The Normal Values for Testosterone and Why They Matter

If you get a lab test for testosterone, the hormone that gives men their distinctively male characteristics, your result will be accompanied by a “normal range” (or “normal values”, or “reference range”, all the same thing), which allow you and your doctor to see where your test result fits in relation to other healthy men. Normal laboratory values are very important for medical decision making, so anyone changing them should have good reasons for doing so. The biggest clinical laboratory in the U.S., LabCorp, recently changed its normal values for testosterone, which has implications for anyone getting tested. Hence this article on the normal values of testosterone and why they matter.

Labs are lowering the reference range for testosterone

LabCorp changed its reference range for testosterone from 348-1197 ng/dL to 264-916 ng/dL. Note that the entire range has been shifted lower. The company explains their reasoning and says the downward shift reflects two changes: 1) a new CDC standardization for the method used to assay testosterone (since different labs may use different methods, giving somewhat varying results), and 2) the new range “reflects a difference in average subjects with higher BMIs”.  Reason number 2 is the most important for our purposes.

The new range comes directly from a recently published paper, “Harmonized Reference Ranges for Circulating Testosterone Levels in Men of Four Cohort Studies in the United States and Europe“.

Normal values are constructed such that 95% of apparently healthy people have values within that range, and the present paper is no different.

But it depends on what you mean by healthy. The paper uses values for men age 19 to 40 with a body mass index (BMI) of < 30, i.e. “healthy non-obese” men. Since it’s been found that obesity in men is associated with lower testosterone levels, they looked at only non-obese men.

However, it’s obvious that “non-obese” doesn’t mean “healthy”. Anyone with a BMI of ≥ 25 is considered overweight, and many men with a BMI less than that have high body fat, a more accurate measure of health risks. (A few, very muscular men may be normal at a BMI of 25 or more, but they’re a small fraction of the population.)

Basically, around 80% of the population has excessive body fat, which is a prime contributor to excessive aromatase activity, which lowers testosterone.

Normal lab values are constructed from the results of fat, sick people.

Do you want to compare yourself to them? I know I don’t.

Secular decline in testosterone and the obesity epidemic

Testosterone levels in men are declining. That means that men of a given age have lower testosterone levels than men of the same age a few decades ago. See chart below.

testosterone secular decline

We can only speculate on the causes of the decline. Obesity has been suspected, but much of the decline remains even when it’s been accounted for. Other causes might be environmental chemicals, less smoking (nicotine inhibits aromatase), processed garbage food (think soy and sugar), and others.

Whatever the cause, it’s clearly happening, and so much so that laboratories are lowering their normal ranges to account for it. Then, when you get tested, they compare you to a group that includes many overweight, unhealthy men who don’t exercise and eat bad food.

Men are getting fatter, which may or may not account for declining testosterone. But just because they’re getting fatter, that doesn’t mean it’s normal or that you should get fatter.

Since LabCorp is the largest clinical laboratory in the country, their decision reverberates to other labs, as well as to doctors and even insurance companies.

If you go to a doctor for evaluation of your testosterone levels, you may not get any treatment unless your test has a value less than 264 ng/dL, because that’s “normal”.

Insurance companies may refuse to pay, even when a doctor is willing, because you don’t technically have low testosterone.

Most unsuspecting men (for instance, those who don’t read this) will just accept their results at face value. If their testosterone comes in at, say, 300, they’ll consider the case closed and that whatever the symptoms they have must come from elsewhere.

Solution: get educated, and don’t compare yourself to fat, sick people.

Ultimately, for any test or for any treatment your doctor proposes, you simply must educate yourself enough to be able to evaluate them yourself.

To be uneducated in health matter is to leave yourself at the mercy of an increasingly impersonal, profit-oriented medical system that doesn’t care about you. The days of your kindly family doctor are over.

Don’t be fooled that being healthy just means being less sick than normal.

Because normal people are fat and sick, they don’t exercise, and are at high risk of diabetes, heart disease, cancer, and a host of other diseases.

Normality today means obesity, depression, SSRIs, statins, sugar, and soy. Not to mention no sense of purpose and 7 hours a day watching television.

The same study cited above found that 5% of men in from age 80 to 89 had testosterone levels above 897 ng/dL. These men are likely healthy and fit, and I call attention to this fact to show that decline isn’t necessary if you actively fight it.

Compare your health, your test results, and your progress only to truly healthy people and to your former condition.

PS: I devote a major section of new book, Best Supplements for Men, to testosterone and how to increase it.

PPS: Check out my Supplements Buying Guide for Men.

Leave a Comment:

19 comments
JP says June 20, 2017

“Insurance companies may refuse to pay, even when a doctor is willing, because you don’t technically have low testosterone”

The good news is that TRT is not very expensive even if you have to pay out of pocket. In fact the quarterly blood tests cost more than the medication and syringes.

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MarkMcCoskey says June 20, 2017

Just had a basic Male Hormone test done, along with a thyroid and iron panel. Iron is now perfect. Hormones are non-existent. Serum testosterone is 35. I’m only 57. Saw a Dr yesterday, and am being referred to another hopefully this week. Since I pay out-of-pocket, am hoping to get testosterone up in the 800 range, unless there are more optimized numbers.

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berny3 says June 20, 2017

Are there any other aromatase inhibitors available besides nicotine?

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bill says June 20, 2017

PD, You state ” The same study cited above found that 5% of men in from age 80 to 89 had testosterone levels above 897 ng/dL. These men are likely healthy and fit, and I call attention to this fact to show that decline isn’t necessary if you actively fight it.”.

Is there any way to validate this likelihood ? Can the data that this study is based on be accessed ?

Also I suspect that in other countries where there is better health care system, like the UK or here in Oz, testosterone is more readily available via a doctor’s prescription.

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    P. D. Mangan says June 20, 2017

    Hi Bill, the full study is available at the link, but it’s merely my interpretation that those older men with high T were fit. I base that on a paper that states

    However, the finding, in some studies, that T levels did not fall significantly with age in exceptionally healthy men raised the question of the relative roles of chronic age-related illness vs. aging per se in producing the observed decreases. Studies of this issue have suggested that age, illness, and smoking all exert independent effects on T and free T levels during aging

    So, this study raises the question, just as I did recently, how much of aging is really aging and how much is poor health? The finding that healthy older men don’t have drops in T tells me that a drop isn’t inevitable.

    Reply
      Bill says June 20, 2017

      Thanks for that reply PD Yes I will take a look at the sources.

      Reply
Nick says June 21, 2017

Got my results yesterday. Age 52, 5’10” / 165#, not particularly hairy, hard-gainer, couple decades of following the low-fat nonsense to some extent….467. Not critically low, and I suspect it’s higher than it was a year ago when I started working to correct what’s wrong with how I fed myself and exercised. It’s a start.

Next challenge has to be learning to be content with 1 or 2 beers a day.

Ferritin: 120. Not as low as I’d hoped it might be, but also only a few blood donations away from 50, I hope.

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louis sir says June 21, 2017

more like evidence of the chemical castration of america

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Montgomery says June 21, 2017

You might want to check this site out:
http://www.peaktestosterone.com/

I had no time yet for an in-depth reading, but at first glance it seems to be a rather good source of information.

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Matt says June 21, 2017

Got a Labcorp full panel done six months ago, 715 ng/dl. At 33 I’m pretty happy with that, I’ll definitely keep up this low carb/high intensity weight training routine as I coast into middle age and beyond.

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Drifter says June 21, 2017

You wrote:

“If you go to a doctor for evaluation of your testosterone levels, you may not get any treatment unless your test has a value less than 264 ng/dL, because that’s “normal”.”

I think the key point here is that people who are actively involved in maximizing their health, presumably everyone reading this site, should not go near any doctor for a hormone related topic unless they know in advance that the doctor specializes in the area and most importantly, treats based on symptoms, not numbers.

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    P. D. Mangan says June 21, 2017

    I agree, but I’d give it a bit more nuance. Long ago a doctor told me that if you get near an endocrinologist, you’ll get even more messed up. Yet most doctors will want you to see an endocrinologist for hormonal issues; they beg off doing anything themselves. So probably the answer is seeing a doctor who is at least willing, and hopefully well-versed, in treating testosterone-related issues.

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James D says June 21, 2017

I’m still awaiting my results – nervously, I’ll admit – but with this post I finally feel like I at least know what the hell I should be looking for and what most of the jargon means. I think another point to make is knowing *when* you need to have tests run. I uhhm’d and aaahhh’d over this for months before finally doing a bit of digging and finding my symptoms matched the diagnosis pretty well (Dr Google, I know, but this list helped a lot http://www.genesysinstitute.com/low-testosterone/ ). Here’s hoping my results aren’t *too* low. Thanks again for the read!

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Chris says June 21, 2017

Wkout Arthur Jones style , eat raw meat, Coconut oil, drink raw milk. These will raise T.

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chez grey says June 21, 2017

Jay Campbell has many excellent podcasts on testosterone and TRT. The podcasts he did a few years ago with Cernovich led me to get tested and as a 30 year old found 480ng/dl. Under the old labcorp values thats ~17%th percentile and what I’d expect if I was in my late 50’s or 60’s. That’s less than optimal for me. Urologist said, of course, that I was too young for TRT and my values were “fine”. The anti aging clinics near me in the north east cost around $3k a year but if you are enterprising and can figure out bitcoin you can devise your own course of treatment via online sources and it might only cost say $600/year. Do your own research, learn how to use a needle, and get your bloodwork done regularly. As Mangan always tells us, you are in charge of your own health, not your doctor, and if your hormones are out of whack you need to get that fixed!

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    Chris says June 21, 2017

    Why pay some doctor I’ll rages fees to fix a problem you could really fix on your own through a little determination and hard work work out as if your life depended On it get a lot more sleep try to Lower your stress as much is possible stay away from pseudo-estrogens , Eat as many raw eggs, Brazil nuts, coconut Oil, raw meat. And raw milk as you can stand. Stay away from all pharmaceutical drugs

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Oscar says June 22, 2017

I usually take soy in my coffee, think I’ll go back to normal milk. Do you have a list of other foods that reduce testosterone?

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    P. D. Mangan says June 22, 2017

    Sugar.

    Reply
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