WHAT’S CONSIDERED NORMAL when it comes to testosterone levels is relative. Normal varies from person to person, and doctors say your actual number may not be as important as you might think. How you feel is what matters most.
“It’s not all about numbers,” explains Paul Gittens, M.D., a board-certified urologist and founder of the Rockwell Centers for Sexual Medicine and Wellness in New York City and Pennsylvania. “It’s about how your numbers reflect with your symptoms.”
Doctors typically use your testosterone numbers as a guide, he says. “I know what’s too high, and I know what’s too low. But, there’s a lot of variation in the middle.”
Having low testosterone doesn’t necessarily require treatment. “There are guys who feel completely normal and may not want an intervention,” says Justin Dubin, M.D., a urologist and men’s health specialist at Memorial Healthcare System. “There’s more to people than just numbers, so you treat someone based on their story and their labs.”
How you feel is more important, Dr. Gittens emphasises. Low testosterone can cause a lot of unpleasant effects, including a low sex drive, muscle loss, a tanking mood, and low energy.
Testosterone is a hormone produced by your testicles that plays an essential role in your sex drive, sperm production, muscle growth, bone growth, hair growth, voice deepening, and red blood cell production.
The tricky thing is that everyone functions at a different level, Dr Gittens says. Your testosterone can also fluctuate throughout the day.
“Truthfully, it’s not really black or white,” Dubin adds. “Physicians have to understand the situation.”
What testosterone level is considered normal?
A normal, healthy testosterone level can fall into a wide range. Healthy levels are typically between 264 nanograms per deciliter (ng/dL) and 1,000 ng/dL, according to some doctors. Anything below 264 ng/dL is low, and high testosterone is above 1,000 ng/dL.
Still, there’s variation within the normal range, says Dr. Gittens. “Some people feel miserable at 310 or 350. So, you have to take individuals and look at their symptoms.”
Generally, testosterone levels tend to decrease with age, starting in your 30s, says Brian Black, D.O., an American Osteopathic Association board-certified family medicine physician.
Testosterone levels also fluctuate throughout the day and are usually at their highest in the morning, Dr Black says. That’s why doctors typically test your levels in the morning.
Two tests are done on different days to get a good reading. If your testosterone is on the low end, your doctor will determine the best treatment plan, Dr. Black adds. Testosterone therapy is a common treatment.
What affects testosterone levels?
Many factors influence your testosterone levels. And even if your level is below 264 ng/dL, you might not experience the symptoms of low testosterone. “It’s not like if someone hits 300, automatically, you have low testosterone, or if you have 315, you don’t have low testosterone,” says Dr Dubin. Other doctors say healthy T can still be healthy at 264 ng/dL.
Age is a big influencer. As you get older, you’ll likely see your total testosterone levels decline by about 1.6 per cent a year.
Weight plays a role, too. There’s a link between obesity and low testosterone. Leptin, a hormone found in fat cells, is thought to inhibit testosterone production, Dr Dubin says. Excess fat cells can also increase estrogen levels, which lowers testosterone.
Other factors that might lower your testosterone include:
- Medication, including chemotherapy
- Testicle injury
- Thyroid functioning problems
- Chronic diseases or infections, like HIV, hypertension, or high cholesterol
- Opioid drug use
- Steroid use
More testosterone isn’t always better
When it comes to your testosterone numbers, higher isn’t always better. Testosterone levels aren’t a measure of masculinity, doctors say.
“Just because your testosterone is very, very high doesn’t mean you have a better libido or anything,” Dr. Dubin says. “Everyone’s body is different.”
Dr. Gittens says he sometimes sees patients who are focused on having their testosterone at a certain level – often because of something they’ve read online. “They’re just looking at those numbers, and it can be harmful to patients,” he adds.
If you’re on the higher end, it can actually be harmful, depending on the numbers, says John Lynam, D.O., an endourologist who is board-certified by the American Osteopathic Association. High testosterone can trigger a number of symptoms, like low sperm counts, high blood pressure, mood swings, insomnia, and high blood pressure.
It’s rare for men to naturally have high testosterone, however. If they do, it’s usually due to testicular tumours or adrenal gland conditions. Men who take anabolic steroids or use testosterone therapy without a doctor’s supervision could have high levels, too, Dr Black says.
How to know what your testosterone levels are
Generally, doctors say it’s not necessary to worry about your exact testosterone number – or even know what it is – unless you’re experiencing concerning symptoms, explains Dr Black.
“My philosophy has always been more emphasis on treating the person and their symptoms over absolute numbers,” Lynam says. “If your testosterone levels are on the lower end, there are treatment options. If you are on the higher end, it can be harmful. Too much of a good thing can certainly not be a good thing.”
If you’re having symptoms of low testosterone – like low libido, fatigue, depression, erectile dysfunction, or difficulty concentrating – talk to your doctor about getting your testosterone levels checked. If your levels come back low and you have symptoms of low testosterone, you may be a candidate for testosterone therapy.
Doctors might also recommend lifestyle adjustments, such as exercising more, losing weight, getting more sleep, reducing stress, and eating a healthy diet, Dr Gittens says.
“People are embarrassed many times to talk about these signs and symptoms because there’s a stigma associated with it,” Dr Dubin says. “But we can’t help you unless you come to see us.”
This story originally appeared on Men’s Health U.S.
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