From the Guidelines
Normal testosterone levels for adult males typically range from 300 to 1,000 nanograms per deciliter (ng/dL). This range is based on the most recent and highest quality study available, which was published in 2020 in the Annals of Internal Medicine 1. It's essential to note that testosterone levels can vary by age, sex, and time of day, with levels being highest in the morning and decreasing throughout the day.
Key Considerations
- For adult females, normal testosterone levels are much lower, typically between 15 and 70 ng/dL.
- Testosterone levels naturally decline with age in men, decreasing about 1-2% per year after age 30.
- When evaluating testosterone levels, it's crucial to consider symptoms alongside lab values, as some men may experience symptoms of low testosterone even with levels in the "normal" range.
- Factors like obesity, certain medications, chronic illness, and stress can all affect testosterone production.
Important Factors to Consider
- The American College of Physicians suggests that clinicians should reevaluate symptoms within 12 months and periodically thereafter, and discontinue testosterone treatment in men with age-related low testosterone with sexual dysfunction in whom there is no improvement in sexual function 1.
- There is no well-defined, universally accepted threshold of testosterone levels below which symptoms of androgen deficiency and adverse health outcomes occur 1.
- The incidence of low testosterone in the United States is reported to be approximately 20% in men older than 60,30% in those older than 70, and 50% in those older than 80 years 1.
From the FDA Drug Label
Testosterone gel 1.62% delivers physiologic amounts of testosterone, producing circulating testosterone concentrations that approximate normal levels (300 ng/dL to 1000 ng/dL) seen in healthy men.
The normal testosterone level is between 300 ng/dL and 1000 ng/dL as seen in healthy men 2.
From the Research
Normal Testosterone Levels
The normal testosterone level in men is not explicitly stated in the provided studies. However, the studies discuss the restoration of normal serum testosterone concentrations through testosterone replacement therapy (TRT) in hypogonadal men.
Testosterone Replacement Therapy (TRT)
- TRT aims to improve symptoms and signs of testosterone deficiency by increasing serum testosterone levels to the physiologic range 3.
- The goal of TRT is to restore normal serum testosterone concentrations, and relieve symptoms in most hypogonadal men 4.
- Different modalities of TRT are available, including intramuscular, subcutaneous, buccal, nasal, subdermal, transdermal, and oral preparations 5, 3.
Testosterone Levels in Hypogonadal Men
- Hypogonadal men treated with TRT showed significant increases in total testosterone, free serum testosterone, and direct free testosterone levels 5, 6.
- The normal range of testosterone levels is not explicitly stated, but the studies suggest that TRT can restore testosterone levels to the physiologic range 4, 3.
- The optimal testosterone level for an individual may vary, and clinicians must consider the unique characteristics of each patient when managing testosterone deficiency 3.
Monitoring Testosterone Levels
- Monitoring of testosterone levels is essential to minimize the risks associated with TRT 3.
- Clinicians must consider the potential risks and benefits of TRT, including the effects on estradiol, hematocrit, and prostate-specific antigen (PSA) levels 6.
- Regular monitoring of testosterone levels, as well as other health parameters, is necessary to ensure the safe and effective use of TRT 3.