High Testosterone in Men: Causes and Signs of High T Levels

If you’ve seen guys at the gym who use anabolic steroids to build muscle mass and amp up their performance, you might think you have a visual of what high testosterone levels can do. But having too much testosterone can be just as concerning as low testosterone—and just as serious. High testosterone levels in men can lead to changes in behavior and mood, skin problems, disrupted sleep, a lower sperm count, and more.

High testosterone levels are most often linked to anabolic steroid use, certain medical conditions, or in rare cases, genetics.

Here’s what you need to know about high testosterone in men, including the signs to look out for, causes, and how it can be treated safely and effectively.

What Are Normal Testosterone Levels for Men?

Healthy testosterone levels are between 300 and 1,000 nanograms per deciliter (ng/dL).
Levels fluctuate with age, peaking in your late teens and early twenties, then starting to decline over time, says urologist Joshua Calvert, M.D..

Testosterone is the primary male sex hormone. It regulates your sex drive, your ability to pack on muscle, your sperm production, and more. Testosterone is produced mostly 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 testosterone levels naturally start to decline at a rate of around 1 percent per year. ¹

High testosterone vs low testosterone

The general range for what is considered to be low testosterone, average testosterone, and high testosterone levels is as follows:

• Low testosterone: <300 ng/dL
• Average testosterone: 300–1,000 ng/dL
• High testosterone: >1,100 ng/dL ²

While any hormone imbalance can cause unpleasant side effects, men might experience different symptoms depending on their condition:

• Hypogonadism is clinically low testosterone levels typically caused by aging or during recovery from anabolic steroid use. Low testosterone symptoms include fatigue, low sex drive, weight gain, and a decrease in muscle mass.
• Hypergonadism: Clinically high testosterone levels in men have been linked to symptoms ranging from headaches, hair loss, and oily skin to weight changes, mood swings, difficulty sleeping, aggravation of any existing benign prostatic hyperplasia (enlarged prostate), and infertility.

While rates of low testosterone (hypogonadism) are increasing, naturally high testosterone levels in men are relatively rare. “It’s uncommon for men to naturally have too much testosterone,” says Calvert. Research from the American Urological Association suggests that up to 40 percent of adult men and 20 percent of men under age 40 are testosterone deficient. ³

Signs of High Testosterone Levels

A blood test can determine if you have high testosterone. Anything over 1,100 ng/dL might be considered a high testosterone level in men ⁴ and potentially cause these effects.

Increased muscle mass

Men with high testosterone levels often experience rapid increases in muscle mass. ⁵ The hormone is linked to muscle protein synthesis, which helps those traps, lats, and other muscles repair and rebuild after workouts. Recent research has found that higher testosterone is linked to greater muscle mass, though not necessarily more muscle strength.⁶

Testosterone drives up the body’s production of a muscle-stimulating hormone called Insulin-like Growth Factor-1 (IGF-1), which then encourages activation of growth hormone throughout the body. ⁷

Along with bulkier muscles, men with high testosterone can experience negative side effects.

Mood swings

Testosterone contributes to overall emotional and mental wellbeing, so if your testosterone levels are high, you might feel more energetic and confident. But men with high levels can also feel irritable and moody—also more impulsive, aggressive, and angry, especially if estrogen levels also climbed with treatment. ⁸

Difficulty sleeping

Both too much and too little testosterone can disrupt sleep or cause insomnia. ^{9 10} Research is limited, but a small, older study suggests that high testosterone levels can throw off melatonin production, which regulates the sleep-wake cycle. ¹¹

Acne

High testosterone levels can increase acne due to testosterone’s role in the production of oily sebum, a fatty substance that moisturizes the skin. Just like in their teen years, men with high testosterone might have a face (or back) spotted with clogged pores, whiteheads, and pimples. ¹²

Enlarged prostate

Research is unclear on whether high testosterone levels lead to increased prostate size. For years, doctors noticed that men with prostate cancer or benign enlarged prostate (prostatic hyperplasia) often saw their prostates shrink when treatments lowered testosterone.¹³

However, a recent study of middle-aged and older men with low testosterone found no significant difference in prostate issues between those who received testosterone replacement therapy (TRT) and those given a placebo. ¹⁴

Changes in Sexual Performance

While men with high testosterone may have a high sex drive, ¹⁵, they may also have difficulty getting erections due to an enlarged prostate. ¹⁶ While clinically prescribed testosterone replacement therapy (TRT) should not result in prostate changes, taking high dosages of anabolic steroids is more likely to increase prostate size. ¹⁷

Fertility

High testosterone can also impact fertility and lower sperm production. When testosterone levels get too high, the brain dials back production of two hormones that are crucial for sperm production: follicle-stimulating hormone (FSH) and luteinizing hormone (LH). As a result, sperm count plummets. ¹⁸

One physical indication of a reduced sperm count is a decrease in testicle size. Hormone disruptions with FSH and LH affects testosterone production within the testicles, which then causes testicular atrophy. While either TRT or anabolic steroid use can result in testicular atrophy, overall health risks are more severe for anabolic steroid use. ¹⁹ Research has found there’s more shrinkage from injectable TRT compared to other forms. ²⁰

Hair loss

When men have more testosterone than they need, the body converts the excess into dihydrotestosterone (DHT), a more potent form of the hormone, potentially resulting in hair loss. ²¹ Men who have more of the alpha DHT (the biologically active form of the hormone, vs. beta DHT, the biologically inactive form) at the scalp are more likely to have hair loss. Popular hair growth treatments such as finasteride work by interrupting this conversion process. ²²

Headaches

High testosterone can sometimes trigger headaches. ²³ One possible reason is polycythemia, which happens when testosterone stimulates production of red blood cells, thickening your blood and making it harder for it to move through blood vessels—including the ones in your head. ^{24 25}

High testosterone can also raise blood pressure, putting extra strain on the blood vessels in your brain and neck, which can contribute to headaches. ^{26 27}

Hormone swings in general may play a role. When testosterone levels rise or drop suddenly, it can throw off blood flow and pain signaling, making you more sensitive to pain. ²⁸ Some men notice headaches when their hormone levels are shifting. Emerging research supports a link between changing androgen levels and headache risk. ²⁹

Weight changes

Higher levels of testosterone can lead to weight loss or weight gain, depending on factors like diet, lifestyle, and other health conditions.

You might lose weight with high testosterone because the hormone is associated with greater muscle mass, and muscle increases the metabolism to help burn fat. ³⁰

But you could also gain weight with high testosterone as the body sends hunger signals to compensate for an increase in resting metabolic rate. ³¹ A revved-up metabolism might make you eat more.

Learn More About Testosterone

Free Testosterone Levels vs. Total T: High vs. Low

Is TRT Steroids? Anabolic Steroids vs. Testosterone Replacement Therapy

What Causes High Testosterone in Men?

It’s rare for men to have too much testosterone naturally, says Calvert. High testosterone in men is usually driven by supplementation of the hormone or a medical issue:

Anabolic steroid use

Abnormally elevated testosterone levels are often 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.

TRT

Testosterone replacement therapy (TRT) can sometimes lead to high testosterone levels, which are typically elevated in the first weeks of treatment. Spikes in testosterone are common with intramuscular injections—typically peaking about 48 to 72 hours after dosing. If the dose is too high or not timed correctly, hormone levels can temporarily exceed the normal physiological range. ³²

“When you first start testosterone therapy, your doctor will titrate the dose and monitor your T levels closely,” Calvert explains. “In rare cases, T levels can get too high too fast, and downward dose adjustments are necessary.” This is why it’s critical to keep in contact with your provider’s office and have frequent lab checks. When prescribed to treat clinically low testosterone levels, TRT can restore your testosterone levels to a normal range, says Calvert.

Testosterone levels can also get excessively high when you use 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 a topical testosterone product.

Tumors in the adrenal glands or testes

Adrenal gland tumors that produce high testosterone levels in men are rare; you’ve got about a two in a million chance of developing one ³³, and they aren’t always cancerous. Tumors in the Leydig cells of the testes (where sperm is produced) can also increase testosterone levels, but they are rare and are usually benign. ³⁴

Genetics

Although it’s rare, researchers have found that some men are genetically predisposed to high testosterone.³⁵ 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 to the brain and lungs. ³⁶

Is It Bad to Have High Testosterone?

It can be bad to have high testosterone levels, though it depends on your overall health and how high your levels are. Generally, people with high testosterone levels will feel both positive and negative effects, experiencing increased strength alongside emotional issues, hair loss, and testicular atrophy.

In addition to the side effects of high testosterone listed above, the biggest dangers of excess testosterone include:

• Increased risk of heart attack. High doses of anabolic steroids increase heart attack risk, ³⁷ but TRT, when medically supervised, has not been shown to increase cardiovascular risk in men treated for low testosterone. ³⁸ “Left untreated, high testosterone can increase cholesterol levels and raise your risk of high blood pressure and major cardiovascular events, including heart attack or stroke,” says urologist Joshua Calvert, M.D.
• Infertility. Elevated testosterone levels may 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. Men who want to have children can look at medications like Clomid as an alternative to TRT. Clomid reduces symptoms of low testosterone while leaving fertility intact. Alternatively, emerging research indicates that combining TRT with human chorionic gonadotropin (hCG) may support fertility. ³⁹
• Liver disease. High doses of testosterone from androgenic and anabolic steroids have been linked to liver damage and disease. ^{40 41}
• High blood pressure. Recent research suggests TRT in men with low testosterone can be good for blood pressure, but too much can cause high blood pressure. ^{42 43}

TRT Side Effects

High Hematocrit on TRT? Here’s How to Reduce It.

TRT Side Effects in Men: What The Science Says

When Should I Consider Testing?

A blood test can determine whether your testosterone levels are too high. Testosterone tests should be taken in the morning for the most accurate measurement, typically between 7 a.m. and 10 a.m. Testosterone levels are naturally at their highest in the morning, and then dwindle as the day goes on. ⁴⁴

High testosterone is less common than low testosterone, but it’s worth checking your levels if you:

• Take anabolic steroids or testosterone therapy. These can temporarily or persistently raise testosterone above normal.
• Use performance-enhancing drugs that affect hormones.
• Notice changes like unusual muscle growth, increased acne, hair loss, or mood and behavior changes that don’t match your usual patterns.
• Experience unexplained infertility, which is sometimes linked to hormonal imbalance from high testosterone suppressing sperm production.

How to Treat High Testosterone Levels in Men

Treatment for high testosterone levels in men depends on why they’re elevated in the first place. Your doctor can help you find the best treatment option, which may include:

• Quitting anabolic steroid use. Men who quit anabolic steroids will likely experience withdrawal symptoms, including a significant drop in testosterone levels. ⁴⁵ Post-cycle therapy may be needed to supplement the body’s natural production of testosterone. One of the most common medications prescribed for steroid recovery is Clomid, which supports a faster return to normal testosterone levels. ⁴⁶ During the recovery process, your doctor can monitor your testosterone levels and start you on the right dose of TRT if they determine that’s the best treatment.
• Adjusting TRT. If you’re already on TRT, your doctor can adjust your dose until it’s in the normal range.
• Treating tumors. If a tumor is causing your testosterone levels to spike, your doctor may recommend surgery to remove it. If the tumor is cancerous, your physician can help you determine the best treatment.

Mentioned in This Article:

Clomiphene Citrate

By boosting your body’s production of testosterone, clomiphene citrate (generic Clomid®) increases energy and improves mood and focus while preserving fertility.

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Testosterone

Testosterone provides the foundation for Hone’s testosterone replacement therapy plans, used to treat low testosterone levels and boost energy, strength, and libido. Available via injections, cream and dissolvable troches.

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About the author

Stephanie Anderson Witmer is a freelance journalist and content creator based in Pennsylvania. She's written health and lifestyle stories for Women's Health, Redbook, Prevention, Good Housekeeping, USA Today, Better Homes & Gardens, Giddy, Parade, Yoga Journal, and more.

About the reviewer

Natalie Kunsman, M.D., is a board certified physician specializing in functional, anti-aging, and regenerative medicine. She is a fellow of the American Academy of Anti-Aging medicine and the American Academy of Family Physicians.