10 signs of high testosterone in men

More is not necessarily better when it comes to testosterone. High testosterone levels may result in acne, hair loss, mood swings, higher blood pressure, low sperm count, and more. Read on to learn more about the signs of high testosterone in men, causes of high testosterone, and what to do about it.

Higher-than-normal testosterone levels are uncommon in men who are not taking hormones or anabolic steroids. 

If your levels do spike and stay high for a while, you may experience signs of high testosterone like acne, hair loss, mood swings, and trouble sleeping — but all of these symptoms can have other causes, so a blood test is needed to confirm whether testosterone levels are actually elevated. Let’s take a look.

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1. Acne

Testosterone can increase sebum production (an oily substance found on the skin), which may lead to clogged pores and acne. Acne may become more noticeable after starting testosterone or using anabolic steroids, but acne alone does not mean that testosterone levels are high.

2. Hair loss

Testosterone and its derivative hormone, dihydrotestosterone (DHT), play a role in male-pattern hair loss. However, genetics and the sensitivity of the hair follicles are more important than the levels of testosterone in the blood. 

In people with a genetic predisposition to male pattern baldness, testosterone treatment or anabolic steroid use may accelerate male-pattern hair loss, but a high testosterone blood level does not reliably predict balding.

3. Mood swings

Elevated testosterone levels — from  high doses of testosterone or anabolic steroids — may contribute to irritability, aggression, depression, mania, or other mood changes. These effects are not reliable signs of a mildly elevated natural testosterone level, since they could be related to other things.

These symptoms may make you more prone to take risks, especially if the cause of your high T is anabolic steroid abuse. 

4. Sleep problems

Trouble sleeping is not a specific or reliable sign of high testosterone. However, testosterone therapy may worsen sleep apnea in some people. If you were prescribed testosterone replacement therapy (TRT), tell your healthcare provider if snoring, breathing interruptions, or daytime sleepiness begins or worsens after starting treatment.

5. Blood pressure and circulation

It’s possible that high testosterone from external sources, like TRT, can result in polycythemia, which is an increased production of red blood cells. When there are too many red blood cells, it can make your blood thicker, which can lead to blood clots. Testosterone products can also raise blood pressure, so your healthcare provider will likely monitor both your blood pressure and hematocrit during treatment.

6. Heart and liver strain

As we just saw, testosterone products can raise blood pressure and hematocrit. And anabolic steroid misuse — particularly at high doses — has been associated with serious cardiovascular problems. However, in a large clinical trial, medically supervised TRT did not increase the risk of heart attack or stroke compared with placebo. 

If your excess testosterone is due to anabolic steroid use, this can put strain on the liver, potentially leading to liver injury and damage. 

7. Libido fluctuations

Testosterone plays a major role in libido (aka your sex drive), and low levels may contribute to a lower sex drive. In men with confirmed testosterone deficiency and low sex drive, testosterone treatment may improve libido.

However, very high levels don’t always lead to a consistently stronger libido — particularly when the high testosterone is linked to inappropriate anabolic steroid use. Research shows that nonmedical anabolic steroid use can decrease libido when a man’s natural testosterone production becomes suppressed or when he stops the drugs.

8. Low sperm count and infertility

Used appropriately, TRT should only raise your levels to the normal range, but any TRT use may cause low sperm count (due to slowed sperm production) and infertility. So, if you are on TRT and you and your partner have been having trouble getting pregnant, speak with your healthcare provider about other options. 

Inappropriate anabolic steroid use can also lead to infertility. 

9. Rapid muscle growth

High testosterone can lead to rapid muscle growth and increases in strength, especially if you’re combining anabolic steroids with strength training. As nice as that might sound in theory, nonmedical anabolic steroid use can cause serious cardiovascular, hormonal, psychiatric, fertility, and liver-related complications.

10. Shrinking of the testicles

Testosterone taken from an outside source — including TRT and anabolic steroids — can suppress your body’s natural testosterone production. When the testicles aren’t working as hard to produce testosterone, they may shrink slightly, which is known as testicular atrophy. 

High levels of testosterone don’t usually happen naturally. Men with too much testosterone may have high levels due to:

• Testosterone replacement therapy (TRT):  Whether taken through injections or topical methods, such as testosterone gel, TRT raises testosterone levels in men with low T. However, it’s possible that a dose could be too high and lead to higher-than-normal T levels. 

• Using anabolic steroids: If you’re using anabolic steroids inappropriately or illegally, it can cause high T, since anabolic steroids (aka anabolic-androgenic steroids) are synthetic testosterone derivatives. 

• Adrenal or testicular tumors: If you have a rare tumor on your testicles or adrenal glands, it can lead to irregular hormone production, including testosterone production.  

• Pituitary gland issues: The pituitary gland in your brain helps regulate hormone production in your body, including testosterone. Pituitary disorders usually cause low testosterone, rather than high testosterone. Only very rare pituitary tumors raise the hormones that stimulate testosterone production

• Medications and supplements: Medications that increase testosterone levels, such as Clomid (clomiphene) can potentially cause higher than normal T levels. 

High testosterone is treated differently depending on the cause. If your symptoms or use of testosterone medications or anabolic steroids suggest your body may be getting too much testosterone, your healthcare provider may run a simple blood test to measure your testosterone levels. An appropriate treatment plan will depend on the cause of your high T.  

Here are some ways to treat high testosterone:

Adjust testosterone replacement therapy (TRT)

If you’re on TRT for low testosterone and your hormone levels get too high, your healthcare provider will work with you to adjust your dosage and get your blood levels back within a normal range.

Decrease or stop anabolic steroids

If you use anabolic steroids for muscle gains and your T levels spike, you might experience signs of high testosterone. Tell your healthcare provider about any anabolic steroids you use. Do not abruptly change a long-term regimen without medical advice, because withdrawal and prolonged hormone suppression may need evaluation and support. 

Long-term health problems associated with anabolic steroids include severe medical conditions, like heart disease, kidney problems, liver disease, and blood clots, potentially leading to heart attacks and strokes.

Treat underlying conditions

If a rare tumor on the testicles, adrenal glands, or pituitary glands is affecting your hormone levels, treating it may bring your testosterone levels back into the normal range. 

Most testosterone in the blood is attached to proteins and a small amount circulates as free testosterone. Together, these make up your total testosterone. A "normal” reading of total testosterone levels falls anywhere between 300 and 1000 nanograms per deciliter (ng/dL), depending on what lab processes your sample or who you ask. When it comes to defining “abnormal” testosterone levels, meaning levels that are too low or too high, it’s important to remember that the cutoffs for testosterone are not as well-defined as other blood values, like hemoglobin levels.

For example, according to the American Urological Association (AUA), having symptoms and a testosterone value below 300 ng/dL is a “reasonable cut-off” to be diagnosed with low testosterone, which can trigger treatment. But healthcare providers might still treat someone with slightly higher T levels if the signs and symptoms are typical of low T. 

Low testosterone (hypogonadism) — which may happen due to aging, trauma, genetic conditions like Klinefelter syndrome, and more — may cause low libido, low sperm count and infertility, erectile dysfunction (ED), weight gain, or a loss of pubic or armpit hair.

If you experience signs of high testosterone, especially while using testosterone or anabolic steroids, visit your healthcare provider. They can test your levels, work with you to determine why your testosterone levels are high, and make a treatment plan to bring them back to the normal range.

• Signs of high testosterone in men can include acne, hair loss, mood swings, sleep problems, high blood pressure, infertility, and more — but none of these symptoms are specific enough to diagnose high testosterone on their own.

• High testosterone may be caused by something you’re taking (such as testosterone replacement therapy or anabolic steroids) or underlying health conditions.

• Consult a healthcare provider to get your testosterone levels checked through a blood test. They can help create a plan to either treat underlying conditions or any other causes.