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Understanding Testosterone Levels by Age in Males

Testosterone, a hormone present in both men and women, holds significant importance in male physiology, influencing characteristics like muscle mass development, sexual drive in men, and sperm production. Additionally, it plays a role in shaping behaviors such as competitiveness and aggression and is vital in functions such as sleep, mood regulation, self-confidence and more.

As individuals age, testosterone levels typically decline by 1-2% annually, prompting common questions about this vital hormone from patients like “What should my testosterone levels be?”, or “Are my T levels good for my age?”  These questions about average testosterone levels by age and the assessment process involved are important to understand and can help patients and providers navigate the process of determining if testosterone therapy is warranted or not. This article dives into these questions, examining what constitutes a healthy testosterone level for men by age and how it's measured.

From fetal development to adulthood, testosterone exerts its effects at various stages of life. Doctors measure testosterone levels through blood tests, typically reporting results in nanograms per deciliter (ng/dL). These tests will measure the total testosterone in the bloodstream, a portion of which is bound to a protein known as sex hormone binding globulin (SHBG). While another test can assess "free" testosterone, its accuracy is often debated, but can add valuable insight into the entire “hormonal picture” when understanding a patient’s endocrine health. It often helps a prescribing physician determine the most effective protocol for patients with Low T seeking help.

Historically, diagnosing testosterone deficiency lacked age-specific considerations. The range will cover all men, at all stages of life which in not very specific at all. Ultimately, recognizing that reference ranges will naturally differ between younger and older men underscores the importance of integrating age-specific norms into evaluations. For example, a 24 year old with a testosterone level of 300 is certainly lower when compared to a 75 year male counterpart who has the same level of 300, and would typically show much more significant signs and symptoms of low T than the older patient. Several studies have been done within the past few years to get a more specific range based on age, which a extremely valuable data for medical providers to have.

Average Testosterone Levels by Age

Given the pivotal role testosterone plays in male biology, questions about optimal levels often arise from patients who want to know if they’re levels are healthy or if perhaps they’re potentially contributing to some unwanted signs and symptoms of Low T. Individuals wonder about appropriate testosterone levels for different age groups, seeking clarity on what constitutes a healthy range and how testosterone is produced in men.

Typical testosterone levels vary by age, with reference charts providing insights into these fluctuations. It's crucial to understand that these values represent ranges rather than fixed benchmarks, with the goal being overall health and well-being rather than chasing the upper limits of these ranges or even seeking performance enhancing numbers to help achieve cosmetic or athletic advantages.

As reported by Medical News Today in their article “Typical Testosterone Levels in Males and Females.” and Baptist Health in their article titled “Normal Testosterone Levels by Age”,  they provided some of the following data, however it should be said that the examples below are common measurements for results for these tests, and that the extreme high and low values can be considered outliers. We are looking for the typical average hormone range, or the “top of the bell curve” if you will. Normal value ranges may vary slightly among different laboratories so the same patients blood results may be considered normal in one labs results and high in another. Some labs use different measurements or test different specimens. For example, the University of Rochester Medical Center published normal ranges between 270 to 1,070 ng/dL for men (depending on age), so there is clearly confusion among men seeking information due to so many different ranges and answers being provided. Talk to your provider about the meaning of your specific test results as they should be able to help understand the relationship between lab values and your specific signs and symptoms.

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Looking deeper into the data, we can take the average middle range of testosterone levels in men between the ages of 20 to 44 years old to get a better understanding of the typical testosterone levels by age group. In a study conducted in 2022, researchers examined the testosterone levels of 1,486 men aged between 20 and 44. To determine the typical testosterone level for each age group, they selected the middle third of the data and identified these values as normal results, aligning with the definition of normal testosterone established by the American Urological Association. The study titled “What Is a Normal Testosterone Level for Young Men? Rethinking the 300 ng/dL Cutoff for Testosterone Deficiency in Men 20-44 Years Old” published in the journal of Urology, provided us with the following results.

Considering that this dataset defines “what is normal” based on the middle third, it's possible that these normal ranges might be overly restrictive. With the accumulation of additional data, it's probable that reference ranges for testosterone will evolve to encompass age-specific values in the future to provide a more accurate glimpse into a patients’ actual health, instead of just providing information based on a range for ALL men.

However, what holds greater significance is the influence of your testosterone levels on your health and whether you're experiencing any symptoms due to having low T. If you're asymptomatic but find yourself at the lower end of the normal range, this could still be within your normal range. However, if you are in the low end and are experiencing some of the tell tale signs of andropause, there may be a correlation that can possibly be treated with TRT or other lifestyle modifications to improve hormone production and optimize levels.

In a cross-sectional cohort study involving 434 men, it was observed that symptoms were more prevalent when testosterone levels fell below the following thresholds:

Testosterone Levels - Signs/Symptoms

‍15 nmol/L -      Fatigue and decreases in energy

12 nmol/L -                     Unwanted weight gain

10 nmol/L -                      Fluctuations in mood

8 nmol/L -                  Erectile dysfunction (ED)

The aging process adds another layer of complexity. Testosterone circulates in the bloodstream in two primary forms: bound to specific proteins or in a free, unbound state. While tightly bound to sex hormone-binding globulin, it attaches weakly to another protein, albumin. Only the free and albumin-bound testosterone forms are biologically active, collectively referred to as bioavailable testosterone. With age, the levels of sex hormone-binding protein tend to increase, meaning an older man might have a normal total testosterone reading but still possess lower bioavailable testosterone levels, which are crucial and thus begin to feel the symptoms associated with hypogonadism or Low T.

Understanding the intricacies of testosterone metabolism may not be necessary for every man, but it's essential to grasp that these complexities underlie significant limitations in much of the research on testosterone replacement therapy. To assess one's status accurately, requesting measurements of both total testosterone and free or bioavailable testosterone levels, preferably conducted in the morning, is advisable. The following table illustrates testosterone levels observed in a study involving healthy men aged 40 to 79 years as reported by Harvard Medical Schools article titled “Testosterone, Aging and the Mind.”

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The Process of Testing Testosterone Levels

Testing testosterone involves obtaining a blood sample, typically done between 7 a.m. and 10 a.m. for optimal accuracy. In some cases, multiple samples may be necessary to confirm results, particularly if they fall below expectations.

Why Testosterone Testing is Performed

Doctors may recommend testosterone testing for individuals exhibiting symptoms of abnormal hormone production, such as early or delayed puberty in boys, infertility, erectile dysfunction, diminished sexual interest, or bone density loss in men. The benefits of optimized hormone levels are well documented and are vital for men who look forward to enjoying a better quality of life as they age.

Interpreting Testosterone Test Results

Normal testosterone levels typically range from 300 to 1,000 ng/dL for males and 15 to 70 ng/dL for females. However, these values can vary slightly among different laboratories and measurement methods, necessitating discussions with healthcare providers for personalized interpretation as signs and symptoms are an equally important consideration when determining treatment options. The Androgen Deficiency in Aging Males (ADAM) questionnaire is a simple way to answer questions about your Testosterone levels and sexual health, which may help to see if you need to have your testosterone levels checked. Click here to take the ADAM test online.

Potential Causes of Abnormal TestosteroneLevels

Low testosterone levels may stem from various factors, including chronic illnesses, pituitary gland dysfunction, hypothalamic issues, thyroid disorders, testicular diseases, obesity, sleep disturbances, excessive exercise, or stress. Conversely, elevated testosterone levels could result from androgen resistance, ovarian or testicular tumors, congenital adrenal hyperplasia, or certain medications, aging and more. In summary, understanding testosterone levels, their fluctuations across age groups, and the implications of abnormal results is crucial for informed healthcare decisions. Regular monitoring and proactive management can help individuals maintain hormonal balance and overall well-being throughout life.

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