Standard Measure of Low Testosterone Doesn’t Apply to Young Men

Standard Measure of Low Testosterone Doesn't Apply to Young Men

Accurate measurements are essential for determining testosterone levels. As with all medical procedures and prescriptions, the crucial word is balance. Too little therapy will not deliver the results desired, and too much will result in adverse side effects and a “too much of a good thing” outcome.

As with all things in the medical field, testosterone research continues. Testosterone Replacement Therapy (TRT) is continually monitored, refined, and measured to restore testosterone to healthy levels in the safest, most efficient manner.

A recent study published in The Journal of Urology stated that the typical cutoff point for low testosterone levels (aka “Low-T”) might not be accurate for men in their mid-forties and younger.

"Young men have different testosterone reference ranges than older men," comments lead author Alex Zhu, DO, of the University of Michigan, Ann Arbor. "Our findings suggest we should use age-specific cutoffs when assessing testosterone levels in younger men."

Different limits for Low-T in younger men

Men with low testosterone (hypogonadism) have low levels of the male hormone testosterone, aka “the manly hormone.”

Some of the symptoms of Low-T are:

• Chronic fatigue
• A severely diminished libido
• Erectile dysfunction
• A weakened immune system
• Depression
• Brain fog
• Painful joints and muscles
• Insomnia
• Trouble maintaining balance

These symptoms are usually seen in elderly men. However, in recent times there has been a dramatic escalation of young men with the same symptoms.

Accurately diagnosing low testosterone in young men is not easy. The standard cutoff point for low testosterone is 300 nanograms per deciliter (300 ng/dL). However, that metric is derived from testosterone research of older men and ignores the regular age-related drop in testosterone levels.

To create several age-specific cutoff points, Dr. Zhu and colleagues from the University of Michigan Department of Urology reviewed data on 1,500 men aged 20 to 44 from a national health study (the National Health and Nutrition Examination Survey, or NHANES).

The study did not include men on TRT or those with a history of testicular cancer or testicular removal (orchiectomy). Because of everyday daily vacillations in testosterone levels, the analysis used only morning testosterone measurements.

The range of testosterone levels was measured in five-year age groups. The middle group (one-third) of the testosterone level distribution in each five-year age group was defined as the normal range. Levels lower than this range were used to calculate age-specific thresholds for Low-T.

As anticipated, testosterone levels plummeted as men aged. Age-specific cutoff points for low testosterone ranged from 409 ng/dL at age 20 to 24 years to 350 ng/dL at age 40 to 44 years – substantially higher than the standard cutoff point. Each one-year increase in age was linked with a 4.3 ng/dL drop in testosterone levels.

Abandoning the one size fits all approach.

The study provides "the first evaluation of normative, population-based testosterone levels for young men in the United States," according to the authors. They emphasized that their study reflects the racial/ethnic diversity of the American population and doesn't exclude men with health issues other than testicular cancer or prior orchiectomy.

"In today’s age of personalized medicine, clinicians can now use age-specific testosterone levels to evaluate young men instead of relying on a "one size fits all approach," Dr. Zhu and coauthors write. They highlight the need for further studies, including how to interpret age-specific cutoffs in the context of testosterone deficiency symptoms. The researchers also note that the age-specific cutoffs may affect insurance policies – which sometimes do not cover testosterone therapies unless the testosterone level is below the standard 300 ng/dL cutoff.

The Journal of Urology is an Official Journal of the American Urological Association (AUA) and published in the Lippincott portfolio by Wolters Kluwer.

https://www.newswise.com/articles/standard-threshold-for-low-testosterone-doesn-t-apply-to-young-men

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