The standard threshold for low testosterone doesn’t apply to young men

Newswise — October 28, 2022 — The standard cutoff point for low testosterone levels may not be accurate for men in their mid-40s and younger, a study reports. Journal of Urology®, official journal of American Urological Association (AUA). This journal is featured in the Lippincott Portfolio. Walters Kluwer.
“Younger men have a different testosterone reference range than older men,” comments lead author Alex Zhu of the University of Michigan, Ann Arbor. “Our findings suggest that age-specific cutoffs should be used when assessing testosterone levels in young men.
Different thresholds for low testosterone in young men
Patients with testosterone deficiency have low levels of the male hormone testosterone, with associated symptoms such as low libido and erectile dysfunction. Testosterone deficiency is usually considered a disease that affects older men. However, urologists are aware that an increasing number of young men have concerns related to testosterone deficiency.
Diagnosing low testosterone in young men poses other challenges as well. The standard cutoff point for low testosterone is 300 nanograms per deciliter (300 ng/dL). However, that threshold is based on testosterone studies in older men and overlooks the normal age-related decline in testosterone levels.
To develop a set of age-specific cutoff points, Dr. Zhu and colleagues at the University of Michigan Department of Urology collected data from approximately 1,500 men aged 20 to 44 years from the National Health Survey. and Nutrition Examination Survey). , or NHANES). The study excluded men on hormone therapy, men with a history of testicular cancer or an orchiectomy (orchectomy). Due to normal daily fluctuations in testosterone levels, only morning testosterone measurements were used in the analysis.
A range of testosterone levels was assessed in the 5-year-old group. The middle third (one-third) of the testosterone level distribution for each 5-year-old group was defined as the normal range. Values below this range were used to calculate age-specific thresholds for low testosterone levels.
As expected, testosterone levels declined with age. Age-specific cutoff points for low testosterone ranged from 409 ng/dL at ages 20-24 to 350 ng/dL at ages 40-44, significantly higher than standard cutoff points. Testosterone levels decreased by 4.3 ng/dL for each year of age.
Breaking away from the “one size fits all” approach
According to the authors, the study provides “the first assessment of standard population-based testosterone levels in young U.S. men.” and did not exclude men with testicular cancer or other health conditions other than previous orchidectomy.
“In today’s era of personalized medicine, clinicians can now assess young men using age-specific testosterone levels, rather than relying on a ‘one size fits all’ approach,” Dr. Zhu and co-authors said. is writing They highlight the need for further research, including how age-specific cutoffs are interpreted in relation to testosterone deficiency symptoms. It also mentions that testosterone therapy may not cover testosterone therapy unless testosterone levels are below the standard 300 ng/dL cutoff.
read [What Is a Normal Testosterone Level for Young Men? Rethinking the 300 ng/dL Cutoff for Testosterone Deficiency in Men 20-44 Years Old]
DOI: 10.1097/JU.0000000000002928
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