Testosterone Testing

Posted by Dr. Michael White, Updated on August 25th, 2023
Reading Time: 5 minutes

Testosterone Testing

Before you can start a testosterone replacement treatment program, you need to know what your current levels of testosterone are.

This information is discovered with a simple blood test that is conducted at your first appointment with one of our specializing physicians.

The unit of measure for testosterone is nanogram per deciliter (ng/dL) or nanomoles per liter (nmol/L) when measuring total testosterone and picogram per deciliter (pg/dL) or picomoles per liter (pmol/L).

For those of you who are counting a gram = 1,000,000,000 nanograms and a nanogram =1000 picograms. A little goes a long way.

Once they get your results back from the lab, they can determine whether your levels are low enough to require testosterone replacement therapy and what dosage will be necessary for you to maintain a healthy level of testosterone.

In men, any level lower than 500 ng/Dl will usually lead to at least some of the negative symptoms related to testosterone deficiency, and levels in the 250300ng/Dl range are often associated with severe symptoms and a general feeling of being discontent with oneself.

Why are Testing Testosterone Levels Important?

Doctor testing testosterone levelsWhile there are many symptoms associated with testosterone deficiency and usually diagnosing it is relatively straightforward there are other disorders and diseases that can cause some of the same symptoms.

By having the testing done by a physician you can be sure that the underlying cause of your symptoms is related to your testosterone levels and not something else that might be more serious or even life-threatening.

Under no circumstances should you attempt to start your own testosterone therapy without first getting tested by a physician and getting a legal prescription.

Another critical reason to have an initial testosterone level test, as well as follow-up tests every 3-6 months is to make sure your dosage is set correctly.

Overdosing is the leading cause of the side effects of testosterone therapy and the only way to be sure this doesn't become an issue is to monitor your levels.

On the other hand, under-dosing means you won't be getting all the benefits of testosterone replacement therapy that you should be.

As you age your natural levels will continue to fall and this decline happens at a different rate for different people so it's important to keep track of this so you and your doctor can increase your dosage when necessary.

How Testosterone Produced in the Body

In men, testosterone is produced primarily in the testes and secondarily in the adrenal glands. In women, it is created in the ovaries and adrenal glands. Natural testosterone production is regulated by the pituitary gland.

The pituitary gland increases testosterone production by releasing luteinizing hormone (LH) which is used to send a signal to the testes instructing them to increase testosterone production.

Causes of Low Testosterone

There are two categories of underlying factors behind lowered testosterone. When the reason is in the testosterone-producing organs is referred to as "primary hypogonadism."

When the cause is in the pituitary gland, it is called "secondary hypogonadism." When the problem is related to the hypothalamus, it is referred to as "tertiary hypogonadism."

Testing for testosterone levelsPrimary Hypogonadism:

  • Undescended testicles - If the testes fail to migrate from inside the abdomen into the scrotum during fetal development or in the first year or two of life, the testes may become damaged and unable to produce adequate amounts of testosterone.
  • Injury to the scrotum - If the testes are injured, they may not be able to produce adequate testosterone. Damage to one testicle does not often to lead to low levels if the other testis remains normal.
  • Cancer therapy - Chemotherapy and radiation therapy can damage the interstitial cells in the testes responsible for testosterone production. This decrease in testosterone production may be temporary as the cells recover, or it may be permanent.
  • Aging - Testosterone levels decrease with aging. Usually, enough testosterone is manufactured to allow for adequate bodily functions.
  • Mumps orchitis - The mumps virus can cause inflammation of the testes in males, and if the illness occurs in puberty or adulthood, the damage to the testes may lead to low testosterone production. Immunization against the mumps has significantly decreased the incidence of this illness.
  • Chromosomal abnormalities - A typical male has one X and one Y chromosome (an average female has two X chromosomes). In Klinefelter's syndrome, in men, an extra X chromosome is present, and among other anatomic issues, there is abnormal development of the testes and decreased ability to manufacture testosterone.
  • Ovary conditions in women - Premature ovarian failure and surgical removal of both ovaries (bilateral oophorectomy) are conditions associated with lower circulating testosterone levels.

Improve your testosterone testing with boxingSecondary and Tertiary Hypogonadism:

  • Pituitary Gland Damage - Damage to the pituitary gland may occur because of tumors of the gland itself or because of damage caused by the side effects of treatment of nearby brain tumors.
  • Malformed Hypothalamus -  Hypothalamus malformations can prevent normal function. Kallman's syndrome is one example.
  • Circulation Problems - Compromised blood flow to these glands from other conditions such as excessive systemic blood loss.
  • Disease Induced Inflammation - Inflammation caused by tuberculosis and sarcoidosis may affect the pituitary gland.
  • HIV/AIDS Induced Inflammation - HIV and AIDS may also cause inflammation of both the hypothalamus and pituitary.
  • Non-Prescribed Medications - Illegal use of anabolic steroids, for example in bodybuilding, can cause hypogonadism and low testosterone levels.

Treating Low Testosterone Levels

Managing low testosterone levels is very straightforward. Once you've seen a doctor and confirmed that you are suffering from low levels of testosterone your doctor will prescribe you one of many types of testosterone (which includes injections, gels, creams, and patches) based on your needs and medical history.

Simply follow the prescribed course of treatment, and you will be able to correct your levels and enjoy the benefits of testosterone replacement therapy.

How to Get a Prescription for Testosterone

If you're ready to take control of your health and do something about your testosterone levels, please give us a call at 1-800-469-3343 or fill out the contact form on the right side of the page.

We will connect you with one of our specializing physicians in your area who can help you get started.


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