep the bandage on for 4-6 hours.
  • Skip heavy lifting or strenuous exercise for the rest of the day.
  • Drink extra water to rehydrate.
  • Monitor the site for redness, swelling, or pain.
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Your membership includes:

  • An annual full body test and report across 100+ biomarkers
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Many concierge clinics charge $10k – $100k for their services, we’ve built technology to make the world’s best healthcare as accessible as possible via an all-in-one membership.

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Does Superpower replace my primary care provider?

Superpower specializes in prevention-based testing and treatments and is not intended for emergency or immediate health issues.

While you will have a Superpower care team, your annual membership is designed to complement a primary care doctor if you have one, not replace them.

We are happy to help you share any test results with an outside provider to ensure you receive well-rounded medical care.

How fast are blood test results and how do I read them?

Your annual lab test panel takes about a week to process. We will text you as soon as they become available in your dashboard. Other types of tests may have different testing windows. The Superpower concierge is your own health assistant who helps answer your questions on your results, ensure smooth scheduling, coordination of any office-based tests, specialist referrals as needed, and navigating you to interface with your care team.

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Superpower membership and products are all eligible for HSA/FSA funding.

We see Superpower like a gym membership for those committed to prevention and performance. Superpower is a bridge between wellness and healthcare. Health insurance traditionally focuses on reactive care whereas, at Superpower, we believe it’s never too early to start looking out for your long-term health.

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Frequently Asked Questions about Testosterone, Bioavailable Test

What is bioavailable testosterone and how is it different from total testosterone?

Bioavailable testosterone is the portion your tissues can actually use. Testosterone circulates bound tightly to SHBG, loosely to albumin, or unbound (free). Only free testosterone and albumin-bound testosterone can enter cells and activate receptors, so they make up “bioavailable” testosterone. Total testosterone includes all three forms, which can look normal even when usable (bioavailable) testosterone is low.

How does a bioavailable testosterone test measure the testosterone my body can actually use?

Bioavailable testosterone testing focuses on the free and albumin-bound fractions - the testosterone that can move into tissues. Because SHBG-bound testosterone is tightly “handcuffed” and largely unavailable to cells, bioavailable testosterone provides a clearer window into active hormone function than total testosterone alone, especially when SHBG or albumin levels are abnormal.

Why can my total testosterone be normal but my bioavailable testosterone be low?

When SHBG rises, more testosterone becomes tightly bound and unavailable to tissues. In that situation, total testosterone may appear normal, but bioavailable testosterone drops - explaining persistent symptoms despite “normal” totals. This is why results are best interpreted alongside SHBG, total testosterone, and clinical symptoms, particularly in settings like obesity, liver disease, or thyroid dysfunction that can alter SHBG.

What symptoms can low bioavailable testosterone cause in men and women?

Low bioavailable testosterone can reduce androgen activity reaching tissues, contributing to fatigue, low libido, mood changes (irritability or mild depression), brain fog, and loss of muscle mass. Men may also notice erectile difficulties and reduced bone density over time. Women can experience decreased energy, diminished sexual interest, and loss of bone strength, especially after menopause when ovarian production declines.

What does it mean if my bioavailable testosterone is high, and what symptoms should I watch for?

High bioavailable testosterone usually suggests androgen excess, altered binding dynamics, or exogenous hormone use. In women, elevated levels commonly point to PCOS and may cause acne, excess body hair (hirsutism), irregular periods, and sometimes voice deepening. In men, naturally high levels rarely cause symptoms, but very elevated results warrant evaluation for supplementation or rare testosterone-secreting tumors.

How is SHBG involved in bioavailable testosterone and hormone symptoms?

SHBG (sex hormone-binding globulin) binds testosterone tightly and prevents it from entering cells. Higher SHBG can lower bioavailable testosterone even if total testosterone looks normal, leading to low-testosterone symptoms. Because SHBG shifts with conditions like obesity, liver disease, and thyroid dysfunction, measuring SHBG alongside bioavailable and total testosterone helps explain mismatches between symptoms and standard hormone panels.

Why should bioavailable testosterone be interpreted together with SHBG, albumin, and symptoms?

Bioavailable testosterone reflects free plus albumin-bound testosterone, but binding proteins strongly influence how much hormone reaches tissues. Abnormal SHBG or albumin can change bioavailable levels and symptom relevance. Interpreting bioavailable testosterone with total testosterone, SHBG, and clinical symptoms provides a more accurate picture of hormone activity and helps distinguish true androgen deficiency or excess from binding-protein effects.

How does bioavailable testosterone relate to energy, muscle, bone density, and mood?

Bioavailable testosterone is the biologically active fraction that reaches androgen receptors in tissues. Adequate levels support muscle maintenance, bone density, libido, energy, and mood stability in both men and women. Chronically low levels are linked to frailty, osteoporosis risk, and reduced vitality with aging. Because it reflects active hormone delivery, it can better match changes in strength, body composition, and mood than total testosterone alone.

How can bioavailable testosterone help guide testosterone replacement therapy or other hormone treatments?

Bioavailable testosterone can clarify whether symptoms reflect insufficient active hormone, even when total testosterone appears normal. It can support treatment decisions for testosterone replacement therapy or other hormone therapies by showing how much active hormone is available to tissues. It’s also useful for tracking response over time, helping clinicians see whether therapy is increasing the usable testosterone fraction that actually reaches target organs.

What conditions are associated with abnormal bioavailable testosterone, and why is it tied to metabolic health?

Low bioavailable testosterone may be associated with age-related hormonal decline, chronic illness, obesity, insulin resistance, sleep apnea, thyroid disorders, stress, and certain medications. High levels in women may suggest PCOS; in rare cases, tumors or exogenous hormone use can elevate levels. Bioavailable testosterone is linked to insulin sensitivity, cardiovascular health, cognitive function, and bone integrity, and chronically low levels correlate with metabolic syndrome risk.

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