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The normal testosterone levels in your body are made up of free testosterone and total testosterone.
Testosterone (T) is the most important male sex hormone; however, women’s bodies also make and need it. Most of the hormone in your blood is attached or bound to proteins in both men and women. Some in the bloodstream are not attached to protein and are traveling unbound through the bloodstream. This is what doctors refer to as “free.” The combination of the two is known as your total T. Only the “free” kind is active and available to your body.
Think of it this way: if all of the T in your body was traveling in a fleet of Amazon package delivery trucks, your “total T” would be all of the “boxes” in every truck, whether they were parked at the warehouse, stuck in traffic, on a lunch break or whatever, and free T would be only the trucks that are actively dropping “boxes” of at people’s doorsteps.
Doctors need to know your total just as it is important for Amazon to know where all of their packages are at any given time. Still, to you, the consumer, their delivery is the most important thing, just as to your body and overall health, your free testosterone level is more important than you total T level.
Testosterone is the most important male hormone. It is largely responsible for building muscle and bones in boys and the ongoing development of the sex organs. Once a male child reaches the age of puberty, testosterone levels spike dramatically. This increased production and release of this hormone brings on the secondary characteristics typical of “maleness,” such as facial hair, larger muscles, and a deeper voice.
While it is a male hormone, women’s bodies make and need it too. In both men and women, it is needed to build muscle and healthy bones. It can lower the risk of several health conditions, such as diabetes and heart disease. It also is vital for:
Most of the time, the T in your blood is “bound” to proteins. But, less frequently, it glides through the blood unbound or “free.” This male hormone is active and available for your body to use right away. It’s like having money in your pocket that you can spend whenever you want. This “free T helps with things like energy, muscle growth, mood, and sex drive.
“Total T” represents all of the hormones in your system in any state— both bound to proteins and the portion that is “free” or unbound.
Both free and bound testosterone levels decrease as you age and can lead to age-related testosterone deficiency. Returning to our Amazon truck analogy, Sometimes, even if you have a lot of trucks (total T), only a few might be working (free T). The rest could be tied up or parked, not helping the company as much.
So, even if your total number looks fine, you could feel tired or weak if your free level is low because not enough is available to complete the job!
If your doctor suspects you may have low T, you will most likely first be given a simple blood test for your total T. Suppose your total testosterone levels return as low. In that case, your doctor may follow up with a test for your free only, as this will give your healthcare provider a more accurate picture of your ability to produce adequate amounts of testosterone.
Tota total T is measured via a simple blood test. Based on the results of your total T-test, your doctor may follow up with a free T-test.
The following chart illustrates the normal total testosterone levels for men and women by “Tanner Stage” and age. The Tanner Scale breaks down the observable signs of puberty into five stages, running from Stage I from about age 10 to Stage V at 15 for boys and about age 8 to 15 for girls.
|
Tanner Stage |
Male |
Female |
|
Testosterone |
Testosterone |
|
| I | <3 | <3−6 |
| II | <3−432 | <3−10 |
| III | 65−778 | <3−24 |
| IV | 180−763 | <3-27 |
| V | 188−882 | 5−38 |
| Adult Male | Adult Female | |
| >18 y: 264-916 | 20 to 49 y: 8−48 | |
| >49 y: 3−41 |
Source: LabCorp
To compare so that you can better understand how variable the “so-called” normal levels of testosterone can be, the following chart gives the “normal” testosterone levels from Quest Diagnostics, another respected testing lab. Quest does not use the Tanner Scale but indicates the normal ranges for males and females by age.
| 1-5 Years | ≤5 | ≤8 |
| 6-7 Years | ≤25 | ≤20 |
| 8-10 Years | ≤42 | ≤35 |
| 11 Years | ≤260 | ≤40 |
| 12-13 Years | ≤420 | ≤40 |
| 14-17.9 Years | ≤1000 | ≤40 |
| ≥18 Years | 250-1100 | 2-45 |
Source: Quest Diagnostics
If you compare this chart to the first chart from LabCorp, you can see how the “normal” ranges differ. These two charts come from two of the most respected testing labs in the country, yet they differ.
That should help you to understand why it can be quite hard to pinpoint what is the “normal” total testosterone level for any given person of any given age. This is precisely why our doctors try to bring every patient to a “target level” that we have found optimal for most patients, regardless of age or gender.
Once we determine your unique optimal level, we can tailor treatments that will get you in that zone so you can perform at your best, regardless of your age.
It could be more important for your doctor to know your free testosterone level than your total T. Sometimes, men could be suffering from low T even if your total T level is in the normal range.
If your standard blood test for total T shows up as normal and yet you exhibit symptoms of low T, getting your free testosterone level can shed light on why you may be experiencing signs of testosterone deficiency. In many ways, free testosterone levels better predict testosterone deficiency symptoms than your total testosterone levels.
Testing free T is also important in patients who may be suffering from metabolic conditions such as diabetes or obesity, which can artificially lower total testosterone levels.
Your free or bioavailable testosterone influences the use and production of other critical hormones, which, in turn, can impact your total testosterone level.
Free Testosterone Levels and HGH – Men with low free T levels often also have low levels of human growth hormone (HGH). Several studies have concluded that when testosterone replacement therapy is prescribed for older men in combination with HGH therapy, greater overall improvements in strength and energy are achieved than when given either therapy alone.
One study concluded, “Supplemental (T) injections produced significant gains in total and appendicular lean mass, muscle strength, and aerobic endurance with significant reductions in whole-body and trunk fat. Outcomes appeared to be further enhanced with HGH supplementation.”
Free Testosterone Levels and Thyroid Hormones – Sub-normal levels of thyroid hormones (hypothyroidism) have been associated with low levels of free T in men. This type of hypogonadism is reversible with thyroid hormone replacement therapy.
Free Testosterone Levels and Insulin – Medical researchers have found that low free testosterone levels are common in men with type 2 diabetes and, therefore, may be associated with insulin resistance. Such studies have concluded that free testosterone deficiency is common in men with diabetes, regardless of the type. This has led to an avenue of research that testosterone replacement may be a possible way to treat or prevent adult-onset diabetes in men.
Low T, a condition also known as hypogonadism, can sometimes be related to testicular failure due to an injury or disease condition. However, low T in men is often caused by the steady drop of male hormones as you age. This “age-related” testosterone deficiency is also known as andropause. It is similar to menopause in women. However, unlike menopause, which occurs at a specific time in a woman’s life, the symptoms of andropause develop gradually over time. Most men between the ages of 40 and 65 are likely to feel some of the symptoms of low T.
Regardless of the cause, men with low hormone levels are treated with hormone therapy.
The signs and symptoms of low T include:
There can be several causes of low T, sometimes referred to as “male menopause” or andropause. Any disease, injury, or condition that negatively affects the testes could result in andropause. However, the most common cause of the condition, particularly in men over 40, is the normal decline in testosterone levels that occurs as men age.
Testosterone production starts in the womb. It continues through adolescence until it reaches its highest level at about eighteen. In most men, their testosterone levels will stay at or pretty close to that maximum level through their 20s. Then, once you are over 30, your testosterone level will start on a steady downward slope. By the time you are over 40, most men will be feeling the negative impacts of low T.
Testosterone replacement therapy, or TRT, delivers synthetic male hormones directly into your body, increasing free T in your blood. TRT is the safest and most effective treatment there is for patients diagnosed with hypogonadism.
Testosterone replacement therapy can take several different forms. Our doctors have found that injections tend to be the most effective form of testosterone therapy for most patients. Injections are intramuscular, which means that they are given into the muscles. The very vascular muscles of your arm, thigh, or the “glutes” are the most common injection sites. The needles used to deliver low T treatments are very thin, much like the ones diabetics use to deliver insulin. Once you learn how to give yourself your injections, you will find them easy to do and quite painless.
There are many benefits to testosterone therapy for men. One of the first benefits most men see after starting testosterone therapy is an increased sex drive and improved sexual performance.
Besides improving your sex life, some of the other benefits of testosterone therapy for men include:
Some of the other benefits of TRT include:
In adult males, TRT has also been shown to reduce the risk of many chronic conditions, such as metabolic syndrome, diabetes, osteoporosis, and cardiovascular disease.
For most patients, the benefits of TRT outweigh any potential adverse effects.
TRT will be tailored to your unique needs and lifestyle, so the time you need to be on replacement therapy will vary from patient to patient. Typically, however, TRT treatments last six months to a year for your first Low-T treatment. After that, you will be evaluated for the need to continue your TRT.
Take the first step to a younger, stronger you. Contact us today, fill out the short form, and one of our healthcare advisors will contact you to help you determine if TRT is right for you!
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