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question from a user

Why do the testosterone reference ranges vary widely depending on practitioner / lab? Is there a study demonstrating a shift towards lower Total Testosterone reference ranges in 2024 compared to the reference ranges used say 40 years ago or similar time frame? I feel like lower and lower TT is becoming normalised, but that isn’t a good thing.

AlphaMD's Answer

What is "average" and what is "normal" are not the same thing. The average person in most developed nations is obese, so does that mean obesity is "normal" just because it is average? "Normal" does not equate to "healthy". Testosterone levels are dropping, so now the "normal" level is well below what normal used to be.

Men today have on average 25-33% less testosterone than their fathers did at the same age. Our fathers have on average 14% lower testosterone than their fathers did at the same age.Insurance companies now have adopted these lower testosterone levels as "normal" because it excludes millions of men who need treatment, which of course saves them money. They can deny care for men who are in the "normal" range.Insurance companies for the most part decide what they will & won't cover. They make the most amount of money when the least amount of care is covered. They are typically for-profit companies.

Giving such a wide range and claiming that anyone in that range is fine, is very detrimental to the health of millions of men suffering from low Testosterone symptoms. There is no other hormone, or any other lab value for that matter, where the "normal" range is as wide as the range labs have given for testosterone (180-1100 is the widest I have seen).

Hormone levels in men are subjective to the individual. Insurance companies don't like that. GP who haven't looked at hormone treatments in decade or not had continuing education on the matter don't like that, and they are far less comfortable/confident working with something they don't know well & would rather shy away from it using their own biases.

It needs to be okay to say that a man needs help with his hormones without it being a bad thing or without other men shaming him for it.

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