From the Guidelines
A total testosterone level of 975 ng/dL is slightly above the typical normal range for adult males, which generally spans from approximately 300 to 1000 ng/dL, but it does not necessarily indicate any medical concern requiring immediate intervention. This level suggests that the testes are producing testosterone at a rate that is at the upper limit of what is considered normal. Testosterone is a crucial hormone that plays a significant role in regulating various bodily functions, including muscle mass, bone density, fat distribution, red blood cell production, and sex drive 1. While being on the higher end of the normal range, this level does not inherently signify a health issue that needs treatment. However, it is essential to consider this result in the context of overall health and any symptoms that may have prompted the test, such as fatigue, decreased libido, or mood changes. These symptoms could be related to other factors since the testosterone level is at the upper end of the normal range.
Considerations for Health Maintenance
- Regular health check-ups, including annual physical examinations, are recommended to monitor overall health and address any concerns.
- Lifestyle factors such as getting adequate sleep, engaging in regular exercise, maintaining a balanced diet, and managing stress can help support healthy testosterone levels and overall well-being.
- If this test was part of a comprehensive health assessment, discussing the complete results with a healthcare provider is crucial for a thorough evaluation and to determine if any further testing or action is necessary.
Given the information from the study by the American College of Physicians 1, which prioritizes patient-centered outcomes and notes the importance of considering symptoms associated with hypogonadism, it's clear that a testosterone level of 975 ng/dL, while on the higher end of normal, does not in itself necessitate treatment without other clinical indications. The study highlights the limitations of current evidence, including the lack of long-term data on the benefits and harms of testosterone treatment, especially in men without underlying medical conditions causing hypogonadism. Therefore, monitoring and maintaining a healthy lifestyle, rather than immediate medical intervention for the testosterone level alone, is the recommended approach.
From the Research
Significance of Total Testosterone Level
- A total testosterone level of 975 ng/dL is significantly higher than the normal range for most adults, which can vary depending on factors such as age and sex 2.
- Elevated serum testosterone levels can cause virilizing effects, as well as lead to hypercholesterolemia, insulin resistance, hypertension, and cardiac disease 3.
- In postmenopausal women, high testosterone levels can be a sign of hyperandrogenism, which may be caused by rare but serious androgen-producing tumors of the adrenal glands or ovaries 3, 4.
Potential Causes and Associations
- A total testosterone level of 975 ng/dL may be associated with conditions such as polycystic ovary syndrome, congenital adrenal hyperplasia, ovarian hyperthecosis, Cushing syndrome, or iatrogenic hyperandrogenism 3.
- In some cases, elevated testosterone levels can be caused by the application of testosterone gel at or near the phlebotomy site, leading to spuriously elevated measurements 5.
- In pediatric patients with congenital adrenal hyperplasia, high serum testosterone levels can be correlated with the volume of testicular adrenal rest tumors (TARTs) 6.
Diagnostic Considerations
- Measurement of serum testosterone, sex hormone-binding globulin, dehydroepiandrosterone sulfate, androstenedione, and inhibin B is necessary in postmenopausal women with complaints and signs of hyperandrogenism 3.
- Magnetic resonance imaging of the adrenal glands or ovaries may be recommended to identify the source of elevated testosterone levels 3, 4.
- Serum 17-hydroxyprogesterone may be used as a biomarker for evaluating intratesticular testosterone levels in men receiving medications that alter serum testosterone 2.