Average Testosterone Levels in Indian Adult Males
The average total testosterone levels in Indian adult males range from 3.287 ± 1.494 ng/ml (1.12-9.61 ng/ml), with free testosterone levels averaging 7.476 ± 2.902 pg/ml (2.18-21.76 pg/ml), which is lower than levels typically observed in Caucasian males. 1
Testosterone Levels in Indian Population
Prevalence and Measurement
- A 2019 study of Indian men found that the mean total testosterone level was 3.287 ± 1.494 ng/ml (range: 1.12-9.61 ng/ml) 1
- Free testosterone levels in the same population averaged 7.476 ± 2.902 pg/ml (range: 2.18-21.76 pg/ml) 1
- The prevalence of testosterone deficiency syndrome (TDS) in the Indian population was found to be 28.99% 1
- Among symptomatic men with androgen deficiency symptoms, 60.17% had biochemically confirmed testosterone deficiency 1
Ethnic Differences
- Evidence suggests that Indian (South Asian) men demonstrate lower androgenicity compared to white Caucasian men 2
- Indian men have lower levels of circulating free testosterone, lower PSA levels, and lower lean body mass compared to white Caucasian males 2
- These differences appear to be due to lower mean circulating testosterone levels rather than differences in androgen receptor sensitivity or sex hormone binding globulin (SHBG) levels 2
Age-Related Considerations
Age-Specific Variations
- Testosterone deficiency prevalence increases progressively with each decade of life in Indian men (p=0.034) 1
- In the general population, age-specific middle tertile testosterone levels vary significantly:
- 20-24 years: 409-558 ng/dL
- 25-29 years: 413-575 ng/dL
- 30-34 years: 359-498 ng/dL
- 35-39 years: 352-478 ng/dL
- 40-44 years: 350-473 ng/dL 3
Clinical Implications
- The American Urological Association recommends target testosterone levels in the middle tertile of the normal reference range (450-600 ng/dL) for patients undergoing testosterone replacement therapy 4
- This target range is higher than the average levels observed in Indian males, suggesting that ethnic-specific reference ranges may be needed
Associated Factors
- Higher prevalence of testosterone deficiency is observed in Indian men with:
- Diabetes
- Hypertension
- Coronary artery disease
- Obesity
- Metabolic syndrome 1
Diagnostic Considerations
- Using a single testosterone measurement for diagnosis is insufficient and represents a common pitfall 4
- The American College of Physicians notes that most studies define testosterone deficiency as levels below 300 ng/dL 5
- However, this cutoff may not be appropriate for all age groups or ethnicities, as demonstrated by the lower average levels in Indian males 1, 2
- Free testosterone measurement may be a better single test for diagnosis of hypogonadism than total testosterone measurement in Indian men 6
Trends Over Time
- Recent research indicates a general decline in testosterone levels among men in recent decades 7
- This trend is observed even among men with normal BMI, suggesting factors beyond obesity may be contributing 7
- This declining trend may further impact the already lower baseline testosterone levels observed in Indian males