The standard low testosterone threshold does not apply to young men

The standard low testosterone threshold does not apply to young men

Newswise – October 28, 2022 – The standard threshold for low testosterone levels may not be accurate for men in their 40s and younger, a study reports. The Journal of Urology®, an official journal of the American Urological Association (AUA). The journal is published in the Lippincott portfolio by Wolters Kluwer.

“Young men have different testosterone baseline ranges than older men,” comments lead author Alex Zhu, DO, of the University of Michigan, Ann Arbor. “Our results suggest that we should use age-specific thresholds when assessing testosterone levels in younger men.”

Different low testosterone thresholds in younger men

Patients with testosterone deficiency have low levels of testosterone, a male sex hormone, with associated symptoms such as decreased libido and erectile dysfunction. Testosterone deficiency is generally considered a disease affecting older men. However, urologists are seeing increasing numbers of younger men with concerns about testosterone deficiency – often with less specific symptoms such as lack of energy and fatigue.

Diagnosing low testosterone in young men also poses other challenges. The standard threshold for low testosterone is 300 nanograms per deciliter (300 ng/dL). However, this threshold is based on studies of testosterone in older men and does not take into account the normal decline in testosterone levels with age.

To develop a set of age-specific thresholds, Dr. Zhu and colleagues at the University of Michigan’s Department of Urology analyzed data from nearly 1,500 men, ages 20 to 44, from a national health survey (the National Health and Nutrition Examination Survey, or NHANES). The study excluded men on hormone therapy or those with a history of testicular cancer or removal of the testicles (orchiectomy). Due to normal daily fluctuations in testosterone levels, the analysis only used morning testosterone measurements.

The range of testosterone levels was assessed in five-year age groups. The middle tertile (one-third) of the testosterone level distribution in each five-year age group was defined as the normal range. Values ​​below this range were used to calculate age-specific thresholds for low testosterone levels.

As expected, testosterone levels declined at older ages. Age-specific thresholds for low testosterone ranged from 409 ng/dL at ages 20-24 to 350 ng/dL at ages 40-44, which is significantly higher than the standard threshold. Each one-year increase in age was associated with a 4.3 ng/dL decrease in testosterone levels.

Moving away from the “one size fits all” approach

The study provides “the first assessment of population-based normative testosterone levels for young men in the United States,” according to the authors. They note that their study reflects the racial/ethnic diversity of the US population and does not exclude men with health conditions other than testicular cancer or a previous orchiectomy.

“In the current era of personalized medicine, clinicians can now use age-specific testosterone levels to assess young men instead of relying on a ‘one-size-fits-all’ approach,” write Dr. Zhu and colleagues. co-authors. They point to the need for further studies, especially on how to interpret age-specific thresholds in the context of testosterone deficiency symptoms. The researchers also note that age-specific thresholds can affect insurance policies — which sometimes don’t cover testosterone therapies unless the testosterone level is below the standard threshold of 300 ng/dL.

Lily [What Is a Normal Testosterone Level for Young Men? Rethinking the 300 ng/dL Cutoff for Testosterone Deficiency in Men 20-44 Years Old]

DOI: 10.1097/JU.0000000000002928


About The Journal of Urology®

The Official Journal of the American Urological Association (AUA), and the most widely read and cited journal in the field, The Journal of Urology® provides robust coverage of the clinically relevant content needed to stay at the forefront of the dynamic field of urology. This leading journal features investigative studies on critical areas of research and practice, investigative articles providing brief editorial commentary on the best and most important literature in urology worldwide, and reports focused on practice on important clinical observations. The Journal of Urology® covers the broad spectrum of urology including pediatric urology, urological cancers, kidney transplantation, male infertility, urinary stones, female urology and neurourology.

About the American Urological Association

Founded in 1902 and headquartered near Baltimore, Maryland, the American Urological Association is one of the leading advocates for the specialty of urology and has more than 23,000 members worldwide. The AAU is a leading urological association, providing invaluable support to the urological community in pursuit of its mission to foster the highest standards of urological care through education, research and formulation of health care policy. health. To learn more about the AAU, visit:

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