How Aging Affects Testosterone and Muscle Mass in Men

High testosterone in males: Signs and symptoms

Potential signs and symptoms include a lowered sex drive (libido), erectile dysfunction, loss of facial or body hair, loss of muscle mass, thinning bones, enlarged breasts, unexplained anemia, low sperm count and reduced energy. The most common “out of balance” testosterone levels are found to be on the low side of normal; this occurs because a male’s highest testosterone level usually peaks at about age 20, and then it decreases slowly with age. It has been suggested that a 1% decrease in testosterone level per year is not unusual for middle-aged (30 to 50 years old) and older males. While this decrease may not be noticeable in some men, others may experience significant changes starting in their middle-aged years or more commonly at age 60 and above. This drop in testosterone levels is sometimes termed hypogonadism, “male menopause” or andropause. The mortality of men with testosterone deficiency is significantly higher than among men with normal testosterone levels.

If you wonder whether testosterone therapy might be right for you, talk with your doctor about the risks and benefits. Your doctor will likely measure your testosterone levels at least twice before recommending testosterone therapy. Hypogonadism hampers the ability to produce normal amounts of testosterone due to a problem with the testicles or with the pituitary gland that controls the testicles.

However, what is considered clinically low levels of testosterone varies across guidelines, typically from 230–340 ng/dL. Your lab report should show the range that your lab uses for each test. Your doctor will also look at your results based on your age, health, and other factors. A value that isn’t in the normal range may still be normal for you. Treatment for high testosterone depends on the cause, but generally, it is a combination of lifestyle changes and medications.

By taking and testing a small sample of a person’s blood, doctors can check for many kinds of diseases and conditions. Blood tests help doctors check how long does trt take to work the body’s organs are working and see if medical treatments are helpful. Complicating this matter is the fact that testosterone levels don’t stay the same through life, through the year or even through the day – at least in men. Testosterone levels change throughout the day in men, peaking at around 4-8am and falling to their lowest at about 12 hours later. They can also vary across the year, although these seasonal highs and lows will differ around the world. These daily and seasonal variations can see levels change by as much as 19%.

Symptoms include irregular periods, reduced fertility, excess or coarse hair on the face, extremities, trunk and pubic area, male-pattern baldness, darkened, thick skin, weight gain, depression and anxiety. One treatment available for many of these problems is spironolactone, a special type of diuretic (water pill) that blocks the action of male sex hormones. Testosterone deficiency during fetal development doesn’t allow male characteristics to develop normally. This is called androgen insensitivity syndrome (AIS) and occurs when someone is genetically male but is insensitive to androgens (male sex hormones).

However, due to fluctuations in testosterone levels throughout the day, multiple tests may be necessary to confirm your levels accurately. Low testosterone (Low T) is more common than high testosterone in men. Low testosterone levels can lead to a variety of symptoms that can vary from person to person. If a clinician expects hypogonadism based on history and physical, a total serum testosterone between 8 AM and 10 AM should be drawn. If levels are low, a repeat level and FSH and LH levels should be obtained. Low testosterone in the setting of normal FSH/LH indicates secondary hypogonadism. The next steps would be to get prolactin, T4, 8 AM cortisol, iron, ferritin levels, and a brain MRI.

Completion of a controlled substance contract should be considered before prescribing. The complications of untreated hypogonadism differ depending on when it develops — during fetal development, puberty or adulthood. The pituitary gland and the hypothalamus are located within the brain and control hormone production. Hypogonadism can begin during fetal development, before puberty or during adulthood. It is unclear whether it is also due to similar genetic factors, but testosterone can also be different depending on where you live and how wealthy you are. So a universal “normal range” may not apply to all groups of people. But it is difficult to know what is the right level of testosterone, and these ranges are often not agreed on by experts from different societies, countries or laboratories.

Testosterone (tess-TOSS-tuh-rone) is a hormone that plays an important role in sexual development. As puberty approaches — usually when kids are between 10 and 14 years old — the pituitary glandsecretes two hormones (luteinizing hormone, or LH; and follicle-stimulating hormone, or FSH). These hormones work together to stimulate the testes to make testosterone. The myLAB At Home Fitness test checks for your levels of testosterone along with other hormones and health metrics for men and women, including progesterone, dehydroepiandrosterone (DHEA), cortisol, high-sensitivity C-reactive protein, and vitamin D. Together, these key indicators can help you understand your overall health. A total testosterone test measures both bound and free testosterone in a blood sample.

Due to the challenges in testosterone methodology, there is considerable variability in testosterone reference ranges.13  The specific reference ranges used to diagnose testosterone deficiency are discussed in more depth later in this document. However, practicing clinicians who review testosterone lab results will commonly face the dilemma of whether to use the reference ranges published by their specific lab or the absolute measure itself. As an example, a total testosterone value of 250 ng/dL may be considered low based on the current guideline but be marked within the normal range by the laboratory. This situation commonly occurs as reference laboratories often define a normal value as ranging within the 5th (or 2.5th) and 95th (or 97.5th) percentiles of a sampled population.

Bone mineral density is a measure of the thickness of bones, and bone turnover is the process of resorption followed by replacement by new bone with little change in shape. One important aspect of study design is the specific endpoints and objective measures used to identify outcomes. Studies are often specifically powered and designed to address a key efficacy endpoint, such as a particular symptom improvement, and not to address secondary symptom improvement or adverse events. Roughly 40% of males aged 45 or older and 50% of males aged 80 or older live with hypoandrogenism, or low testosterone. Symptoms of hypoandrogenism include erectile dysfunction and low libido. Pellets and long-lasting injections may provide more stable testosterone levels over the long term, Dr. Rogers says, and can be more convenient than daily self-treatments. Around age 12 or 13, the pituitary gland signals the testicles to start producing testosterone.