Mean peak total testosterone levels are dose-dependent, with a mean of 746, 866, and 913 ng/dL noted with 8, 10, and 12 pellets administered (not BMI adjusted).446 The duration of effect is similar, however, and is relatively independent of dosing. Administration of 750 mg of IM testosterone undecanoate at weeks 0, 4, and every 10 weeks thereafter maintained total testosterone levels between 300-1,000 ng/dL for 94% of men.438 No men experienced maximal values Adverse Effects. In the uncommon circumstance where men have prior available off-therapy testosterone laboratory data considered reliable (early morning testing, appropriate assay), clinicians may consider titrating testosterone therapy dosing to return patients to their 'baseline' total testosterone level. Prostate cancer patients on testosterone therapy should have their PSA levels monitored on the same schedule as men without testosterone deficiency; however, clinicians may choose to increase the frequency of testing.
If a patient's first test is At this time, there is no definitive evidence indicating what the optimal time interval should be between the two separate tests. The Panel urges clinicians to use their clinical judgment in the management of such patients. The Panel does not recommend using free testosterone measurements as the primary diagnostic method for testosterone deficiency. Some authorities have advocated that free testosterone should be the primary measure used to define testosterone deficiency. However, practicing clinicians who review testosterone lab results will commonly face the dilemma of whether to use the reference ranges published by their specific lab or the absolute measure itself. Due to the challenges in testosterone methodology, there is considerable variability in testosterone reference ranges.13  The specific reference ranges used to diagnose testosterone deficiency are discussed in more depth later in this document.
Serum estradiol should be measured in testosterone deficient patients who present with breast symptoms or gynecomastia prior to the commencement of testosterone therapy. Clinicians should use a total testosterone level below 300 ng/dL as a reasonable cut-off in support of the diagnosis of low testosterone. We assessed the accuracy and precision of the plasma and salivary assays by measuring testosterone levels at four concentrations in ten replicates Table 1. To account for endogenous testosterone levels in blank plasma, we subtracted the peak area ratio that was observed with the blank plasma from the peak area ratios that were observed with the spiked samples and regressed the difference against nominal testosterone level. It's best to measure free testosterone levels in the morning.
In recent years, researchers (and pharmaceutical companies) have focused on the effects of testosterone deficiency, especially among men. Among women, perhaps the most common cause of a high testosterone level is polycystic ovary syndrome (PCOS). Testosterone levels are too carefully controlled by the brain for that to occur. The proper balance between testosterone (along with other androgens) and estrogen is important for the ovaries to work normally. Adolescent boys with too little testosterone may not experience normal masculinization. For example, did you know that testosterone is a key player in prostate cancer?
Even with an abnormally low level that is replicated on a repeat test, the decision to begin testosterone replacement therapy and the proper dose requires a careful conversation with your doctor. Because prostate cancer is so common, doctors tend to be leery of prescribing testosterone to men who may be at higher than average risk of having undiagnosed prostate cancer. Testosterone therapy is approved for the treatment of delayed male puberty and abnormally low production of testosterone secondary to malfunction of the testes, pituitary or hypothalamus. Although testosterone may make prostate cancer grow, it is not clear that testosterone treatment actually causes cancer. As surprising as it may be, women can also be bothered by symptoms of testosterone deficiency. Some men who have a testosterone deficiency have symptoms or conditions related to their low testosterone that will improve when they take testosterone replacement. A study published in the Journal of Clinical Pharmacy and Therapeutics found that testosterone cypionate stored at high temperatures (over 25C) for extended periods of time had a significant reduction in potency.
Of those, five were analyzed, and the others were placed at −20°C, repeating the cycle two more times. Further, five aliquots were placed at room temperature (24 h) or −20°C (48 h) after processing and before analysis. For each sample, five aliquots were processed and immediately analyzed (baseline), five were stored at room temperature (24 h) before processing, and five were placed at −20°C (8 weeks) prior to processing. Two QC samples (1.5 and 45 ng/ml for plasma and 30 and 360 pg/ml for saliva) were used for stability studies.
As an example, a total testosterone value of 250 ng/dL may be considered low based on the current guideline but be marked within the normal range by the laboratory. Well-established reference ranges constitute the essential basis for identifying whether the circulating levels of a particular analyte, testosterone in this case, are normal or low. Evidence strength refers to the body of evidence available for a particular question and includes not only individual study quality but consideration of study design, consistency of findings across studies, adequacy of sample sizes, and generalizability of samples, settings, and treatments for the purposes of the guideline. The goals of this document are to (i) guide clinicians in how to assess patients for testosterone deficiency and manage them with testosterone products, and (ii) educate clinicians in key areas of testosterone in which many clinicians are deficient (e.g., interpreting the testosterone literature, understanding testosterone laboratory testing). Testosterone levels should be measured every 6-12 months while on testosterone therapy. Patients should be informed that there is no definitive evidence linking testosterone therapy to a higher incidence of venothrombolic events.

Maple Gorham, 20 years
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Because we’re still unsure of how nicotine affects testosterone, it’s difficult to conclude how quitting smoking will affect someone’s testosterone levels. In some cases, studies have found that nicotine can increase testosterone levels ― while other studies have found a decrease in testosterone with nicotine use. Our objectives were to examine the association of cigarette smoking and serum levels of sex hormone-binding globulin (SHBG), total testosterone (TT) and free testosterone (FT) in a large male population. Since cigarette smoking is a major health problem and highly prevalent among men, several groups have studied the effects of cigarette smoking on testosterone levels in men. The reported effects of cigarette smoking on testosterone levels in men are conflicting, and smoking may be an important confounding factor when evaluating the relationship between testosterone levels and CHD. If a doctor diagnoses low testosterone, they may recommend hormone replacement therapy, which can effectively increase your testosterone levels. A small 2017 study with 50 participants found that taking 500 mg of fenugreek extract per day increased free testosterone levels by up to 46% in 90% of participants after 12 weeks.
Clearly, smoking affects hormones well beyond just testosterone. This occurs because smoking changes how the liver processes estrogen, which reduces the amount of the hormone in the body. Cortisol, the stress hormone, can cause health issues when its levels stay high for too long. These can include age, hormone status, and other lifestyle choices.
Some studies show that it can increase testosterone, while others describe the opposite effect. The impact of smoking on testosterone is unclear yet. Overall, nicotine is not a safe way to increase testosterone.
Researchers suggest this may occur because smoking damages cells in the testicles, reducing testosterone production. These studies suggest the link between smoking and testosterone is complex. Quitting smoking is one of the best choices for your overall health, no matter its effect on a single hormone.
Symptoms of low testosterone in females are not well characterized. Testosterone is an androgen steroid hormone and the principal male sex hormone, but it is also produced in females. Buy this testosterone test, visit a nearby Quest location, and get fast results. In females, the role of testosterone is only partially understood, but it helps produce estrogen and may help regulate how eggs develop in the ovaries. Testosterone is often referred to as "the male sex hormone", but it is also produced in (and important for) females.
A 2021 study involving 289 participants concluded that smokers had a lower testosterone level than non-smokers. Unlike these studies that demonstrate a positive correlation between smoking and testosterone, some studies show that smoking decreases testosterone. However, this effect is only temporary as smoking can lead to low T in the long run by negatively impacting overall health.
Research on testosterone boosters is inconclusive, but some ingredients may be beneficial. Tests purchased on questhealth.com are only for individuals who intend to pay directly for testing and do not want to submit a claim for reimbursement under their health insurance. Tests purchased on questhealth.com are intended for individuals paying directly—we do not bill insurance, and purchases cannot be submitted for insurance reimbursement. Testosterone levels fluctuate throughout the menstrual cycle, but it remains important throughout life. Questhealth.com offers 150+ consumer-initiated Quest Diagnostics lab tests to empower you to have more control over your health journey. Quest Mobile is currently only available for individuals ages 18+.
If you’re looking for a simple way to try and naturally increase testosterone levels, the supplements on this list may be beneficial. However, while there are evidence-based ways to naturally support healthy testosterone levels, there’s limited research on the effectiveness of testosterone boosters. These supplements include compounds that can either increase testosterone or related hormones directly, or help prevent your body from converting testosterone into estrogen.
It features vitamin D3, which can increase vitamin D blood levels more and for longer than vitamin D2. However, people with low or deficient vitamin D levels require much larger dosages of supplemental vitamin D. That said, maintaining optimal vitamin D status is essential for overall health. In its active form, vitamin D functions as a steroid hormone in your body and is essential for male sexual function. Moreover, researchers aren’t sure exactly how ashwagandha works to support testosterone and DHEA-S levels. Also, keep in mind that these effects on testosterone and DHEA-S are not sustained over time after ashwagandha is discontinued — meaning you’d have to keep taking ashwagandha supplements to possibly maintain these effects.

Woodrow Bunch, 20 years
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