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We usually think of testosterone as a good thing — it drives libido, muscle growth, and overall vitality. Yet, too much testosterone can tip the body’s natural balance, leading to issues like lower sperm count or fertility challenges.
Recognizing the signs of high testosterone can make all the difference in keeping that balance right. Here’s everything you need to know about high testosterone levels in men.
Key Takeaways
- Testosterone is a male hormone that peaks around age 20 and naturally declines with age.
- Acne, mood swings, and an enlarged prostate are some possible signs of high testosterone in a man.
- High testosterone can counterintuitively cause infertility. It impairs sperm production and shrinks the testicles.
- Abnormally high testosterone is a side effect of steroids and testosterone replacement therapy.
- A hyperactive thyroid or tumor can also be responsible for high testosterone levels.
- Treatment depends on the specific cause of high testosterone levels.
- Antiandrogen medications can help lower high testosterone levels when there’s no known cause.
What Does Testosterone Do?
Testosterone is the major sex hormone for men. It’s responsible for men’s primary sexual development. Testosterone is responsible for the changes that happen during puberty, such as:
- Descent of the testicles
- Production of sperm
- Enlargement of the penis and testes
- A normal libido (sex drive)
Testosterone also helps regulate secondary male characteristics, such as:
- Male hair patterns
- Vocal changes and voice deepening
- Growth spurts
- Muscle growth
- Red blood cell production
Testosterone levels peak around age 20. After that, they tend to decline with age. As men get older, they may notice smaller testicles and a drop in libido. Lower testosterone also means reductions in muscle mass, bone density, and red blood cells. In addition, body fat levels usually creep upward as testosterone levels go down.
What Are Normal Testosterone Levels?
Your healthcare provider usually asks for a blood test to measure your total testosterone and free testosterone levels.
Different laboratories may have different standards for a normal testosterone range. Generally, total testosterone in men should be somewhere between 270 and 1,070 ng/dL.
Note: Most of the testosterone in the blood attaches to one of two proteins: albumin or Sex Hormone-Binding Globulin (SHBG). However, some testosterone in the blood is unattached or “free.” The total testosterone measurement includes both types, free testosterone and testosterone that’s attached to protein. However, a free testosterone test measures only the testosterone that’s not attached.
If your doctor suspects that you have symptoms of high testosterone, they’ll check your total testosterone levels first. Free testosterone testing is usually for people with low testosterone levels.
Signs of High Testosterone in a Man
Higher levels of testosterone aren’t always a big concern. One potential benefit of high testosterone in men is more muscle mass. Higher testosterone levels enhance protein synthesis. That means it makes it easier for muscles to recover and grow after exercise.
However, testosterone values above 1000 ng/dL can cause health problems. Here are some of the negative signs of high testosterone in a man.
Skin blemishes
Acne is a common sign of high testosterone in women and men. Studies show that people with acne produce more androgens (male hormones). Specifically, their skin has higher levels of a type of testosterone called 5α-dihydrotestosterone (5α-DHT).
Androgens regulate sebum production. Sebum is a naturally occuring oil that protects the skin. Androgens can lead to too much sebum, which clogs pores and causes pimples.
Fertility and urinary problems
High testosterone levels can lead to a low sperm count. Too much testosterone suppresses the production of follicle-stimulating hormone (FSH). Low FSH means reduced sperm production and sometimes, infertility.
High testosterone can also lead to an enlarged prostate gland, a condition known as BPH (benign prostatic hyperplasia). Men with BPH may have trouble urinating. They often wake up at night to urinate and experience problems like an interrupted urine stream.
Dihydrotestosterone (DHT) is a powerful hormone that comes from testosterone and has a crucial role in the growth of prostate cells. DHT gets converted from testosterone by an enzyme called 5α-reductase. Higher activity of 5α-reductase in the prostate can lead to higher DHT levels and a bigger prostate.
Cardiovascular concerns
Higher levels of testosterone in men may raise blood pressure. While this effect isn’t completely understood, experts think it could be related to the renin-angiotensin system.
High testosterone from Testosterone Replacement Therapy (TRT) or steroid use can lower good cholesterol levels (HDL). However, testosterone that’s naturally produced by the body doesn’t seem to have this effect.
Testosterone also stimulates red blood cell production. Polycythemia is a condition where the body overproduces red blood cells. Testosterone, particularly in TRT, can sometimes lead to secondary polycythemia.
Polycythemia may cause symptoms such as:
- Blurry vision
- Fatiguetumor
- Headache
- Tingling sensations (paresthesias)
Your healthcare provider should take a baseline hematocrit value before starting testosterone therapy. Hematocrit reflects the concentration of red blood cells in your blood. When starting testosterone therapy, your doctor should check your bloodwork at 3, 6, and 12 months. After that, it should be monitored yearly. High hematocrit means thicker blood. And thicker blood is more likely to form dangerous blood clots.
Mood changes
Testosterone doesn’t just affect your physical health. It can also impact your emotions. Testosterone replacement therapy can help reduce depression in men with low testosterone levels. However, men with high testosterone may feel more aggressive and irritable. They may also have greater mood swings, poor judgment, and, in severe cases, delusions.
If a man is acting in a way that seems out of character, it might be time to get a testosterone blood test. It’s possible that hormone changes are partly to blame for a sudden change in mood or behavior.
Possible Causes of High Testosterone in Men
High testosterone is a common and dangerous side effect of anabolic steroids. It can also be caused by TRT. Doctors may prescribe TRT if you have a testosterone deficiency or related symptoms. However, the effects can be too strong and leave you with high testosterone.
Keeping up with routine bloodwork is crucial to monitoring how your body responds to TRT. Your dosage may need to be adjusted if your levels get too high.
High testosterone can also be caused by underlying health conditions, including:
- Tumors of the adrenal glands or testicles
- Congenital adrenal hyperplasia
- Hyperthyroidism (Men with hyperthyroidism produce more SHBG, leading to increases in total testosterone levels.)
Treatment Options for High Testosterone Levels
Signs of high testosterone in a man are a good reason to have a blood test. For abnormally high testosterone levels, your healthcare provider will need to investigate. They need to find the cause before they can treat it.
Men who use anabolic steroids or TRT will need to stop taking these substances to get their levels back down to the healthy range. But it’s not always clear what’s causing high testosterone. If your doctor’s not sure, they’ll run tests to screen for underlying problems. For example, they may check for tumors or high thyroid hormone levels (hyperthyroidism). Treating these conditions can help normalize testosterone levels.
If your healthcare provider can’t identify the cause of high testosterone, they can prescribe medication to lower your levels. Antiandrogens, like spironolactone or cyproterone, help reduce testosterone.
FAQs
Signs of high testosterone in a man can prompt testing to check blood levels. Your healthcare provider can measure how much total testosterone is in your blood. Usually, levels between 270 and 1,070 ng/dL may be considered normal. But there may be some exceptions based on your age and other factors.
Signs of high testosterone in a man can show up in different ways, including:
- Acne
- Mood changes
- Increased muscle mass
- High red blood cell counts (hematocrit)
- Low sperm production
- Shrunken testicles
Men can face serious health problems when testosterone levels are too high. High testosterone increases the risk of blood clots and cholesterol problems.
Optimal testosterone levels in men promote fertility and sexual function. Testosterone also supports mental and physical health when it’s in the normal range for men (between 270 and 1,070 ng/dL).
Some studies suggest that elevated testosterone levels lead to a stronger body odor in men. But researchers haven’t found a distinct smell or definite proof that testosterone changes how a man smells.
Testosterone is responsible for men’s libido. High levels increase the drive to have sex.
High testosterone can increase a man’s ability to build stronger muscles and bones. However, abnormally high testosterone levels pose risks.
Excess testosterone increases the chance of developing dangerous blood clots. It also lowers good cholesterol levels, which protect the heart. Other signs of high testosterone in a man may include acne, aggressive behavior, an enlarged prostate, and infertility.
High testosterone can promote aggression and irritability in men. However, it’s not the only possible cause of anger. Since mood changes can be related to hormone levels, it’s worth checking testosterone levels if anger suddenly becomes a concern.
Testosterone levels vary by age. Total testosterone levels over 1000 ng/dl can be too high. A healthcare provider needs to review your individual results. They’ll also consider your medical history and other factors before deciding if you have high testosterone.
High testosterone can be good, but only to a point. Ideally, testosterone levels should stay in the normal range, which can be anywhere between 270 and 1,070 ng/dL for most men. When testosterone levels are too high, there’s a greater risk of health and fertility problems.
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