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Testosterone supplementation
Sep 7, 1999

Dear docs, what are the appropriate levels of testosterone in a male, 40 years old, soropositive? When supplementing it is necessary? Thanks. Congratulations for your work.(Brazil)

Response from Dr. Dieterich

Great question. The easiest measure of testosterone is the total amount in the bloodstream. "Normal" values range broadly in healthy men, between about 250 to 1100 nanograms per deciliter. But this doesn't really tell the whole story, and indeed is misleading. In fact, each person has his own set-point for testosterone (actually, for all hormones) that is individualized and generally maintained throughout the person's lifetime. So a statistically "normal" level (say, 450 ng per dl) may be low for a particular person and may result in symptoms of deficiency.

This all becomes very important in men with HIV infection. It turns out that the most common value of testosterone in men with HIV, especially if there has been some weight loss, is between 200-450 ng per dl. It was not certain until recently, however, that these "lowish" values were functionally important -- that is, were having an effect on the body that mattered. But we now know that giving androgen therapy (such as nandrolone, oxandrolone or testosterone) to men with this range of blood testosterone has very beneficial effects: the men gain weight, lean tissue, and strength.

So, the bottom line answer to your question is that your values of total testosterone should probably be above 500 ng per dl or so, especially if you have any symptoms that might relate to testosterone deficiency (including fatique, loss of sex drive, erectile dysfunction, loss of energy, depression). If your levels are lower than this, you might well benefit from replacement therapy.

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