What is a Normal Blood Level of Testosterone? What Do Guidelines Say?

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Normal values may vary from lab to lab depending on what reference range they use. Depending on the country, ranges are in nanograms per deciliter (usually in the United States) or nanomoles per liter (Europe and other countries). The conversion factor is:

Click here: What’s a “Normal” Testosterone Level and How to Measure Your T

From: Pharmacokinetics of testosterone - Wikipedia

Hormone Ranges


QUEST DIAGNOSTICS:

LABCORP:

Many doctors treat men who have under 350 ng/dL of total testosterone and who present with most of the symptoms listed by the ADAM questionnaire.

LabCorp Vs Quest free testosterone lab ranges: Why are they different?

Quest Diagnositcs' range is 35-155 pg/mL for Free Testosterone. That's 3.5-15.5 ng/dL. Labcorp's range is 9-25 ng/dL. That's a big difference. 3.5-15.5 and 9-25. My question is: If you tested at 25 ng/dL on a Labcorp test, does that mean you would've tested at 15.5 ng/dL on the Quest...

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How do you know you need a testosterone blood test?

Testosterone Level: How Low is Too Low? Health Consequences of Low Testosterone

 

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Testosterone Fractions in the Blood

1- Total testosterone (total amount produced by the body. For a healthy male this production ranges from 5-7 mg per day)

2- Free testosterone (testosterone fraction not bound to any proteins. This is the active fraction)

3- Albumin-bound testosterone (this is testosterone's "savings account". They body draws from it when it needs more testosterone to become free testosterone)

4- Sex hormone binding globulin bound testosterone. This bound testosterone cannot be released into the blood stream. It is the body's "breaks" for avoiding excessive testosterone. Inflammation, aging, medications, and other factors can increase sex hormone binding globulin.

When we add free testosterone plus albumin bound testosterone we come up with bioavailable testosterone (the testosterone available to the body).

These are metabolites of bioavailable testosterone:

 

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These values are the testosterone blood levels used for diagnosis of low testosterone in several guidelines:

 

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LabCorp Testosterone Reference Range Changing (Decreasing) Effective July 17, 2017

 

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Low Testosterone Blood Level Cut-Off from Different Treatment Guidelines

Source: Evolution of Guidelines for Testosterone Replacement Therapy

 

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Comparison of testosterone blood test levels that guidelines use to recommend starting TRT (TTh) for testosterone deficiency.

Guidelines from the Canadian Medical Association Journal, American Urological Association, European Association of Urology, Endocrine Society, International Society for Sexual Medicine, and British Society for Sexual Medicine were included for review. Recommendations were generally consistent across guidelines. Key differences include the biochemical cutoff for low T, and recommendations for patients with low to normal T, prostate cancer, or cardiovascular disease.

 

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Testosterone Level: How Low is Too Low? Health Consequences of Low Testosterone

 

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A Critique of the AUA Guidelines on Testosterone Deficiency

 

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Most of the guidelines in Table 1 share the context in regard to cardiovascular risk, development of prostate cancer, and infertility. The safety of testosterone therapy in patients with treated prostate cancer has been on the rise in recent decades. The relationship between testosterone treatment and the development of prostate cancer is conclusive in 5 studies in Table 1. In terms of saturation theory [10], prostate cancer (and benign prostate hyperplasia) is suppressed in only the castrated level of testosterone; vice versa, testosterone therapy in TD may neither aggravate prostate cancer (and prostate-related lower urinary tract symptoms) nor cause prostate cancer. For the same reason, the EAU and ISSM guidelines clarified the possibility of testosterone therapy in patients with treated prostate cancer. Most researchers in urology agreed with this concept because all patients scheduled in prostatectomy should undergo bilateral orchiectomies if testosterone is responsible for developing prostate cancer.

Reference: Efficacy and Safety of Testosterone Therapy Based on Guideline Recommendations; Re: Clinical Practice Guideline by the American College of Physicians

 

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Monthly Variations in Testosterone Levels: Results from 8,367 Middle-Aged Men

Monthly Variations in Serum Testosterone Levels: Results from 8,367 Middle-Aged Men Jun Ho Lee 1, Sung Won Lee 2 J Urol. 2020 Dec 22;101097JU0000000000001546. doi: 10.1097/JU.0000000000001546. Online ahead of print. Abstract Purpose: We investigated whether serum testosterone levels vary...

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Variance in Peak and Trough T Levels in Men Using Intramuscular T Injections

MP85-14 VARIANCE IN PEAK AND TROUGH TESTOSTERONE LEVELS IN MEN USING INTRAMUSCULAR TESTOSTERONE Bruno Nascimento*, Helen L Bernie, Elizabeth Schofield, John P. Mulhall, New York, NY INTRODUCTION AND OBJECTIVES In men using intramuscular testosterone (IM T), clinical experience shows us that...

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Interesting poster presentation at a conference

American Urological Association

 

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I am sure this study will not be used in regular clinical practice.

What Is a Normal Testosterone Level for Young Men? Rethinking the 300 ng/dL Cutoff for Testosterone Deficiency in Men 20-44 Years Old - PubMed

Diagnosis of testosterone deficiency has traditionally been performed in an age-indiscriminate manner. However, young men have different testosterone reference ranges than older men. Accordingly, age-specific normative values and cutoffs should be integrated into the evaluation of young men...

pubmed.ncbi.nlm.nih.gov

 

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What Is a Normal Testosterone Level for Young Men?

What Is a Normal Testosterone Level for Young Men? Rethinking the 300 ng/dL Cutoff for Testosterone Deficiency in Men 20-44 Years Old (2022) Alex Zhu, Juan Andino, Stephanie Daignault-Newton, Zoey Chopra, Aruna Sarma, and James M. Dupree Study Need and Importance: Testosterone reference ranges...

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