Ideal Testosterone: What Is It?

What Is the Ideal Testosterone Level?
I had someone write into the Peak Testosterone Forum and ask about the ideal target testosterone level? This is an very interesting and confusing question, primarily because doctors have such a wide range of approaches and opinions.  Some doctors are very cautious and only wish to raise testosterone a little bit.  For example, one man just wrote in the following story, where he asked his doctor, “How do you gauge if the HRT is working?”  The doctor’s answer:

“I maintain total testosterone between 400 and 500 using gels or injections.” [1]

So this physician, a urologist in this case, basically ignores all symptoms and maintains pretty low levels of testosterone compared to the clinics.  In his mind, he is “playing it safe.”

The is in direct contrast with the typical anti-aging doctor or HRT clinic out there, who insists that you want youthful peak testosterone levels, where youthful by their definition is usually around 1200 ng/dl peak.  (Their average testosterone levels are usually around 800-900 ng/dl.)  That is a wide difference, of course, so who is right?

Let me tell you why I believe both of the above approaches are wrong and the truth lies in a much more rational middle ground.  First of all, let’s look at four things that need to be considered with regards to HRT:

1. Classic Low Testosterone Symptoms. This includes items like low libido, erectile dysfunction, lack of morning erections, fatigue, poor sleep, depression, anxiety, mental fog, etc.  These are the symptoms that plague so many hypogonadal men out there and get them in the doctors office in the first place.  “I don’t feel right, doc!”  One more I would add is like of gains and motivation to go to the gym.

2. Medical Conditions. This can include things like prediabetes, elevated insulin levels, elevated blood glucose level, osteoporosis, and anemia. Venous leakage is another big one and I urge you to read my link on The Symptoms and Causes of Venous Leakage.  Low testosterone can can be a root cause for venous leakage or any of the other medical conditions.  Why?  Testosterone almost always lower insulin levels and increases insulin sensitivity;  it increase red blood cell production; and one of its “byproducts,” estradiol, keep your bone mass healthy.  (I have many links on these subject, so use the Search button above if they apply.)

3. Side Effects. Unfortunately, HRT is not without side effects from time to time.  These include acne, enlarged prostate, elevated blood pressure, gyno, hair loss and elevated red blood cell counts. None if these are very common from what I have seen but they do happen from time to time.

4. Estradiol Symptoms.  If a man goes high enough with his testosterone, estradiol will follow behind and also go higher.  These leads to symptoms like bloating, water retention, gynocomastia and moodiness. Some doctors will, instead of lowering testosterone, put a man on Arimidex.

NOTE:  Of course, many men can lower the symptoms by losing weight. Even losing 10 pounds or 20 pounds for some men can make a big difference in these types of symptoms.so high estradiol symptoms can be a combination of extra fat and overly high testosterone levels. And some men are just “high converters.”

So here is my formula for testosterone:

Go as low as possible to eliminate your low testosterone symptoms, side effects and any high estradiol issues but high enough to cure any medical conditions that have resulted from being hypogonadal. 

The key thing is that you need lots of adequate testing and a physician that knows what he is doing to do the above.  The alternative is to just start out high and go all out with higher testosterone levels.  The clinics will often do this so the guy gets that “wow!” effect and is a paying customer from what I have seen.  However, I would argue that this may not be the safest strategy.  One of the reasons is that there is some evidence that, for men with certain clotting issues, higher testosterone, estradiol and Arimidex levels may be putting him at risk.  Read my page on Testosterone Risks for more information.

Of course, your situation will be very different from mine and so you will have to make your own judgement, working of course with your doctor. The strategy is always similar though:  you want to minimize negative issues and still reach your baseline goals.

So is the magic number for you 600? 900? 1200? Again, the answer is that it really depends. In my case I started out a little high in testosterone and this is not necessarily a good thing.  I believe that it did get me over my venous leakage more quickly, but I ended up with a bit of gyno for a few months.

The truth is that I probably only need testosterone levels of six or seven hundred. This is when I have noticed that my morning erections are frequent. I also have noticed that I seem to feel pretty good mentally with testosterone around six or seven hundred and near the end of mine weekly injections cycle. But there are many who feel very good in the 400’s and 500’s. So every case is different and every man’s situation and requirements will be different.

In my opinion, you want to be as safe as possible. The word here is sustainable.  Is this something that you can do the year after year, decade after decade and end up more healthy and more fit and better able to produce at your job and make you a better parent (if applicable)?

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