A Total Testosterone Level of 600 ng/dL is Normal and Does Not Require Treatment
A total testosterone of 600 ng/dL falls well within the normal range and does not require any medical intervention, including testosterone replacement therapy. This level is actually at the upper end of the target range used when treating hypogonadism.
Understanding the Normal Range
The lower limit of normal testosterone is approximately 300 ng/dL, as established by the American Urological Association, though some guidelines use thresholds between 230-350 ng/dL 1, 2.
Harmonized reference ranges from large cohort studies of healthy, nonobese men aged 19-39 years establish the normal range as 264-916 ng/dL (2.5th to 97.5th percentile) 3.
Your level of 600 ng/dL falls in the mid-normal range, which is actually the therapeutic target when treating hypogonadism. The American Urological Association recommends achieving testosterone levels of 450-600 ng/dL when initiating replacement therapy 1, 4.
Clinical Context for Treatment Thresholds
The Princeton III Consensus and multiple international guidelines establish clear treatment thresholds 2:
- Testosterone >350 ng/dL does not usually require substitution therapy 2
- Testosterone <230 ng/dL typically benefits from testosterone replacement therapy 2
- Testosterone 231-346 ng/dL may warrant a trial only in symptomatic men (decreased libido or erectile dysfunction) after careful discussion of risks and benefits 2
Why No Intervention is Needed
At 600 ng/dL, you are functioning at optimal testosterone levels. This level:
- Exceeds all diagnostic thresholds for hypogonadism by a substantial margin 1, 2
- Falls within the target range used as a treatment goal for men with actual testosterone deficiency 1, 4
- Represents the middle tertile of normal reference ranges 1
Important Caveats
Diagnosis of hypogonadism requires both low testosterone AND symptoms, not just a number 1, 5. Even if testosterone were borderline low, treatment would only be considered if accompanied by:
- Decreased libido or erectile dysfunction 2
- Reduced muscle mass and increased adipose tissue 5
- Depressed mood or loss of psychological energy 5
- Other signs of androgen deficiency 5
Laboratory variability exists, with reference ranges varying significantly among laboratories (lower limits ranging from 160-300 ng/dL across facilities) 6. However, at 600 ng/dL, you are well above even the most conservative thresholds.