Normal Male Testosterone Levels: Optimal Range

More and more men are facing a problem where their body's testosterone, an important hormone, is not as high as it should be. In the past 20 years, men's testosterone levels have gone down by 20%, and even younger guys are feeling the harmful effects of not having enough of it. You can see more people dealing with this issue nowadays.

Many might not realise what's wrong and feel down or anxious, daily struggling. I've been through this myself.

So, what's causing this problem, and why aren't more people discussing it as a serious concern?

It corresponds to around 9.36 - 37.10 nmol/L in EU units.

More men are getting help for this problem, but not as many as you'd think, considering how common it is for men's hormone levels to be lower these days.

There are a lot of reasons why men might have less of this critical hormone, like being overweight or being around certain chemicals. But doctors still find it tricky to figure out when to say someone has this issue and how to help them.

This could be because doctors don't know enough about it, people feel embarrassed to talk about it, or the tests that check hormone levels might not always be right.

We will discuss what's considered normal for men's hormone levels, look back at how these standards came about, and how they're checked. We'll explain why just looking at these numbers might only tell part of the story about someone's hormone health.

It's important to remember that one number doesn't tell everything. We must think about other things that can change how much hormones work.

Testosterone is a special kind of body chemical, made mainly by the testicles in men and a little bit by women, too. It's known as a sex hormone because it helps develop male features and behaviours.

This hormone works all over the body, influencing how we look, think, act, and even how well we can have children.

It's essential for men's health and happiness. Sadly, it often gets a bad reputation because some people misuse similar substances to try to get stronger or look more muscular.

Testosterone levels are usually checked by taking a small blood sample. You can do this with a simple kit at home or have it done by a healthcare professional, such as a doctor, nurse, or someone who specialises in drawing blood.

The best time to take the test is around 9 in the morning. That's because your body has a natural cycle called the circadian rhythm that affects when testosterone is released. Early in the morning is when your testosterone levels are usually at their peak. The amount of testosterone can vary by 10-20% during the day, and this change might be less noticeable in older men.

After collecting the blood, it's sent to a lab. There, they check it out and measure not only testosterone but also other hormones.

"Normal values" on lab reports show the range of testosterone levels that studies have found in groups of men.

These values often come from studies of men aged between 20 and 80. But, these men might not all be healthy or without symptoms. They could include men who are sick or dealing with different levels of stress or environmental issues.

Scientists gather all the testosterone levels from these diverse groups of men and plot them on a chart. Then, they use maths (like standard deviations, which is a way to measure variation from the average) to cut off a certain percentage of the highest and lowest values. What's left is considered the "normal" range for men's testosterone levels.

When we look at testosterone levels, we know they tend to decrease as men get older, starting from around age 30. So, comparing the testosterone levels of a 20-year-old with those of an 80-year-old doesn't make sense. The problem is the "normal" ranges that labs use to say if testosterone levels are okay or not aren't based on when men start showing symptoms. Instead, they take a big group of men's results, ignore the top and bottom 5%, and call the middle 95% normal.

This method can mean that some men might have lower testosterone than is healthy or good for them but still be told they're within the "normal" range. This leads to a lot of men not getting the help they need because doctors think their levels are acceptable based on these lab ranges.

We've heard stories like one of our friends who was told he couldn't have low testosterone because he could grow a beard, even though his level was 10nmol/l, which is on the lower side. He got treatment from a specialist, and it's helped him. Another friend was dismissed because he was muscular despite having symptoms of low testosterone. This shows there's a lot of misunderstanding about low testosterone and how it affects men.

Mostly, doctors might give men antidepressants instead of looking into testosterone treatment, which can make the problem worse by lowering testosterone levels even more. Plus, different labs have different ideas about what's considered "low" testosterone, so where you get tested can affect whether you get treatment.

It's clear there's a lot of confusion and disagreement about how to handle low testosterone, and it's causing problems for men who could benefit from the proper treatment.

Testosterone levels can vary depending on where you are and the guidelines used. In the EU, for instance, the range can be between 6.9 and 27 nmol/l, while it can range from 10 to 41 nmol/l in other places. The British Society of Sexual Medicine (BSSM) suggests that if your total testosterone is below 12 nmol/l or your free testosterone is below 0.225 nmol/l, you might benefit from testosterone replacement therapy (TRT). They also advise considering TRT for men with high levels of LH (luteinising hormone), which stimulates testosterone production.

In some parts of the US, doctors might recommend TRT based on symptoms alone, regardless of testosterone levels. However, this approach carries risks, especially with higher doses commonly used in US clinics. Some studies indicate that symptoms like low mood and energy can be present in men with testosterone levels below 15 nmol/l. But even at this level, not all men may benefit from TRT. New evidence suggests that TRT can help men with testosterone levels up to 14 nmol/l if they have prediabetes.

Despite being a better indicator, there's limited evidence on how symptoms relate to free testosterone levels. Also, considering levels of SHBG (sex hormone-binding globulin) is crucial when assessing symptoms, although this is often overlooked.

Changes can influence total testosterone levels in SHBG (a protein that carries testosterone in the blood), which can happen due to being overweight, getting older, having diabetes, thyroid problems, acromegaly (a hormone disorder), or taking certain medications.

The Endocrine Society advises against only using total testosterone levels for assessment because they might not give the whole picture significantly since conditions like obesity or medications can change how much testosterone is available for the body to use. Tests that measure the free or bioavailable testosterone (the testosterone that's not bound to proteins and can be used by the body) are more accurate. Still, doctors don't use them as commonly because they're more expensive, more challenging to get, and not as widely known. The Endocrine Society suggests these tests should be done in specialised labs for reliable results.

Only a tiny part of the testosterone in our blood is "free," meaning it's not attached to anything else. There's also a kind called "bioavailable testosterone," which includes the free kind plus some that's lightly attached to a protein called albumin. This kind is easy for our bodies to use, too.

Doctors check for "free" or "bioavailable" testosterone levels when the total amount in the blood is low or if they think there's something off with a protein called SHBG. This is especially important for older people or those with weight issues, diabetes, ongoing illnesses, or thyroid problems.

So, just looking at the total testosterone doesn't give the whole picture, especially since problems with SHBG are pretty standard, particularly in older individuals or those with long-term health issues. That's why, if someone has symptoms, doctors also check the free testosterone levels.

We don't have precise data showing what normal testosterone levels look like in people who don't have any health issues. We have a mix of average levels and research examining when people start having symptoms.

It's important to remember that everyone is different. Just because your testosterone level might be considered 'low' doesn't automatically mean that testosterone replacement therapy (TRT) is right for you. These insights have been around since 1996, but often, they're overlooked in favour of more general numbers.

Ideally, lab tests should use more detailed studies that combine the average testosterone levels in men with the levels that typically cause symptoms.

Studies show that testosterone levels tend to drop as men age. They also show that SHBG (a protein that binds to testosterone and stops it from working) levels go up with age, which means the amount of free testosterone (the kind that the body can use) tends to decrease as men age. This highlights why it's essential to test both SHBG and free testosterone levels.

As men age, their SHBG levels increase, which leads to a decrease in free testosterone. This is a key reason why older men might experience symptoms of low testosterone and why checking free testosterone levels is crucial when investigating these symptoms.

Research indicates that men's testosterone levels decrease gradually with age - about 1.6% per year for total testosterone and 2-3% for free testosterone.

DHEA, a precursor to testosterone (meaning testosterone is made from it), also decreases significantly with age. DHEA is important for many male characteristics and physical changes. It has been found to boost strength and reduce body fat in men, which is why some take it as an anti-ageing supplement.

With the decline in testosterone, the production of DHEA also drops significantly.

The main takeaway is that understanding testosterone levels and their effects on men is complex and still evolving. Here's why:

Individual Differences: A man who had high testosterone levels in his youth may experience significant symptoms if his levels drop to the lower end of the "normal" range, yet he might be told his levels are acceptable based on standard lab ranges.

Age And Symptoms Matter: A young man with the same testosterone level as an older man with low testosterone might feel extremely tired and depressed, but lab ranges might still consider him "normal." This could lead to misdiagnosis and inappropriate treatment, such as being prescribed antidepressants for symptoms that stem from low testosterone.

Need For Comprehensive Testing: Doctors should assess low testosterone by combining total and free testosterone levels and a patient's symptoms. This approach is more personalized and can help avoid misdiagnosis.

Research And Lab Ranges: More research is needed to identify symptomatic male testosterone ranges. Labs should update their "normal" ranges based on the latest research, not just statistical averages from population studies.

If you need assistance, feel free to reach out to Androgenix. Our team is dedicated to providing support and guidance regarding testosterone-related concerns. Contact us for expert advice and personalised solutions tailored to your needs.

Geoff Hackett et al., British Society for Sexual Medicine Guidelines on Adult Testosterone Deficiency, With Statements for UK Practice.

Lauren Riggin and Gideon Koren, Effects of selective serotonin reuptake inhibitors on sperm and male fertility.

Barry R. Zirkin and Joyce Lisa Tenover, Aging and Declining Testosterone: Past, Present, and Hopes for the Future.

Beth A. Mohr et al., Normal, bound and nonbound testosterone levels in normally ageing men: results from the Massachusetts Male Ageing Study.

Nikolaos Samaras et al., A Review of Age-Related Dehydroepiandrosterone Decline and Its Association with Well-Known Geriatric Syndromes: Is Treatment Beneficial?

Gary Wittert et al., Testosterone treatment to prevent or revert type 2 diabetes in men enrolled in a lifestyle programme (T4DM): a randomised, double-blind, placebo-controlled, 2-year, phase 3b trial.