Testosterone Levels in Men by Age: What’s Normal in Australia

Testosterone levels in men by age

In Vively members, total testosterone barely changed with age: the median was 16 to 19 nmol/L in every group from 18 to 29 through to 60 and over. The middle half of men sat between about 12 and 25 nmol/L at every age.

Free testosterone tells a different story. The median fell from about 400 pmol/L in men aged 18 to 29 to about 340 pmol/L in their 40s and 50s, and about 290 pmol/L at 60 and over. Over the same ages, median SHBG rose from 31 to 40 nmol/L. More SHBG binds more testosterone, so less is free to act on the body even when the total looks the same.

Larger studies show the same pattern. In the Massachusetts Male Aging Study, total testosterone fell by about 0.8% for each year of age, while free testosterone fell by about 2% a year and SHBG rose by about 1.6% a year. Australia's Healthy Man Study found no drop in total testosterone with age in men who rated their health as very good or excellent, which suggests weight gain and illness explain much of the fall seen in older men.

Normal testosterone range for men in Australia

Most Australian labs report an adult male range for total testosterone of roughly 10 to 35 nmol/L. Ranges differ between labs and assays, so always read your result against the range printed on your report.

In every age group, 6% to 9% of Vively men had a total testosterone below the range on their own lab report. A low number on its own does not mean low testosterone as a medical condition (androgen deficiency). Healthy Male, Australia's men's health body, says diagnosis needs symptoms plus low results on at least two fasting, morning samples taken on different days, along with LH and FSH.

The Vively optimal range is what we aim for to support long-term health. It is not a diagnostic cut-off.

Total testosterone, free testosterone and SHBG

Total testosterone is all the testosterone in your blood. Most of it is bound to SHBG (sex hormone binding globulin) or albumin, and only about 2% is free.

Free testosterone is the unbound part that can act on muscle, bone, brain and sexual function. Most Australian labs calculate it from total testosterone, SHBG and albumin rather than measuring it directly, which is why free testosterone ranges vary more between labs than total testosterone does.

SHBG explains a lot of confusing results:

• High SHBG (more common with age, a lean build, liver disease, an overactive thyroid and some medicines) can make total testosterone look fine while free testosterone is low.
• Low SHBG (common with extra weight around the middle and insulin resistance) can make total testosterone look low while free testosterone is in range.

That is why we report total testosterone, free testosterone and SHBG side by side.

What changes your testosterone result

Testosterone moves through the day and with your health, so the conditions on test day matter.

• Time of day: levels are highest in the morning. Book a collection before 10am.
• Fasting: a meal, especially a large one, can lower testosterone for a few hours. Healthy Male recommends fasting morning samples.
• Recent illness or a hard week: an infection, surgery or a run of poor sleep can lower testosterone for a while. In one small study at the University of Chicago, a week of five hours' sleep a night lowered daytime testosterone by 10% to 15% in young men.
• Body weight: extra weight lowers both total testosterone and SHBG. A 2013 meta-analysis found testosterone rose with weight loss, more so with larger losses.
• Medicines: opioids and steroid medicines such as prednisone can lower testosterone. Testosterone treatment or anabolic steroids change every result in the panel, so tell your practitioner if you use them.
• Alcohol: heavy drinking lowers testosterone and can raise SHBG.

Do you need to fast? Yes, for the most reliable result. Fast overnight and have your blood taken before 10am. The Baseline Health Check is a fasting test too, so the two fit in the same early collection.

What does low testosterone mean?

One low result is a reason to repeat the test, not a diagnosis. Testosterone varies from day to day, so doctors confirm a low result on a second fasting morning sample before drawing any conclusions.

Common reasons for a low result in men who otherwise feel well:

• extra weight, insulin resistance or type 2 diabetes
• poor or short sleep, including sleep apnoea
• a recent illness or a very stressful period
• opioids, steroid medicines or past anabolic steroid use

Less common causes include conditions of the testes or the pituitary gland, and haemochromatosis (iron overload). Symptoms that can go with low testosterone include low sex drive, fewer morning erections, erection problems, low energy and loss of muscle. Many of these have other causes, which is why the blood test and the symptoms are read together.

On the PBS, testosterone treatment for men is only subsidised for confirmed androgen deficiency, for example a testosterone below 6 nmol/L, or 6 to 15 nmol/L with a raised LH, alongside a diagnosed cause.

What does high testosterone mean in men?

High testosterone in a man who isn't taking testosterone or anabolic steroids is uncommon. The usual explanations are a sample taken soon after a testosterone dose, high SHBG lifting the total while free testosterone is normal, or, rarely, a hormone-producing condition. If your result is above the range and you aren't using testosterone, see your GP.

How testosterone fits with your other results

Testosterone makes most sense next to SHBG, LH and your metabolic markers.

How to support healthy testosterone levels

Most of what lowers testosterone in otherwise healthy men is in your hands.

• Protect your sleep. Aim for 7 to 9 hours. If you snore loudly or wake unrefreshed, ask your GP about sleep apnoea.
• Work on weight around the middle. If you carry extra, a steady loss of 5% to 10% of body weight improves insulin resistance, and testosterone often rises with it.
• Move most days. Combine walking with two or three strength sessions a week to keep muscle and insulin sensitivity.
• Keep alcohol low. Try to keep several days a week alcohol free.
• Skip the boosters. A 2020 review of popular "testosterone booster" supplements found little evidence for most of their claims, and some ingredients may harm.

Retest about three months after a change, on a fasting morning sample, so you're comparing like with like.

When to see your GP

See your GP if your testosterone is below the range on your report and you have symptoms, if it is low on two separate morning tests, or if it is below about 6 nmol/L. Also see your GP for breast swelling or tenderness, loss of body hair, shrinking or soft testes, concerns about fertility, or new headaches with changes in your vision. Talk to your GP before starting any testosterone treatment, because it can stop sperm production.

Testing testosterone with Vively

Total testosterone, free testosterone and SHBG are in the Male Hormone Health Test, an add-on to the Baseline Health Check. You don't need to see your own GP first: a doctor in our network reviews and signs your request. You have one blood draw at one of our 3,700+ partner collection centres (book an early morning slot and fast overnight), and your results arrive in the Vively app, usually within a few days. A Vively practitioner then reads your hormones with your metabolic and liver markers. Order the Male Hormone Health Test.