Younger Men With Hypogonadism May Have Higher Testosterone Levels Than Once Thought

A new study finds that men younger than 40 who have testosterone levels between 300 to 400 ng/dL can still experience hypogonadism. These levels are higher than the traditional minimum threshold of 300 ng/dL or below.

Renal and Urology News reports that researchers from the Baylor College of Medicine in Houston have found that men with a 300-400 ng/dL testosterone level (which would be considered “low testosterone”) are at greater risk for hypogonadism than once thought. Hypogonadism, or the failure of the male testes to work properly, was once thought to be present in men with a testosterone level of 300 ng/dL or below. However, the researchers found that figure to be derived from earlier studies heavily focusing on elderly men rather than men in their adulthood.

“The notion that common and uniform concentrations of androgen levels can be applied to describe the increasing prevalence of testosterone-related symptoms in young men should be challenged on the basis of the conclusions from the present study,” wrote lead researcher Dr. Larry I. Lipshultz.

The research team suggested that along with the common symptoms of hypogonadism and a general assessment, a 400 mg/dL testosterone level should be considered an indicator of hypogonadism for men under 40. Though, the researchers point out, the testosterone threshold alone should not be used as a reason to pursue testosterone replacement therapy.

“Many symptoms of low testosterone can include fatigue, weight gain, decreased libito, and poor concentration,” said Kevin Meuret, Founder of the Low T Institue. “The diagnosis of low testosterone requires a complex set of blood tests, including total testosterone, free testosterone, and estrogen levels. If a physician is trying to diagnose on total testosterone alone, then there can be misdiagnosis and missed diagnosis.”

Dr. Lipshultz and his team of four medical researchers reviewed the medical history of 352 men younger than 40 who attended an outpatient clinic in 2013-2014 and cited “low testosterone” as an issue. In addition to their medical history (including, of course, their testosterone levels), the doctors studied their responses to the Androgen Deficiency in Aging Male (ADAM) questionnaire, which is considered a valid method of determining hypogonadism.

Published in the medical journal BJU International last month, the study also found that sexual symptoms such as low libido do not indicate hypogonadism in younger men as they do in elderly men. Rather, men under 40 with hypogonadism typically experience low energy, depression, decreased strength and agility, and a decline in work performance. Low energy is considered the most common indicative symptom.

“Young men are less likely to have organic factors contributing to ED, and our present data suggests that sexual symptoms often seen in elderly hypogonadal men are less important in diagnosing clinical hypogonadism in younger men,” the study concluded.