What does an androstenedione level of 87 indicate?

Androstenedione Level of 87 ng/dL: Clinical Interpretation

An androstenedione level of 87 ng/dL is within the normal range for adults and does not indicate pathology requiring intervention. This value falls well below thresholds that would suggest adrenal cortical carcinoma, virilizing tumors, or significant androgen excess.

Normal Reference Ranges

• Adult males: Typical androstenedione levels range from approximately 50-250 ng/dL 1
• Adult females: Normal ranges vary by menopausal status, generally 30-200 ng/dL 2
• Your value of 87 ng/dL: Falls comfortably within normal limits for both sexes

When Androstenedione Testing Is Indicated

According to current guidelines, androstenedione measurement should be reserved for specific clinical scenarios 3:

• Suspected adrenal cortical carcinoma (ACC) with signs of virilization (deepening voice, clitoromegaly, male-pattern baldness, rapid onset hirsutism) 3
• Adrenal incidentalomas with imaging characteristics concerning for malignancy 3
• Rapid progression of androgenic symptoms that cannot be explained by more common conditions like PCOS 4

In ACC cases, androstenedione levels are typically markedly elevated (often >200-300 ng/dL or higher), not mildly elevated 3

Clinical Context Matters

If You Are Male:

• A level of 87 ng/dL requires no further workup in the absence of symptoms 1
• This is a normal physiologic level representing androstenedione's role as a testosterone precursor 1, 5
• Focus should shift to evaluating testosterone levels directly if hypogonadal symptoms exist (low libido, erectile dysfunction, fatigue), using morning total testosterone <300 ng/dL as the diagnostic threshold 3

If You Are Female:

• A level of 87 ng/dL is normal and does not indicate PCOS, adrenal tumor, or other pathology 4, 2
• PCOS diagnosis requires clinical features (menstrual irregularity, hirsutism, acne) plus elevated androgens or polycystic ovaries on ultrasound—not isolated androstenedione measurement 4
• If virilization signs are present despite this normal value, measure DHEA-S and testosterone instead, as these are more sensitive markers 3, 4

What Does NOT Require Action

Do not pursue further endocrine workup based solely on this value 3:

• No adrenal imaging needed (CT/MRI) 3
• No additional androgen panel (17-OH progesterone, 11-deoxycorticosterone) unless clinical virilization present 3
• No repeat testing unless symptoms develop 4

Key Pitfall to Avoid

The most common error is over-investigating normal androstenedione levels. Androstenedione is a weak androgen and intermediate metabolite—it does not directly cause clinical effects at this level 1, 5. Elevated levels requiring investigation typically exceed 200-300 ng/dL in the context of rapidly progressive virilization or known adrenal mass 3.

Monitoring Recommendations

• No routine follow-up needed for an isolated value of 87 ng/dL in asymptomatic individuals 4
• If symptoms of androgen excess develop (new hirsutism, acne, menstrual changes in women; none expected in men at this level), measure DHEA-S and testosterone as first-line tests 3, 4
• Repeat androstenedione only if initial comprehensive androgen evaluation suggests evolving pathology 4