Start with a blood test
By Mike Kocsis | 10 minutes read | Last updated: January 3, 2020 Categories: Men's Health Testosterone Testosterone levels TRT Women's Health
Medically Reviewed by Dr. George Touliatos
Contrary to popular belief, testosterone is a hormone that’s produced in both men and women. It regulates important processes and is largely responsible for the physiological changes that turn boys into men. Testosterone levels vary throughout a person’s life, here we take a look at what normal testosterone levels should look like in both men and women.
What influences normal testosterone levels?
Testosterone is a hormone and it is also known as androgen. Most people associate it with men and although it’s primarily known as a male sex hormone, females also need a certain amount of testosterone which mainly converts into the sex hormone estradiol in the female body.
- Age
- Sex
- Lifestyle
- Health
In males, the testicles produce testosterone, and the ovaries produce testosterone in females. Testosterone levels are also controlled by the adrenal glands which produce small amounts of testosterone in both sexes.
What testosterone is used for in males:
- Body development through puberty
- Sperm creation and development
- Building of muscles and bones
- Sex drive and libido
What testosterone is used for in females:
- Balancing other female hormones
- Creating new blood cells
- Sex drive and fertility
- Correct menstrual cycles
Testosterone plays a key role in libido and fertility for both men and women. By contrast, It’s more common for men to have too low testosterone while women are more likely to have too high testosterone levels.
Factors that can impact normal testosterone levels include:
- Chemotherapy / cancer treatments
- Metabolic disorders such as hemochromtosis
- Trauma to the testes or other testicular issues
- Age (testosterone productions slows in men after 30 years of age)
- Alcohol abuse
- Supressed immune system (HIV/AIDS)
- Chronic kidney failure
- Certain medication
- Obesity
- Uncontrolled type 2 diabetes
How are testosterone levels measured?
Doctors most commonly measure testosterone levels in a unit known as nanograms per deciliter (ng/dl). If your doctor suspects you have low testosterone, they’ll want to perform a blood test to confirm or rule out the diagnosis. Your GP will take a blood sample and send it off to an endocrinologist for testing. Alternatively, you can order a discrete at-home blood test from us by clicking the button below.
What are normal testosterone levels by age?
Testosterone normally peaks around age 20 and then drops by 3-10% each decade after. Shbg levels are at their lowest at age 20 and tend to increase with age. The exception is that metabolic syndrome tends to have a lower amount of Shbg usually non the teens or single digits.
Testosterone levels by age chart
The following outlines testosterone levels by age in chart format so you can understand normal testosterone levels by age range.
Normal testosterone levels in Infants and children
| Age | Male (in ng/dl) | Female (in ng/dl) |
| 0 to 5 months | 75-400 | 20-80 |
| 6 months to 9 years | Less than 7-20 | Less than 7-20 |
| 10 to 11 years | Less than 7-130 | Less than 7-44 |
Normal testosterone levels in Adolescents
| Age | Male (in ng/dl) | Female (in ng/dl) |
| 12 to 13 years | Less than 7-800 | Less than 7-75 |
| 14 years | Less than 7-1,200 | Less than 7-75 |
| 15 to 16 years | 100-1,200 | Less than 7-75 |
Normal testosterone levels in men and women (Adults)
| Age | Male (in ng/dl) | Female (in ng/dl) |
| 17 to 18 years | 300-1,200 | 20-75 |
| 19 years and older | 240-950 | 8-60 |
Doctors may also measure testosterone levels alongside Tanner staging, this is where the Tanner scale will track the visual development of children during puberty according to five stages rather than a person’s specific age range. An example of this stage II, relates to when the growth of a boy’s testicles or the development of breast buds in a girl, it does not refer to the age of the boy/girl. You can use our testosterone calculator to convert the above units.
The Tanner scale indicates the following levels of testosterone as healthy:
| Tanner stage | Male (in ng/dl) | Female (in ng/dl) |
| I | Less than 7-20 | Less than 7-20 |
| II | 8-66 | Less than 7-47 |
| III | 26-800 | 17-75 |
| IV | 85-1,200 | 20-75 |
| V | 300-950 | 12-60 |
What are low testosterone levels?
Hormone levels change for men and women as we age. Women can experience dramatic changes in hormones, with levels falling until they reach menopause. For men, the decrease in testosterone levels is more gradual with losses starting at just 30 years of age.
Many men choose to get TRT in the UK to counter the effects of low testosterone.
It’s been reported that worldwide testosterone levels are declining compared to previous generations as are sperm counts. It’s fair to say that grandad had higher levels of testosterone than you do now. These levels may be decking due to lifestyle and exposure in the womb and through life to endocrine disrupters or endocrine disrupting chemicals. In his book sex love and listen to your hormones, dr Kryger discusses the edc in pesticides sprayed on crops and animal feed which are then ingested by animals and persist in their fat ready to be consumed by people. This vicious cycle may be responsible for the decline in testosterone levels as well as fertility rates globally. It’s fair to say testosterone supplementation may be an option to overcome these chemicals responsible for disrupting our natural hormone balance.
What makes it worse is that some of these endocrine-disrupting chemicals not only decrease testosterone levels in men they may also be blocking the androgen receptor from binding to your testosterone rendering it useless and creating an artificial androgen insensitivity syndrome.
Symptoms of low testosterone levels in men include:
- Decrease in muscle mass and tone
- Lower sex drive (libido)
- Disturbed mood and sleep patterns
- Concentration and memory problems
- Hair loss on the body and face
Symptoms of low testosterone levels in women include:
- Lower sex drive (libido)
- Weak bones
- Irregular or missed periods
- Vaginal dryness
- Fertility problems
What are high testosterone levels?
Having high testosterone levels is much less common than having low testosterone levels in adult males. If a child has higher than normal testosterone levels, chances are they may have a growth spurt or start puberty early. Having high levels of testosterone is considered dangerous and may cause problems in both males and females, especially when it comes to fertility.
Steroid use
If you are a man or woman and are using steroids, you are at greater risk of having higher than normal levels of testosterone in your body.
Both men and women may experience excessive hair growth on the face and body from high levels of testosterone, alongside greasy skin and a host of other problems. Women specifically may get a deeper voice and experience irregular periods along with male pattern baldness.
Coming off steroids may cause serious problems with your body’s natural ability to produce testosterone, please check out our youtube video on how to recover from anabolic steroid suppression.
Polycystic ovary syndrome
Polycystic ovary syndrome (PCOS) affects females and their fertility. When the ovaries produce too much testosterone through having PCOS they may have the following symptoms:
- Oily skin
- Acne
- Irregular or missed periods
- Increased hair growth on the face, back or chest
Normal testosterone levels in the UK
Testosterone levels can be affected by the efficiency of your testes to produce testosterone, your body’s ability to metabolise testosterone, the rate at which you clear the testosterone from your body, the amount of gonadotropins lh or fsh required to stimulate your testes to make testosterone in the first place, and the number of binding proteins, in particular SHBg which can determine the amount of free or bioavailable testosterone you have.
Will my doctor tell me my testosterone levels are normal even though I don’t feel normal?
You may have had the feeling that something was amiss and asked your GP to test your levels only to receive the response that you’re fine or normal. You may have asked yourself what normal means as you have these symptoms and certainly don’t feel “normal”. Your GP, and in many cases or even your endocrinologist, may not be versed in the intricacies of modern testosterone optimisation therapy and send you home after only measuring your “total testosterone” level.
That can be a potentially deadly mistake as low Testosterone has been linked to prostate cancer, and the most aggressive form at that. PSA tests may not detect cancer because your “normal” level may mask an aggressive growing cancer. Having ‘normal’ levels in many cases is not optimal, and to make matters worse the so-called ranges have been shifting lower every decade and in the UK most laboratories do not age adjusts or age match levels.
What testosterone levels does the NHS treat?
The NHS national British treasure has created dubious guidelines based on cost and efficiency in order to limit the use of testosterone in the general public. They put cost savings ahead of life-saving yet demonise the private sector for helping men regain their youthful levels of testosterone.
The NHS realises they made a costly mistake approving HRT for women and are now terrified that they may have to pay for TRT for men in the UK. Because of how big this they have created deliberate barriers to getting TRT treatment on the NHS. Levels of 7nmol/l and below may be treated but we have even heard of patients being denied at this level. In some cases, a second test will come back slightly higher and the patient will be turned away or denied treatment. We also know that the NHS will drag out the process and it can take up to a year of blood testing.
The NHS will only look at total testosterone and not free testosterone or Shbg. Normally Shbg isn’t even ordered and if a free testosterone test is ordered it’s usually an unreliable assay.
The NICE guidelines are adhered to as strict rules rather than general guidance all in the name of cost-cutting austerity.
When it comes to safety, being treated for testosterone deficiency the NHS may be the provider of last resort.
What is free testosterone level?
Free testosterone is the amount or portion of testosterone not bound by blood proteins which include both albumin and ShBG or sex hormone-binding globulin. Both these proteins can bind your testosterone with varying affinities. Albumin is more weakly bound to testosterone and this testosterone albumin affinity is called bioavailable testosterone because the albumin can more easily disassociate than Shbg can from testosterone. The SHBG binds tightly to testosterone and traditionally has been considered unusable with no biological function other than to leave you deficient. More recent evidence points to a role for the Shbg/testosterone binding complex as having a binding site within the nucleus of the cell but its full purpose is not completely understood.
Some will argue that lowering Shbg is not ideal because of this although the traditional view and the view of many practitioners is to take the free testosterone level seriously as men with normal total testosterone but high Shbg and therefore low calculated levels of free testosterone report symptoms of low testosterone similar to men with low total levels. A study published in 2017 addresses the importance of using free or calculated free testosterone as a tool to diagnose low testosterone. In fact, it demonstrated that men with low free testosterone suffered some of the worst symptoms compared to men with low total testosterone.
What is the difference between free testosterone and calculated free testosterone?
Most assays or blood tests that directly measure free testosterone may be flawed or vary from lab to lab so the accuracy and precision can be called into question. A more reliable tool and one used in most peer-review studies is the calculated free testosterone level. Calculated free uses the results from albumin, total testosterone and SHGB to calculate free testosterone. You can calculate your free testosterone using our free testosterone calculator here.
Balance my Hormones offers complete testosterone tests and always includes total, Shbg, albumin, and calculated free for the same price or less than some blood testing companies charge for a total-only test. If you would like your testosterone tests professionally checked by industry experts please use our contact form at the bottom of the page.
What is the normal range of free testosterone?
In the UK calculated free testosterone levels are given in nanomoles per litre. Nmol/l. A normal range is anything above 0.300 and an optimal range is above 0.45nmol/l. Your free testosterone should be at least 2% of your total testosterone levels. Different countries and labs use different ranges and units of measure. To convert your testosterone results click here.
What level of testosterone is needed to be treated (for men)?
Looking only at narrowly defined reference ranges without considering symptoms, calculated free testosterone, and Shbg is folly.
It all depends on how you look at all the data including symptoms and the ADAMS questionnaire. Other tools may include comparing your blood levels from the past to the present may reveal that you are deficient when stacked up against by your past self. This is why it’s highly desirable if not essential that you start blood testing for full testosterone from a young age and it’s key to include total testosterone levels and Shbg and calculated free testosterone. Our complete testosterone test is available for only £39.95 and is an excellent way to get your early baseline whilst you’re still in your late teens or early twenties.
Symptoms of low testosterone including fatigue and some sexual dysfunction may start at levels around 15nmol/l total testosterone level. But if you had higher levels when you were younger and drop from 35 to 20 you may have all the symptoms of low T as you had been previously accustomed to not having more generous levels despite being in the standard or normal range. Chances are you will have normal total levels but with age, your SHGB will choke off your free testosterone leaving you low and symptomatic.
How to get your testosterone levels tested
Balance My Hormones can help get your testosterone levels tested.
Testosterone can be measured in the blood, urine or saliva. The problem with salivary tests is that any cut in the mouth may taint the saliva sample with blood leading to inflated levels or inaccurate readings.
24-hour urinary testing may reveal various metabolites and tissue levels of testosterone but this is not routinely ordered and may be difficult to decipher. The community standard of care in the UK and thought most of the world is a serum blood test for the determination of testosterone deficiency syndrome.
The blood test can be produced through a venus sample normally taken from the vein in the arm, and occasionally from a capillary sample taken from a fingerprick test. The accuracy of the fingerprick test varies and the extraction method can be difficult for some to collect enough blood for proper analysis. Nonetheless, a fingerprick or capillary test can be used reliably at home with little risk or discomfort and posted back to the lab. This makes it more convenient for collecting early morning samples.
If you are concerned you might have low or high levels of testosterone, fill out our form below and we will get you tested as soon as possible and put you on the path to optimal hormone balance.
Get your testosterone levels checked
Contact one of our medical doctors today by clicking the button above to get your blood analysed for low testosterone or speak to one of our consultants about your health concerns.
Scientific References / Resources / Further Reading / Study Material
The below links are scientific references, resources to perform further analysis and reading along with studies that have been conducted:
https://www.medicalnewstoday.com/articles/323085
https://www.medicinenet.com/high_and_low_testosterone_levels_in_men/views.htm
https://www.health.harvard.edu/newsletter_article/testosterone_aging_and_the_mind
https://www.southtees.nhs.uk/services/pathology/tests/testosterone/
Evidence Based Research
This article has been researched and written based on scientific evidence and fact sheets that have then been crossed checked by our team of doctors and subject matter experts.
References, sources and studies used alongside our own in-house research have been cited below, most of which contain external clickable links to reviewed scientific paper that contain date stamped evidence.
Our team of healthcare experts and GMC registered doctors are licensed to UK GMC standards. We strive to provide you with the latest evidence based, researched articles that are unbiased, honest and provide you with accurate insights, statistics and helpful information on the discussed topic to ensure you gain a better understanding of the subject. You can read more about our Editorial Process by clicking here.
We value your feedback on our articles, if you have a well-researched paper you would like to share with us please contact us.
Quick Low Testosterone Test
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About the Author: Mike Kocsis
Mike Kocsis has an MBA with a focus on healthcare administration and is an entrepreneur and medical case manager for Balance My Hormones Ltd which offers medical services in the UK and Europe. Mike has over 20 years of experience in the healthcare sector, much of that working with people who have hormone imbalances. Mike has appeared on podcasts and radio and is an expert speaker on the subject of hormone imbalance. He specialises in Testosterone Replacement Therapy (TRT) and Hormone Replacement Therapy (HRT) and has helped thousands of people suffering from hormone imbalances recover and regain control of their lives. You can follow him on LinkedIn and on the Balance My Hormones YouTube Channel.
Last update: January 3rd, 2020
