Elevated Endogenous Testosterone Levels are not Associated With Significant Clinical Morbidity

Area of Science:

• Endocrinology
• Men's Health
• Clinical Research

Background:

• Testosterone therapy is associated with side effects, but safe upper limits are unknown.
• Data on physiological effects of naturally high endogenous testosterone is limited.

Purpose of the Study:

• To investigate the association between elevated endogenous testosterone and adverse effects.
• To compare physiological effects in men with naturally high vs. normal testosterone levels.

Main Methods:

• Analysis of National Health and Nutrition Examination Survey data (2011-2016).
• Included men aged 18+ not on testosterone therapy, with testosterone levels between 300-800 ng/dL (normal) and >800 ng/dL (elevated).
• Used multivariable logistic and linear regressions for comparisons.

Main Results:

• 3673 men met inclusion criteria; 4% had elevated testosterone (>800 ng/dL).
• Elevated testosterone was not associated with sleep disorders, urinary symptoms, or depression.
• Men with elevated testosterone showed higher hematocrit, AST, and ALT levels.

Conclusions:

• No association found between higher endogenous testosterone and adverse events linked to testosterone therapy.
• Slightly increased hematocrit was not clinically significant, questioning current testosterone therapy safety targets.
• Further prospective studies are needed to define safety of elevated endogenous and exogenous testosterone levels.