Study: Up to a Quarter of US Army Troops Could Be Flagged for Low Testosterone
The US Defense Department's planned universal testosterone screening could return low readings for roughly 15–26 percent of active-duty Army soldiers, depending on the threshold used. Experts question the value of such mass screening.
New research suggests that the universal testosterone screening introduced by the US Department of Defense could flag a substantial share of active-duty US Army soldiers as having low levels. The screening rests on the Pentagon's clinical guidance, but medical experts have long cautioned against this kind of approach.
What the estimates show
Among the Army members surveyed, the weighted mean morning total testosterone level was 405 ng/dL (nanograms per deciliter). The Pentagon's guidance defines low testosterone as below 300 ng/dL, in line with recommendations from the American Urological Association (AUA). Extrapolating to the whole Army, the researchers estimate that about 26 percent of active-duty soldiers would receive a result suggesting low testosterone under that cutoff.
The US Centers for Disease Control and Prevention (CDC) uses a harmonized reference cutoff that is slightly lower, at 264 ng/dL. With that threshold, about 15 percent of soldiers would be expected to have a low result.
Age and weight
The likelihood of a low result rose with weight and age: the older a man was, or the higher his body mass index, the greater the odds of a reading below either threshold. Among men under 30, 19.5 percent had a low measurement, compared with 33 percent of men aged 30 and older.
Why experts are wary
Specialists generally advise against universal screening of men for low testosterone, because measurements can vary widely and may not be helpful. Levels can fall for many reasons, including age, time of day, obesity, illness, physical stress, poor sleep, trauma and various medications. Clinically significant low testosterone, known as male hypogonadism, is rare, affecting at most 1 percent of men. Causes include genetic conditions and pituitary gland problems.
Experts recommend that evaluation begin when patients report symptoms themselves. Doctors then use repeat testing and comprehensive assessments to reach a firm diagnosis. Because this is the current norm, researchers are not sure exactly what the military's new universal screening will produce.
