There was a time when having low testosterone was taboo, but that's no longer the case. Today, testosterone insufficiency is discussed in the same way as menopause. It's a fact of life that levels of hormones such as testosterone decline with age. It is also a fact that some men and women will suffer the harmful effects of this reduction, while others will go about their daily lives without anything changing. The same goes for women who are going through menopause. Some suffer greatly from hot flashes and night sweats preventing sleep while others go through no change.
People who experience adverse symptoms associated with hormone dysregulation turn to hormone replacement therapy specialists for blood tests that measure their various hormone levels. These tests show whether testosterone, progesterone, growth hormone, or estrogen levels are higher or lower than normal.
Measuring testosterone levels is not a simple thing. First, there are three different types of tests:
– Total testosterone – Free testosterone – Bioavailable testosterone
Some doctors choose to only measure total or free testosterone, which is not advised. Although it is not essential to check bioavailable testosterone levels, both free and total testosterone should be measured. Total testosterone includes the percentage of testosterone that is bound to albumin or sex hormone-binding globulin (SHBG), as well as free testosterone in the bloodstream. It is free testosterone that can impact a person's well-being because only free testosterone can be utilized by the body. Albumin and SHBG transport bound testosterone through the blood to receptor sites and then the testosterone is released for use. Bioavailable testosterone includes both free and albumin-bound testosterone.
Unfortunately, there is also an enzyme called aromatase waiting to convert this free testosterone into estradiol (estrogen) before it can be used by the body. If this happens, the person may experience symptoms of low T and estrogen dominance.
What is a “normal” testosterone level?
The word "normal" applies to testosterone levels in different ways. First of all, there is a numerical range that various organizations and health labs have set according to what they think is the adequate amount of testosterone in men or women at a given age. Unfortunately, there is no established consensus between these groups, so what one may consider high or low, another will define as being in the middle spectrum. Normal is also defined by how well each person's body manages their testosterone levels.
How can a doctor make a diagnosis if there is no defined reference range?
By considering what is considered to be the lowest as well as the highest of the normal spectrum, endocrinologists can get a rough idea of where the patient is on the chart.
For example, normal total testosterone levels in adult men can be between 270 and 1070 ng/dL depending on their age. Free testosterone averages between 50 and 210 pg/mL.
A woman should have total testosterone ranging from 15 to 70 ng/dL and free testosterone between 1.0 and 8.5 pg/mL.
In addition to age, women also show differences caused by contraceptive use, as well as having had an ovariectomy (surgical removal of the ovaries).
Normal levels are so varied and numerous that doctors will only diagnose a person with low testosterone if they are below the limit of what is considered normal while also showing symptoms of testosterone deficiency. This is why a clinical examination and a complete examination relating to the history as well as the history of the disease are also included in the diagnostic process.
How to interpret the results of a testosterone test?
It is important not to obsess over testosterone test results. A man can have levels below the limit of the normal spectrum without showing any symptoms. In such cases, treatment is not necessary, because in the end, low testosterone levels do not affect the patient's quality of life. In other cases, although the testosterone level is not below the tolerated limit, symptoms may appear and considerably alter the patient's quality of life. The endocrinologist will always make the diagnosis of testosterone deficiency in this type of case, because the symptoms confirm that the decline in testosterone production has significant repercussions.