“My GP said my testosterone levels are normal and so he doesn’t recommend testosterone therapy.”
This is something I hear a lot.
What is normal when it comes to testosterone levels? The reference range most labs use is 348-1197 ng/dL. What your doctor doesn’t tell you, and quite possibly doesn’t understand himself, is that those so-called ‘normal’ levels don’t take into account age or fitness level. So, your level may be normal … for an 80 year old man in bad shape.
Yeah, that makes a lot of sense, doesn’t it?
What it means is that a lot of guys go home from their doctor’s office feeling like they must be hypochondriacs. “My doctor says my testosterone level is fine, but I still feel like crap. It must be all in my head.”
While having the best of intentions, a doctor who doesn’t have specialized training in hormones can actually dissuade a guy from seeking out the help he needs, thus making the situation worse. When you look at your hormones, you really need to find a doctor with specialized training in this area.
My own husband went through this with several doctors. We wasted a couple of years of our lives going to doctors who didn’t have the training they needed to deal with my husband’s low testosterone. Our marriage was on the rocks because of my husband’s medical issue and what we really needed was for someone to say, “Hey, I’m not sure what’s going on with you, but let’s find you someone who can help.”
I’ve seen a lot of guys suffer due to the same issue.
Here’s what you need to know.
‘Normal’ doesn’t mean optimal, but unless your doctor has specialized training in hormones, he may not know that. Here’s a chart that breaks T levels down for you by age.
| Avg Age | Tot. Test. |
| 30 | 617 |
| 40 | 668 |
| 50 | 606 |
| 60 | 562 |
| 70 | 524 |
| 80 | 471 |
| 93 | 376 |
If your T level is 378, congratulations. You’re normal ………… for a 93 year old man!
And if you’re in that low T fog, you know that 378 doesn’t feel so good.
What you need to remember is that ‘normal’ and ‘optimal’ are not the same thing. And if your doctor tells you that “you’re normal, you’re just getting older, there’s nothing to be done,” then you need to walk away and find a more experienced doctor. Would you stick with an eye doctor who told you not to worry about the fact that you’re having a hard time reading small print, that it’s normal to not be able to see well enough to read as you get older, it happens to all of us?
“I’m sorry, Mr. Smith. Your eyesight is getting worse because you’re getting older. Just go out and buy yourself a magnifying glass so you can keep reading. Or better yet, I’ve got these stretches that will make your arms longer so you can hold the book out further.”
Of course not. That’s ridiculous.
Just as it’s normal to lose your reading vision as you get older, it’s also normal for your T levels to decrease with age. What’s not normal is to pretend that it’s not a problem, to refrain from correcting it if possible. Both conditions are treatable and need to be addressed in order to retain your quality of life.
So … your doctor just told you your T levels are ‘normal’ and won’t treat you because it’s ‘not safe’. Now what?
The next post will discuss why finding an experienced hormone replacement specialist is so important ……
Hi, I’m Rebecca Watson. Author of I Want Sex, He Wants Fries.
Thank you so much for this post. We just encountered this this morning. The doctor even said the 284 we had from 1.5 yrs ago was almost within range and therefore pretty good. He said he could treat my husband if he really wanted to, but after knowing he sees 385 as a shoot for number, what would be the point. At least right now when he works really, really hard at it watching his diet, exercising, and less stress at work and with extended family, we might see 425 for a day or 2. So frustrating!
Hi BC –
It is frustrating when the doctor doesn’t realize the ramifications of testosterone levels that low. And what you’re not being told is that his risk for heart disease, Alzheimer’s disease, diabetes and depression go up substantially as his testosterone gets lower.
How old is your husband?
Rebecca
Mine is supposedly normal but won’t RX because of elevated PSA and family HX of prostate cancer. Note dad’s wasn’t found until he was 78. So, what am I supposed to do for the next 25 years? Depressed, lethargic, weepy, borderline ED, fat etc. Couldn’t he just pop with a quick injection “just to see what happens” So to speak?
I was aware of depression link, but does it work in the other direction too. Been fighting back the “blackness” my whole life. Is there a connection with depression causing low T as well?
As far as this article, tried it all over 31 years and sex is still her way or the highway. Read that as “no way”. HA!
@Longsuffering —
My heart goes out to you.
Okay, first thing you have to do is find out why your PSA is high. It could be something as simple as having an infection, which can be cleared up with an antibiotic. Presumably, your doctor has ruled that out.
While having active prostate cancer is an absolute contraindication for testosterone therapy, some doctors argue that it is perfectly safe … and maybe even advisable … to increase T levels once the cancer has been treated.
Take a look at Dr. Abraham Morgentaler of Harvard. https://www.harvardprostateknowledge.org/testosterone-supplementation-after-prostate-cancer
He wrote Testosterone for Life, and is an expert in the field. He is still actively treating patients; in fact, I worked with a guy who sung his praises. My recommendation would be to make an appt with Dr. Morgentaler, and travel if necessary.
Let me know how it goes.
Rebecca
Annual follow up typically goes something along these lines.
1. Go for annual visit. PSA is high.
2. Take course antibiotic, drops back to “safe” numbers. See ya next year.
He JUST told me a few weeks ago that if you aren’t having either sex, ejaculation or nocturnal emission at least twice a week that it can jack up the PSA results cause infection etc. After seeing him for 10 years! Wife hasn’t wanted sex that much since the honeymoon! HA! Sad, I know, but there it is.
Note that I have had TWO prostate biopsies and he hasn’t found a thing. Any guys lurking out there that have had one could tell you how much “fun” those are.
After the first biopsy found zipola, he sent me for some genetic thing that supposedly identifies the actual “zone” the cells prone to becoming cancerous are located. So he did the second biopsy with a few extra hot daggers (oops I meant biopsy needles) in the “zone” and still found zipola.
I will see him next week and hope to share some of this blog in the 15 minute visit the HMO allows. HA! Also, any folks out there with similar problem there are supposed to be functional MRI and pet scans that supposedly can see prostate cancer now to help make the biopsy process more focused and hopefully less traumatic.
I have done some looking as well as talked to some folks that have had a prostatectomy for cancer. All I could find that were willing to talk to me about results wound up sexually non-functional as well as incontinent because of nerve damage. I have told my urologist I will risk the cancer if it means never having sex again and he still refuses T treatment. I guess it is time to find an endocrinologist if insurance will cover it.
YES, as little action as I get, and as many issues as my “beloved” throws up between me and anything even approaching a normal sex life, I would rather be dead!
So maybe that will give you some idea of how committed I am to getting treatment for this. And I will be looking for Dr. Morganthaler’s book too.
Looking back, I think I have probably been borderline or “sub-optimal” my entire life. I also read Athol’s stuff, but haven’t got books yet. I have probably made every mistake he and yourself have identified. Miracle I found anybody, beta as I am.
Competitive sports? Please! I have never been, or felt any need to be competitive in anything.
Always been prone to depression that numerous medications haven’t done anything for BTW. Finally gave up, side effects started getting a little scarier.
Family gets overweight young and has to struggle to lose weight and keep it off. Not technically obese just overweight. Just about enougg to be disgusting to the opposite sex if allow youself to gain it. Grandfather was a farmer who worked from zero dark thirty until zero dark thirty his entire life, and didn’t smoke or eat red meat either. Still overweight. Has me wondering about the genetics of this is all.
Lifting weights? Every time I have tried, all I get is the pain with little if any gain. Never gets easier, never does not hurt, and never gets results. Muscle or “attraction”. Even toning up is a slog. Guys who started at same time with same build would wind up looking like the hulk and I would only gain a few inches and stop and we were doing the same reps, routines, weights, same days etc. Workout buddies. I still went because I was their ride at the time. Nothing. Depressing. And definitely never enough to impress the ladies.
In military would usually pump iron 5 days a week. Nothing else to do but drink. Kept weight off is about it. Bulk up to about 190 to 195 and plateau. 5 days a week for 10 pounds of muscle you could barely even notice! Squat 200+ and still have “chicken legs”. HA!
Can low or “sub optimal” testosterone cause this?
Probably doesn’t matter much any more for me at age 55, but maybe it will cause some younger gents to look at this in their 20’s or earlier instead of in their 50’s with a 31 year marriage at risk.
I also have a busted, pretty much inoperable back injury. So lifting is out of the question now anyway I guess. I have been trying to ride a bike some to try and help keep the gut off, but even that has had me running for the heating pad. HA!
No energy, check.
No ambition, check.
Depression, check.
Overweight no matter what, or how little, I eat, or exercise, check.
Hopelessness in general, check.
No sex, check.
Guys, take it from a geezer, low T is the fast track to loser-dom. Get help early and often. If you can find it.
Rebecca I just wanted to get your opinion, we just had my husband’s T tested as he is 63 now and have had some issues on occasion. His test come back at 529 and it was done late in the day. Is that a decent figure for a man his age? We are just trying to figure out the problem that arises sometimes. He thinks it’s just his age and wants to try Vuagra but omg it is so exspensive 6 pills for 350 dollars ugh. Anyway just wondered what that number looked okay for man of 63.
Hi Cathy –
Each man’s ‘sweet spot’ for testosterone is unique to him. Most guys tend to feel their best somewhere in the 700’s-900’s.
Does your husband have a lot of low T symptoms? How is his general energy and libido? Does he have a tough time losing weight? Is he able to put on muscle when he works out? Does he have a lot of ab fat? Does he have morning erections?
If he’s struggling with erections, there could be a number of factors at play. Testosterone levels factor into it. The penis is loaded with testosterone receptors, and when there’s insufficient testosterone, the actual make-up of the spongy chambers in the penis can change, calcifying and hardening, so they don’t absorb and hold blood as well, resulting in inadequate erections.
Multiple factors can affect erections … blood flow issues, alcohol use, diabetes, low testosterone. The vast majority, upward of 90%, are physiological, rather than psychological.
What’s your husband’s lifestyle like? Diet, exercise, alcohol, etc.?
Rebecca
I know I am way late finding this post, but Viagra is a real soap box issue with me. Viagra was being developed initially as a drug to lower blood pressure. One of the side effects noticed was it aided no small percentage of men who had had difficulty in achieving and maintaining erections. Pfizer quickly dropped the blood pressure trials and aimed their efforts into promoting it as a PDE5 inhibitor. It was highly successful from an income standpoint if not always as an erectile enhancing drug.
Initially it sold for about $65 a dose. It sells for somewhat less today and there are non-US sources purporting to sell it or an equivalent for much, much less. I can’t attest as to the validity of their claims nor do I know of an endorsed source.
My point here is I know of no broad-based anti-hypertensive that sells for that kind of money and I will never believe Pfizer developed it for hypertension with plans of selling it at anywhere near that price.
“•For patients not covered by health insurance, hypertension treatment typically costs between $740 and $1,200 or more per year, with an annual average cost of $454 for doctor’s visits, and $407 for prescription medication, according to a report by the Agency for Healthcare Research and Quality”
Depending on whether ACE inhibitors, beta blockers or calcium channel blockers the monthly costs may be as low as $10 and peak at $200. At $65 a dose, on an apples-for-apples comparison, 30 days of Viagra for blood pressure would have sold for $1950. I know an infinitesimal number of men with ED are having sex daily, but even at the accepted statistical average of 2 times a week, the total price of 8 Viagra would have been $590 per month. Nobody would have paid that for an anti-hypertensive in that competitive a market. Pfizer saw gold, downed their own drug and proceeded to put the screw to us for decades.
Even now as a generic we are asked to pay heinous prices for this medication which is not 100% reliable as to effectiveness. The reason this is a soap box issue with me is sex is primarily how the greatest number of men connect intimately with their wives. This issue is not just about sexual satisfaction, but addresses the quality of intimacy in the marriage and not only sexual intimacy. For men, sexual potency is a quality-of-life issue in that it directly affects the marital relationship. Pfizer and many other manufacturers of PDE5 inhibitors do not even consider this with an eye toward being socially responsible for helping to foster healthy marriages.
As to profitability, if 1 in 10 men would pay $20 a dose, how many more would gladly pay $5 per dose. If you decrease the sell price to 25% of that $20 price, but 6 men in 10 then buy at $5, you now make $30, an increase in sales of 50%. A 50% increase in sales is big in any business. And that does not take into consideration greater profit margin additionally realized by manufacturing expense reductions of raw materials because of the increase in volume.
Just sayin’.
@Dan —
You’re right. In the US, where Viagra (and Cialis) are still patented, the prices are quite high for most people, even with insurance.
A lot of guys I’ve talked with use online pharmacies and order the generic version which is much more affordable. Usually manufactured overseas, most guys I know have been satisfied with the quality. North Drug Store is a popular on-line pharmacy, along with others.
Rebecca
Great article, I agree that some of the reference ranges are so low, a man will feel at his best when he is closer to 800.
There are also natural ways that any man can achieve this through good food, exercise, and rest.
Thank you for the T chart. The range for “normal” testosterone levels can differ from lab to lab because of this seeing a doc who specializes in this problem can also be a problem. After several tests and several doctors I badgered our PCP into researching the use of clomiphene citrate for low T. This has provided a big boost to my husbands testosterone level (without the alarming shrinkage of the testes caused by T gels). It’s not the whole answer to the libido problem but he sure does feel more like himself and has more energy and interest in life.
@Alyce —
Great that he’s feeling better. : )
What I’m seeing with Clomid (clomphene citrate) is that while it does bring up T levels … the labs look absolutely beautiful … it simply doesn’t have the same impact on sex drive. Most guys also report that they simply feel better with testosterone.
One work-around is to use testosterone plus HCG (which keeps the testicles working and prevents atrophy).
And with Clomid, make sure to keep an eye on estrogen levels. Clomid tends to jack them up fairly quickly.
Rebecca
Sir I’m 28 year old
My T level is 385 is this normal or not please suggest how to increase
@Shamshad —
It’s normal, but not optimal, and most likely affecting your energy, confidence, and sex life.
Rebecca