Normal threshold for low testosterone does not apply to youthful males, examine finds

The usual cutoff level for low testosterone ranges might not be correct for males of their mid-forties and youthful, experiences a examine within the Journal of Urology.

“Younger males have completely different testosterone reference ranges than older males,” feedback lead creator Alex Zhu, DO, of College of Michigan, Ann Arbor. “Our findings recommend we needs to be utilizing age-specific cutoffs when assessing testosterone ranges in youthful males.”

Totally different thresholds for low testosterone in youthful males

Sufferers with testosterone deficiency have low ranges of the male intercourse hormone testosterone, with associated signs resembling decreased intercourse drive and erectile dysfunction. Testosterone deficiency is usually thought to be a illness affecting aged males. Nevertheless, urologists are seeing a rising variety of youthful males with considerations associated to testosterone deficiency—usually with less-specific signs resembling low power and fatigue.

Diagnosing low testosterone in younger males poses different challenges as properly. The usual cutoff level for low testosterone is 300 nanograms per deciliter (300 ng/dL). Nevertheless, that threshold relies on testosterone research of older males, and overlooks the traditional age-related decline in testosterone ranges.

To develop a set of age-specific cutoff factors, Dr. Zhu and colleagues from the College of Michigan Division of Urology analyzed knowledge on almost 1,500 males, aged 20 to 44 years, from a nationwide well being examine (the Nationwide Well being and Vitamin Examination Survey, or NHANES). The examine excluded males on hormone remedy or these with a historical past of testicular most cancers or testicular elimination (orchiectomy). Due to regular each day fluctuations in testosterone ranges, the evaluation used solely morning testosterone measurements.

The vary of testosterone ranges was evaluated in five-year age teams. The center tertile (one-third) of the testosterone stage distribution in every five-year age group was outlined as the traditional vary. Values under this vary had been used to calculate age-specific thresholds for low testosterone ranges.

As anticipated, the testosterone ranges decreased at older ages. Age particular cutoff factors for low testosterone ranged from 409 ng/dL at age 20 to 24 years to 350 ng/dL at age 40 to 44 years—considerably increased than the usual cutoff level. Every one-year improve in age was related to a 4.3 ng/dL lower in testosterone stage.

Transferring away from the ‘one measurement matches all method’

The examine offers “the primary analysis of normative, population-based testosterone ranges for younger males in the US,” based on the authors. They notice that their examine displays the racial/ethnic variety of the US inhabitants, and does not exclude males with well being circumstances aside from testicular most cancers or prior orchiectomy.

“In in the present day’s age of personalised drugs, clinicians can now use age-specific testosterone ranges to guage younger males as an alternative of counting on a ‘one measurement matches all’ method,” Dr. Zhu and coauthors write. They spotlight the necessity for additional research, together with find out how to interpret age-specific cutoffs within the context of testosterone deficiency signs. The researchers additionally notice that the age-specific cutoffs might have an effect on insurance coverage insurance policies—which typically don’t cowl testosterone therapies except the testosterone stage is under the usual 300 ng/dL cutoff.