About Hormones Men What's a low level?
What's a low level?
The damaging effects of low T prompted the Food and Drug Administration (FDA) to approve testosterone as a treatment for hypogonadism. Now the important question becomes: What testosterone level is low enough to cause hypogonadism? Although that seems to be a very direct question, only needing the measure or amount that means “too low”, it’s just not that simple.
Depending on the laboratory used, testosterone is measured in nanograms per deciliter (ng/dl). That is the number of billionths of a gram found in 100 milliliters of blood serum. The range usually reported on a laboratory report as “normal” can span from 290 ng/dl to 900 ng/dl. But there’s a problem with this “normal range.” It is determined using a standard Gaussian distribution (yes, the “bell curve” used by school teachers to grade papers). The “bell” is composed of all of the patients who (at any given time and for whatever reasons) have had their blood levels tested for testosterone. The low (290 ng/dl) number equals two standard deviations below the average and the higher (900 ng/dl) number equals two above it. Two “standard deviations” means this: if your level is below the 290, then your testosterone is in the bottom 2.5% of all male testosterone levels. Unfortunately, most doctors aren’t specialists in this area. They think that if your test value falls in the “normal” range, then it’s no problem. They don’t understand that there are few similarities among the groups of men forming the basis for the “normal range” at most laboratories. The men can be age 82, or 21; some are chronically ill, others very healthy; they can be thin or obese; under maximum stress or stress-free. Every one of these conditions can profoundly change a man’s testosterone level.
The standard medical definition of hypogonadism generally sets the level at “below 300 ng/dl.” That is because virtually all men falling below that range demonstrate the signs and symptoms we discussed above. So, what about levels of 350 or 450 ng/dl? Between one man with the 350-450 ng/dl level and another who meets the 300 ng/dl “hypogonadism” cut-off number the difference is less than between him and the man with an 800 ng/dl level. Also, what about the average level of about 600; is it sufficient or does a man with a level of 900 have denser bones, stronger muscles, greater sexual potency, and just generally feel better?
Anecdotally, think back to how you felt when you were 18 years old, when your testosterone levels run between about 800 and 1500 ng/dl. Scientifically, there are a number of studies showing improvements in strength, muscle, and libido when men with “normal” middle-aged testosterone levels have their levels increased to the high end of normal or even above it with TRT.
Can you think of a legitimate reason why a man should be denied treatment if his testosterone level is 500 ng/dl? Just because that man has only a mildly decreased libido and slightly reduced musculature – is that a reason he should not be treated and function at the top of his game? This is the heart of the issue in the debate over the use of testosterone for anti-aging treatment. We’ll open that debate right after we discuss what typically happens to a man’s testosterone levels as he ages.
NEXT PAGE: Testosterone and Aging
