The Standard Cut-Off Point for Low Testosterone May Be Inaccurate for Many Men

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According to the scientists’ findings, testosterone levels in more youthful males ought to be assessed utilizing age-specific cutoffs.

A research study released in The Journal of Urology, an Official Journal of the American Urological Association (AUA), recommends that for males in their mid-forties and more youthful, the common limit for low testosterone levels might not be appropriate.

“Young men have different testosterone reference ranges than older men,” remarks lead author Alex Zhu, DO, of the University of Michigan, AnnArbor “Our findings suggest we should be using age-specific cutoffs when assessing testosterone levels in younger men.”

Different limits for low testosterone in more youthful males

Patients struggling with testosterone shortage have low levels of the male sex hormonal agent testosterone, which triggers signs such as reduced libido and impotence. Testosterone shortage is frequently believed to be an illness that impacts older males. However, more youthful males with fret about testosterone shortage are ending up being more typical, and they frequently present with less-specific signs like tiredness and low energy.

Detecting low testosterone in young males likewise provides extra troubles. 300 nanograms per deciliter (ng/dL) is the accepted limit worth for low testosterone. That requirement, nevertheless, neglects the regular age-related drop in testosterone levels and is based upon testosterone research studies of older males.

Dr Zhu and associates from the University of Michigan Department of Urology evaluated information on approximately 1,500 males, aged 20 to 44, from a nationwide health research study (the National Health and Nutrition Examination Survey, or NHANES) to develop a set of age-specific cutoff points. Men on hormonal agent treatment or with a history of testicular cancer or testicular elimination (orchiectomy) were omitted from the research study. Because of the regular day-to-day changes in testosterone levels, the research study entirely utilized early morning testosterone measurements.

The series of testosterone levels was assessed in five-year age. The middle tertile (one-third) of the testosterone level circulation in each five-year age was specified as the regular variety. Values listed below this variety were utilized to compute age-specific limits for low testosterone levels.

As anticipated, testosterone levels reduced at older ages. Age- particular cutoff points for low testosterone varied from 409 ng/dL at age 20 to 24 years to 350 ng/dL at age 40 to 44 years– significantly greater than the basic cutoff point. Each 1 year boost in age was connected with a 4.3 ng/dL decline in testosterone level.

The research study supplies “the first evaluation of normative, population-based testosterone levels for young men in the United States,” according to the authors. They note that their research study shows the racial/ethnic variety of the United States population, and does not leave out males with health conditions aside from testicular cancer or previous 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 compose. They highlight the requirement for more research studies, consisting of how to analyze age-specific cutoffs in the context of testosterone shortage signs. The scientists likewise keep in mind that the age-specific cutoffs might impact insurance plan– which often do not cover testosterone treatments unless the testosterone level is listed below the requirement 300 ng/dL cutoff.

Reference: “What Is a Normal Testosterone Level for Young Men? Rethinking the 300 ng/dL Cutoff for Testosterone Deficiency in Men 20-44 Years Old” by Alex Zhu, Juan Andino, Stephanie Daignault-Newton, Zoey Chopra, Aruna Sarma and James M. Dupree, 1 December 2022, The Journal of Urology
DOI: 10.1097/ JU.0000000000002928