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What Does Testosterone Level Of 339 Ng\dL Indicate?
Question: Could I have hypogonadism if my testosterone level 339 ng\dL after long term treatment with testosterone gel 1%?
According to my primary physician, I was not responding to the topical treatment so he just switched me to 200 mg/ml of injectable testosterone. In my medical history below I detailed many other concerns and perhaps other issues that may or may not be related, but I really would like to know what my testosterone levels indicate when all things are considered.
Brief Answer:
Please find detailed answer below
Detailed Answer:
Hi
Thanks for writing in to us.
Normal testosterone in adult males can be any where between 270-1,070 ng/dl. At your age the normal testosterone levels should be somewhere around 606 ng/dl. You surely have a decreased testosterone level for your age.
Naturally declining testosterone levels don’t cause signs and symptoms of aging but can cause symptoms like reduced sexual desire, fewer spontaneous erections and infertility.
There is a lot of confusion in testosterone tests being done by various labs. This is because the reference population varies widely in each lab. Therefore an age optimized testosterone level is more significant in most men.
Testosterone therapy can help reverse the effects of hypogonadism, but it's unclear whether testosterone therapy would have any positive effect on older men who do not have any serious health problems.
Testosterone therapy has its own side effects and must be discussed before starting it. Some of the adverse effects of testosterone therapy are
Contribute to sleep apnea — a potentially serious sleep disorder in which breathing repeatedly stops and starts
Increase your risk of a heart attack
Cause acne or other skin reactions
Stimulate noncancerous growth of the prostate (benign prostatic hyperplasia) and growth of existing prostate cancer
Enlarge breasts
Limit sperm production or cause testicle shrinkage
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dr. Viveck,
Thank you for the quick response, but the original question about the possibility of hypogonadism was I was hoping to get your opinion on. My main concern is that my testosterone levels could be indicative of what I see as a much more serious medical issue that would explain a lot if I knew the answer. I tried to keep my request "clinical" by providing you with all the data I have available, but the initial emphasis on a problem that could be rooted in a hormonal disorder would fit with what I see as instability with regard to my perception of my gender identity, which seems to fluctuate in cycles. I have read quite a bit about conditions that could be associated with low testosterone levels, and what caught my attention was that despite taking testim for 2 years, that my levels were still roughly half of what it should be. I don't know what the original test results were but will ask my primary physician when I see him next month, but I do recall his comment that I had the "T" level of a 97 year old man and that he wanted me to start taking testim and see if it would get that number to a more age appropriate level. I have no problem with my testosterone being low, or even extremely low, in fact it might explain why I have an increasingly androgynous appearance as I age with my testicles receding, my penis not functioning without ED medication and it's incremental but steady decrease in size both flaccid and when erect, and breasts that are not simply "man titties" that go along with obesity. I am overweight without a doubt, but chest is increasingly looking like female breasts; even when I lose a lot of weight. I will attach a photo so you can see what I mean.
I realize that you cannot diagnose my condition without further tests and being able to physically examine me to verify my claims of bodily changes, but the number of symptoms that I have seem highly consistent with a number of Endocrinol conditions related to testosterone; perhaps other hormones that may play a role in interfering with my body's ability to either produce or interfere with other gender and sex related hormones. My thinking was that if after years of artificially being given testosterone to boost it to normal levels that I am still about half of where I should be if all was well, I should talk to my doctor about doing more than just going from testosterone gel to injectable doses known to yield greater results. If I have a condition, I want to know so I can deal with some of the more personal aspects of some of the other symptoms that effect my marriage and frankly some personally troubling questions about sex and gender that an answer that gave me more to work with would accomplish.
Ultimately I am asking you here because I really don't like talking to my doctor about some of the things I mentioned of a personal nature with regard to sex and gender, and I'll need a better grip on some of the possibilities such as indicators of hypogonadism or any number of other related hormone related disorders. It is in this area that I need your expert medical opinion so I can begin a dialogue with him based in medical opinion rather than what I think might be the problems because I read about it on the internet. I would be very grateful if you could help guide me to some of the possibilities based upon medical facts so when we talk next month I wont be in the uncomfortable position of discussing how I feel and gender and sex to go along with just my testosterone level from the last test.
Brief Answer:
Please find detailed answer below
Detailed Answer:
Hi XXXXXXX lounsbury,
Thanks for writing back with an update.
Medical facts on androgen deficiency is detailed below. I understand your apprehension at starting a dialogue with your doctor directly concerning gender snd sexual orientation issues. You may go through the matter given below in detail and the choose to start your conversation on conditions that are relevant for you and then direct your dialogue accordingly.
It is medically proven that androgen (testosterone) deficiency may be primary, due to a problem with the testes, or secondary, due to a problem with the hypothalamic-pituitary-gonadal axis or combined primary and secondary. The etiology of androgen deficiency may be organic, in which there is a pathological physical change in the structure of an organ or within the hypothalamic-pituitary-testicular axis. Androgen deficiency may be functional in which there is no observable pathological change in the structure of an organ or within the hypothalamic-pituitary-testicular axis. Organic defects are usually long lasting or permanent while functional defects are potentially reversible.
Organic primary androgen deficiency may be due to:
1. Genetic abnormalities – Klinefelter’s Syndrome and variants (i.e. 47,XYY/46XY,
46,XX testicular DSD, 45,X/46,XY), dysgenetic testes, myotonic dystrophy
2. Developmental abnormalities – cryptorchidism, congenital anorchia
3. Metabolic abnormalities – hemochromatosis (usually consistent with secondary
hypogonadism)
4. Direct testicular trauma, surgical bilateral orchidectomy, testicular torsion
5. Orchitis – severe bilateral with subsequent testicular atrophy due to mumps or
other infections.
6. Radiation treatment or chemotherapy
Organic secondary androgen deficiency may be due to:
1. Genetic abnormalities – Isolated hypogonadotropic hypogonadism (IHH) and variants
2. Pituitary disorders – hypopituitarism, tumor, infection, hemochromatosis,
hyperprolactinemia due to prolactin-secreting pituitary tumor
3. Structural and infiltrative effects of systemic diseases – CNS developmental
abnormalities, infection, β-thalassemia/hemoglobinopathies, granulomatous diseases,
lymphocytic hypophysitis hemochromatosis, sickle cell disease
4. Anatomical problems - pituitary stalk section, hypophysectomy, pituitary-hypothalamic
disease, traumatic brain injury
Functional androgen deficiency may be due to:
1. Severe emotional stress
2. Morbid Obesity, untreated obstructive sleep apnea
3. Overtraining, malnutrition/nutritional deficiency, eating disorders
4. Medication – opioids, androgens, selective androgen receptor modulators
(SARMs), glucocorticosteroids, progestins, estrogens, medication-induced
hyperprolactinemia
5. Chronic systemic illness (chronic organ failure, diabetes mellitus, malignancy,
rheumatic disease, HIV infection, Crohn’s disease, inherited metabolic storage
diseases)
6. Constitutional delayed puberty
7. Aging/Late onset hypogonadism (LOH)
8. Alcohol excess
Defects in androgen action include:
1. Androgen receptor defects of which there is a full spectrum from testicular feminization
to Reifenstein’s Syndrome to mild defects. Serum testosterone levels are not reduced and
LH and estradiol levels may be increased.
2. 5α-reductase deficiency: May present with selective signs of partial androgen
deficiency. Serum testosterone levels are not reduced.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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