Think Low Testosterone Is Only in Older Men? Think Again


We often think of testosterone deficiency as a condition affecting older men. While it is normal to see hormones gradually decrease with age, we are increasingly seeing low testosterone levels in younger men as well.

A 2018 study published in the journal Scientific Reports found that 23% of young men, 36% of middle-aged men, and 35% of older men had testosterone deficiency (less than 300ng/dl). Surprisingly, this finding shows that many young and middle-aged men have testosterone deficiency approaching levels we see in older men.

Common effects of low testosterone

  • Low sex drive
  • Erection difficulties
  • Fatigue

Other conditions associated with low testosterone

  • Muscle atrophy (sarcopenia)
  • Osteopenia
  • Obesity
  • Type 2 diabetes
  • Arthritis
  • Pulmonary disease
  • High cholesterol
  • High blood pressure
  • Cardiovascular disease
  • Depression

The study found that multimorbidity, or the finding of several chronic diseases in the same person, was significantly more prevalent in men with testosterone deficiency compared to men with normal testosterone levels in all age groups but especially younger and older men. This is of concern, as recent trends show the development of chronic diseases rising in general and starting at earlier ages.

One of the study’s authors noted “Men should be concerned about declining total testosterone, even if it has not reached a level to warrant a clinical diagnosis (<300 ng/dL).”

 "A lot of men may not be aware of the risk factors for testosterone deficiency because of their current lifestyle. And more importantly, that declining levels could be contributing to a silent decline in overall health … ”

The study concluded that results suggest that a much higher prevalence of deficiency occurs in men across the adult age-span than what has been previously reported and that especially younger and older men with testosterone deficiency have a higher risk of multiple chronic disease conditions as compared to their counterparts with normal testosterone levels.

At SFNM, I see many men seeking a wholistic approach to their health care with the goal of preventing chronic disease and aging healthfully. I am seeing more younger men complaining of libido issues and lack of vitality as well. In screening lab work in men of all ages, I almost always include a male hormone profile to check levels of testosterone and other important hormones, and am seeing a number of test results in younger men indicating low testosterone. 

Health benefits of testosterone replacement therapy

I consider any testosterone result under 300 as a sign of deficiency; between 300-500 as a borderline low finding which I evaluate with screening history and physical exam; and 500 and above in the healthy range. When doing testosterone replacement, I often aim to get values above 500 and even closer to 700. In my clinical experience I find men feel best in this range.

The health benefits I see don’t just include increased sex drive and improved performance. It is very common to see improvement in mood, vitality, blood pressure, cholesterol as well as other cardiovascular risk factors, stamina and response to exercise. All this occurs with blood levels in the normal range, not supra physiological doses common in gym culture and body building. Appropriate testosterone replacement can improve health without causing side effects associated with excessive testosterone supplementation.

If you would like to check your testosterone levels or haven’t had a screening exam in some time, you are welcome to contact me at 415-643-6600 and I will work with you to screen for low testosterone as well as help you improve your health and reduce your risk of chronic disease.

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Dr. Carl Hangee-Bauer is SFNM’s founder and Clinic Director. He has a general naturopathic medical practice and specializes in immune support for allergies, autoimmunity and cancer support, functional gastroenterology and pain management. He has over 30 years of clinical experience using individualized care and treatment plans to provide effective naturopathic based care.