One reason lab conversations around TRT become confusing is that testosterone values are not independent of timing. This means women's TRT targets should not be "as high as possible while feeling good." The better standard is "the lowest effective exposure that stays within the female physiologic range and supports the specific symptom target under monitoring." Major consensus statements emphasize that there is no blood testosterone cutoff that can diagnose a female androgen-deficiency syndrome the way clinicians diagnose male hypogonadism. In younger men, some authors have argued that a one-size-fits-all cutoff may miss clinically relevant low values when symptoms are present. It does mean that physiologic replacement should look physiologic, not pharmacologic enhancement (Travison et al., Journal of Clinical Endocrinology & Metabolism, 2017). In healthy nonobese men aged 19 to 39, harmonized reference work identified an approximate normal range of 264 to 916 ng/dL, with a median near 531 ng/dL. Several studies showed that a high-protein diet actually decreased testosterone levels. The best types of exercise to increase your testosterone levels are weightlifting and high-intensity interval training (HIIT). Supplements aren't the only way to increase your testosterone levels naturally. However, a subsequent study showed that taking 3 grams of D-aspartic acid did not affect testosterone levels. A recent study found that it may increase levels of follicle-stimulating hormone and luteinizing hormone. While the primary outcomes of the study focused on the metabolic syndrome, secondary outcomes included various prostate parameters. The Saturation Model postulates that the androgen receptors on the prostate are saturated at physiologic and even subphysiologic levels of T, such that there is minimal response of the prostatic tissue to TRT. Only seven men throughout the study were found to have PSA levels above 4.0 ng/ml, six of whom were treated for suspected prostatitis with a resultant interval decrease in PSA. One hundred and sixty-one men completed the 1-year study and 115 entered into a 5-year study extension; 51 men completed the sixth year of the study and reported a statistically significant increase from a mean baseline of 0.50 ng/ml to a mean level of 0.80 ng/ml (95% CI 0.19–0.41). To date, there are no prospective studies that have evaluated the risk of VTE in men receiving exogenous T supplementation. Additionally, the authors admit that they were unable to explore whether or not the increase in CVD mortality was directly related to serum T levels or baseline TD. A limitation of this study centers on utilization of a healthcare database that did not include information on either serologic or diagnostic criteria for men who received TRT. Testosterone therapy in women has a much narrower evidence-based indication, with the strongest support in postmenopausal women with hypoactive sexual desire disorder (Davis et al., Journal of Sexual Medicine, 2019; Parish et al., Climacteric, 2021). The question of women's TRT target levels is even more delicate. It helps determine who may qualify for therapy alongside symptoms; it does not mean every treated man should be driven to the same number regardless of response or formulation (Mulhall et al., Journal of Urology, 2018). For men, the goal is usually to bring testosterone into the normal range for healthy men and match that to clinical response. There is no universal magic number that is ideal for every patient on testosterone therapy. Overall 10 patients at one point in the study had a velocity greater than 0.4 ng/ml, yet no cases of prostate cancer were observed. These findings demonstrate an association between TD and increased mortality; however, the association between TD and cardiovascular mortality is only apparent at lower levels. The authors concluded that overall, and particularly in trials not funded by the pharmaceutical industry, exogenous T increased the risk of cardiovascular-related events Xu et al. 2013. A man using injections measured at trough will not necessarily show the same lab value as a man using transdermal therapy measured under a different protocol. That distinction matters even more when men and women are discussed in the same article. If you search for testosterone targets on TRT, you will usually find a chart, a clinic range, or a single number presented as the answer. That's made it interesting as a possible remedy for menopause symptoms like depression, bone loss, and sexual problems.
