When it comes to testosterone, most men are worried about not having enough. Makes sense, given low T can deliver a host of symptoms that can wreck your physical, mental, and emotional health. But as any guy who has tried to get his money’s worth on an endless fries deal knows, there’s a fine line between the sweet spot and ‘Houston, we have a problem.’ And so it goes with testosterone. Because high testosterone in men can be as problematic as low T.
Some good news: While low testosterone is becoming increasingly common—research from the American Urological Association (1) suggests that up to 40 percent of adult men and 20 percent of men under the age of 40 are testosterone deficient—high testosterone is relatively rare.“It’s uncommon for men to naturally have too much testosterone,” says urologist Joshua Calvert, M.D.
However, genetics, steroid use, and some medical conditions can push testosterone levels out of the healthy range. An overabundance of T can lead to behavior and mood changes, skin issues, sleep problems, lower sperm count, and more.
Worse, left untreated, high testosterone can raise your cholesterol, upping your risk for high blood pressure and cardiac events like a heart attack or stroke, says Calvert.
What is Testosterone
Testosterone is the primary sex hormone in men. It regulates your sex drive, your ability to put on muscle, sperm production, and more. Testosterone is primarily produced in the testes, which ramp up production of the hormone as puberty approaches. They keep pumping it out at a decent clip until your mid 30s, when T levels naturally start to decline.
Having a testosterone level in the normal range is essential for health. If your T levels dip too low, you can develop a cluster of symptoms including:
- Weight gain
- Low libido
- Decreased muscle strength
- Mood swings
- Erectile dysfunction
- Hair loss
What Are Normal Testosterone Levels for Men?
Testosterone is measured in nanograms per deciliter (ng/dL) and levels fluctuate with age, says Calvert. T peaks in your late teens and early twenties, with healthy levels between 300 and 1,200 ng/dL.
Around the time you enter your mid-thirties, T levels start to decline at a rate of around one percent per year (2). But increasingly, more men are seeing sharper declines. “If your testosterone level drops to 200 ng/dL or below, and you have symptoms of low T, that’s when you’ll be diagnosed with a testosterone deficiency,” says Calvert.
While eating certain foods and adopting healthy behaviors can help nudge T levels up, most men need medical treatment. Testosterone replacement therapy—a form of hormone optimization where testosterone is supplemented via injections, topical treatments, under the tongue lozenges, or other delivery methods—can get your T levels back in the normal range, says Calvert.
“With TRT, most men start to feel better within a few months,” says Calvert. “Their sex drive is back, they lose weight, build muscle, and have more energy.”
High Testosterone in Men
If you’ve seen guys at the gym who use anabolic steroids to build muscle mass and amp their performance, you probably have a visual of what high T levels can do. High testosterone in men can make it easier to build muscle, but men with high testosterone—which is anything over 1100 ng/DL (3)—can experience unpleasant and even dangerous side effects (4).
Symptoms of High Testosterone
- Low sperm count
- Heart muscle damage
- Prostate enlargement
- Liver damage
- Weight gain / Increased appetite
- High blood pressure
- Sleep problems, including sleep apnea
- Increased muscle mass
- Mood swings
- Aggressive behavior
- Excessive body hair or hair growth
KNOW YOUR T
What Causes High Testosterone in Men?
It’s rare for men to naturally have too much testosterone, says Calvert. However, researchers have found that some men are genetically predisposed to high T.
More often, abnormally elevated T levels are a result of anabolic steroid use. “Anabolic steroids that guys take to boost their athletic performance and build muscle mass can have between 10 and 30 times the testosterone of a prescribed TRT dose,” says Calvert.
Tumors in the adrenal glands or testicles can also cause T levels to spike. Adrenal gland tumors that produce sex hormones are rare; you’ve got about a 2 in a million chance of developing one (5), and they aren’t always cancerous. Tumors in the Leydig cells of the testes (where sperm is produced) are also rare, and are usually benign (6).
Another—albeit temporary—cause of high testosterone: TRT. “When you first start TRT your doctor will titrate the dose and monitor your T levels closely. In rare cases, T levels can get too high too fast and dose adjustments down are necessary. This is why it is critical to keep in contact with your provider’s office and have frequent lab checks,” says Calvert.
Another way that TRT can excessively elevate your testosterone levels is if you choose topical TRT. If you don’t wash all of the testosterone cream or gel off of your hands after application, you could accidentally transfer more of it onto your skin than prescribed. The simple fix: scrub up with soap and water after you use them.
Is it Bad to Have High Testosterone?
In addition to the symptoms listed above, the biggest dangers of excess testosterone include:
You might assume that since testosterone is needed to make sperm, that move of it would equal more swimmers. But elevated T levels will decrease sperm count—even if they don’t surpass the normal range. “That’s why I don’t prescribe TRT for men who want to have children,” says Calvert.
TRT raises testosterone levels but it also lowers sperm production by decreasing levels of another hormone, called follicle stimulating hormone (FSH), which is necessary to produce sperm. For men with low T who want to have children, treatments such as Clomid can reduce symptoms of low T while leaving fertility intact.
According to a 2019 study, men with a genetic predisposition to high testosterone levels have a nearly eightfold increased risk of heart disease and twice the risk of blood clots that can block arteries that lead to the brain and lungs (7).
Treating High Testosterone in Men
If you’re experiencing symptoms of high testosterone in men and a blood test shows that your T levels are too high, dialing them back down depends on why they’re elevated in the first place.
Anabolic steroid use
If you’re taking anobolic steroids, stop. If you started to take them because you thought you had low T, talk to your doctor. He or she can monitor your testosterone and get you on the right dose of TRT if they determine that’s the best treatment.
If you’re already on TRT, your doctor can adjust your dose and monitor your T until it’s in the normal range.
Adrenal or testicle tumors
If a tumor is causing your T levels to spike, your doctor may recommend surgery to remove the tumor. If the tumor is cancerous, your physician can help you determine the best treatment.
The Bottom Line