Normal testosterone levels in men typically range between 10-30 nmol/L. The variation in levels can be attributed to factors such as individual hormone sensitivity, where some individuals may have lower levels without necessarily having a deficiency, while others may have higher levels due to less sensitive testosterone receptors. Additionally, the majority of testosterone in the blood is bound and inactive. Individual variations further complicate interpretations. Therefore, there is no exact lower threshold, and it is not possible to say that higher is always better. However, there are some general guidelines that healthcare providers usually follow:
<8 nmol/L: Likely testosterone deficiency. Consider treatment if symptoms are present.
8-12 nmol/L: Gray area where symptoms determine if it is deficiency or normal.
12 nmol/L: Likely normal.
Testosterone levels in the body decrease by approximately 1% per year in middle-aged men (40-70 years).
Whether or not you should get your testosterone levels checked is a difficult question to answer. There is no general response to this question. The factors that influence the importance of testing are the same factors that increase the risk of it being testosterone deficiency. If you experience symptoms consistent with testosterone deficiency, you may need an evaluation. If you are unsure, you can contact your primary healthcare provider.
There are several factors that can affect our testosterone levels. Some factors can be influenced by ourselves, while others cannot. Common examples of factors that can affect testosterone levels include:
In men, obesity is the single most important factor leading to testosterone deficiency. It outweighs age and other comorbidities.
The symptoms and presentation of testosterone deficiency vary depending on the age at which it occurs.
If testosterone deficiency occurs before puberty, there will be a lack of pubertal development, and growth will be affected, resulting in altered body proportions known as eunuchoid proportions.
In adult men, testosterone deficiency is likely to present with a combination of various symptoms.
Symptoms strongly associated with hypogonadism:
Lack of pubertal development
Decreased or absent sexual desire
Decreased occurrence of spontaneous erections
Breast growth (gynecomastia)
Decreased secondary hair growth and reduced need for shaving
Very small and shrinking testicles (volume < 5mL)
Decreased height and fractures with minor trauma (osteoporosis)
Decreased muscle mass and muscle strength
Hot flashes and sweating
Symptoms that may be related to hypogonadism:
Decreased energy, motivation, and initiative, increased irritability
Moodiness and depression
Impaired concentration and memory
Sleep disturbances, increased sleep needs
Mild normochromic, normocytic anemia (within the normal range for women)
Increased subcutaneous and intra-abdominal fat accumulation
Reduced mental and physical work capacity