Normal Testosterone Levels

[ed1223]

What is considered a "normal" testosterone level for a healthy 45 year old man?  I have been suffering from a variety of symptoms consistent with low testosterone: low sex drive, lack of morning erections, less intensity during ejaculation, less hard erections, irritability, etc..  I had my doctor run blood tests and everything came back normal.  Testosterone was 257 on a scale of 241 - 800.  Doctor says this is normal and will not consider hormone treatments.  The only medication I take is a statin, which has lowered my cholestorol to normal levels.  I am not overweight, nor do I feel depressed.  This has become a major quality of life issue, as my wife is feeling somewhat undeisrable and neglected. I'm not ready to give up on a healthy sex life, but now that my doctor has determined thal all is "normal," I'm not sure what my next step is.  I have unable to find a chart that lists normal testosterone levels by age.  I'm hoping that if I could find some evidence of what I suspect (that my testosterone is indeed low) then I might be able to convince my doctor to consider treating me.  Can you help?

[Dr_Veena]

Hi,
      Thanks for writing in. What you may consider normal testosterone levels for
one person, may be different for another. As when you age, your testosterone requirements can change over time. The typical male testosterone level is between 250ng/dl to 850 ng/dl. In a 45 year old man normal testosterone levels are around 600 ng/dl.

Discuss with your doctor regarding the symptoms you have and ask for a hormone replacement therapy.
Best.

[ed1223]

Thank you for your response.  I have discussed this with my doctor and he maintains that my number (257) is normal and that no hrt is necessary.  I was hoping to find a study or a medical reference or a medical chart that listed normal testosterone levels by age so that I could go back to him with that and convince him to treat me.  Any suggestions?

[Dr_Veena]

Hi,
     How are you? I can understand your situation, but I would suggest that you discuss with your doctor regarding, why he does not want HRT for you. In some patient’s with obesity, treating obesity itself resolves the condition, but it takes time and is a safer method. Also, check the link provided below for age related testosterone levels chart and other information.
http://www.mens-hormonal-health.com/normal-testosterone-levels.html

[ed1223]

Thank you.  I will take the chart and talk to him about why is doesn't want to treat me.  I am not overweight, so that isn't the issue.  If he still declines to treat me, what sort of doctor should I see next - a urologist or an endocrinologist?

[James186282]

First, I'm not a doctor so take this as 2 cents worth from a fellow patient.  From what I've read what is normal Testosterone levels and what is considered treatable has changed a bit in the last couple of years.  There are some good references out there that may help you understand what the current thinking is.

Google the AACE Guidelines to Male Hypogonadism.  This is a little bit dated but I think if you want hard technical information on this condition that will be a good reference.  Its not easy reading however.  If you want a book that is geared for the patient I liked "The Testosterone Syndrome" by Dr E. Shrippen.  He writes in an easy to read style that I think you will enjoy.

As to what is normal.  The doctor is correct.  Age plays a factor.  Download the Age vs (Average) Testosterone chart in the Files area.

http://health.groups.yahoo.com/group/supportEDpartners

If you look it over you will see that at your level it would be "normal" but you would need to be over 100 years old!  Not good.  The average normal level at your age is  over 600 ng/dL and the current thinking from the AACE guidelines is that levels under 325 ng/dL are the new treatment (or further diagnosis at least) indicated.  If you have symptoms be sure your doctor knows about them because this is a piece they need to know.

Try to find out if your form of Hypogonadism is primary or secondary.  If you have testicular failure there are a variety of treatments that will work (Androgel, Androderm, Testim, Injectable Testosterone etc)  If the failure is the control signals to the testes they can try a variety of meds to try to kick start them into function but they should try to figure out why these hormone signals are not present.  

Be proactive!  Keep on this and work with your doctor.  Don't be afraid to read up about this and share what you find.  But DO remember that what you read on the Internet in particular may not be medical fact.

- James

[accesstd]

I went through the exact same thing. My test level was 218 and I am 35 years old. Lots of good and accurate advice given so far on this message string. But, one thing you may want to look into that hasn't been mentioned is the possibility of a pituitary tumor. Yes, it is a type of brain tumor, but don't freak out. I found out that I had one and that it was the culprit behind my problems. Get an MRI done. If it comes back clean, then I would start researching the hrt and the possibility of hypogonadism. But, if you do have a tumor, get it removed. There are other complications other than low testosterone that the tumor can do. My surgery was done through the nose, and I was out of the hospital in 5 days. Unfortunately, my tumor caused permanent damage to my pituitary and I ended up having to be on hrt. But, I was lucky enough to save my eyesight. Good luck.

[rafe44]

I know what your going thru. I'm a 44 yr old male. My libdo had gone to nothing and my wife was feeling un loved and i thought i was going crazy. Because i always enjoyed sex. So i got blood tested and my level was 125. So i ask to beput on test. We started with andro gel 10mg for about 3 months and i was tested again . I had not noctice any change and my level was 150. So i ask for the injections and we started at 1cc of 200 mg depo test a month. I did it for two months and just went back this monday for blood work and my testosterone level had dropped to 135! So nw he pu me on 1cc every two weeks. I will make sure i ask them to check my glands out! I know he felt around and looked up my nose and throat,bu no MRI was done. But Ed i know what your going thru, Low test cause alot more problems than just sexual.It seems im tired , with no entergy all the time. But to look at me you'd think im a very healthy guy. Not over weight at all. He thinks my problem may stem from a terrible Motorcycle accident i was in 9-1-04 that has caused me to have over 50 operations . The last being 10-08. So if you've had any serious broken bones or head injuries it could be a thought. Hope this helps.

[christopher47]

Hey Rafe. Please tell me more about this connection between the trauma/accident and the low testosterone levels. I'm 47 and very athletic. In May 2008, while I was hiking, a freak gust of wind blew me off a 60-foot cliff. I almost died. I broke 11 ribs in multiple places, pierced both lungs and both lungs collapsed, I shattered my left shoulderblade, crushed my L1 vertebrae, all my transverse processes on the left side of my thoracic spine were sheared off, and had blunt trauma and a laceration to the head. It's a miracle I survived. I'm mostly recovered and am primarily just dealing with the chronic pain from all that my body went through. Was doing a lot better until about three months ago (May 2009) when I started having a set of symptoms that just debilitated me. I spent half of June in bed with extreme fatigue/exhaustion; difficulty concentrating, focusing and thinking; terrible headaches; nausea and dizziness; and a general feeling of being "unwell." My primary care physician didn't know what was going on, so I switched PCPs. The new guy ordered an MRI of my head to rule out a brain tumor (the results only showed "cerebral atrophy consistent with a 47-year-old male" ... jeez) but he noticed that my thyroid/pituitary readings were out of whack and he couldn't figure out why, so he sent me to an endocrinologist, who I saw yesterday and who re-tested my TSH and T4 and found my thyroid/pituitary readings back to normal. But he also tested my testosterone and my total testosterone was 169 (normal is 175-781, and as one of the guys in this thread pointed out, guys our age should have testosterone readings around 600). We're waiting for my "free" vs. "bound" testosterone reading to come back (it won't be in for another week), but I'm wondering why my testosterone is so low. You and I are both around the same age, with similar test. readings, and we both have the tired/no energy thing going on (even though we look healthy). My interest is in this connection between trauma (your motorcycle accident/operations and my fall off the cliff) and our bodies' low testosterone production. Please keep me informed of anything more you find out about that connection between trauma and low testosterone.

Also, have you been taking a narcotic to treat your pain from the accident and operations? I've been taking oxycodone for over a year now, and I'm wondering if there's a connection between narcotic usage for chronic pain and suppressed testosterone production.

[wilfredtr]

WoW. Guys, I have just one thing to say. GET ANOTHER DOCTOR. Do not let "your doctor" play God in your life. He's someone elses Dr also, so there no reason for you to have him/her as your only Doctor. I had low T, 157 and for TWO YEARS, I got all the blah blah blah that I see in this post. The biggest issue with Low T (under 300 total) is finding the right doctor. DO's rather than MD's seem to know better. Get on this moderated Group and find out the truth.

http://groups.yahoo.com/group/hypogonadism2/summary

[jake1977]

To Rafe44 & Christompher47. I know for a FACT that anyone taking opioid narcotic pain medicin for an extended period of time will have an extremely HIGH chance of having Low Test. I have been seeing a pain specialist for over 4 years now. My monthly pain meds include 15x100mg fentanyl + 60 Opana ER 40mg pills(these ar a little over twice the strength of "2" 80mg Oxycotin), 120 Percocets & mucsle relaxer. My Pain doc recently tested my test and it was 164. I am 32 years ol 6ft 3in tall, weigh 220 lbs, played college football, ^& am in decent shape considering I have just started excericising again after 10 years(VERY light exercise). My pain doc told me that ANYONE who has been on pain killers for an extended period of time will more than likely have low T when tested. He has just put me on this med called andro gel. Have not picked up from pharmacy yet and tried though. I had depression (did not know it until i started taking webutrin to stop smoking and just kind of woke up one morning with a little brighter outlook on life), not as strong erections, tired ll of the time, not alot of enjoyment out of life,etc. Still have a decent sexdrive, but not as strong as once before. will keep posted on how gel works.

[rcarbery]

I had my testosterone recently checked and it came back at 236, I am 40 years old.  I have steatohepatitus (according to liver biopsy done in June) enlarged spleen (mri), enlarged lymph nodes (visually noticable), (hiv neg, had test done several times)(hep a,b,c ..ect came back clean).  I have constant diehrea, abdominal pains, NO energy, I get dizzy a lot with any slight movement, I can sleep 10 hrs at night and get up to do things around the house and be ready to go back to bed within 20 minutes of getting up.  I am starting to have really bad depression because of the doctors telling me there is nothing wrong with me out of one side of their mouth then tell me all this other stuff at the same time!!
I told my Family dr that I have been falling down the stairs when I attmept to go downstairs, his comment "well things happen quickly" .. like what the hell is that supposed to mean?  My billiruben was 2.14 in June (had blood work for a life ins policy - which was denied) and then last month it went up to 2.4..  If there is nothing wrong with me, why is it I got denied for a 20k life insurance policy due to my medical history? and why is it that I am so tired all the time? I am wondering what it is they are NOT telling me.  and I applied for SSDI twice and was turned down both times, I am appealing it this time.  I have no clue what to do at this point.

[John_42]

I am a LOT less tired after starting treatments, where my T was tested at 168!!! I now feel like King Kong, and am back to working out and nearing the physical conditioning I had 10 years ago. Life, including my sexual functions, are night and day. I am able to run again, lift weights without fatiguing too easily, and am losing weight.

For anyone who is low on the normal range, I encourage you to look into trying this therapy. Of course you should consult with a proper physician. If you get a 'no' answer, see another. I connected with a urologist after being told I didn't need this by my internal med doctor, and can relate many examples where I had legitimate conditions where doctors swore I had no problem. It took five to find one who could feel my hernias, for example ... three of them. I knew my body, and I knew they were there.

And I agree ... there's a range ... try this and see where it 'feels right'.  

It's changing my life in six months, after feeling like dogcrap for at least 10.