Hypogonadal symptoms in young men are associated with a serum total testosterone threshold of 400 ng/dL
Scovell et al. asked at which serum level young men actually begin to feel hypogonadal, rather than at which level a laboratory reports an abnormal value. The answer sat considerably higher than most European reference ranges: symptoms were associated with a total testosterone threshold of 400 ng/dL (14 nmol/L). Crucially, the symptoms that predicted low testosterone best were not sexual but energetic and cognitive — the everyday complaints usually attributed to stress, workload or simply getting older.
Focus
Symptom threshold
Published finding
400 ng/dL
Source
10.1111/bju.12970
Record
Ref 09
Structured abstract
Method
Scovell et al. asked at which serum level young men actually begin to feel hypogonadal, rather than at which level a laboratory reports an abnormal value. The answer sat considerably higher than most European reference ranges: symptoms were associated with a total testosterone threshold of 400 ng/dL (14 nmol/L). Crucially, the symptoms that predicted low testosterone best were not sexual but energetic and cognitive — the everyday complaints usually attributed to stress, workload or simply getting older.
Result
Hypogonadal symptoms in young men were associated with a total testosterone threshold of 400 ng/dL (14 nmol/L). Lack of energy was the most important single predictive symptom. Sadness, decreased strength and endurance, decreased ability to play sports and deterioration in work performance were also strongly predictive. The threshold lies above the cut-off used by many treating clinics, so symptomatic men are routinely told they are normal.
What to take with you
In young men the strongest predictor of low total T was lack of energy, clustering already at 400 ng/dL (14 nmol/L), above many European laboratory lower limits.
Why it matters
In young men, hypogonadal symptoms clustered already at 400 ng/dL (14 nmol/L) — above many European laboratory lower limits; lack of energy was the strongest signal.
Study frame
Symptom threshold
Scovell et al. asked at which serum level young men actually begin to feel hypogonadal, rather than at which level a laboratory reports an abnormal value. The answer sat considerably higher than most European reference ranges: symptoms were associated with a total testosterone threshold of 400 ng/dL (14 nmol/L). Crucially, the symptoms that predicted low testosterone best were not sexual but energetic and cognitive — the everyday complaints usually attributed to stress, workload or simply getting older.
Finding
Hypogonadal symptoms in young men were associated with a total testosterone threshold of 400 ng/dL (14 nmol/L).
Contrast
Lack of energy was the most important single predictive symptom.
Context
Sadness, decreased strength and endurance, decreased ability to play sports and deterioration in work performance were also strongly predictive.
DOI
10.1111/bju.12970
Category
Symptom threshold
Findings listed
4
Type
As published
What to take from the numbers
Boxes below use only wording already in the published summary for this study.
Reported finding
400 ng/dL
Hypogonadal symptoms in young men were associated with a total testosterone threshold of 400 ng/dL (14 nmol/L).
Reported finding
2
Lack of energy was the most important single predictive symptom.
Reported finding
3
Sadness, decreased strength and endurance, decreased ability to play sports and deterioration in work performance were also strongly predictive.
This was a cross-sectional questionnaire study in young men; a symptom threshold identifies where complaints cluster, not who will benefit from treatment.
Why it matters when reading your own result
Pulled from the study's own findings.
Hypogonadal symptoms in young men were associated with a total testosterone threshold of 400 ng/dL (14 nmol/L).
Symptom threshold
Lack of energy was the most important single predictive symptom.
Symptom threshold
Sadness, decreased strength and endurance, decreased ability to play sports and deterioration in work performance were also strongly predictive.
Symptom threshold
Clinical reading
How to use this page
Scovell et al. asked at which serum level young men actually begin to feel hypogonadal, rather than at which level a laboratory reports an abnormal value. The answer sat considerably higher than most European reference ranges: symptoms were associated with a total testosterone threshold of 400 ng/dL (14 nmol/L). Crucially, the symptoms that predicted low testosterone best were not sexual but energetic and cognitive — the everyday complaints usually attributed to stress, workload or simply getting older.
Related studies in this library
New England Journal of Medicine · 2010
Identification of late-onset hypogonadism in middle-aged and elderly men
Journal of Clinical Endocrinology & Metabolism 91: 4335–4343 · 2006
Association of specific symptoms and metabolic risks with serum testosterone in older men
Journal of Clinical Endocrinology & Metabolism 96: 2430–2439 · 2011
Reference ranges for testosterone in men generated using LC–MS/MS in healthy non-obese young men (Framingham Heart Study)
Your own numbers
Measure before you decide what this page means for you.
The figures here describe men who were actually measured.
- Total testosterone and SHBG
- Symptoms written down
- Haematocrit as a safety baseline
- Repeat labs before any protocol change