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General Medical Questions
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Question : What does it mean when you have a high level of testosterone?
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The Trusted Source
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Howard LeWine, M.D.

Anthony L. Komaroff, M.D., is professor of medicine and editor-in-chief of Harvard Health Publications at Harvard Medical School. Dr. Komaroff also is senior physician and was formerly director of the Division of General Medicine at Brigham and Women's Hospital. Dr. Komaroff has served on various advisory committees to the federal government, and is an elected Fellow of the American Association for the Advancement of Science.

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May 26, 2011
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A:

To answer your question, I'd need to ask you two questions. But first, I need to explain a few things about testosterone.

There are two kinds of blood testosterone levels: total testosterone and free testosterone. Testosterone is a hormone. Most testosterone is produced in the testes. Similar to all hormones, it travels in the blood to have effects on other parts of the body.

When testosterone enters the bloodstream, other proteins in the blood quickly attach themselves to most of the testosterone. Any testosterone that is attached (or "bound") in this way cannot have effects on the body. Only the testosterone that is "free" (not bound) can have effects.

My first question for you is whether your total testosterone, free testosterone or both are elevated. If only the total testosterone was measured, then your doctor should measure the free testosterone. If the free testosterone level is high, then it is accurate to say that you have a high level of testosterone.

My second question is whether you take any kind of testosterone treatment. The most common is testosterone gel applied to the skin. If you do, and if your free testosterone is high, it means you are taking too much. You just need to cut back. If your free testosterone level is high without taking testosterone treatment, however, you should consult with an endocrinology specialist. There are several rare conditions associated with a high testosterone level that need to be evaluated.

What are the possible bad effects of having naturally high levels of testosterone? There are not many men with naturally high levels, and so there are few good studies to answer this question.

Many doctors have been taught that persistently high levels of testosterone can cause small prostate cancers to grow and spread. In my judgment, there is not much evidence for that.

There also is a concern that high testosterone levels might increase your risk for heart disease, although this still is a controversial issue.

There are some myths about having a high testosterone level that you don't have to worry about. It won't make you bald and it won't make you muscle-bound (unless you also spend a lot of time in the gym).

Finally, as my colleague Abraham Morgentaler says in his book Testosterone for Life, it won't cause hair to grow on your palms and soles -- unless, of course, you are a werewolf.

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