Normal Testosterone Levels Aren't Normal: What You Really Need to Know About Your T-Levels

Over the last few years, men's health has finally been given the attention it deserves, particularly when it comes to testosterone levels and TRT treatment. 

Drops in T-levels have been a major concern for men recently, naturally leading to many searching for answers.

The most prominent question is: "What are normal testosterone levels for men?" or "What should your testosterone levels be?"  A simple question with a not-so-simple answer. The response you get can largely depend on who you ask. 

The Decline of Male Testosterone Levels Over Time

Testosterone is the male's primary sex hormone. In simplest terms, it's what makes men, men. 

After puberty, this powerful hormone is released and circulates through the body, triggering and supporting a multitude of male traits, including;

• Muscle growth
• Sex drive
• Energy and mood 
• Supporting mental health

These testosterone levels will rise rapidly, generally peaking in their early 20s. From here, levels are relatively stable until after the age of 30-40. Depending on the person, after this time, levels begin to drop at 1-2% a year.¹ 

Average Testosterone Levels Of Men Have Dropped Steadily

What makes all this so much more worrisome is that males' T-levels have been dropping as a whole over the past few decades.

This is a much larger issue than this paper can adequately address, but discussion of testosterone levels would be incomplete without discussing the overall decline in T-levels over time.

There was a monumental study in 2007 that analyzed data from the Massachusetts Male Aging Study. This study had physiological measurements of men over almost two decades (1987–2004).¹

They randomly selected men aged 45-79 at three different time points and compared their T-levels.

T1. 1987-1989 (age: 45-71)

• Median: 501 ng/dL
• Interquartile: 392-614 ng/dL

T2. 1995-1997 (age: 50-80)

• Median: 435 ng/dL
• Interquartile: 350-537 ng/dL

T3. 2002-2004 (age: 57-80)

• Median: 391 ng/dL
• Interquartile: 310-507 ng/dL

So here we see an obvious drop over time. After further calculations, researchers found the median testosterone levels dropped 56 ng/dL or 11.2% in a decade! Here's what that looks like;

• 1987-1989: A 65-year-old had median levels of 500 ng/dL. 
• 1995-1997: 65yo had median levels of 444ng/dL.

After analysis, they concluded, "recent years have seen a substantial, and as yet unrecognized, age-independent population-level decrease in T in American men…"

As such, we're starting this whole discussion using the lowest testosterone levels in history to define what's normal.

What Are "Normal" Testosterone Levels?

Currently, a "normal range" as defined by the medical community, such as the AUA, can range anywhere from 300-1.000 ng/dL. 

That's a massive range in itself, suggesting two men can have very different levels – Man A can have 3x the t-levels as Man B, and both are considered "normal".

Where Did "Normal Ranges" Come From?

If "normal ranges" were based on health and biological standards, you would assume they have been consistent over the years and agreed upon. But this is not the case. 

The AUA (American Urological Association) notes that there are at least 7 different "authoritative" organizations that list different cut-offs for normal ranges.² 

• American Association of Clinical Endocrinologists: 200 ng/dL
• Endocrine Society: 264 ng/dL
• American Urological Association: 300 ng/dL
• British Society of Sexual Medicine: 345 ng/dL
• European Association of Urology: 345 ng/dL
• International Society of Sexual Medicine: 350 ng/dL
• International Society for the Study of Aging Male: 350 ng/dL

Using these "cut-off" levels for the lower end of "normal" is an entirely different problem in itself, which we'll look at below.

However, where did these numbers even come from? We'll look at two of the more famous and instrumental studies used to establish them.

1. Framingham Heart Study Reference Ranges (2011): In 2011, researchers measured T-levels of healthy, non-obese 19–40 y/o men and discovered the following numbers;

• Mean (Average): 723.8 ng/dl
• Median (Middle): 698.7 ng/dl
• 2.5 Percentile (Lowest/Cut-off): 348.3 ng/dl

The researchers determined men who had lower than 348.3 ng/dl had a greater risk of health complications, such as;

• Metabolic dysfunction 
• Erectile dysfunction
• Mental health issues

So while 348.3 ng/dL is the "threshold", why use this number as "normal"? It's literally the lowest you can go before you're at significantly greater risk of health complications.  

Have you seen the classic film Speed? Where the driver can't drop below 50mph? Imagine the driver sits right at 50mph and everyone acts like everything is fine.… Would you feel safe?

That's what considering 300ng/dl as normal is doing. 

In reality, according to this study, 700ng/dl is what we would consider average, and anything below is thus below average. 

2. Harmonized International Reference Range (2017)- In 2017, a group of researchers examined the data of 4 cohorts of healthy, non-obese men (US and Europe). They came up with the following numbers based on percentiles.

• 97.5th: 916 ng/dL
• 95th: 852ng/dL
• 50th: 531ng/dL
• 5th: 303 ng/dL
• 2.5th: 264ng/dL

Again, we see the lowest numbers in the 300ng/dL range, specifically 264ng/dL in this study - so I guess that means we should drop the threshold?

But when we look at the middle range, we see 531 ng/dL.  So while this has dropped, the average in this study is twice as much as the lower threshold.

Why "Normal Testosterone Levels" Are Misleading

Above, we saw there's a massive range for T-levels that are deemed to be normal. Here are 3 reasons why they shouldn't be.

1. Normal Testosterone Ranges Are Age-Independent (Standard regardless of age)- The 300 ng/dL cutoff used applies to all men. This means a 24-year-old is using the same standards as their 70-year-old grandpa.

This obviously doesn't make any sense and is even admitted by leaders in an article published in the American Urological Association. ²

• "Testosterone levels decline with age, yet urologists and endocrinologists have used an age-independent cutoff to evaluate all men."
• "This 300 ng/dL cutoff was derived from… men older than 45 years of age. This makes it challenging to evaluate and treat men <45 years old."

Imagine treating hormonal issues of a 23-year-old girl with the same standards as a 60-year-old woman. This is obviously not medically conducive, but it illustrates the issue men face when looking for guidance. It's ridiculous.

In the past few years, this has been addressed, and an attempt has been made to establish age-dependent cut-offs.⁵

• 20-24 years old: 409-558ng/dl
• 25-29 years old: 413-575ng/dl
• 30-34 years old: 359-458ng/dl
• 35-39 years old: 352-478ng/dl
• 40-44 years old: 350-473ng/dl

2. These "Normal" Numbers Are Statistical. Many of the numbers used to establish ranges  account for the entire population, including;

• Athletes
• Obese 
• Sedentary
• Sick

This means your T-levels are based on what overweight sedentary men are! As a result, these numbers are purely statistical and have nothing to do with health. 

The average man today is overweight, but that doesn't mean being overweight is "normal" from a health perspective — it means something is terribly wrong with diet and physical activity to make that "normal".

3. The Lower Range Is The Threshold For Health. As we mentioned above, the lower range isn't what's average but rather the lower threshold. Going below this number would drastically increase your chance of various health concerns.

Actually, even being above this level can present health issues.

For some reason, it has been decided by some in the medical community to dance on this line rather than promote higher, healthier levels.

Why "Normal" T-Levels Aren't Good Enough

Remember when we said numbers are based on statistics and not health or performance? The fact is, you can be above the cut-off yet still experience health complications – and probably will.

A  2015 review looked at available data and found a threshold for when men begin to see a rise in symptoms.⁶

• Young Men (<40 years old): <400ng/dl
• Middle/Older: <317 ng/dL

However, after treatment, these symptoms often aren't relieved until 500 or 600ng/dl!

In addition to all this, there are 3 things to consider:

1. The same study admits that many issues occur on a spectrum; you don't just wake up one day without the ability to get an erection. 

2. Research shows that various side effects can present at different levels.

3. Some health issues are chronic in nature and have several factors. These may take months or years to fully develop, with diabetes being a good example. Why wait until a person is pre-diabetic or diabetic to treat it? 

Here's why it's so important. Because so many in the medical community view these arbitrary thresholds as being normal, men who have health issues but have higher numbers are told there's no problem. As a result, they can't get legal treatment. 

Luckily, this is beginning to change with the rise in TRT clinics and better education, but this shouldn't still be an issue.

Normal Testosterone Levels Are More Than Lab Readings

One important thing to keep in mind is that low T-levels are not the issue; symptoms are. Let us explain.

For example, let's say two 30-year-old men have levels of 500ng/dl. For this age, it's near the lower end but not below the threshold. However;

• Man A has erectile dysfunction, drop in mood, and low energy
• Man B feels great, has a healthy sex life, and is very active

Man B probably doesn't need to worry about seeking treatment. On the other hand, Man A may be more susceptible and may need to seek out a medical solution.

Ironically, this issue illustrates another issue with men's health in that you must have a health issue present to be treated. Again, why wait until there's an issue?

Regardless, if you have health issues and are on the lower end of the spectrum, seek out a second opinion if your doctor uses a single, arbitrary number to diagnose you.

It's finally time to start taking men's health seriously, and this begins with acknowledging the lack of quality treatment for their hormones. This has been changing, though, providing men with more options.

If you're a man, get your T-levels checked. If you have 

Redefining "Healthy" T Levels

So if the current recommendations for normal ranges can't be trusted to provide optimal health, what T-levels should men have?

The answer lies with recognizing that the lower "threshold" likely does not promote optimal health in most men. In reality, we need to determine the lower threshold of optimal health.

What Are "Optimal" Ranges?

Now we've established that "normal ranges" are not "optimal ranges", what should you aim for as a man?

As above, there is surprisingly no agreed-upon number. However, we can look at various research as well as practices of TRT facilities.

- Above, we mentioned that men can begin to experience symptoms lower than 400ng/dl and begin to see relief at 500ng/dl - 600ng/dl.

- The American Urological Association (AUA) recommends practitioners who prescribe TRT to "adjust testosterone therapy dosing to achieve a total testosterone level in the middle tertile of the normal reference range." This equates to 450ng/dl-600ng/dl.

Reference

1. Travison TG, Araujo AB, O'Donnell AB, Kupelian V, McKinlay JB. A population-level decline in serum testosterone levels in American men. J Clin Endocrinol Metab. 2007;92(1):196-202. doi:10.1210/jc.2006-1375
2. What Is a Normal Testosterone Level for Young Men? American Urological Association News. Published November 27, 2023. Accessed [today's date]. https://auanews.net/issues/articles/2023/november-extra-2023/what-is-a-normal-testosterone-level-for-young-men
3. Bhasin S, Pencina M, Jasuja GK, et al. Reference ranges for testosterone in men generated using liquid chromatography tandem mass spectrometry in a community-based sample of healthy non-obese young men in the Framingham Heart Study and applied to three geographically distinct cohorts. J Clin Endocrinol Metab. 2011;96(8):2430-2439. doi:10.1210/jc.2010-3012 https://pmc.ncbi.nlm.nih.gov/articles/PMC3146796/#sec13
4. Travison TG, Vesper HW, Orwoll E, et al. Harmonized Reference Ranges for Circulating Testosterone Levels in Men of Four Cohort Studies in the United States and Europe. J Clin Endocrinol Metab. 2017;102(4):1161-1173. doi:10.1210/jc.2016-2935 https://pubmed.ncbi.nlm.nih.gov/28324103/
5. Zhu A, Andino J, Daignault-Newton S, Chopra Z, Sarma A, Dupree JM. What Is a Normal Testosterone Level for Young Men? Rethinking the 300 ng/dL Cutoff for Testosterone Deficiency in Men 20-44 Years Old. Journal of Urology [Internet]. 2022 Dec 1 [cited 2025 Aug 21];208(6):1295–302. Available from: https://doi.org/10.1097/JU.0000000000002928 
6. Maganty, A., Shoag, J. E., & Ramasamy, R. (2015). Testosterone threshold – does one size fit all? The Aging Male, 18(1), 1–4. https://doi.org/10.3109/13685538.2015.1004047 
7. Evaluation and Management of Testosterone Deficiency: AUA Guideline. American Urological Association. J Urol. 2018;200(3):423–432. https://www.auanet.org/guidelines-and-quality/guidelines/testosterone-deficiency-guideline