Testosterone Test: Free & SHBG, High vs Low vs. Normal Levels

Testosterone Test: Free & SHBG, High vs Low vs. Normal Levels

When a patient says, “I am not feeling right,” to simply dismiss those symptoms as “nonspecific” is a disservice. The question in medicine always comes down to balancing benefits vs. harms. For many years, what held us back in prescribing testosterone therapy was that we could somehow precipitate the development of new prostate cancer, or, if there was a hidden cancer, we might cause it to grow more rapidly. Today, we know that neither of those is true, based on extensive studies. Male hypogonadism should be diagnosed only if there are signs or symptoms of hypogonadism and total serum testosterone levels are low on at least two occasions.

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.

As more data becomes available, it’s likely that the reference ranges for testosterone will improve to include age-specific values. To understand why testosterone levels decline, it’s useful to understand how testosterone levels are controlled. Several conditions can lead to a drop in testosterone, including infections, testicle injuries, viruses, certain medications, obesity, alcohol abuse, HIV or AIDS, Type 2 diabetes, pituitary disorders, and thyroid problems. Based on what we find, you may need to undergo a few more tests to determine the cause of your decreased testosterone. These are classic consequences of decreasing testosterone levels, but they may also indicate other conditions. The only way to know for sure is to visit The Endocrine Center for a simple test. The U.S. Food and Drug Administration clarified in 2015 that prescribing testosterone for low testosterone levels due to aging constitutes off-label use.

But if it’s just slightly low, as is more common, you’d definitely want to have symptoms,” says Bradley Anawalt, MD, chief of medicine at the University of Washington. But perhaps what’s more important is the overall trend of your testosterone level and whether you have symptoms. If you have no symptoms but are at the lower end of normal, this may well be normal for you. Two areas of the brain are involved called the hypothalamus and pituitary gland. The hypothalamus instructs the pituitary gland to release luteinising hormone (LH) which prompts the Leydig cells in the testes to produce testosterone.

Still, these are approximations of the truth in specific populations with specific genetics, backgrounds and disease. Like the story of the blind men feeling different parts of an elephant, we can only build up a picture of the truth from small parts in the search to find the answers. Some labs report testosterone levels up to 800 or 1000, but the average man probably won’t measure that high, and there is not a benefit to having a significantly higher testosterone level. For instance, your sex drive at 500 is not going to differ from your sex drive at a level of 350.

Patients who are on long-acting SQ pellets require two separate assessments of testosterone to determine the dose and frequency required. The first testosterone measurement should be obtained two to four weeks after initial implant to determine if the number of inserted pellets needs to be increased or decreased to achieve the appropriate therapeutic level. Patients who are on long-acting IM testosterone (testosterone undecanoate) should have blood work tested once steady state levels have been achieved.

In teens and adults, testosterone levels can help doctors evaluate fertility or menstrual problems and sexual function. Using average levels of testosterone from lots of people from different populations to establish normal ranges is useful to help identify people outside of this range with a related disease. But many factors have to be considered when deciding whether someone has normal testosterone or not and whether there truly is a “normal” testosterone level at all.

However, steroids can affect testosterone levels in both males and females. High testosterone levels are unusual in adult males, while children with high testosterone levels may have a growth spurt or start puberty early. High testosterone in all sexes can cause infertility, obesity, and in some cases, metabolic disorders. If any of these organs — your hypothalamus, pituitary gland or gonads — aren’t working normally, that can cause abnormal testosterone levels. Testosterone is a hormone that your gonads (testicles or ovaries) mainly produce. If testosterone levels are too high or too low, it can cause certain symptoms. A low testosterone level alone isn’t necessarily a cause for alarm.

Men outperform women on tests of mathematical reasoning, but women do better on arithmetical calculation tests. Males tend to have superior musical and mathematical skills; women, enhanced verbal abilities. Testosterone is produced by the Leydig cells of the testicles. The starting point is cholesterol, notorious for its effects on the heart but critical for its role as the building block of all sex hormones, both male and female.

Testosterone is testosterone therapy covered by insurance a hormone that your gonads (sex organs) mainly produce. More specifically, both testicles and ovaries produce testosterone. Low testosterone — also known as hypogonadism or low T — can affect your overall health. But some doctors say it’s just a normal, harmless part of aging.