Normal Is Not Always Optimal

When men experience symptoms of low testosterone and seek evaluation it often ends in being told their level is normal. The problem is that normal is not always optimal. Lack of sleep, sedentary lifestyles, overconsumption of processed foods, and stress are all normal e.g., common parts of modern-day life but that does not make them optimal aspects of human existence. But it goes beyond that. Normal for one person is not necessarily normal for another. Each individual is a unique combination of genetic material. Even identical twins can have small variations in their genetic makeup due to mutations that occur over the course of their development. This means that individuals need to be assessed as such. Medicine is based on ranges and standardizations that work for most people, but clinicians should never rely on a one-size-fits-all approach. Testosterone levels specifically have a wide range of what is considered normal and because of that men often do fall in the so-called normal range. But what is normal for one person may not be normal for another. Take this example, a man presents with many of the symptoms of low testosterone and has his level checked and it comes back normal at 400 and is dismissed. What if the normal level for that individual is 800? Yes, 400 falls in the normal range but it might not be normal for him which is why he is experiencing symptoms. It is our job as clinicians to look at the bigger picture and take both lab values and symptoms into account when making a diagnosis. Let’s look at another parallel example, a woman presents with symptoms of iron deficiency and has her labs checked. Her ferritin (the measure of iron stores in the body) comes back at 15 which is on the low end of the normal range. But there is something else, she is a runner. So, that level of 15 which might be okay for a sedentary woman is not high enough for her (runners should maintain ferritin levels of at least 40). What this tells us is that we also need to consider the goals of the patient when prescribing treatment. This applies to testosterone as well. A level of 400 might be okay for a sedentary man but is far from okay for a man trying to maintain an active lifestyle. These are just a few examples that illustrate all the factors that go into a thorough exam of men’s health issues. This is why it is important to have an evaluation completed by someone who specializes in this area. If you are having symptoms of low testosterone and have been told your level is normal you are not alone. If you are trying to optimize your life don’t settle for normal.