From the Guidelines
Normal testosterone levels for a 59-year-old male typically range from 300 to 1,000 ng/dL for total testosterone, while free testosterone usually falls between 5 to 21 ng/dL or 0.17 to 0.72 nmol/L. These ranges may vary slightly depending on the laboratory and testing method used 1. As men age, testosterone levels naturally decline by about 1-2% per year after age 40, so a 59-year-old man would typically have lower levels than younger men but should still fall within these reference ranges.
Key Considerations
- Testosterone levels fluctuate throughout the day, with highest levels typically occurring in the morning, which is why testing is usually recommended between 8-10 AM 1.
- Symptoms of low testosterone such as fatigue, reduced libido, erectile dysfunction, decreased muscle mass, and mood changes should be considered alongside laboratory values when evaluating hormonal health.
- If levels fall below the normal range and symptoms are present, consultation with a healthcare provider about potential treatment options would be appropriate, considering the potential benefits, harms, costs, and patient's preferences 1.
Evaluation and Management
- The diagnosis of low testosterone should be made only after two total testosterone measurements are taken on separate occasions with both conducted in an early morning fashion 1.
- Clinicians should consider measuring total testosterone in patients with a history of unexplained anemia, bone density loss, diabetes, exposure to chemotherapy, exposure to testicular radiation, HIV/AIDS, chronic narcotic use, male infertility, pituitary dysfunction, and chronic corticosteroid use even in the absence of symptoms or signs associated with testosterone deficiency 1.
From the Research
Normal Testosterone Levels
- The normal total testosterone level for a 59-year-old male is generally considered to be above 300 ng/dL, as stated in a study published in 2008 2.
- Free testosterone levels can vary, but they are typically estimated using an accurate formula or measured using equilibrium dialysis, as recommended in a guideline published in 2018 3.
Testosterone Level Ranges
- Total testosterone levels:
- Free testosterone levels:
- No specific range is provided in the available studies, but it is recommended to measure free testosterone concentrations using either equilibrium dialysis or estimating it using an accurate formula in men whose total testosterone is near the lower limit of normal or who have a condition that alters sex hormone-binding globulin 3
Diagnosis and Treatment
- A diagnosis of hypogonadism should only be made in men with symptoms and signs consistent with testosterone deficiency and unequivocally and consistently low serum testosterone concentrations 3.
- Testosterone replacement therapy (TRT) may be considered for men with symptomatic testosterone deficiency to induce and maintain secondary sex characteristics and correct symptoms of hypogonadism, after discussing the potential benefits and risks of therapy and of monitoring therapy and involving the patient in decision making 3, 4.