Understanding the Causes of High Testosterone Levels

Direct answer: High total testosterone is most commonly caused by the use of anabolic-androgenic steroids. However, it can also be a sign of underlying medical conditions, such as tumors on the adrenal glands or testicles. These tumors can produce excess testosterone or related hormones, leading to significantly elevated levels. A medical evaluation is necessary to determine the exact cause, as symptoms alone are not enough for a diagnosis. Proper diagnosis is critical for appropriate treatment and management.

TL;DR Elevated total testosterone levels can stem from external sources, like steroid use, or internal medical issues, such as tumors. While anabolic steroids are a frequent cause, it's crucial not to overlook the possibility of adrenal or testicular tumors that can secrete excess hormones. Symptoms of high testosterone—including acne, mood swings, and increased muscle mass—are nonspecific and require a thorough medical investigation to pinpoint the underlying reason. A healthcare provider can use blood tests and other diagnostic tools to differentiate between these causes and recommend the correct course of action.

• The most common cause of abnormally high testosterone is the use of anabolic-androgenic steroids for performance or physique enhancement.
• Tumors on the adrenal glands, which sit atop the kidneys, can produce excess androgens, leading to high testosterone levels.
• Testicular tumors, specifically Leydig cell or Sertoli cell tumors, can also secrete testosterone directly, causing a significant increase.
• Symptoms are not a reliable way to diagnose the cause. They can include acne, oily skin, increased body hair, aggression, and changes in libido.
• A medical diagnosis is essential. It involves a physical exam, a detailed history, and blood tests to measure hormone levels.
• Treatment depends entirely on the cause, ranging from stopping steroid use to surgical removal of a tumor.

Want the full explanation? Keep reading ↓

Got High Testosterone Results? Let's Talk About What That Really Means

So you got your lab results back, and the number next to "Total Testosterone" is high. It's completely normal to feel a bit confused or even worried when you see a result flagged as "abnormal." You might be wondering what this means for your health, especially when you hear scary words like steroids or tumors.

Let's cut through the noise. As an endocrinologist, I help people figure this out every day. Most of the time, a high number isn't a sign of the worst-case scenario. But it is a signal from your body that we need to pay attention to, so let's break down what's going on in simple terms.

First, What Exactly is a "High" Testosterone Level?

Before we dive into causes, it's important to know what "high" actually means. Labs have reference ranges, but these can vary. What's high for one person might be different for another, depending on age and sex.

Generally, doctors look at ranges like these. Remember, your lab's specific range is the most important one to consider.

If your numbers are above the upper limit for your group, your doctor will likely flag it as high. Understanding the context of [normal testosterone levels by age] can help you see where you stand.

Feeling Off? How High Testosterone Affects Your Body and Mind

You might not feel any different, or you might have noticed some changes that you couldn't quite explain. High testosterone can throw your body's delicate balance out of whack, affecting everything from your mood to your metabolism.

Common symptoms associated with high testosterone include:

• Mood Swings: Increased irritability, aggression, or anxiety.
• Energy Levels: You might feel a surge of energy, but it can also lead to restlessness and difficulty relaxing.
• Sleep Problems: Insomnia or poor-quality sleep are common complaints.
• Physical Changes (Men): Acne, oily skin, increased body hair, and sometimes testicular shrinkage.
• Physical Changes (Women): Deeper voice, acne, male-pattern hair growth (hirsutism), and irregular periods.
• Metabolism: While often linked to muscle growth, unnaturally high levels can also increase risks for heart issues over time.

It's a strange spectrum. While many people worry about the symptoms of [low testosterone, or "Low T,"] having levels that are too high comes with its own set of problems.

Uncovering the Cause: Why Are Your Testosterone Levels High?

Okay, this is the part you're probably most concerned about. When I see a patient with high testosterone, my job is to play detective. We start with the most common causes and work our way to the less likely ones.

The Most Common Culprit: External (Exogenous) Testosterone

Let's be direct: the most frequent reason for very high testosterone levels is using testosterone or other anabolic steroids.

• Prescription TRT: If you're on Testosterone Replacement Therapy (TRT), your dose might be too high. This is a relatively easy fix that involves working with your doctor to adjust your dose.
• Anabolic Steroid Use: Using steroids for performance enhancement or bodybuilding will cause your levels to be significantly elevated. It's crucial to be honest with your doctor about this so they can give you the right medical advice and help you stay safe.

Medical Conditions That Can Raise Testosterone

If you're not taking any form of external testosterone, your doctor will investigate medical causes. This is where a comprehensive [total testosterone test for men's and women's health] becomes the starting point for a deeper diagnosis.

Tumors (The Scary but Rare Cause)

Hearing the word "tumor" is terrifying, but please know this is not a common cause of high testosterone. When it does happen, the tumors are often benign (non-cancerous).

• Adrenal Gland Tumors: Your adrenal glands, small glands that sit on top of your kidneys, can sometimes develop tumors that produce excess hormones, including testosterone.
• Testicular Tumors (in Men): Certain types of tumors in the testicles can secrete high amounts of testosterone. Your doctor will likely perform a physical exam and may order an ultrasound to check for this.
• Ovarian Tumors (in Women): Similarly, some ovarian tumors can produce testosterone, leading to symptoms like facial hair and a deeper voice.

The key takeaway: Don't jump to the worst conclusion. Your doctor will run follow-up tests (like imaging scans or more specific hormone tests) to rule these possibilities out if they suspect them.

Other Conditions

• Polycystic Ovary Syndrome (PCOS): This is a very common endocrine disorder in women that often causes moderately high testosterone levels, leading to irregular periods, acne, and cysts on the ovaries.
• Congenital Adrenal Hyperplasia (CAH): A rare, genetic disorder that affects the adrenal glands and can cause high testosterone from birth.

What's Next? Your Action Plan

Seeing a high number on a lab report is the beginning of a conversation, not the final word.

1. Don't Panic. Seriously. Stress won't help, and the most likely causes are manageable.
2. Talk to Your Doctor. Schedule a follow-up appointment to discuss the results. Be prepared to talk openly about your symptoms, lifestyle, and any medications or supplements you're taking.
3. Get Re-Tested. Lab errors happen. Your doctor will probably want to repeat the test to confirm the result before moving forward with more invasive or expensive diagnostics.
4. Follow Medical Advice. Whether it's adjusting a prescription, getting an ultrasound, or making lifestyle changes, follow the plan your healthcare provider lays out for you.

You're right to be concerned about your health, but you're also taking the right step by seeking out information. Let this test result be a catalyst for working with your doctor to get the full picture of your health.

Frequently Asked Questions

What is the most common cause of abnormal Total Testosterone levels?

For high Total Testosterone, the most common cause by far is external (exogenous) use, such as prescribed TRT at too high a dose or the use of anabolic steroids. For low testosterone, the causes are more varied and often related to age, obesity, chronic illness, or pituitary gland issues.

How often should I get my Total Testosterone tested?

If your levels are normal and you have no symptoms, you likely don't need regular testing. However, if you're on TRT, your doctor will monitor your levels every 3-6 months initially, then annually once your dose is stable. If you have a medical condition that affects hormones, your doctor will recommend a specific testing schedule for you.

Can lifestyle changes improve my Total Testosterone levels?

Yes, absolutely, especially for levels that are on the lower end of normal. Regular exercise (especially strength training), maintaining a healthy weight, getting enough sleep, managing stress, and eating a balanced diet rich in zinc and vitamin D can all help support healthy testosterone production. For significantly high levels caused by a medical condition, lifestyle changes are supportive but are not a substitute for medical treatment.