Low Total Testosterone Linked to Chronic Disease

A male's total testosterone level may be linked to more than just sexual health and muscle mass preservation. Low amounts of the hormone could also be associated with chronic disease, even among men 40 years of age and younger.

The prevalence of total testosterone (TT) deficiency in men increases with age, and is associated with several deleterious effects to the musculoskeletal system including osteopenia and sarcopenia, as well as with higher rates of all-cause mortality.


Scientists from University of Michigan (Ann Arbor, MI, USA) evaluated the association between total testosterone (TT) deficiency and weakness on multimorbidity in men. Analyses were performed to examine the prevalence of multimorbidity among 2,399 young, middle-aged, and older men, with and without testosterone deficiency. Fasting and non-fasting measures of HDL-cholesterol, triglycerides, and glucose were measured. Non-fasting serum measures of glycated hemoglobin (HbA1c) were included as a diagnostic test for untreated diabetes, which reflects average plasma glucose for the previous ~three-months. TT levels were measured in serum using isotope dilution liquid chromatography tandem mass spectrometry.

The investigators found that multimorbidity was more prevalent among men with testosterone deficiency, compared to normal TT in the entire group (36.6% versus 55.2%). However, differences were only seen within young (testosterone deficiency: 36.4%; normal TT: 13.5%; and older men (testosterone deficiency: 75.0%; normal TT: 61.5%). Low TT and weakness in men were independently associated with multimorbidity at all ages; however, multimorbidity was more prevalent among young and older men with testosterone deficiency. Prevalence of testosterone deficiency was 30.8% for the entire sample, and 22.6%, 35.8%, and 34.6% for young, middle-aged, and older men, respectively.

Mark Peterson, PhD, MS, FACSM, an assistant professor and lead author of the study, said, “We found a large dose-response relationship between the age-specific low total testosterone and moderate total testosterone levels and multimorbidity, even after adjusting for obesity and muscle strength capacity. This means that men should be concerned about declining total testosterone, even if it has not reached a level to warrant a clinical diagnosis of less than 300 ng/dL (10.4 nmol/L).” The study was published on April 12, 2018, in the Journal Scientific Reports.

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