Men & Testosterone: 10 Q&As That Decode Hormones, Symptoms, and Test Results

Written by

Louise W Lu, PhD, MPH, BMLS

Written/Reviewed by

Michelle Ordner, Registered Nurse

1｜Why Is the Reference Range for Total Testosterone in Men So Wide?

Have you ever noticed that some reports list 300–1000 ng/dL (approx. 10.4–34.7 nmol/L) as the normal range, while others say it’s 230–1000 ng/dL (approx. 8.0–34.7 nmol/L)?
That’s a huge span!

In fact, this “range” isn’t a strict health standard. It’s just a statistical distribution—basically, if you line up testosterone levels from a large group of men, the middle 95% is defined as “normal.” That’s why it looks so wide.

But here’s the catch: those data often mix everyone together—men in their 20s and men in their 70s. Of course younger men tend to have higher testosterone, often around 700–900 ng/dL (24.3–31.2 nmol/L), while older men might drop to 300–400 ng/dL (10.4–13.9 nmol/L). When you average that out, the “normal range” gets stretched.

2｜Why Do Different Labs Report Different Total Testosterone Ranges?

You might notice that even in the same city, testosterone “reference ranges” can vary depending on the hospital or health centre. No, you're not imagining it—and it doesn’t mean there’s something wrong with you. It's because—

👉 Different labs use different testing methods and reference populations, so their “normal” values end up different.

Here are the main reasons why:

• Different reference populations: Some labs base their reference ranges on their own internal samples, others follow national guidelines, and some use outdated datasets. If the sample pool is skewed younger or older, the final numbers shift accordingly.
• Time of day: Testosterone has a strong diurnal rhythm (higher in the morning, lower in the afternoon), so the time you get tested matters. If the lab’s reference range is based on morning samples, but you had your test in the afternoon, it might “look low.”

• Different testing methods: The two main methods are immunoassays (e.g. ECLIA) and liquid chromatography–mass spectrometry (LC-MS/MS). The former is faster but more prone to errors; the latter is more accurate but costly. Immunoassays can over- or under-estimate levels by 10–20%, which matters a lot near clinical cutoffs.

So really—don’t place too much faith in a reference range without understanding the context.

3｜Should Testosterone Levels Be Compared to Your 20s? Why the Drop Matters More Than the Value

Many men feel relieved when their report says 350 ng/dL (12.1 nmol/L) — “Hey, that’s still within the normal range.”

But here’s the catch: that "normal range" is a horizontal comparison — it tells you how you stack up against others, not how much you've changed yourself.

Some men are born with higher testosterone — maybe they had 800 ng/dL (27.8 nmol/L) in their 20s. If they drop to 350 now, that’s more than half gone. No wonder they feel it.

Others may have started lower — say from 500 to 350. That drop is less dramatic, so the body may not complain as much.

That’s why some men feel low energy, poor sleep, and mood swings even when their numbers are still “normal,”

while others with even lower numbers feel totally fine.

The faster the decline, the louder the body’s alarm bells. So don’t just ask “am I below 300?” — ask “how fast did I drop?”

4｜Is it possible to have normal total testosterone but low free testosterone? What does it mean?

Yes, absolutely.
Total testosterone tells you the overall amount in your blood, but what your body actually uses is free testosterone (Free T).

Think of it this way—
Total testosterone is like all the money in your bank account, but free testosterone is the cash in your hand.
If most of your money is locked in fixed deposits (bound to proteins like SHBG), you might look “wealthy,” but you can’t spend it.

Why does SHBG increase? Here are some common reasons:

• Aging – liver metabolism slows down, SHBG tends to go up;
• Insulin resistance – insulin normally suppresses SHBG, but with lower insulin sensitivity, this suppression weakens;
• Liver dysfunction, hyperthyroidism, and chronic stress can all raise SHBG as well.

This leads to a common scenario:

• 👉 Total testosterone = 500–600 ng/dL (17.3–20.8 nmol/L), looks fine
• 👉 Free testosterone <220 pmol/L (≈6.3 ng/dL), actually functionally low
• 👉 Fatigue, low libido, poor sleep—but no clear “diagnosis” on paper

So, normal total testosterone ≠ usable testosterone.
To truly assess whether your body has enough, you need to check your free testosterone.
Many standard reports don’t include it unless you specifically ask for it, so be sure to request “Free T” in your next test.

5｜Why Are Some Men Very Sensitive to Testosterone Drop, While Others Feel Nothing?

Have you noticed? Some men still have a total testosterone level of 400–500 ng/dL (13.9–17.3 nmol/L), but already feel drained, low libido, emotionally down. Others may drop below 300 and still feel fine.

It’s all about how sensitive your body is to testosterone.

The actual effect of testosterone isn’t just about the number in your blood test—it’s shaped by a few key factors:

• 1. Androgen receptor gene sensitivity: Some people naturally respond more strongly to testosterone—even small amounts make a big difference. Others need higher levels to feel any effect.
• 2. Brain sensitivity to hormones: Some brains rely heavily on sex hormones. Even a slight drop can affect mood, sleep, focus. Others? Not so much.
• 3. How fast testosterone drops: A sudden crash (e.g. after chronic stress) is more likely to cause “cliff-drop” symptoms than a slow, gradual decline.

Studies confirm this. Male menopause (andropause) isn’t just about the numbers.

The EMAS study found that you only consider it testosterone-related when there’s a combo of:
Low total testosterone + low free testosterone + ≥3 sexual symptoms.

If you’re unsure, don’t just ask “Am I below a certain number?”
Ask instead: “Do I feel off? Are these symptoms hormone-related?”

6｜Can LH (Luteinizing Hormone) Be Tested? What Does It Tell Us?

Yes! And LH is a key clue when it comes to understanding whether testosterone is truly low.

Here’s how you can think of it—

• Low testosterone + High LH → Your body is trying hard to fix the problem but failing. That suggests an issue with testosterone production itself, called primary hypogonadism.
• Low testosterone + Normal or low LH → Your brain isn’t even sending the signal. This is secondary hypogonadism, often caused by chronic stress, illness, or medication disrupting the HPG axis.
• Normal testosterone + High LH → Your body is working overtime to keep levels up. This compensated state could crash later if stress increases or function declines.

For example:

A 48-year-old man has total testosterone of 310 ng/dL (10.7 nmol/L)—just above the cutoff—but his LH is only 2.5 IU/L (normal range: 1.5–9.3). That means his body isn’t even trying to compensate. It’s like the brain gave up sending the command.

👉 In this case, we’d be concerned about HPG axis dysfunction or chronic stress shutting down the signaling pathway.

7｜Can a blood test alone confirm male menopause?

The answer is: no, a blood test alone is not enough.

This is a common scenario we see:

And that’s exactly why male menopause is often overlooked:

• ✔ It’s not just about low testosterone — it’s about a slow burnout of metabolism, recovery, mood regulation, and energy.
• ✔ Many men still show typical andropause symptoms even with “normal” testosterone (e.g. 350–500 ng/dL / 12–17 nmol/L): low energy, irritability, poor sleep, loss of libido, muscle loss, belly fat…
• ✔ Some men, even at 280 ng/dL (9.7 nmol/L), function well with no noticeable symptoms.

So, the real question isn’t “Have I dropped below a certain number?”, but:

These tell you far more than a lab number ever could.

Think of male menopause as a low-energy state from declining “fuel supply” — not a binary lab diagnosis.

8｜Does Testosterone Protect Cardiovascular Health?

This has been a controversial question for decades.

Early opinions claimed, “Testosterone causes heart disease!” — mainly because of its association with stereotypes like “aggression,” “short temper,” and “meat cravings.”

But more recent studies have shown that low testosterone in men is actually associated with:

• Visceral fat accumulation — especially belly fat
• Reduced insulin sensitivity, leading to blood sugar and lipid issues
• Poor vascular endothelial function, increasing risk of atherosclerosis
• Higher risk of heart attacks and strokes

A 2022 systematic review in Front Cardiovasc Med found that:

So the current consensus is:
Healthy levels of testosterone help protect the heart and lower the risk of metabolic syndrome.

But that doesn't mean “the higher, the better!”

Research shows that people with supraphysiological levels (e.g. from steroid or testosterone abuse) may face:

• Excess red blood cells and thickened blood
• Increased risk of hypertension
• Arrhythmia and cardiac hypertrophy

The key question is not “Should you take testosterone?” but rather:
👉 Is your testosterone level truly healthy?
👉 Has it dropped out of your own optimal range?

9｜Should You Take Supplements If Your Testosterone Is Low?

Let’s get straight to the point:

Testosterone can drop for many reasons: high stress, poor sleep, unhealthy diet, lack of exercise, staying up late...
Sometimes, just improving your lifestyle habits is enough for your body to bounce back.

So when should supplements be considered?

• If you're feeling off lately—tired, low motivation, losing muscle, gaining fat—
  but your testosterone levels are still in the “normal” range, then nutrition support might be worth a try.
• But if your total or free testosterone is clearly below normal, and symptoms are significant,
  then it’s time to talk to a doctor about whether TRT (Testosterone Replacement Therapy) might be right for you.

At the end of the day—supplements are just that: supportive, not magic.
They won’t “fix” everything, but if your body is stuck, a little nudge might help.

10｜A Functional Guide to Nutrients & Supplements Supporting Testosterone Health

When facing low testosterone or related health issues, many men are drawn to so-called “T-booster” products. But from a nutritionist’s perspective: not every ingredient is effective, and not everyone needs a “strong testosterone push.” Testosterone production, release, and signaling involve multiple systems — including the neuroendocrine axis, mitochondrial energy metabolism, antioxidant status, liver and kidney detoxification, and prostate function.

That’s why we’ve categorised all evidence-supported and safety-verified nutrients and supplements into five key functional groups:

• Neurohormonal Regulators: Support communication between brain and testes
• Mitochondrial & Energy Cofactors: Fuel the biochemical process of testosterone synthesis
• Antioxidant & Anti-inflammatory Agents: Reduce oxidative stress that suppresses testosterone
• Muscle & Androgen Response Support: Enhance your body’s sensitivity to testosterone
• Prostate & Detox Support: Protect local hormone balance and conversion efficiency

The following tables list the recommended nutrients under each category — including their physiological roles, typical doses, and product links — to help you build a safe, effective, and personalised support strategy.

These nutrients are involved in the synthesis and regulation of testosterone, supporting communication between the brain and the testes. Imbalances may lead to dysfunction of the neuroendocrine axis.

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Testosterone production depends heavily on mitochondrial energy. These nutrients help generate and transport the “fuel” needed for hormone synthesis.

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Testosterone production is sensitive to oxidative stress and chronic inflammation. These antioxidants help protect testicular cells, mitochondrial function, and hormonal signaling stability.

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These nutrients support protein synthesis and enhance the body's response to testosterone signals, helping maintain lean muscle mass, especially in aging men.

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The liver plays a vital role in hormone clearance and detoxification, while the prostate is a sensitive androgen target. These nutrients support anti-inflammatory balance and detox pathways in both systems.

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Authors:

Louise W Lu

Registered Nutritionist (NZ Reg. 82021301), PhD of Nutrition Science, Honorary Academic at the University of Auckland. Louise blends clinical research with public health to help people eat better and live stronger.

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Michelle Ordner

Registered Nurse (RN)
Michelle's expertise spans healthcare, nutrition infusion, and menopausal care. She began her nursing career in New Zealand in 1991 and has since served 17 years in critical care across the USA. After returning to NZ, she trained in cosmetic medicine and stem cell therapy, and holds a UK certification in intravenous nutrition. Her work focuses on integrative care for menopausal health and wellness.

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