Testosterone is the prototypical male hormone. It’s what puts hair on your chest and muscles on your frame during puberty. Put simply, testosterone is what makes a man a man. In healthy men, normal testosterone levels generally range between 300 ng/dL and 1050 ng/dL. Unfortunately, levels decline with aging and may fall below the normal range. Read on to learn about testosterone levels by age as well as symptoms of low testosterone and testosterone replacement therapy.
Testosterone Levels by Age: The BAD News
As men age, total testosterone levels decline. Even worse, free testosterone (testosterone not bound in the blood to sex hormone-binding globulin (SHBG)) levels decline more rapidly than total testosterone. Studies have shown that total testosterone decreases by approximately 30% in healthy men between the ages of 25 and 75. Free testosterone levels decline even more significantly with decreases of approximately 50%.1-3
The official term for this decline is Late Onset Hypogonadism (LOH) also known as andropause, but it’s more commonly referred to as low testosterone or, simply, “Low T”. The following table by A. Vermeleun (1996) shows total testosterone levels by age as well as free testosterone levels and SHBG levels in a sample of men.4 As you can see, total testosterone declines with aging. Also, the amount of SHBG increases with aging causing the much more dramatic drop in free testosterone. This natural decline is the major reason for the increasing prevalence of low testosterone in older men. The additional table below by D. Simon (1996) shows total mean, medium, 5% and 95% testosterone levels by age.5 Unfortunately, aside from study data, no medical organizations/communities provide any reference normal testosterone levels based on age that men can look to as a reference.
To get your testosterone and other male hormone levels measured at a conveniently located lab, check out EMG’s Direct-to-Consumer Testing Lab Resources.
A. Vermeleun (1996)
D. Simon (1996)
Does Every Older Man Have Low Testosterone?
No. Many men have normal testosterone levels throughout their lives and will never need treatment. In fact, among men over the age of 60, only about 1 in 5 men have a total testosterone level that falls below the normal range. However, many men, even those in the lower end of the normal range, still suffer from symptoms associated with low T and could potentially benefit from testosterone replacement therapy.
Normal testosterone levels generally range between 300 ng/dL and 1050 ng/dL.6-10 This wide range means that one man can have nearly three times more total testosterone than another man, but both can still be normal. The change in testosterone levels by age over a lifetime can be just as important as the actual clinical value for the presentation of symptoms. This means that many men fall within the normal range but still suffer from symptoms of low T.
There is no absolute consensus among medical organizations for the exact cutoff for low testosterone. In general, the cutoff ranges from high 200s to low-to-mid 300s ng/dL.11-13 For most symptoms, the average testosterone threshold corresponds to the lower end of the normal range for young men, i.e. approximately 300 ng/dl, with a greater likelihood of having symptoms below this threshold than above it.14-15
Normal Testosterone Levels Chart
|300 – 1050 ng/dL (10 – 36 nmol/L)*||Normal Testosterone Levels|
|5 – 21 ng/dL (174-729 pmol/L)**||Normal Free Testosterone Levels|
* Testosterone levels vary day-to-day and hour-to-hour. So, one measurement alone is generally not enough to diagnose a man with low testosterone. If a first test reveals levels between 200s to low-to-mid 300s ng/dL, a second test along with a free testosterone measurement is needed as confirmation. Since levels are the highest in the morning, the best time for the blood sample to be taken is between 7 a.m. and 10 a.m.
** Free testosterone levels are as important, if not more important, as total testosterone. It should be noted that labs use different assays and methodologies to measure free testosterone. A free testosterone (direct) test will yield values outside of the above range if you try to convert the values. In this case, use the reference range provided by the specific lab. Compare your lab results directly to the lab provided range to assess where you stand. Below are the normal ranges for AnyLabTestNow, LabCop, and Quest Diagnostics.
What Problems Result From Low Testosterone?
Low testosterone has been correlated with unwanted changes in body composition such as increased abdominal fat and decreased muscle mass.16-20 Unfortunately, abdominal fat affects organs like the heart, liver and kidneys more adversely than fat anywhere else, in terms of cardiovascular risk. Unsurprisingly, low testosterone levels are associated with an increased risk of cardiovascular disease and metabolic problems, such as diabetes. Low testosterone can also cause erectile dysfunction, depression, mood changes, and low bone density.6
Testosterone Levels by Age: The GOOD News
Fortunately, many healthy lifestyle choices, such as resistance and aerobic exercise, good quality sleep, and a healthy diet, may actually increase testosterone production naturally.
Additionally, the simple hormone treatment of testosterone, known as testosterone replacement therapy (TRT), for men with low testosterone can improve many symptoms associated with low T including sexual function, muscle mass and strength, body composition, and bone density,21-23 and may also benefit other critical functions including metabolic, cardiovascular, and cognitive function.24-27
Will TRT Cure All of the Ailments Associated with Aging? Will TRT Reverse Aging?
The answer to both of these questions is NO. Testosterone replacement therapy will not make up for poor diet, lack of exercise, and a generally unhealthy lifestyle. It is not a magic bullet, nor will it reverse aging.
For those with low testosterone, combining proper diet, exercise, good sleep, and other positive lifestyle modifications with testosterone replacement therapy can make you stronger and leaner and feel better.
Check out the links below to learn more about signs of low testosterone.
- Testosterone Replacement Therapy
- Types of Testosterone
- Benefits of Testosterone Therapy
- Side Effects of Testosterone Therapy
- FDA Statement on Testosterone
External Resources: Medscape: Testosterone Deficiency
Updated: May 5, 2015
1. Moffat SD, Zonderman AB, Metter EJ, Blackman MR, Harman SM, Resnick SM. Longitudinal assessment of serum free testosterone concentration predicts memory performance and cognitive status in elderly men. J Clin Endocrinol Metab. Nov 2002; 87 (11): 5001-5007.
2. Morley JE, Kaiser FE, Perry HM, et al. Longitudinal changes in testosterone, luteinizing hormone, and follicle-stimulating hormone in healthy older men. Metabolism. Apr 1997 ;46 (4): 410-413.
3. Araujo AB, O’Donnell AB, Brambilla DJ, et al. Prevalence and incidence of androgen deficiency in middle-aged and older men: estimates from the Massachusetts Male Aging Study. J Clin Endocrinol Metab. Dec 2004; 89 (12): 5920-5926.
4. Vermeulen A. Declining Androgens with Age: An Overview. In Vermeulen, A. & Oddens, & B. J. (Eds.), Androgens and the Aging Male. 3-14.
5. Simon, D., Nahoul, K., & Charles M.A. (1996). Sex Hormones, Aging, Ethnicity and Insulin Sensivity in Men: An Overview of the TELECOM Study. In Vermeulen, A. & Oddens, and B. J. (Eds.), Androgens and the Aging Male (pp. 85-102).
6. Miner MM. Low Testosterone Medscape CME Expert Column Series. Issue 3: Delivering Safe and Effective Testosterone Replacement Therapy. Medscape Education. 2011.
7. Miner MM, Sadofsky R. Evolving issues in male hypogonadism: evaluation, management, and related comorbidities. Cleveland Clin J Med. 2007;74(suppl 3):S38-S46.
8. Dandona P, Rosenberg MT. A practical guide to male hypogonadism in the primary care setting. Int J Clin Pract. 2010;64:682-696.
9. Corona G, Rastrelli G, Forti G, Maggi M. Update in testosterone therapy for men. J Sex Med. 2011;8:639-654.
10. Bhasin S, Cunningham GR, Hayes SJ, et al. Testosterone therapy in adult men with androgen deficiency syndromes: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2010;95:2536-2559.
11. Anderson RJ, Bergman DA, Garber JR, Hamilton CR, Hershon KS, Jovanovic LG, Kleerekoper M, Mechanick JI, Palumbo PJ, Peters AL, Rettinger HI, Rodbard HW, Rubenstein HA, Seibel JA, Tourtelot JB. American association of clinical endocrinologists medical guidelines for clinical practice for the evaluation and treatment of hypogonadism in adult male patients. AACE Hypogonadism Guidelines, Endocr Pract. 2002; 8 (6): 439-456.
12. Wang C, Nieschlag E, Swerdloff R, Behre HM, Hellstrom WJ, Gooren LG, Kaufman JM, Legros JJ, Lunenfeld B, Morales A, Morley JE, Schulman C, Thompson IM, Weidner W, and Wu FCW. Investigation, treatment and monitoring of late-onset hypogonadism in males ISA, ISSAM, EAU, EAA and ASA recommendations. Eur J Endocrinol. 2008 Nov; 159(5): 507–514.
13. Namiki M, Akaza H, Shimazui T, Ito N, Iwamoto T, Baba K, Kumano H, Koh E, Tsujimura A, Matsumiya K, Horie S, Maruyama O, Marumo K, Yanase T, Kumamoto Y. Clinical Practice Manual for Late-onset Hypogonadism Syndrome. International Journal of Urology. 2008; 15 (5): 377-388.
14. Zitzmann M, Faber S, Nieschlag E 2006 Association of specific symptoms and metabolic risks with serum testosterone in older men. J Clin Endocrinol Metab 91:4335–4343.
15. Kelleher S, Conway AJ, Handelsman DJ 2004 Blood testosterone threshold for androgen deficiency symptoms. J Clin Endocrinol Metab 89:3813–3817.
16. Kaufman JM, Vermeulen A. The decline of androgen levels in elderly men and its clinical and therapeutic implications. Endocr Rev. Oct 2005; 26 (6): 833-876.
17. Makhsida N, Shah J, Yan G, Fisch H, Shabsigh R. Hypogonadism and metabolic syndrome: implications for testosterone therapy. J Urol. Sep 2005; 174 (3): 827-834.
18. Kapoor D, Malkin CJ, Channer KS, Jones TH. Androgens, insulin resistance and vascular disease in men. Clin Endocrinol (Oxf). Sep 2005; 63 (3): 239-250.
19. Liu PY, Death AK, Handelsman DJ. Androgens and cardiovascular disease. Endocr Rev. Jun 2003; 24 (3): 313-340.
20. Pitteloud N, Hardin M, Dwyer AA, et al. Increasing insulin resistance is associated with a decrease in Leydig cell testosterone secretion in men. J Clin Endocrinol Metab. May 2005; 90 (5): 2636-2641.
21. Rhoden EL, Morgentaler A. Symptomatic response rates to testosterone therapy and the likelihood of completing 12 months of therapy in clinical practice. J Sex Med. Jan 2010; 7 (1 Pt 1): 277-283.
22. Page ST, Amory JK, Bowman FD, et al. Exogenous testosterone (T) alone or with finasteride increases physical performance, grip strength, and lean body mass in older men with low serum T. J Clin Endocrinol Metab. Mar 2005; 90 (3): 1502-1510.
23. Isidori AM, Giannetta E, Greco EA, et al. Effects of testosterone on body composition, bone metabolism and serum lipid profile in middle-aged men: a meta-analysis. Clin Endocrinol (Oxf). Sep 2005; 63 (3): 280-293.
24. Heufelder AE, Saad F, Bunck MC, Gooren L. Fifty-two-week treatment with diet and exercise plus transdermal testosterone reverses the metabolic syndrome and improves glycemic control in men with newly diagnosed type 2 diabetes and subnormal plasma testosterone. J Androl. 2009 Nov-Dec 2009; 30 (6): 726-733.
25. Kapoor D, Goodwin E, Channer KS, Jones TH. Testosterone replacement therapy improves insulin resistance, glycaemic control, visceral adiposity and hypercholesterolaemia in hypogonadal men with type 2 diabetes. Eur J Endocrinol. Jun 2006; 154 (6): 899-906.
26. Chahla EJ, Hayek ME, Morley JE. Testosterone replacement therapy and cardiovascular risk factors modification. Aging Male. Jun 2011; 14 (2): 83-90.
27. Zitzmann M. Testosterone and the brain. Aging Male. Dec 2006; 9 (4): 195-199.