High endogenous testosterone levels do not spell greater adverse events

Elevated endogenous testosterone levels do not necessarily translate to increased adverse events, as shown in a study.

The study used the 2011–2016 data from the National Health and Nutrition Examination Survey, including adult males not on testosterone or androgen ablation therapy and excluding men who had testosterone <300 ng/dL.

Researchers examined the physiologic effects of naturally elevated endogenous testosterone levels by comparing men with elevated testosterone (>800 ng/dL) to those with normal testosterone (300–800 ng/dL).

A total of 3,673 men were included in the analysis. Of these, 146 men (4 percent) had elevated testosterone >800 ng/dL.

Multivariable logistic and linear regressions showed that men with high vs normal testosterone were similar in terms of sleep disorders, urinary symptoms, and depression. However, men with elevated testosterone had greater haematocrit regression coefficient (βi, 1.30, 95 percent confidence interval [CI], 0.69–1.90; p<0.01), aspartate aminotransferase (βi, 8.48, 95 percent CI, 0.31–16.66; p=0.04), and alanine aminotransferase (βi, 12.23, 95 percent CI, 0.70–23.77; p=0.04).

The findings show no association between higher endogenous testosterone levels and adverse events, questioning what is considered a safe target for testosterone therapy. Additional prospective studies are required to establish the safety of elevated endogenous and exogenous modulated levels of testosterone.