High testosterone—also known as hypergonadism or hyperandrogenism—is when your testicles overproduce the hormone testosterone. Untreated high levels can lead to infertility, obesity, and in some cases, metabolic disorders. In men, levels are known to vary widely. Also testosterone is known to stimulate growth of prostate cancer in men diagnosed with the condition. Given that the direct method for free testosterone measurement is also time-consuming and labor intensive, calculation derived free testosterone measurement is more commonly used, however there is considerable variation in total testosterone assays as well as the clinical conditions that affect serum albumin and SHBG, all of which impact this measurement. There is a great deal of variability across studies with respect to the forms of testosterone measured (total versus free), the assays utilized to measure testosterone, the time of day when the sample is obtained, and the number of testosterone measurements taken. Establishing total testosterone thresholds for a diagnosis of testosterone deficiency is challenging considering the heterogeneity that exists in the testosterone deficiency literature. The testosterone therapeutic space is relatively unique. For most pharmaceutical products, the usage, dosage, and application is consistent across brands, and identification by chemical compound is sufficient to communicate to the reader when to use a given medication. The AUA has a policy that all pharmaceutical and biological agents are referred to only by their chemical compound formulation in guidelines, white papers, and best practice statements and not by their brand or generic name. Expert Opinion refers to a statement, achieved by consensus of the Panel, that is based on members' clinical training, experience, knowledge, and judgment for which there is no evidence. A Clinical Principle is a statement about a component of clinical care that is widely agreed upon by urologists or other clinicians for which there may or may not be evidence in the medical literature. Where gaps in the evidence existed, the Panel provides guidance in the form of Clinical Principles or Expert Opinion with consensus achieved using a modified Delphi technique if differences of opinion emerged. Conditional Recommendations also can be supported by any evidence strength. Accompanying the weight gain is muscle loss, and the inability to perform workouts to the same levels as before, but also seeing fewer results from the same workouts. "What I’ve noticed in my patients," says McDevitt, "is that anyone in the 400s will start to exhibit symptoms of low T." On the other hand, free testosterone is floating around your body, ready to be recruited by your cells. Testosterone levels peak in the earlier phases of life as a teen and young adult (6). The average male who reaches 70 years old will have testosterone production that’s 30 percent below his peak (5). However, once you’re in your late 20s, you’ll want a baseline to compare against as you age, says McDevitt. You used to have to go to the doctor’s office, or to a clinic that specializes in hormone evaluation. Too much testosterone can also cause hypertension, or high blood pressure (8).
