The Testosterone Level Tipping Point: Understanding Your
Symptoms and Low T Thresholds
As men age, the conversation surrounding testosterone
usually moves from general health to specific symptoms that each individual
experiences. While a gradual, age-related decline of about 1-2%
annually is typical for most of us, the point at which this natural change
begins to have an impact a person’s quality of life is what truly matters. It
happens slowly over time but one morning you wake up and start to realize that
you aren’t the same man that you used to be. Getting up is harder. The motivation
to hit the gym is gone or maybe you find that you’re gaining weight and have a
decreased libido, just to name a few of the symptoms most men begin to experience.
At NovaGenix Health and
Wellness, we know that understanding your individual threshold is the first
step toward reclaiming your vitality and improving the way that you feel so
that the process of aging doesn’t have to mean decreased enjoyment in life.
The standard reference range for total testosterone in men
will vary from one laboratory reference range or study to the next. Generally, it
can be anywhere from 250 to 1,000 ng/dL which
is broad and offers little insight into what constitutes a "healthy"
level for you, or when that level starts causing noticeable symptoms. Age,
genetics, lifestyle factors all contribute to what a normal
testosterone level for a man is and since we’re all unique, it’s important
to factor in the signs and symptoms of low T just as much as what the blood
test results show…something many physicians won’t do. The real value lies in
understanding the T-Level Tipping Points…the concentrations below which
specific, debilitating symptoms become statistically more prevalent as this is
where the levels actually matter as it begins to affect us in our lives
and finding a doctor
who prescribes testosterone is vital in this journey.
The Thresholds of Low T Symptoms
Research has provided us with a crucial insight into Low
T and symptom onset by linking common symptoms of Low T
(hypogonadism) to specific testosterone level thresholds. These findings have highlighted
that many men will begin experiencing negative physical, sexual and
mental/emotional changes long before their total T-level dips below the
traditional "low" mark of 250 ng/dL.
Notice how some of the earliest and most common complaints of fatigue
and weight gain will begin to appear when levels are still well within
the supposedly "normal" range. For example, a man with a level of 380
ng/dL is technically within "normal" ranges but is already below the
threshold where unwanted weight gain is observed to be more prevalent. Because
the numbers are considered “normal” most doctors won’t even address this with
the patient. This demonstrates why a simple lab value alone is often
insufficient for proper diagnosis and treatment. Most general practitioners don’t
even test hormone levels, let alone treat them. At our clinic we often get
complaints about how their doctor won’t prescribe them testosterone and that
they were told “It’s just a normal part of life.” We couldn’t disagree more. We
believe that patients should be in control of their own medical decision making
and we’re here to offer expert guidance and support along the way.
Beyond Total T: The Role of Bioavailable Testosterone in
Men
To complicate matters even further for patients and
providers, testosterone circulates in your blood in two primary forms: bound
to proteins or in a "free," unbound state. With age, the
binding protein SHBG (Sex Hormone-Binding Globulin) often increases,
effectively "locking up" more testosterone. This means an older man
might have a normal total testosterone reading but still possess lower
levels of free or bioavailable testosterone, which is the only
form your body can actively use for muscle building, energy, and mood
regulation. This is why testing
for both total and free/bioavailable testosterone is often recommended. We
have seen patients with relatively high total T levels BUT with all the symptoms
of suboptimal hormones. When the results for the free levels come back we have
to look into WHY those levels are low and it turns out more often then not that
SHBG is the culprit. Lowering Sex
Hormone-Binding Globulin (SHBG) may be an option for optimizing hormone
health because a high level reduces the amount of active, free testosterone
available in the body however this may not always be an easy fix. Strategies to
lower SHBG primarily involve improving insulin sensitivity through
weight management and diet (reducing sugar/refined carbs, increasing healthy
fats), and using over the counter supplements like Boron, Magnesium,
and Vitamin D may help but often not enough to make a major impact on
increasing bio-available testosterone levels.
Taking the Next Step for Better Health
If you or someone you know may be experiencing any
combination of these symptoms—from a decrease
in libido and/or erectile dysfunction to signs like persistently
feeling drained, fatigue and mood swings—it's a good indication
that your testosterone level is impacting your quality of life, regardless of
where it falls on a generic reference chart. A test developed to determine
whether you fall into the category, called the ADAM test (Androgen Deficiency in Aging Males)
can help determine the probability of you having low T levels and can be taken
online.
At NovaGenix, we emphasize a comprehensive approach that
looks past a single number. Our physician, Dr. Timothy W. Mackey will evaluate
your symptoms alongside your total and free testosterone levels
(preferably tested in the morning for optimal accuracy), as well as other
relevant health factors and biomarkers to determine your eligibility for
hormone therapy. It’s a very simple and relatively non-invasive process.
Testosterone
Replacement Therapy (TRT), is becoming more accepted and popular and
can be available through injections, gels, patches, or pellets. It’s a highly
effective treatment option for many men to restore androgen levels within
normal levels and alleviate symptoms. Additionally, simple lifestyle
modifications such as a eating a healthy diet, stress reduction techniques
like yoga and getting adequate sleep each night, and targeted exercise like
weight training can naturally support hormone production and improve overall
health.
We tell our patients that you don't have to settle for
"normal" if you don't feel normal. Consulting with an experienced
healthcare provider who specializes in hormone replacement therapy is the first
and most important step into understanding your unique overall hormonal picture
and regaining your health and well-being as you age.
The Low T Options: Injections, Gels, Patches, and Pellets
Once you and your healthcare provider determine that Testosterone
Replacement Therapy (TRT) is appropriate for you, the next decision to be
made is choosing the right delivery method. The goal of TRT is to restore your
T-levels to an optimal range, mitigating the symptoms of Low T like fatigue,
low libido, and mood fluctuations.
Here is a breakdown of the most common TRT options, which
are available through NovaGenix Health and Wellness:
1. Intramuscular
Injections (Testosterone Cypionate/Enanthate)
- How
it works: The testosterone is injected directly into a muscle (usually
the glute or thigh).
- Frequency:
Typically administered every one to two weeks.
- Pros:
It is often the most cost-effective option and can provide higher
total testosterone levels. The dosing schedule is simple and predictable.
Cons: Requires an injection, which some people dislike. It can lead to a "roller-coaster" effect, with high T-levels right after the shot and lower levels before the next dose.
2. Topical Gels and Solutions
- How
it works: A clear gel is rubbed onto clean, dry skin (like the
shoulders, upper arms, or abdomen) and absorbed into the bloodstream.
- Frequency:
Applied daily, typically in the morning. (Here is a link for the
best way to administer testosterone creams/gels)
- Pros:
Provides steady, consistent testosterone levels, closely mimicking
the body’s natural release. It is needle-free and easy to use.
- Cons:
There is a risk of transference to partners or children if the
application site is not covered. It may cause skin irritation in some
users.
3. Patches (Transdermal Systems)
- How
it works: A testosterone-containing patch is applied to a clean area
of the skin.
- Frequency:
Applied daily.
- Pros:
Like gels, they offer a steady release of the hormone.
- Cons:
They are sometimes visible and can cause significant skin irritation
or a rash, which often leads to poor compliance.
4. Subcutaneous Pellets (Testosterone Implants)
- How
it works: Small pellets, about the size of a grain of rice, are
inserted under the skin (usually in the hip or buttocks area) during a
minor office procedure.
- Frequency:
The pellets dissolve slowly, requiring re-implantation every three to six
months.
- Pros:
This is a convenient option, eliminating the need for daily application or
weekly injections. It provides a long-term solution to increase testosterone
levels.
- Cons:
Requires a minor surgical procedure for insertion and removal (if
necessary), and the dose cannot be adjusted once inserted. Patients may
notice a decrease in effectiveness of the pellet over time and cannot have
their dose adjusted. Also some
patients get infections or the body pushes the pellets out though the skin.
At the end of the day the best TRT protocol for you depends on your lifestyle, your comfort level with injections, and the consistency of your blood work. At NovaGenix, Dr. Mackey will work with you to find the treatment that best optimizes your hormones while minimizing side effects. Call us today at 561-277-8260 to learn more and schedule a free initial consultation to discuss options with our expert medical team.
Here is a list of the studies and sources mentioned
- Study
on Young Men's Testosterone Levels: The article cited a 2022 study
titled, "What Is a Normal Testosterone Level for Young Men?
Rethinking the 300 ng/dL Cutoff for Testosterone Deficiency in Men 20-44
Years Old," published in the Journal of Urology. (This
study provided the data for men aged 20-44).
- General
Reference Ranges: The article stated it used data from:
- Medical
News Today in their article "Typical Testosterone Levels in
Males and Females."
- Baptist
Health in their article titled "Normal Testosterone Levels by
Age."
- Alternative
Reference Range: The University of Rochester Medical Center was
mentioned as publishing a normal range between for men.
- Symptoms
Thresholds: The article mentioned a cross-sectional cohort study
involving 434 men that observed symptoms were more prevalent when
testosterone levels fell below specific thresholds.
- Testosterone
and Aging: Data on testosterone levels in healthy men aged 40 to 79
years was reported by Harvard Medical School in their article
titled "Testosterone, Aging and the Mind."
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