Welcome back to Testosterone Week! If you’re just joining us, I recommend checking out our two previous posts in the series: the benefits of testosterone and a short primer on how T is made.
Today we’ll be taking a look at what’s considered a normal testosterone level and how you can get your testosterone levels tested. As I began researching testosterone levels and hormone testing for this series, I quickly learned that there’s a lot of conflicting and confusing information out there — some websites will say that “X” is a normal testosterone level, while another website says “Y” is the ideal range. Even medical labs give conflicting numbers on what’s a normal testosterone level.
Why so much confusion?
The problem is that there hasn’t been much standardization in hormone testing, particularly regarding T levels. Different labs use different methods (and measurements), which has only created confusion among consumers and even family doctors about what testosterone level results even mean.
Hopefully, the current state of confusion will soon change. The Center for Disease Control here in the U.S. started a project in 2010 to get labs to agree on standard hormone testing procedures. It’s slowly gaining ground, but not every lab has signed on.
I also learned that the bottom range of what’s considered “normal” by many doctors is actually woefully underestimated. Doctors are telling men who come to them with symptoms of low testosterone, “Well, you’re barely within normal range, but it’s still normal, so… you’re fine!”
No, Dr. Everything’s-A-Okay. It’s not fine.
I hope in this post I can clarify some of the confusion surrounding testosterone levels and hormone tests. I’ll be straight with you. This stuff is super confusing. I’ve done my best to synthesize all the disparate info out there into an easy-to-read format for the layman and have sought to create the most accessible resource on the web. But, I’m not a scientist or doctor, and may have gotten a few things wrong. If any of you professional endocrinologists see an error, I welcome your corrections.
Total and Free Testosterone Levels
Before we begin, I want to reiterate the fact that there are three different types of testosterone floating in your body: free testosterone, SHBG-bound testosterone, and albumin-bound testosterone. When you get tested, there are two tests you can get: total testosterone and free testosterone.
Total testosterone is the total amount of T floating in your blood at the time of the test: free, SHBG-bound, and albumin-bound combined. Total testosterone is typically measured in ng/dl, or nanograms per decilitre.
Free testosterone is the measurement of — you got it — free testosterone (which often includes albumin-bound testosterone as well because it can easily convert to free T). Free T is typically measured in picograms per milliliter. As we’ll discuss later in this post, because free testosterone makes up such a tiny, tiny percentage of your total T, it’s really hard to measure accurately. So, when you see research on normal testosterone levels, it usually focuses on total testosterone. Consequently, most of the numbers in this post will be about total T levels. With that said, I do include some references to research that indicates what average and optimal free testosterone levels are.
What’s a “Normal” Testosterone Level?
When you go to get tested for testosterone, the lab will often show you what’s considered the “normal” range among patients who have tested with that particular lab. It’s called the “reference range.”
For example, LabCorp (the lab I used to test my T levels here in Tulsa, OK) shows a reference range of 348 – 1197 ng/dl (nanograms per decilitre) for total testosterone levels. According to this reference range, my total testosterone level of 383 ng/dl at the beginning of my experiment would mean my total T levels were — barely — within the normal range.
Here’s the problem.
That reference range consists of a wide variety of men who tested with LabCorp: 80-year-old men and 20-year-old men; obese men and super fit men; men with pituitary gland problems and men with glands that work like champs.
Sure, my 383 ng/dl was considered normal, but normal compared to whom? An 80-year-old man with Type 2 diabetes?
The fact that reference ranges don’t break patients down by age or health status explains why a 30-year-old man can go to his doctor with the symptoms of low T, only to be told that his T levels are fine because they’re within the “normal” range. If you’re 30 (or even 50), but have the same testosterone level as an 8o-year-old, diabetic man, your doc may say you’re okay, but you’re still not going to feel good. Plain and simple.
What’s interesting is that for many years, the bottom number of the reference range for T levels at many medical labs was much lower. For example, up until last year, LabCorp’s reference range for testosterone was 249-836 ng/dl. You could have had a testosterone level of 250 (which is super low) and still be told by your doctor that you were normal.
All this is to say that the “normal” levels put out there by doctors and labs aren’t all that useful.
Average Testosterone Levels by Age
When determining what’s considered a normal testosterone level, it’s best to look at what the reference range is for men your age. Researchers have known for years that T levels typically drop by about 1% every year after you hit your mid-30s. So if you’re 35, comparing yourself to a bunch of 80-year-old men isn’t very useful because they likely have really low T levels.
Unfortunately, many labs don’t break down reference ranges by age. However, studies have been done in which researchers do just that. Below, I include the results from two such studies.
| Measurements in Conventional Units (ng/dl), SHBG in (nmol/L) |
| Age | # Subjects | Total Test. |
Stand. Dev. |
Free Test. |
Stand. Dev. |
SHBG | Stand. Dev. |
|---|---|---|---|---|---|---|---|
| 25-34 | 45 | 617 | 170 | 12.3 | 2.8 | 35.5 | 8.8 |
| 35-44 | 22 | 668 | 212 | 10.3 | 1.2 | 40.1 | 7.9 |
| 45-54 | 23 | 606 | 213 | 9.1 | 2.2 | 44.6 | 8.2 |
| 55-64 | 43 | 562 | 195 | 8.3 | 2.1 | 45.5 | 8.8 |
| 65-74 | 47 | 524 | 197 | 6.9 | 2.3 | 48.7 | 14.2 |
| 75-84 | 48 | 471 | 169 | 6.0 | 2.3 | 51.0 | 22.7 |
| 85-100 | 21 | 376 | 134 | 5.4 | 2.3 | 65.9 | 22.8 |
The above chart groups men into seven ten-year age increments. It’s based on results from this 1996 study. According to this chart, my T level at the beginning of the experiment (383 ng/dl) was closer to the average of an 85-100-year-old man. Yikes! This chart also lists the average free testosterone levels of the subjects. My beginning free testosterone was below the average of men my age and my end level was above average.
In a study done that same year by another team of researchers, they produced the following chart of testosterone levels broken down by age:
| Measurements in Conventional Units (ng/dl) (source) |
| Age | Number of Subjects |
Mean Total Test |
Stand. Dev. |
Median Total Test |
5th % | 10th % | 95th % |
|---|---|---|---|---|---|---|---|
| <25 | 125 | 692 | 158 | 697 | 408 | 468 | 956 |
| 25-29 | 354 | 669 | 206 | 637 | 388 | 438 | 1005 |
| 30-34 | 330 | 621 | 194 | 597 | 348 | 388 | 975 |
| 35-39 | 212 | 597 | 189 | 567 | 329 | 388 | 945 |
| 40-44 | 148 | 597 | 198 | 597 | 319 | 378 | 936 |
| 45-49 | 154 | 546 | 163 | 527 | 329 | 358 | 846 |
| 50-54 | 164 | 544 | 187 | 518 | 289 | 348 | 936 |
| 55-59 | 155 | 552 | 174 | 547 | 319 | 338 | 866 |
While this chart doesn’t show average free testosterone levels, I like the fact that it shows the T levels of men in the bottom five and ten percentiles as well as the T levels of the men in the top 95%. You can see how you compare to men with the lowest and highest T levels.
According to this chart, my beginning T level (383 ng/dl) was near the bottom 5% and 10% across all age groups. Even for 55-59-year-old men. (Boo!)
My testosterone level after 90 days of good living (778 ng/dl), was above average for my age group (Bully!).
These charts are a much better source than labs’ reference ranges to check if your T levels are normal. If your doctor tells you that your T levels are normal, make sure to compare the results to these charts to ensure he’s not shortchanging you.
As far as normal percentages of free testosterone go, ~2-3% is considered normal. If you’re significantly below that percentage range, you’ll likely experience symptoms of low T even if your total T is average or above average.
Go For Optimal, Not Average
If your testosterone levels match up with the average in the charts above, it’s safe to say that you have adequate amounts of T in your system. But we don’t want to go for just adequate, we want optimal testosterone levels so that we can derive as much benefit as we can from this virile molecule.
What’s an optimal T level, you ask? Great question.
The answer is: “It depends.”
Every man is different, so their level of optimal testosterone will be different, too. For some men, a testosterone level of 600 ng/dl will make them feel great, while other men need to be around 800 ng/dl in order to experience the benefits of optimal T.
Clinical research still hasn’t determined a hard threshold level for when symptoms of low T begin appearing. Some recent research suggests that symptoms of low T might begin appearing in men when their total testosterone level dips below 320 ng/dl. According to anecdotal evidence from the owner of Peak Testosterone, many men start noticing low T symptoms when their total testosterone dips into the 400s. Of course, it’s anecdotal, so take it for what it’s worth, but it’s probably a good idea to stay above 500 ng/dl if you don’t want to experience symptoms of low T.
So that’s a good rule of thumb for the lower threshold. And from there you can shoot for levels that are in the higher range for your age group.
But it’s important to note that optimal testosterone doesn’t necessarily mean you need super-high levels. Past a certain level, testosterone can actually cause a bunch of not-so-good side effects, like sleep apnea and overly thick blood. You typically only have to worry about too much testosterone if you’re using testosterone replacement therapy. Barring some physiological defect, too much T usually isn’t a problem found in men increasing their testosterone naturally through changes in lifestyle and diet.
How to Measure Your Testosterone Level
There are three ways to test your testosterone levels: saliva sample, urine sample, and blood sample. Each method has its pros and cons.
Saliva and urine tests are relatively inexpensive and fast. You can even buy a saliva test kit on Amazon for about $30. Just spit in the cup, put it in the mail, and a week later you’ll get a total testosterone measurement. The problem is that saliva and urine tests aren’t very accurate, which is why endocrinologists typically don’t use saliva or urine samples when diagnosing low testosterone levels. Instead they use blood serum tests.
While blood tests are much more accurate and sensitive than saliva or urine tests, they’re also much more expensive — blood tests for total and free testosterone can set you back $130. Because I wanted the most accurate results, I went with the blood serum testing.
What I didn’t know before I got tested was that there are different kinds of testosterone blood tests, some more accurate than others. As I mentioned at the beginning of the post, there isn’t much standardization amongst labs when it comes to testing. Some labs use one method, while another lab will use another test.
I later learned that the blood test I used to measure my total testosterone for my experiment wasn’t the most accurate on the market and wasn’t what the CDC is recommending labs use in their goal to standardize hormone testing. (I tested myself a month after my 90-day experiment with the blood test the CDC recommends. I’ll share my results in a bit.) I also learned that measuring free testosterone is pretty dang hard and that most free T measurements that labs give are typically just estimates.
Below I share what I learned about the confusing world of testosterone blood tests.
Blood Tests for Total Testosterone
ECLIA Method. When I tested myself for total testosterone for my experiment, the method the lab used was ECLIA, short for Electrochemiluminescent Immunoassay. It’s a fast and affordable method to measure total testosterone in your blood. Many labs use this method because it’s automatic and doesn’t require too much work on a lab technician’s part. However, some studies have shown that values obtained with ECLIA are significantly higher compared to the more reliable LC/MS method. Which brings me to…
LC/MS Method. LC/MS is short for liquid chromatography-mass spectrometry. It’s considered the gold standard method by many researchers in measuring small molecules. Its accuracy and consistency is why the CDC is recommending LC/MS to be the standard method used when testing total testosterone. Because LC/MS is more sensitive than ECLIA, doctors typically use this method when testing patients with really low testosterone levels, such as women and children. While it’s more accurate and sensitive, the LC/MS method is more expensive than ECLIA. And it takes a bit longer to get your results.
A month after my 90-day experiment, I got tested again, but this time using the LC/MS method. My total testosterone level using this method was 826.9 ng/dl. Meaning my T levels increased even more since starting my testosterone changes.
You’ll have to make the call on which method you go with. If you don’t think you have extremely low T, ECLIA will work just fine. Just know that most researchers see LC/MS as the method that produces the most accurate and consistent results. Labs often offer both ECLIA and LC/MS tests. Later on, I’ll share where you can get tested using either method.
Blood Tests for Measuring Free Testosterone
Reading about the myriad of ways to measure free testosterone has nearly put me in the nut house. It’s confusing.
The problem that labs face is that there is so little free testosterone in our body, it’s hard to measure directly. Below I lay out the methods available right now to measure free T.
RIA Direct. It’s cheap, fast, but not very accurate. Recent studies have been calling into question the use of RIA direct methodology to measure free testosterone. Unfortunately, most labs across the country only use RIA direct because of its cost effectiveness. LabCorp, the lab I used, only measures free T using RIA direct. Despite the criticisms levied at RIA direct tests, many researchers believe it’s an adequate method for routine tests.
Equilibrium Ultrafiltration. Many in the field of endocrinology argue that equilibrium ultrafiltration is a superior and more accurate testing method to RIA direct. The problem is that many commercial labs don’t offer the method because it’s so time consuming and requires well-trained technicians. If you can find a lab that uses equilibrium ultrafiltration, expect to spend a bit more than you would for a RIA direct.
Calculated free testosterone. Instead of directly measuring free testosterone in your blood, it’s possible to get a rough estimate by calculating the amount of albumin, SHBG, and total testosterone in your blood. The problem with this method is that 1) it’s not very accurate and 2) it requires you to pay for three different tests: albumin, SHBG, and total testosterone. This can get pretty expensive, pretty fast.
As you can see, you have a variety of options when getting tested for T levels. My recommendation is to try to get your total testosterone number using the LC/MS method and use whatever method is available and cost effective to measure free testosterone. Of course, I’m just a guy who writes a blog about manliness, so take that recommendation with a grain of salt.
Where to Get Tested for Testosterone
Alright, so you might be asking your computer screen, “Where do I get tested?”
If you’re suffering symptoms of low testosterone, ask your doctor to order a blood test for you. Insurance might cover it.
If you’re just curious about your T levels, you actually don’t need a doctor’s order. You can sign-up for a test yourself.
Here’s how:
Order the test. You’ll need to order a blood test using a website that sells blood tests to consumers. No, you don’t send the website a blood sample. These sites contract with labs across the country to draw blood. They basically act as a middleman.Here are the sites I used to buy my tests:
- Health Testing Centers. You can order a total and free testosterone test for $129. Just be aware the methods that Health Testing Center will request are ECLIA for total testosterone and RIA direct for free testosterone.
- Request a Test. You can order a LC/MS total testosterone test from Request a Test. They say you can order an equilibrium ultrafiltration free testosterone test, but when I got my lab results back, it showed that the direct method was used. I’m still looking into that, but wanted to give you the heads up.
You can also order albumin and SHBG tests from both Health Testing Centers and Request a Test so you can use the calculation method to figure out your free testosterone levels.
Go to a local lab. After you pay for your blood test, you’ll get an email from the website with your order information. You’ll also be told which lab you need to visit in your area to have the test done. Both Health Testing Centers and Request a Test sent me to LabCorp. If you’ve ever applied for a job that requires a drug test, you’ve probably been to LabCorp yourself, as they are a national company.
Get blood drawn. A nice nurse will draw some blood samples. The whole process takes less than 2 minutes. It’s best to get your blood drawn first thing in the morning, as T levels are at their highest in the morning and steadily decline throughout the day.
Get your results. Two or three days later, you’ll get an email from the lab with your results.
Test more than once. Because testosterone levels are sensitive to a whole host of environmental factors, it’s important to get tested more than once when diagnosing low T. You could have below average T levels one week, but slightly above average the next. This is particularly important if your doctor is considering putting you on testosterone replacement therapy. You don’t want him to make the decision from a single test!
Conclusion
Whoo, that was a lot of info. If you feel a little lost, here’s a crib sheet:
- Don’t use lab reference numbers to determine if your T is low. They’re not usually accurate. Use the charts above for your specific age range.
- Take a blood test to determine your total T levels. You can get this blood test at the doctor, or by signing up online and going to a local lab. Make sure to get tested in the morning!
- If you can, take the LC/MS test to measure your total T — it’s the most accurate. If that’s not available, the ECLIA test will work okay.
- To find your free T, try to use the Equilibrium Ultrafiltration test — it’s the most accurate. If that method isn’t available, the RIA Direct test will work okay.
I hope this information was useful. I definitely learned a lot in the process. Again, if anybody sees any corrections that need to be made or if I missed anything, please offer your constructive and friendly feedback.
Tomorrow we’ll cover that long awaited subject : how to boost your testosterone naturally.
Testosterone Week Series:
The Declining Virility of Men and the Importance of T
The Benefits of Optimal Testosterone
A Short Primer on How T is Made
What’s a “Normal” Testosterone Level and How to Measure Your T
How I Doubled My Testosterone Levels Naturally and You Can Too
Related Posts
-
Testosterone Week: A Short Primer on How T Is Made
-
Testosterone Week: The Declining Virility of Men and the Importance of T
-
Testosterone Week: How I Doubled My Testosterone Levels Naturally and You Can Too
-
Testosterone Week: The Benefits of Optimal Testosterone
-
Share:
-
- Tweet
-
Email Story to a Friend
-
-
Print
{ 73 comments… read them below or add one }
Ok, so what about all these LOW T centers advertising on the radio all the time? Just a scam to sell natural “enhancers”?
Very nice post! Can’t wait for tomorrow’s.
If you go with Request A Test… Coupon code GWELL10 will get you 10% off!
Great post in this series.
Lots of useful information I was so ignorant about.
Thank you for the compilation work and sharing it here.
So looking forward to tomorrow’s final part.
Fascinating! I really am excited to see what comes out tomorrow!
The Low T centers are a double edged sword. Yes, they are there to make as much money as possible. Your insurance will not cover anti-aging treatment, or any spin off of this recent fad. However, it can be a challenge to find a doctor who know EXACTLY what they are doing to treat your symptoms. Many will just prescribe a gel and leave it at that, which is both expensive and one of the least effective treatments. The “Low T Centers” are going to try to put you on TRT immediately, which without insurance is very expensive. They would not recommend attempting to raise your levels naturally before starting treatment. However, at least they know what the most effective methods are and what levels to monitor (E2, SHBG, DHEA, Vit D, etc) instead of just putting you on a gel and forgetting about the problem. I want to wait until tomorrow to start posting heavily on this topic so I don’t jump the gun. I have throughly enjoyed this series and look forward to tomorrows conclusion. Thanks!
Another great post in a very informative series. Looking forward to the post tomorrow.
I was tested by an endocrinologist because for years, despite how I felt, my GP had told me I was normal. I came back with a 348…my endo told me that I basically had the test level of a 75 year old. I started test supplements, and it’s helped, though I don’t think as much as the drug companies claim. I’ve got to go back in and get a restest here shortly to see how effective the treatment is.
Greatly appreciate the information this week. I recently had to go in due to a possible torsion injury and during the ultra sound found one of my testicles had atrophy and fibrous tissue and scar tissue in it. Which lead to the doc have me go in for a blood test which resulted in a 238 Lf and Free of 6.8 which at 41 is not good so he is looking to get me started on therapy after PSA test. I am looking forward to the information on how to raise it naturally. The good news through it all despite needing to go back every few months for an ultra sound to check tissue is that this goes to explain a lot of what I have had going on. Thank you very much.
That you very much for all of this Testosterone info. I have been suffering the symptoms of low T for years. I have even gone to an Endocrinologist for some tests (that he said were within the normal range, so I am fine):
SHBG of 21 nmol/L (13-74 normal)
Total-T of 329 ng/dl (183-703 normal)
Free-T of 8.3 ng/dl (3.8-12.8 normal)
FSH of 1.6 mIU/ml (1.6-9.7 normal)
LH of 1.6 mIU/ml (1.2-7.8 normal)
Apparently, these numbers are perfectly normal and nothing to worry about for a 25 year old male in good shape…I have been skeptical. But, these results are right from an Endocrinologist, and he basically said that there was no further need for me to see him. So, my general physician moved to the next diagnosis for the Low-T Symptoms > Depression. Just thought that I would add my personal experience to this for anyone else who is looking at this issue.
Great articles, I keep thinking “I want to know what he did for his experiment!” So hopefully that comes in the next post. Thanks for posting this info.
“Optimal Testosterone”. We had all this a few years back with “Optimal Nutrition” – that time it was vitamin pills they wanted to sell us. So the worried well dutifully went and bough their vitamin pills, until we now have the evidence base to show that supplementing vitamins in most cases leads to no improvement, and in some a worsening of mortality rates.
Turning medicine into a consumer product is a disturbing trend since it requires creating demand. This seems to be done by persuading well people to go and get tests done, which they can then um and ah and worry about until they buy the next product to make the number “better”.
The only active testosterone in the body is free. So that is the most important lab value needed in determining T levels. Like you alluded to, T values vary from person to person. That’s why I believe this is a dangerous article. People should not be treated by a standard lab value. People should be treated based on how they feel. I think when people start thinking they have low T based on the lab value there is a definite placebo effect. I think it’s important to get your values checked to determine a baseline value. This will allow you to see how your body is reacting to your lifestyle. This is why it’s interesting to see how your T lab values changed with your lifestyle changes. I believe it is risky when people start getting treated based on a one time lab value based on a standard. I also believe that is poor medicine. Thanks for doing this series.
Great article. I asked my doctor about reference ranges for my age group, but he shrugged it off and said I was fine because I was (barely) within the reference range.
Do you have any testosterone testing instructions for those of us in Canada? Doctors usually don’t order blood tests merely based on a patient’s general concern, and I don’t think the labs you mentioned have canadian locations.
Just below the first table is “seven-year age increments”. Saying “seven ten-year age increments” or something to that effect would better describe the table.
Other than that, everything was presented in an easily understandable manner (a nice break from trying to decipher Nature and Cell articles).
Has anyone used Clomid to address low levels? It is not approved for this use, but “tricks” the body into producing more testosterone. I was wondering if this was effective.
I’m fortunate to have a doctor who advocates the primal/paleo lifestyle and contracts with a company who forgives what insurance doesn’t cover with blood tests, which includes T level testing.
Bret,
Good series of articles. But I haven’t had a blood test since being laid off in 2009. Do typical blood tests also cover T?
Great post, this is the kind of info I’ve been looking for. Seriously not pleased with the local medical community and how they treat this topic. I am looking forward to the next post as I am not a fan of the replacement therapy
Basically the best possible place for medical testing is finding a wellness doctor. Now this not some form of folk medicine or meeting a guy in the back of a gym, but rather a doctor who perhaps is more progressive in the field of anti-aging, and others that might seem of less importance to some in the medical field. They are more likely following a test to prescribe test to get you to that optimal level instead of shrugging you off like some doctors can.
The raw truth of the matter is that most doctors don’t know diddly-dick about testosterone. At the age of 22, (I’m 24 now) I felt like crap. My T was 392 ng/dl and my primary care doctor told me I was fine. When I spoke to a urologist he told me I wasn’t fine and put me on testosterone replacement, where I’ve stayed for two years. Two years of research later I’m finally using a combination of fertility drugs and healthy living to come off TRT and restore my natural balance. I feel like I’m 20 again! I think Bret’s take on increasing testosterone naturally is the way to go. Can’t wait to read the next article.
Mike H. – Texas
Thanks for the post and for the advice, but I’m a bit disturbed by the fact that it may appear in this article that having a low range of T make you not being a worthful man. I agree, plenty, that T is (no shit Sherlock) necessary to act like one, but I should remind you that too much T might have some bad repercussion on your life. Anger, violence, depression, or impulsiveness could be listed as subsidiary effects. Understanding why you’re a man, and how you’ll be a better one is one thing ; trying to force your own nature would never be a good one.
Tabby, I believe that if you would go and read the previous week’s articles on this subject, you’d find that he already addressed (and in some cases countered) the points you were trying to make.
I was fatigued, tired, etc. I had my T checked out and was above average for my age. However, I was convinced I had low-T for me. I started taking T Bomb II after doing some research. I have to tell you the difference was remarkable after a week or so. I have the energy and libido of a 20-something on most days by taking just 3 capsule of the 6 recommended during a day. Once you get above age 40 you need every edge you can get.
What happens to the albumin when its T is freed?
Get measured while you are younger, my T was at about 180 and I was nodding off driving TO work. I tried patches but my skin got rashes. I did the gels but they are a mess and I didn’t absorb well. And now I am doing self-injection once a week.
My doctor described the test between free T and total T as weighing a plate of spaghetti and sauce, wiping off the sauce and measuring it to try and best guess the total T. And from my experience, issues of T may also be issues with prostate, it was for me because of continued use of injections, just BPH, no cancer but it is a problem.
How about a post on treating low T? I haven’t been tested yet but have a lot of the symptoms, would love to know what treatments are available, what the side effects are like, etc etc. Great series though!
So your experiment used two different methods for measuring the two values? Tsk tsk.
Also I would not say hard and fast that ECLIA displays a higher result relative to LC/MS as this will vary between analyser (and it’s settings) and reagent used (manufacturer, how long the reagent cassette has been used, how full it is etc). External quality control is about standardization between methods and labs to attain the sample results. Fudge factors (or ‘calibration coefficients’) are used to take the raw value to the normalized inter method value (standardized to materials thoroughly tested with the the gold standard method).
Also I wouldn’t spout that crap that the labs reference ranges are trash. For some labs they might be. My lab (in New Zealand) stratifies for age and sex. This is what they should be doing. It is also possible they quoted only the range they were using (50s, male say) at the time on the report.
All of this bearing in mind that labs use different ranges based on the method they use, theoretically for their population. Some labs shamelessly rip ranges from publications with differing populations to their own. It all depends on the head scientist or pathologist usually.
@Greg
Your free Testosterone is in the middle of that range, and that is the effector molecule. fT is what triggers the effects of T and so is really the physiologically active portion. It is possible to have low total T and normal fT and be perfectly fine. This works for a lot of hormones and drugs bound to transport molecules.
@Cruz
Albumin reversibly binds a lot of things. After testosterone, or whatever is bound, disassociates, it simply floats on as nothing had happened. T might rebind later on, or more likely a whole number of other molecules might do the same.
(Same with Sex hormone binding globulin [SHBG])
Also GPs obviously while being the jack of all trades are notorious for missing some of the more subtle disorders. I suggest finding a sharp minded GP, one you would peg as a worrier or busy body.
The ‘she’ll be right’ type of doc you see is likely to let things slip more often. More work for them, more money spent, while you have no apparent or urgent disease.
Other than that, good post.
I appreciate how much work you must have put into this, thank you so much.
I’m 24 and looking at the charts at my age group it feels like I should have more energy. and honestly I’m still in college so that makes doing any decent amount to make sure I have good T kind of hard.
I have been on testosterone replacement therapy for nearly twenty years. It started with a smart physician who prescribed a test for levels after listening to me describe my life. At first it meant a weekly office visit. Later I was taught to self inject for the sake of my wallet. Testosterone I relatively inexpensive. A ten ml vial of 200mg/ml costs about a hundred dollars (without insurance), syringes are cheap. A vial lasts for ten weeks. Yes, there are creams and gels that are costly and carry different risks to family members.
This said, it would be a good idea to check the price of “natural testosterone building supplements” with questionable benefits against the real thing with proven results.
The benefits of having high normal level are many both physically and psychologically. Many good physicians know this and are more than willing to work with you to achieve results.
I have never done home testing because the price of labwork is minimal, twenty something bucks for a level test at my local lab. Most doctors will periodically ask for a PSA test as well, a good idea as undetected prostate cancer can be made worse by adding testosterone to the mix.
I guess I felt compelled to comment as someone with experience. Be wary of supplement companies that have “discovered the answer” to low testosterone. They are in it to make a buck and skate a thin line when they taut their clinical studies.
I went to my GP due to a variety of symptoms of low T. My first test showed total T of 146, which was enough to get me a referral to a urologist (not an endocrinologist). But when he tested me again I came back with a 375, which was “normal” and ended my hopes of getting testosterone replacement therapy.
Now it’s been more than a year and I’m still having symptoms. Any ideas on where to go from here?
A good and thorough article, thank you! I am being treated for LowT by Urologist using Testopel implants. These tic-tac shaped pellets go into your butt every quarter (10 – 20) and last for 60 – 90 days. Unfortunately these pellets are out of stock so I’m stuck (literally) using the stinky gel. Still works but I miss the implants.
Sweet. I have the T levels of a 130-y-o man. No wonder i feel like crap.
You guys who self-inject once a week, how’d you talk your doctor into letting you take charge of that?
I’m a diabetic and I give sub-Q fluids and do abdominocentesis on pets, so I’m no stranger to needle work.
In his book on diabetes, Dr. Bernstein prescribes self-injection i-2 times a week to his patients with low T, which along with the unpleasantries we’ve already discussed, shows up as a need for HUGE doses of insulin to get normal readings.
I have to show up at the office every 2 weeks, pay my co-pay, and get popped in the butt by the nurse.
I’d suggest having an endocrin. do a full thyroid workup if you’re fatigued or depressed. many GPs don’t think to test men for thyroid issues. combo of hypothyroid & low T could be an issue.
Does anyone know of a testing center in New York City? I checked both Health Test Center and REq-a-test and both have testing centers in Connecticut 30m miles from where I live and I don’t have a car.
Hey Guys. I’m sure you have researched the T benefits and problems. I just sent off my serum to get checked. Should hear this week and will report back. I owned a Gold’s way back and have seen it all. My thoughts “MAKE SURE TO GET AND KEEP UP THE PSA TEST” for your prostate. Nothing is worth the big C. and DO NOT get into the more T is better syndrom. Get your Thyroid and Adrenalin checked to make sure these aren’t the cause for your low energy. Injection is better than oral due to the threat to the liver of orals.
Oh and if you are wanting muscle growth too, got to move the iron and eat. I’m all for you, just do it right.
Dan
I really think Low T killed my marriage. Medical treatments for an auto immune blood disorder required my husband to take massive doses of prednizone in pulse cycles. 5 days on huge doses and then cold turkey off for 3 weeks, back on for 5 days, off for three weeks, for almost a year. I think he always had lower T and a lower drive, but this killed it, absolutely. No drive, and no function. How distraught I was. The awful thing about Low T, is that without the drive, you aren’t even disturbed by losing the sex. You just don’t care. A 40 year old man should like sex right? So as my drive got greater, I think I was hitting some kind of peak before menopause, he was shutting down. He used drugs like Cialis and Viagra, but they did little to help us, because the desire was gone. It’s awful to force your man to make love, when he clearly isn’t interested. So so sad to lose that part of our lives, then the rest just fell apart too. So get it checked guys, and spend the money, and be patient. Don’t except you lack of interest as normal or part of aging. We became polar opposites and it was a wedge between us for something that had been good and nice. Now he lives with a woman, sleep with her, and doesn’t have sex, says he is honoring God and respecting her by waiting. So he has re-framed his lack of desire into self-control and an honorable admirable personality trait. T is what makes you look, feel, think and act like a man. Don’t let that slip away, as a woman I want a MAN, with all the testosterone produced effects. It’s good to be wanted, maybe the best thing of all. I miss the way it was, but he was unwilling to work this out, and unfortunately I couldn’t force him to do anything. I’m glad this is being discussed and you guys are working on your total health. Take care and all the best to you.
Great article. I’m 47 and know my T has been low most of my adult life. I finally got the balls (pun intended) to get checked out and found a doctor willing to work with me. My T was at 430. I had little interest in sex. Now I’m a little over 1000 and I feel like a man again. Bold, assertive, confident and sexual. I think a lot of men are too prideful to look for help and would rather suffer or rationalize it away than do anything about it. If there was nothing that could be done, that would be one thing, but to have options available and do nothing is just stupid.
Oh Chris – I couldn’t have said it better. Good for you!!! You are going to make your partner(s) very happy… it’s a good part of adult life.. love-making. Glad you didn’t give that up.
So glad that I found this site at this particular time in my marriage. I have been enduring forced celibacy for several years now and was close to “jumping the fence”. Last week, my husband was diagnosed with a low testosterone and will begin treatment (at my insistance). Even though I am in the health care field, I knew little about this condition and he knew even less. I plan to share your site with him when he gets home. I’m sure that he will feel better about the whole situation as I now do. Thank you for doing this great public service.
Alisa – I am excited for you to be out of forced celibacy, and so envious. So glad your hubby is taking action. His overall health will improve, not just that area. Happy for you both.
could your testosterone levels be interfered with by certain drugs as i suspect my jealous resentful ex friend to have administered me with a number of drugs without me knowing whilst on holiday as i have had problems
Just a word about my experience with the Low T centers. I started a month ago, and my T levels have gone from 199 (basically growing a vagina) to 400 in one month. I don’t have insurance, so I pay 400 bucks a month out of pocket. The almost a Dr I work with there is great, and the girls in the office are hot. So that’s one way to check my libido I guess. I’m in and out of there in about 20 minutes on average. So far, I’m very pleased with the services and my results. I get one shot a week right now.
Loved your article. I commend your dedication to doing all the legwork & research to incorporate in this writing. I was diagnosed with low T about 2 years ago & put on 200mg/bi-weekly injections of Testosterone Cypionate (most commonly used here in US; in Europe they use Test Enthanate, the two being almost the same, having about the same half-life of (?) 10-12 days). I don’t know what my Test reading is now, I was just tested 2 days ago (LabCorp) by an Endocrinologist I don’t have much faith in. She was hard-nosed and clung to the belief that as long as I was within the “normal” range, I was fine. I told her that I don’t want to be low-midrange normal, I want to be upper end normal for best benefit. I’m 62, in super physical shape, but have extreme difficulty with ejaculation, have low sex drive, and have trouble getting/maintaining an erection. I HATE THIS!! I believe I deserve better. When I was in my teens/twenties I could get off 5/6 times/day, and now I’m lucky if I can once/week. I live in Los Angeles, which is FULL of beautiful men/women (I’m bisexual with a preference toward men). So I’m in Candyland, seeing all this candy, & I can’t do anything about it.
For a few weeks I was able to increase my Test injections to 200ml weekly and this made a huge difference. So what’s the Endo’s reaction when I tell her this? “200 weekly isn’t necessary, that’s too much”. How ridiculous a statement when it’s the first time I’m seeing her and she knows nothing about me & has never done labs. The results should be in the mid-latter part of this coming week. I’ll be quite interested to see them. From now on I’l ALWAYS be sure to get a copy of all labs & scan them into my Mac. (I’ve gone paperless and it’s wonderful to be able to look up anything I need right on my computer.)
I live in the UK (England). What is the conversion of US to UK Testosterone Units?
So My husband went to get his T checked out he’s a 40 yrs old, his first test showed 535…..the 2nd test 503 we are stumped the doctor says he’s in normal range and doesnt understand why he has all the symptons of Low T per your chart he is under the normal but not that much. So now i am confused HELP please.
Can anyone recommend a doctor in the Los Angeles-area that’s pro-testosterone therapy? It would make things so much easier if I don’t have to negotiate with a doctor, should treatment be necessary.
Hi Gals/Guys,
The Low T Center ran a special in the Columbus, Ohio area for $50.00 bucks. I am 46 y/o 5’7 173lbs, no health issues, hit the gym 4-5 days a week. I have added about 10-15lbs of muscle. I was hoping that my libido would catch up with my new muscle growth. I tested @ 385 ng/dl. The doc would like to set up a plan. From what I read it could get a bit pricey. I took my test on my lunch hour @ 1pm. Thin I might give Lab Corp a try, perhaps in the morning. Any thoughts? Thank you in advance!!!
Edit…I was test @ 285 ng/dl. Sorry!
Very interesting post. I did not realize one could get tested via saliva. At the same time sounds like not very useful. I just am not prepared to spend $130 for a blood test. Maybe a little inaccuracy is better than not knowing about where one is at.
i need help .my doc says that i am normal at 195 testostone that normal . its normal if i am 95years old. please any docs in pa that can help me out. please email me please this has been killing my marrige .4/1/2013 thanks for your time i am 44
Thank you for the article and for the people leaving their comments. I have been “off” for a while, and while the wife and I have been trying to conceive, my sperm count was bottomed out (1.2 million (mobile/good), then another test at 200,000 (mobile/good), a far cry from even the 30 mil I need for in-vitro, and at 33 years old, way off. Testosterone checks, my total was at 47. That’s right, 47. My free-T was at 1.13. This Friday I am to have an MRI of my pituitary glad, and hopefully more answers with my appointment next week with my urologist. Although it sucks for all of us, it’s nice to know I am not alone, and the issues I am experiencing across the board aren’t just issues with my marriage, and can be explained.
I am 56 and have always been active outdoors as well as with the opposite sex. However, I started feeling a decline in my physical activities, motivation in just doing just about anything started to show especially during intimacy. I shrugged it off for a few years blaming it on my divorce and stressful job and went to my doctor and told him about my observations. Let’s take a blood test and check your T level and everything else. Tests came back and everything is fine! The test was taken at 8 am in the morning but he never told me the numbers. Why? I believed him and nothing changed. He gave me a prescription of Cialis and it was not only a band aid I soon discovered but extremely expensive. Okay, so help my sex life but what about everything else in the way I feel. After meeting a friend who is 32 with low T, he runs and stays in shape and explained to me about his experience in T therapy. It was night and day for him all the way around. I went his doctor who tested my T level in the morning and it was 200! The doctor told me it was VERY low. Hmmm imagine that! I am headed to the doctors on Monday for the beginning of my T therapy! I am excited!
Reply to Shawn McNulty,
Shawn, there’s a guy in OKC named Dr. David Jayne, he’s in Edmond, OK. Call him, his # and location are on the internet. If you aren’t close to OKC, call him and ask for a referral doctor in your area. He’ll help you out – you just have to find a local doctor.
For those of you wanting a doctor, go to http://www.mdvip.com/ and search. You’ll have to try several combinations of your city and state but you’ll have a doctor close to you in the US. I can’t speak for the UK or CA but you can find one that will help you.
My doctor using a customized cream, not a gel, that a local pharmacist makes. It’s just like lotion. Apply to inner thigh twice a day, morning and night, and that’s it. It’s in a little clicker bottle that the doctor tells you how many times to click – based on your T-Levels. Works Great. Takes 2 minutes a day. My doctor also prescribes Oxytocin under the tongue once a day. Youtube Oxytocin and listen to the benefits. My program is working great. I did it for soreness from daily workouts. Felt like I was 70 after an easy chest workout at home. Used to take 8 days to recover and now it’s 2 days until I can train that bodypart again. I’ve been on the Test cream for 4 months, along with the Oxytocin and it works great for me!
Guys, Two other things: When you get on a Test cream, if the dose is right, make sure you tell your sig. other because your sex drive will go through the roof. Secondly, if you work out at even medium difficulty, you will see muscle growth. I am shoot for the 800-1000ng/dl range, which, if the charts are right, and they probably aren’t, get me back to the 20yr old range. If your doctor is giving a dose that really makes you feel younger, you will want sex more often and you will gain muscle, no question. I realize there are a lot of factors that go into that stmt but a normal healthy male in his 40′s, that is decent shape and works out a few times a week will see a noticeable difference in body changes and sex drive.
4 weeks ago I had a blood test for low T my wife requested our GP to order it .
I am 72 years old and have had numerous surgeries; heart 4X,anneurisim,double femoral bypass and even had a total colectomy. Also I am diabetic and COPD. I haven’t enjoyed a sex life for years, no interest in it. most of the specialist attributed it to all of my surgeries.
So what did my T test read?
zero!
I am now self admin. a T injection once a week and I’ve just had my fourth. I have only noticed an increase in my appetite but I feel as low as I am it will take some time to feel normal. yes I have felt weak and tired but always blamed that on my “sickly nature”.
The doctor was very vague about the zero reading only that he had never known any one reading this low….
Wish me luck!!!
I’ve been experiencing inhibited sexual response. Saw a D.O. 8 weeks ago to get a comprehensive work up.
Turns out my Total T is 199, and free T is about 7(I think, dont have the paper work with me). Doc says my total T should be between roughly 500 and 1000, if I recall. Free T should be much higher.
I am going on 58 years of age. He also tested for metal toxicity and it turns out I have extremely high levels of lead and high levels of cadium. Going for chelation therapy every other week to detoxic the metals and also on Androgel.
I have also been working out regularly, like six days a week, riding my exercise bike doing spin workouts and lifting weights. My total Cholesterol and LDL have each fallen by 22%. Both were borderline. As of this writing I have also lost 22 pounds. Also eating a much more healthier diet.
zzepher,
Keep the faith. I was told it takes 3-6 months. Took me a little over 3 months before I felt like a new person. It’s a powerful thing – dosage should also be considered if you don’t feel good in X amount of time. The good news would be that I haven’t heard of anyone that it doesn’t work for. I’m sure there are exceptions but you should see results. Good luck!
I was tested by drawing blood at my doctors office. Mine was 572, which he said is normal for my age. I am 56 years old. I still think that is low for me.
Bobby, why do you feel your testosterone level is low?
Im 20 and my levels were 231. I hope they do something for me because my t levels made me go crazy. I think I also have irritable male syndrome, I’ve been treated with multiple bipoar meds and nothing ever worked for me for 5 years. My shrink is giving up on me and telling me now he cant make an official diagnosis because the meds made me worse. I have the worse anxiety. Im praying when I go to the endocrinologist they do something for me
Hey Mark,
You may want to think about going to see a D.O., that is a Doctor of Osteopathy. I am seeing one now, but I am 58, much older than you. This type of doctor will take a holistic approach, and order much more comprehensive blood work than a regular physician will have done. While you might be prescribed hormonal therapy(testosterone), a DO will also recommend more exercise, vitamin and other supplements, and suggesting a better diet. They will likely also test for metal toxicity.
Turns out I have dangerously high levels of lead and cadium, which I am getting chelation therapy to detox. My total and LDL, were okay, but borderline at my first visit, but I have been on a rigorous exercise and dieting regimen and those numbers fell by 22%, my vitamin D was low, and my T level was 199. I am on daily androgel. I will check back here in a day or so. If you have any questions you can email me, I do not know if this site allows exchanges of emails.
Good luck and let me know what you think.
SF
I have often said that too many men need a sex drive like a problem child needs gasoline and matches. Some of them are in prison dreaming up ways to get castrated and break free. I am curious about the relationship to how many urges per week or day relate to these T levels. For example, before my testicle removal, my urges were 3 or 4 times a week almost like clockwork. I don’t miss them. Any research?
Tom,
Testosterone plays a vital role in nearly every health factor in males. Sexual interest and performance are merely two items in a whole list of dozens of health issues in males.
I will name a few items: cholesterol, weight loss, strength, cardio vascular health, mental health, energy…etc…
SF
Very well written piece.
Please help me and your many readers and share with us what you mean by, “good Living” . Your Quote: “after 90 days of good living (778 ng/dl)”
resulting in the increase in testosterone.
Michael Patrcik
i had very low libido for a while which was very frustrating as i am married to a gorgeous woman who is very sexual. i decided that i had to get this sorted out as it is a very important party of our lives and i am in my early 40′s. i had thew tests done a few weeks back and my levels were very low. total T is at 2.62, SHBG at 4.3 and free T at 95.7. I have now been put on testosterone replacement therapy so hope it improves soon. not sure how long it will take to get to above average levels but will wait and see.
Any changes yet Richard? I had my tests done and came back at 400.2 Doc said I am fine. I beg to differ. My last doc had me on TRT. 200mg every 2 weeks. I am 46 yrs old
There are numerous improvements and benefits of being on Testosterone Replacement. There is a wide range of men’s health issues that involve testosterone, and to see improvements in these areas, it takes anywhere from a few weeks to several months.
My baseline T levels, at age 34, was 102 ng/dl. I’d kill to be in the 300s. Building muscle and burning fat is pretty much impossible right now.
I am 52, at 335 and 10.3 free, although i have had the same low levels even in my 30′s, I was a lot more sexual active then. Now im tired in the evenings, i don’t have the stamina to work out. My doctor has suggested T therapy by gel, yet I have been told by a naturalist that by using gels or injection, I am going to shut down my natural production. I read many success stories here that many people used the therapy and increased their T levels and felt better. I didn’t see where they came off it. Anyone out there who has started the the therapy and has come off it after some time ? Thanks!
Great article. I preach to all my patients to always treat the patient not the labs. This is exactly right. Who wants to be normal when “normal” by our western medicine censes has group more andropausal men then normal men into the 40 year old ref range. Go for optimal. The whole idea is to get hormones back to where they were when we were 20-25. so at least 600. Good job!! Mike–Lowtestosterone.com
I suffer from High Testosterone Level(I think),the doctor referce me to an endocrinologist,but I got no money and no health insurance.I’am 56 yrs.old weight 140 lbs. and my lab test revealed an 8.67 ng/mL .It’s really too high?. Thanks