Here’s something that might surprise you: testosterone isn’t just a “men’s hormone.”
Women produce testosterone too, and when those levels drop, the effects can be significant. Yet most conventional doctors either skip testosterone testing for women entirely or dismiss low levels as “normal aging.”
At Ivalo MD, we see this gap in care more than you’d think. Patients come to us after years of being told their fatigue, brain fog, or declining libido is “just stress” or “part of getting older.” Meanwhile, their testosterone levels may tell a different story.
What Testosterone Actually Does (For Everyone)
Testosterone plays important roles in both men and women:
Energy and metabolism: Research shows testosterone helps maintain lean muscle mass and supports metabolic health. When levels drop, many people notice increased fatigue and difficulty maintaining their weight.
Cognitive function: Studies indicate that spatial cognitive abilities and general cognition decline with aging alongside testosterone levels. Research shows that testosterone supplementation can have positive effects on cognitive functioning, helping to maintain mental sharpness and clarity.
Mood and motivation: Mood and motivation: Research demonstrates that testosterone influences anxiety levels, with studies showing testosterone decreases anxiety in both animal and human studies. Testosterone increases key neurotransmitters including dopamine, serotonin, and GABA, the same pathways that many antidepressant and anti-anxiety medications target. Declining levels can contribute to depression and loss of motivation.
Sexual health: For both men and women, testosterone plays a key role in libido and sexual satisfaction.
Bone density: Multiple studies show a positive association between testosterone levels and bone mineral density in both men and women. Research from the Cardiovascular Health Study found that older women with higher free testosterone levels had significantly greater bone mineral density, and studies in hypogonadal men show testosterone therapy increases bone density regardless of age.
The Problem with “Normal” Ranges
Labcorp, a major blood testing company, recently lowered their reference range for male testosterone from 348-1197 ng/dL to 264-916 ng/dL. Yet even in conventional medicine, testosterone levels below 300 ng/dL with symptoms are considered clinically low and warrant treatment. This creates a confusing contradiction: how can levels below 300 be considered both “normal” by lab standards and “low” by clinical standards? This change reflects a broader issue with how “normal” ranges are established.
Reference ranges are typically established by collecting results from a large population and determining an expected average, but most laboratories establish their ranges from populations where detailed information on health status and medications is unknown. As ZRT Laboratory notes, “the testing population is comprised of people concerned about their health; they are therefore more likely to have hormonal issues than not.”
This creates a significant problem. Reference ranges are established by collecting results from populations where detailed health information is often unknown, and many people getting tested are already experiencing health concerns. When more than half the adult population lives with chronic illness, using population averages means “normal” ranges may actually reflect dysfunction rather than optimal health.
Medical literature distinguishes between standard reference ranges and optimal health ranges (the levels associated with the best health outcomes rather than just statistical averages).
Why Your Doctor Might Not Be Testing This
Most conventional doctors receive minimal training in hormone optimization. Recent guidelines suggest that men’s symptoms are the most important factor, with international experts recommending a trial of testosterone replacement therapy even if total testosterone is within the normal range when symptoms are present.
Insurance limitations also play a role, as coverage for hormone therapy is often denied when lab results fall within “normal” reference ranges, regardless of symptoms.
Real Testosterone Deficiency vs. “Normal Aging”
Here’s what research shows about low testosterone symptoms:
For women:
- Studies show that both premenopausal and postmenopausal women with decreased libido also had decreased total and free plasma testosterone levels
- Persistent fatigue despite adequate sleep
- Loss of muscle tone and increased difficulty maintaining healthy weight
- Research shows women with higher free testosterone have greater bone mineral density and lean body mass
- Brain fog and memory issues
For men:
- Clinically, male hypogonadism is diagnosed when testosterone levels fall below 300 ng/dL, though symptoms can appear even in the 400s according to hormone specialists (Optimal levels for most men are typically 600-900 ng/dL, but this must be evaluated alongside free testosterone levels, which many doctors don’t test. Free testosterone is what actually does the work in your body!)
- Low energy and motivation
- Decreased muscle mass and strength
- Weight gain, especially around the midsection
- Mood changes and irritability
- Poor sleep quality
How We Approach Testosterone Optimization
At Ivalo MD, we start with comprehensive testing that goes beyond basic hormone panels. We test total testosterone, free testosterone, bioavailable testosterone, and SHBG (the binding protein that affects hormone availability). We also check estrogen levels.Men need some estrogen, but it’s all about finding the right balance.
Based on your results, we develop a personalized approach that might include bioidentical hormone therapy, lifestyle modifications, targeted supplements, or peptide therapy.
What Optimization Actually Looks Like
Research shows that testosterone therapy increases bone mineral density in hypogonadal men regardless of age, with the greatest increase during the first year of treatment. Studies in hypogonadal men found that testosterone supplementation significantly reduced negative aspects of mood like tension, anger and fatigue while increasing positive aspects such as vigor.
When testosterone levels are properly optimized, patients commonly report:
- Sustained energy throughout the day
- Improved mood and mental clarity
- Better sleep quality
- Increased motivation and drive
- Enhanced physical performance and recovery
- Improved body composition
The Functional Medicine Difference
Functional medicine practitioners typically aim for testosterone levels of 600-900 ng/dL for men (or even >1,000 depending on the individual and what the labs show) and 40-60 ng/dL for women, significantly higher than conventional “normal” thresholds. The key is also optimizing free hormone levels. We target free testosterone at 2-2.5% of the total testosterone.
Our approach to hormone therapy also differs from conventional methods. We use subcutaneous injections rather than intramuscular—they produce equal results but are far less painful, which means better patient compliance. Subcutaneous delivery also causes fewer elevations in estrogen levels and blood count, which must be monitored during therapy. We use smaller, more frequent dosing to keep hormone levels steady rather than the peaks and valleys you get with less frequent, larger doses.
We also address the root causes of hormone decline: chronic stress, poor sleep, nutrient deficiencies, and metabolic dysfunction. Hormone therapy works best when combined with comprehensive lifestyle support.
Your Next Step
If you’re experiencing, or can relate to any of the symptoms of low testosterone, whether you’re male or female, you don’t have to accept feeling suboptimal as “normal aging.”
Comprehensive hormone testing and optimization could be the missing piece in your health puzzle. Here, we take the time to understand your unique situation and develop a plan that addresses your specific needs and goals.
Ready to explore what’s possible? Let’s start with a conversation about your symptoms, your goals, and how hormone optimization might fit into your broader health strategy.Book your discovery call to find out what ‘optimal’ looks like for your body.
