Using Lab Results to Decide on the Right Male Hormone Replacement Therapy

July 25, 2021
Traditional lab results for testosterone can be of immense value because they give us a good idea of where you stand clinically at this moment in time. It helps us have a baseline from which we can decide what kind of male hormone replacement therapy will be right for you.

What Are “Normal” Testosterone Levels?

Conventionally speaking, "normal" total testosterone levels fall between 240–950 ng/dL for men. However, total testosterone levels don’t tell the whole story. In our clinical practice, we have seen men who have completely normal total testosterone levels who nevertheless are suffering the symptoms of low testosterone. That’s why we need to consider bioavailable testosterone levels and free testosterone levels when deciding on male hormone replacement. These are slightly different measurements. We know that albumin binds to testosterone in the blood. While it was once thought that this completely bound up the testosterone and kept it from being bioavailable—available for your body to use—we now know that a portion of this testosterone is actually bioavailable. Further, your free testosterone is the testosterone available in your bloodstream for your body to use at any given time. This measurement is perhaps more important than your total testosterone levels because it tells us what your body is actually using. Just because you have high total testosterone does not mean your body is actually able to use it. Free testosterone levels can explain why a man with high total testosterone levels is still experiencing low testosterone symptoms.  Meaning we want to look at both free testosterone levels and bioavailable testosterone levels. Conventionally speaking, "normal" free testosterone levels are between 9–30 ng/dL. That being said, even if both total testosterone, free, and bioavailable testosterone levels fall within the “normal” range, we must still consider what the word “normal” even means. In our clinical practice, we have seen plenty of men who fall into the “normal” range yet still experience the symptoms of low testosterone. It’s important to consider what normal levels are for you. Your body is unique. It’s different from everyone else’s. Just because one person is not experiencing the symptoms of low testosterone at a particular level does not mean you will be okay at that same level. What’s normal for you might be much higher than these ranges. 240 ng/dL of total testosterone is considered in the normal range, but very few men will feel “normal” if their testosterone is at that level. You should talk to a provider who understands the nuances of these different measurements and can put them into the context of your unique body and the symptoms you are or are not experiencing.

Is Male Hormone Replacement Right for Me?

Before deciding on male hormone replacement, you should consider exactly what you want to get out of treatment so your replacement therapy team can decide on the right approach. What are your goals? Are you eager to get started to achieve maximum effects? Do you want to ease into male hormone replacement and progress more gradually? Some men seek less-than-maximal effects and utilize low doses over a long period of time. Once you think about exactly what you want to achieve, you’ll be able to have a clearer line of communication with your medical provider and determine a concrete plan. Many participants want the effects of male hormone replacement to appear quickly. But many factors are affecting just how fast and how much change will take place. Your overall health, the age you start therapy, and your genetics will all contribute to the speed and degree of change that can happen. Perhaps the safest and now most preferred type of male hormone replacement is the use of bioidentical hormones. These are extracted from naturally occurring plant sources and structurally indistinguishable from hormones created within the human body. This type of treatment is usually more effective and has fewer side effects than other types of male hormone replacement. These hormones are compounded in a lab and specifically tailored by pharmaceutical specialists who perform under FDA guidelines. These ensure that each dose is created with exact precision. Before beginning a course of male hormone replacement, your hormone therapy practitioner should meet with you and discuss your lifestyle, medical history, and symptoms. The fact is, if you are suffering symptoms, you don’t have to suffer in silence just because your levels fall within so-called “normal” ranges. Male Hormone replacement can provide the help you need. Learn more about Low T, its causes, and how male hormone replacement therapy can help you.