Testosterone is a crucial hormone for men's health, and a top urologist says more men should know their levels earlier in life.
Low testosterone can cause loss of energy, muscle, and libido, and can contribute to chronic illnesses such as heart disease, diabetes, and obesity, according to research.
But diagnosing low testosterone can be tricky, because natural testosterone levels can vary.
If you don't already know your baseline, and you start experiencing these symptoms, you may not be able to trust the results of a testosterone test, said Dr. Ananias C. Diokno, former chief medical officer and chair of urology at Beaumont Hospital, Royal Oak.
"If you ask men what their testosterone levels are, they'll scratch their heads. They don't know and doctors aren't testing for this. You should know what your level is by the time you hit 30 to 35," Diokno told Insider.
What we think of as 'normal' testosterone, and why it's not a perfect barometer
Testing for low testosterone is simple, using a blood test.
In healthy men, testosterone levels can range between 260 nanograms per deciliter (ng/dL) and more than 900 ng/dL, depending on age.
Low testosterone is typically defined as less than 250-300 ng/dL, according to the Cleveland Clinic.
However, since natural testosterone levels can vary widely, Diokno said many men can be misdiagnosed for hormone deficiencies.
For example, a person with testosterone levels of 400 or 500 ng/dL won't be diagnosed with low testosterone because it's higher than the defined standard, but if his initial levels were 700 or higher, the drop is significant and may warrant treatment.
"Many practitioners close their minds. Someone may be having symptoms but according to the guidelines, does not have low testosterone. It's frustrating among men and among doctors who can't help them," Diokno said.
One solution is more routine hormone testing so men can establish what a healthy baseline looks like for them, similar to other markers of health like cholesterol, blood pressure, and blood sugar, Diokno said.
Low testosterone can cause low energy, low libido, and loss of muscle
Over time, men's testosterone levels dwindle as a common side effect of aging. However, younger men can also have low testosterone, causing them to experience similar symptoms to much older men.
Telltale symptoms of low testosterone can be mental, physical, and emotional, including:
- Decreased sex drive
- Brain fog
- Depression and mood changes
- Fatigue
- Difficulty building or maintaining muscle
"The lower the testosterone, the more symptoms," Diokno said.
Testosterone therapy may not be as risky as previously believed
For men who have had sudden dips in hormone levels, testosterone therapy can help restore quality of life, energy, and libido, Diokno said.
Previously, testosterone therapy has been carefully regulated, in part because high testosterone has been linked to a higher risk of prostate cancer in some studies.
Diokno said the opposite may be true, according to some observational studies, and healthy testosterone levels may protect prostate health.
Loss of muscle linked to low testosterone can cause other problems, too, including a decreased metabolism that can lead to weight gain and associated health issues.
Available evidence suggests that testosterone therapy, done correctly and with medical supervision, is a safe and effective way to raise hormone levels, and more research is needed to see who could benefit, Diokno said.
"It's a Pandora's Box, I think there are many questions that are still unanswered," he said.
