Understanding Testosterone: Defining Low Testosterone
Thresholds for Low Testosterone: The term “low testosterone” generally refers to levels that fall below a clinically accepted threshold, typically assessed through measurements of total testosterone.
Total testosterone is widely used due to its routine availability, although free testosterone represents the biologically active portion that enters cells and is often considered more indicative of functional testosterone levels.
Guidelines: Looking at the British Society for Sexual Medicine Guidelines on the assessment and management of testosterone deficiency in adult men, the threshold for low testosterone is 12 nmol/L. The guidelines note that the diagnosis of symptomatic TD requires the presence of characteristic signs and symptoms, plus reduced serum concentrations of total testosterone (TT) or free testosterone (FT). These are widely used guidelines amongst clinicians in the UK treating testosterone. It’s important to note that testosterone deficiency should always be treated in the presence of signs and symptoms.