What Is Testosterone?
Testosterone is a hormone produced primarily in the testes in men and in the ovaries and adrenal glands in women. While most closely tied to libido, it also influences a range of processes linked to improved healthspan, including your body’s ability to store and burn fat, red blood cell production, bone density and even your emotions and mood.
Why Testosterone Matters
- Promotes lean muscle development and fat distribution by activating androgen receptors in muscle tissue, stimulating protein synthesis, and helping regulate body fat distribution1
- Supports libido in men and women and maintains erectile function in men by improving blood flow to the penis through nitric oxide signaling and influencing pathways involved in sexual desire.
- Stimulates bone mineralization and maintains bone density by supporting the conversion of testosterone to estradiol, which is critical for bone maintenance
- Improves cardiovascular function by regulating red blood cell production and influencing blood vessel tone
- Improves mood and cognition by modulating neurotransmitters such as dopamine and serotonin and supporting neuronal signaling
- Supports fertility by supporting sperm production in men and contributing to ovarian function in women
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How to Interpret Total Testosterone Levels
(Ranges may vary slightly by lab)
Standard reference ranges represent the middle 95% of healthy individuals but don’t necessarily reflect levels associated with longevity. Optimal ranges are derived from clinical guidelines, peer-reviewed research, and real-world outcomes data, with an emphasis on levels associated with peak functioning and reduced disease risk.
Benefits of Optimizing Total Testosterone
- Maintains muscle mass and strength
- Supports bone density
- Improves libido and sexual satisfaction2
- Stabilizes mood and cognitive clarity
- Supports metabolic health
- Improves cardiovascular health
- Supports red blood cell production and energy levels
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Low Total Testosterone
Symptoms
- Persistent fatigue and reduced energy
- Decreased libido and sexual performance issues3
- Difficulty building or maintaining muscle
- Increased body fat, particularly around the abdomen
- Mood changes, irritability, and low motivation
- Reduced exercise capacity and slower recovery
Causes (Men)
- Aging
- Metabolic conditions such as obesity or type 2 diabetes
- Chronic stress
- Certain medications (opioids)
- Pituitary or hypothalamic disorders
- Sleep apnea
Causes (Women)
- Perimenopause and menopause
- Hormonal contraceptive use
- Overtraining
- Poor sleep
- Restrictive diet
- Adrenal insufficiency
- Certain medications (opioids)
Healthspan impacts
- Chronic low total testosterone increases the risk of:
- Accelerated aging and reduced longevity
- Osteoporosis and fractures
- Cardiovascular disease and metabolic syndrome4
- Type 2 diabetes due to insulin resistance
- Anemia
- Depression and cognitive decline
High Total Testosterone
Symptoms
- Acne and oily skin
- Mood swings and increased aggression
- Fluid retention and elevated blood pressure
- Sleep disturbances (sleep apnea, insomnia)
Causes (Men)
- Anabolic steroid use
- Excessive testosterone replacement therapy (TRT)
- Excessive exercise
- Pituitary disorders
- Adrenal tumors (rare)
- Testicular tumors (rare)
Causes (Women)
- Polycystic ovary syndrome (PCOS)
- Congenital adrenal hyperplasia
- Androgen-secreting tumors of the ovaries or adrenal glands
- Cushing’s syndrome
- Insulin resistance
- Certain medications (anabolic steroids or DHEA supplementation)
Healthspan impacts
Sustained high testosterone can lead to:
- Prostate enlargement in men, specifically benign prostatic hyperplasia (BPH)
- Infertility in men due to suppression of sperm production5
- Liver dysfunction with oral formulations
- Deep vein thrombosis risk from increased hematocrit
How Hone Treats Out of Range Total Testosterone Levels
Your Hone physician evaluates total testosterone alongside free testosterone, SHBG, estradiol, and related biomarkers, along with symptoms and overall health. From there, they will create a personalized treatment plan that may include lifestyle changes, medications, and supplements.
- Testosterone replacement therapy (TRT) (men and women) — to directly raise circulating testosterone levels when the body is not producing enough. TRT can be delivered through injections, cream, or oral lozenges called troches
- Enclomiphene or clomiphene citrate (men) — to stimulate the brain’s release of luteinizing hormone (LH) and follicle stimulating hormone (FSH), encouraging the testes to produce more testosterone
- Anastrozole (men)— to reduce conversion of testosterone into estradiol when estrogen levels are suppressing testosterone production
*If you are on treatment to increase testosterone, regular monitoring is essential. Your doctor will check your total testosterone levels every 3-6 months to ensure you stay within a healthy range.
- Vitamin D
- Zinc
- Magnesium
- Omega-3
- Iron
- Reduce alcohol and tobacco use
- Manage stress
- Get 7-8 hours of quality sleep each night
- Incorporate moderately intense aerobic exercise and resistance training
- Maintain a healthy body weight and metabolic health
A. Qaseem. (2020) Testosterone Treatment in Adult Men With Age-Related Low Testosterone: A Clinical Guideline From the American College of Physicians. Annals of Internal Medicine.
↑S. Diem. (2020) Efficacy and Safety of Testosterone Treatment in Men: An Evidence Report for a Clinical Practice Guideline by the American College of Physicians. Annals of Internal Medicine.
↑J. Hudson. (2023) Symptomatic Benefits of Testosterone Treatment in Patient Subgroups: a Systematic Review, Individual Participant Data Meta-analysis, and Aggregate Data Meta-analysis. The Lancet Healthy Longevity.
↑A.M. Lincoff. (2023) Cardiovascular Safety of Testosterone-Replacement Therapy. The New England Journal of Medicine.
↑M.D. dos Santos. (2020) Benefits and Risks of Testosterone Treatment in Men With Age-Related Decline in Testosterone. Annual Review of Medicine.
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Reviewed for Accuracy by Our Medical Review Board
This biomarker information has been reviewed by a member of Hone’s medical review board. As part of the medical review team, physicians fact-check this content against the latest research and their own experience treating their patients.
Ashley Winter, M.D., is a board-certified urogynecologist trained at Weill Cornell and Cleveland Clinic. She specializes in female and male sexual dysfunction, urinary issues, genital pain, and hormone therapy.
James Staheli, D.O., is the Medical Director for Broad Health, Hone Health’s affiliated medical practice and a family medicine doctor in Atlanta, Georgia.
