Key takeaways
High testosterone levels in men often come from taking anabolic steroids and certain testosterone supplements, as well as high doses of testosterone replacement therapy (TRT).
Signs of high testosterone include acne, mood changes, water retention, smaller testicles, and lower sperm counts.
Fixing high testosterone levels involves finding the cause and stopping any steroids or adjusting the dose of HRT to lower testosterone levels.
Testosterone is the main male sex hormone that helps develop the muscles and bones, boost sex drive, and manage sperm production. High testosterone levels don’t always mean there’s a problem, as many healthy men have or even want levels near the top of the normal range. Testosterone levels can vary throughout life, but typically range from 350 to 700 ng/dL, with levels in the 1,000s being considered high. Here’s what high testosterone can feel like, what can cause it, and when to get checked or treated.
What does high testosterone feel like?
For many men, there are no noticeable symptoms, and high testosterone levels are only found after getting blood tests for other reasons. Common symptoms of high testosterone in men include acne or oily skin, mood swings, and changes in libido (sex drive).
For men with low testosterone levels, TRT can actually help improve mood, bone mass, and overall energy. However, excessive testosterone levels can come with negative side effects, including the following:
- Mood changes, including aggression, irritability, anxiety, or depression
- Fluid retention, which can appear as weight gain
- Headaches
- Excessive body hair
- Hair loss in those at risk of male pattern baldness
- Enlarged breasts (gynecomastia)
- Increased blood pressure
- Smaller testicles
- Low sperm count
When testosterone comes from outside the body, the brain senses there’s enough and decreases luteinizing hormone (LH) and follicle-stimulating hormone (FSH). Without these hormones, the testicles make less testosterone and sperm on their own, which causes them to shrink. That’s why men who are trying to conceive may want to avoid testosterone.
What causes high testosterone in men?
The most common cause of abnormally high testosterone in men is taking anabolic steroids or prescribed testosterone. It’s estimated that 6% to 7% of men have used anabolic steroids, and most people who use them are weightlifters wanting to increase their muscle mass.
Other potential causes of high testosterone include:
- High TRT doses: TRT for testosterone deficiency is usually meant to help bring levels to a normal range. However, a dose that’s too high can lead to abnormally high levels.
- A tumor in the testicle: Leydig cells are responsible for making testosterone in the testicles. A tumor from these cells can lead to high testosterone levels.
- Adrenal gland disorders: Congenital adrenal hyperplasia (CAH) is a genetic problem that causes the adrenal glands to overproduce androgens like testosterone and dihydrotestosterone (DHT)
- Pituitary gland disorders: In rare cases, a pituitary tumor produces extra LH, which causes the testicles to make more testosterone.
Younger age and genetics can also cause testosterone levels that are near the higher end of the normal range. Intense weight lifting may also cause short-term spikes. Still, people with naturally high levels don’t necessarily have a medical condition.
Should I be worried about high testosterone?
You don’t have to worry about a single high reading, especially if you feel fine. If you’ve had repeated tests that show unexpectedly high levels, it’s a good idea to consult your healthcare provider.
Potential complications of high testosterone in men include:
- Thickened blood (polycythemia), which increases the risk of blood clots
- Infertility
- High blood pressure and cholesterol changes that could lead to cardiovascular disease
- Worsened enlargement of the prostate or prostate cancer
Although an increased risk of heart attack and stroke has been reported mostly with high-dose steroid use, the Food & Drug Administration removed a boxed warning for this from testosterone products. A large trial called TRAVERSE found no increased risk of heart attack and stroke, although it did show more blood clots in the lungs.
See a healthcare provider if you experience trouble with mood changes, enlarged breasts, problems having a baby, or a lump in a testicle. Emergency medical attention is necessary for any chest pain, shortness of breath, or sudden weakness.
How is the cause of high testosterone diagnosed?
High testosterone levels are typically found through a blood test for total testosterone and free testosterone levels. These blood tests are typically drawn in the morning between 7 a.m. and 10 a.m., when levels are at their highest for the day.
One of the first things a healthcare provider will ask is whether you’re taking any prescriptions, supplements, or steroids. A healthcare provider may also recommend the following tests to determine what may be causing excessively high levels:
- LH and FSH: High LH and FSH levels could indicate a problem with how the testicles make testosterone, while low levels mean an outside source is causing high testosterone levels.
- DHEA-S: This is an androgen made by the adrenal glands, and high levels could show that there’s an adrenal problem, especially if testosterone is also high.
- 17-Hydroxyprogesterone: This lab marker can help with identifying congenital adrenal hyperplasia that may be causing high testosterone.
If a healthcare provider suspects a tumor, they may recommend an ultrasound of the scrotum. Otherwise, a CT or MRI can also be helpful for checking the adrenal or pituitary glands.
How long does high testosterone last?
Blood levels usually come down within a few weeks of stopping steroids or TRT. Depo-Testosterone (testosterone cypionate) has a half-life of around eight days. It may take longer for testosterone levels to fall after using pellets or long-acting injections.
After using anabolic steroids, some studies show that it could take around six months for levels to normalize. For men with tumors or certain disorders, excess testosterone levels won’t fall until the condition is treated.
How to lower high testosterone
The best way to lower high testosterone depends on what’s causing it. If medications, anabolic steroids, or testosterone supplements are raising testosterone levels, a healthcare provider may recommend changing or stopping them. If you’re receiving testosterone replacement therapy (TRT), ask your healthcare provider whether your dose needs to be adjusted. Don’t change your dose or stop treatment without medical guidance.
Treatment for high testosterone may include:
- Changing medications or supplements: If testosterone therapy, anabolic steroids, or another medication is contributing to high testosterone, a healthcare provider can recommend how to adjust or discontinue it safely.
- Treating congenital adrenal hyperplasia (CAH): Certain forms of CAH may be treated with corticosteroids, such as hydrocortisone, to replace hormones the adrenal glands don’t produce adequately and help reduce excess androgen production.
- Treating a hormone-producing tumor: If an adrenal or gonadal tumor is causing excess testosterone, treatment may include surgery or other therapies, depending on the type and location of the tumor.
Always consult a healthcare provider before changing any medications or supplements. They can determine the cause of high testosterone and recommend the appropriate treatment.
Living with high testosterone
If excessively high testosterone levels seem to fluctuate for you, try a few different lifestyle changes and habits to manage them:
- Track your symptoms. Note down any changes in mood, acne, sleep, and sex drive between medical visits.
- Get regular blood work. Having regular blood tests can help you see your trends more easily.
- Avoid any unregulated supplements. Some bodybuilding products marketed for gaining muscle may illegally contain steroids or steroid-like ingredients.
If your TRT dose or formulation changes, compare prices on the SingleCare testosterone coupon page to potentially lower what you pay.
Expert takeaway
“For many men, it’s surprising that testosterone can shrink the testicles and lower sperm counts,” says Gerardo Sison, Pharm.D., member of the SingleCare Medical Review Board. “If you want to have kids at some point, tell your healthcare provider before starting TRT.”
Bottom line
High testosterone levels are often harmless and can be a goal for many men on TRT. Some men even have naturally high testosterone levels due to genetics. However, excessively high testosterone levels from steroid use, a tumor, or a gland disorder can be dangerous. These levels come down once the underlying cause is taken care of. If testosterone levels stay elevated or occur with chest pain, severe mood changes, or unexpected problems with fertility, it’s best to get checked.
Frequently asked questions
What are the signs of high testosterone in men?
The signs of high testosterone levels can include mood changes like irritability and aggression, acne on the back, oily skin, and increased sex drive. Anabolic steroids, in particular, can cause fluid retention, enlarged breasts, and smaller testicles.
Can high testosterone cause infertility?
Yes, when it’s caused by anabolic steroids or TRT. Testosterone products can shut down the body’s own processes that support sperm production. Sperm counts can recover several months after stopping.
How can I naturally lower my testosterone levels?
The main way is to stop using any steroids or testosterone supplements. Consult a healthcare provider first before trying to lower testosterone on your own.
Can women have high testosterone?
Women can have high testosterone levels, especially from hormonal conditions like polycystic ovary syndrome (PCOS).
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