Testosterone Levels. How low is too low?

One of the questions I am often asked is:

“I suspect I may have low testosterone levels, but I feel pretty good. How low is too low? I would rather not take testosterone replacement therapy for the rest of my life unless I have to.”

And you know, it is one of the fairest questions out there. I mean, why take any medication unless required? Well, I’m going to sound like Mr. Blanket Statement again and say something like everyone is different. And sure, we need to take this n = 1 into consideration when answering a question like this, because the last thing we want to do is get a misdiagnosis and spend more time, money and risk for no good reason. With that said, there is some data to suggest what a testosterone level that is too low could be.

Before I give you the numbers, it is important to understand that testosterone plays vital roles other than mood, libido and muscle. In fact, testosterone plays a role in regulating almost any system of the body! So, with that importance in mind, if we were to diagnose by subjective symptoms only, it is possible we will be making a big mistake. I have always said that both symptoms and lab work are important when making a decision, not one or the other.

Onto what the data says now. The most recent data from Europe and the United States suggests that “normal” total testosterone levels range from 12-38 nmol/L and that a score below 12 nmol/L is likely too low for general health. With these numbers, we could argue that if your total testosterone is 12 nmol/L or less, regardless of whether or not you are symptomatic, you may want to consider TRT or an intervention to increase your testosterone levels. Notice how I did not use the guidelines from Australia for this blog post.