Hormones: Part 3 - Know Your Hormones

Discover the hormones within men that can affect their performance, lifestyle and optimise well-being

Quick disclaimer

This is education and optimisation guidance, not a diagnosis. Hormones are powerful levers. If you have symptoms, abnormal results, or you’re considering testosterone, thyroid medication, aromatase inhibitors, fertility meds, or steroid use, work with a qualified physician/endocrinologist.

Hormones are not just “numbers.” The goal is strong function: libido, energy, muscle, mood, sleep, fertility, metabolism, and resilience.

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Important clarification

There is no separate “Middle Eastern male hormone physiology” versus “European male hormone physiology” in the way most lab ranges are built.

What changes most is:

1. The units used

2. The testing method

3. The lab’s own reference range

4. Age, body fat, sleep, medications, thyroid status, fertility status, and illness

So the smartest approach is:

Use your local lab’s reference range for diagnosis, then use “optimised” ranges as a performance and wellbeing target — not as a medical rule.

The ranges below are practical adult male ranges, especially relevant for men 45+, assuming blood is taken properly: morning, ideally 7–10 am, rested, no heavy training/alcohol the day before.

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Europe / UK / EU Style Ranges

European labs commonly use SI units: nmol/L, pmol/L, IU/L, mIU/L, nmol/L for cortisol.

Core Male Hormone Markers — Europe

Marker	Common “Normal” Range	Practical “Optimised” Range	Notes
Total Testosterone	8–30 nmol/L	18–28 nmol/L	Some healthy men sit lower or higher. Symptoms and free testosterone matter.
Free Testosterone — calculated	170–700 pmol/L	350–650 pmol/L	One of the most important markers. Direct free T tests can be unreliable.
Oestradiol / Estradiol — sensitive	40–150 pmol/L	70–130 pmol/L	Men need oestradiol. Too low can hurt libido, joints, mood, and bones.
LH	1.7–8.6 IU/L	2–6 IU/L	High LH with low T may suggest testicular under-response.
FSH	1.5–12.4 IU/L	2–8 IU/L	Strongly linked with sperm production and testicular function.
SHBG	15–60 nmol/L	20–45 nmol/L	Too high can trap testosterone. Too low often signals metabolic trouble.
Prolactin	70–400 mIU/L	85–250 mIU/L	High prolactin can suppress libido and testosterone. Re-test if elevated.
TSH	0.4–4.0 mIU/L	0.5–2.5 mIU/L	Must be interpreted with free T4, free T3, antibodies, and symptoms.
Morning Cortisol — 8 am serum	140–690 nmol/L	275–550 nmol/L	Timing matters massively. Evening cortisol should be low.

Additional Hormones / Related Markers — Europe

Marker	Common “Normal” Range	Practical “Optimised” Range	Notes
DHT	1.0–3.0 nmol/L	Mid-range	Important for libido, erection quality, drive, prostate, and hair biology.
DHEA-S	Age-dependent; often 1.5–8.0 µmol/L for many men 45–60	Mid-to-upper age-adjusted range	Do not blindly supplement. Can raise oestradiol or DHT.
Pregnenolone	Approx. 0.6–7.5 nmol/L	No firm optimal range	Useful in some adrenal/stress assessments, but not a routine marker.
Progesterone	Approx. 0.3–3.0 nmol/L	Low-to-mid range	Men need small amounts. High levels may reduce libido or drive.
Fasting Insulin	2–25 mIU/L	2–8 mIU/L	Huge metabolic marker. Lower is usually better, but not too low with symptoms.
IGF-1	Age-dependent; often 70–220 µg/L in midlife	Mid-range for age	Reflects growth hormone activity, sleep, nutrition, and recovery.
Leptin	Often 1–10 ng/mL in leaner men	Lower-normal if body fat is healthy	High leptin usually reflects higher body fat/leptin resistance.
PSA	Usually <4.0 µg/L or ng/mL	Stable and age-appropriate	Not a hormone, but important before/while using TRT. Trend matters.

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Middle East Style Ranges

Middle Eastern labs vary. Many private hospitals and clinics in the UAE, Saudi Arabia, Qatar, Bahrain, Kuwait, Oman, Lebanon, Jordan, and Egypt may use a mix of:

• US-style units: ng/dL, pg/mL, ng/mL, µg/dL

• European/SI units: nmol/L, pmol/L, mIU/L

So below I’ll give the common Middle East/private clinic style with conversions.

Core Male Hormone Markers — Middle East

Marker	Common “Normal” Range	Practical “Optimised” Range	Notes
Total Testosterone	230–865 ng/dL	520–800 ng/dL	Equivalent to roughly 8–30 nmol/L normal and 18–28 nmol/L optimised.
Free Testosterone — calculated/equivalent	50–200 pg/mL	100–190 pg/mL	Equivalent to roughly 170–700 pmol/L normal and 350–650 pmol/L optimised.
Oestradiol / Estradiol — sensitive	11–41 pg/mL	20–35 pg/mL	Use a sensitive male assay where possible.
LH	1.7–8.6 IU/L	2–6 IU/L	Same units commonly used globally.
FSH	1.5–12.4 IU/L	2–8 IU/L	Fertility context matters.
SHBG	15–60 nmol/L	20–45 nmol/L	Usually reported in nmol/L even in Middle Eastern labs.
Prolactin	3–18 ng/mL	4–12 ng/mL	Equivalent to roughly 70–400 mIU/L normal.
TSH	0.4–4.0 mIU/L	0.5–2.5 mIU/L	Same unit used in most regions.
Morning Cortisol — 8 am serum	5–25 µg/dL	10–20 µg/dL	Equivalent to roughly 140–690 nmol/L normal.

Additional Hormones / Related Markers — Middle East

Marker	Common “Normal” Range	Practical “Optimised” Range	Notes
DHT	30–85 ng/dL	Mid-range	Equivalent to roughly 1.0–3.0 nmol/L.
DHEA-S	Age-dependent; often 55–300 µg/dL in many men 45–60	Mid-to-upper age-adjusted range	Equivalent to roughly 1.5–8.0 µmol/L.
Pregnenolone	Approx. 20–230 ng/dL	No firm optimal range	Highly lab-dependent.
Progesterone	Approx. 0.1–0.9 ng/mL	Low-to-mid range	High levels are not usually desirable in men.
Fasting Insulin	2–25 µIU/mL	2–8 µIU/mL	µIU/mL and mIU/L are effectively equivalent for insulin.
IGF-1	Age-dependent; often 70–220 ng/mL in midlife	Mid-range for age	ng/mL and µg/L are effectively equivalent.
Leptin	Often 1–10 ng/mL in leaner men	Lower-normal if body fat is healthy	High levels usually track with body fat and insulin resistance.
PSA	Usually <4.0 ng/mL	Stable and age-appropriate	PSA velocity/trend is very important.

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Key Unit Conversions

Useful if you’re comparing results between Europe and the Middle East.

Marker	Conversion
Total Testosterone	ng/dL × 0.0347 = nmol/L
Total Testosterone	nmol/L × 28.8 = ng/dL
Free Testosterone	pg/mL × 3.47 = pmol/L
Free Testosterone	pmol/L ÷ 3.47 = pg/mL
Oestradiol / E2	pg/mL × 3.67 = pmol/L
Oestradiol / E2	pmol/L ÷ 3.67 = pg/mL
Prolactin	ng/mL × approx. 21.2 = mIU/L
Prolactin	mIU/L ÷ approx. 21.2 = ng/mL
Cortisol	µg/dL × 27.6 = nmol/L
Cortisol	nmol/L ÷ 27.6 = µg/dL
DHT	ng/dL × 0.0344 = nmol/L
DHEA-S	µg/dL × 0.0271 = µmol/L

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Corrected and Refined Hormone Notes

1. Total Testosterone

The earlier range of 300–1,000 ng/dL is commonly quoted, especially in American-style discussions, but it is broad.

A tighter practical adult range is closer to:

• Europe: 8–30 nmol/L

• Middle East/common private labs: 230–865 ng/dL

For men over 45 aiming for good vitality, libido, training response, and mood, a practical target is often:

• Europe: 18–28 nmol/L

• Middle East: 520–800 ng/dL

But here’s the key: free testosterone matters more than total testosterone if SHBG is high or low.

2. Free Testosterone

This is where a lot of men get misread.

A man can have “normal” total testosterone but still feel flat if SHBG is high and free testosterone is low.

Practical target:

• Europe: 350–650 pmol/L

• Middle East: 100–190 pg/mL

Best method: calculated free testosterone using:

• Total testosterone

• SHBG

• Albumin

Avoid putting too much trust in cheap/direct free testosterone immunoassays.

3. Oestradiol / Estradiol

The earlier figure of 10–40 pg/mL is fair, but for male optimisation I’d refine it to:

• Europe normal: 40–150 pmol/L

• Europe optimised: 70–130 pmol/L

Or:

• Middle East normal: 11–41 pg/mL

• Middle East optimised: 20–35 pg/mL

Important: use a sensitive oestradiol assay where possible. Standard female-focused assays can be less accurate at male levels.

Too low is bad. Too high is bad. Balanced is the mission.

4. LH

The earlier range of 1.5–9 IU/L is reasonable.

Refined:

• Normal: 1.7–8.6 IU/L

• Optimised: 2–6 IU/L

High LH with low testosterone can mean the testes are struggling.

Low LH with low testosterone can mean the brain/pituitary is not signalling strongly.

5. FSH

The earlier range of 1.5–12 IU/L is also reasonable.

Refined:

• Normal: 1.5–12.4 IU/L

• Optimised: 2–8 IU/L

FSH is especially important if fertility matters.

High FSH can suggest impaired sperm production.

Low FSH can happen with TRT, anabolic steroid use, pituitary suppression, obesity, stress, or illness.

6. SHBG

The earlier range of 10–60 nmol/L was acceptable, but I’d tighten the practical interpretation.

• Normal: 15–60 nmol/L

• Optimised: 20–45 nmol/L

High SHBG can reduce usable testosterone.

Low SHBG often points to:

• Insulin resistance

• Fatty liver

• Obesity

• Sleep apnoea

• Hypothyroidism

• Inflammation

SHBG is not just a sex hormone marker. It’s also a metabolic clue.

7. Prolactin

The earlier range of 2–18 ng/mL is broadly fine, but most labs use something like:

• Middle East/common: 3–18 ng/mL

• Europe/SI: 70–400 mIU/L

Optimised:

• Middle East: 4–12 ng/mL

• Europe: 85–250 mIU/L

If prolactin is high, repeat it properly before panicking:

• Morning test

• Rested

• No sex/orgasm the day before

• No hard training before test

• Avoid acute stress

• Consider checking macroprolactin

Very high prolactin needs proper medical investigation.

8. TSH

The earlier range of 0.4–4.0 mIU/L is correct.

Optimised for many men:

• 0.5–2.5 mIU/L

But never judge thyroid health from TSH alone.

You want to see:

• TSH

• Free T4

• Free T3

• Thyroid antibodies

• Symptoms

• Resting heart rate

• Body temperature

• Cholesterol pattern

A man with “normal” TSH can still have poor thyroid conversion or autoimmune thyroid issues.

9. Cortisol

The earlier range was correct, but cortisol must always be interpreted by time of day.

Morning blood cortisol:

• Europe normal: 140–690 nmol/L

• Europe optimised: 275–550 nmol/L

Or:

• Middle East normal: 5–25 µg/dL

• Middle East optimised: 10–20 µg/dL

The pattern matters more than a single number:

• Morning: should rise

• Evening: should fall

• Night: should be low

A man with high night cortisol will often have poor sleep, belly fat gain, low libido, and poor recovery — even if his morning cortisol looks “normal.”

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Regional Factors That Commonly Affect Hormones

Middle East

Common issues I see affecting male hormones in the region:

1. Vitamin D deficiency despite sunshine

Many men are indoors most of the day, avoid sun due to heat, or are covered outdoors. Low vitamin D is common and can affect testosterone, mood, immunity, and metabolic health.

2. Heat and disrupted training timing

Extreme heat can reduce outdoor activity, increase dehydration, and disrupt sleep if cooling is poor.

3. Late nights and social eating

Late dinners, heavy evening meals, and irregular sleep can push cortisol and insulin in the wrong direction.

4. High rates of insulin resistance

Belly fat, high refined carbohydrate intake, sugary drinks, and low activity can lower testosterone and SHBG balance.

5. Shisha/smoking

Nicotine and smoke exposure can affect vascular health, fertility, oxidative stress, and erectile function.

6. Anabolic steroid/TRT access

Some men use testosterone or anabolic compounds without monitoring. This can suppress LH, FSH, fertility, and natural production.

7. Ramadan and fasting

Fasting can be beneficial for metabolic health, but sleep disruption during Ramadan can temporarily affect testosterone, cortisol, glucose, and recovery markers.

Important: do not under any circumstance take this as a reason not to fast or fulfil the commandment of ramadan. Better organise your time.

Europe

Common issues affecting male hormones in Europe:

1. Winter sunlight deficiency

Low sunlight in autumn/winter can affect vitamin D, mood, sleep rhythm, and testosterone indirectly.

2. Alcohol culture

Regular alcohol intake can raise oestradiol, lower testosterone, worsen sleep, affect liver function, and increase belly fat.

3. Sedentary office lifestyle

Long sitting, low daily steps, and poor strength training habits reduce insulin sensitivity and testosterone health.

4. Chronic stress and poor recovery

Work stress, commuting, poor sleep, and low downtime can disrupt cortisol rhythm.

5. Endurance over strength

Some men do plenty of cycling/running but little resistance training. Strength training is a major testosterone and insulin-sensitivity signal.

6. Seasonal mood changes

Low winter light can affect dopamine, serotonin, sleep, appetite, and training consistency.

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Best Testing Setup for Accurate Results

If you want useful numbers, do this:

• Test between 7–10 am

• Fasted or lightly fasted

• Sleep normally the night before

• No alcohol for 24–48 hours

• No heavy training the day before

• No sex/orgasm before prolactin testing

• Avoid testing during acute illness

• Repeat abnormal testosterone/prolactin before making big decisions

• Use the same lab where possible for trend tracking

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Best Core Male Hormone Panel

For a serious male optimisation review, I’d want:

• Total testosterone

• SHBG

• Albumin

• Calculated free testosterone

• Sensitive oestradiol

• LH

• FSH

• Prolactin

• TSH

• Free T4

• Free T3

• Thyroid antibodies

• Morning cortisol, if stress/fatigue is an issue

• DHEA-S

• Fasting insulin

• Fasting glucose

• HbA1c

• Lipids

• Liver enzymes

• Kidney markers

• Full blood count

• Ferritin

• Vitamin D

• PSA, especially if over 45–50 or considering TRT

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Bottom Line

For Europe, use mostly SI units:

• Testosterone: 18–28 nmol/L optimised

• Free T: 350–650 pmol/L optimised

• Oestradiol: 70–130 pmol/L optimised

• Cortisol: 275–550 nmol/L morning optimised

For the Middle East, many labs use American-style units:

• Testosterone: 520–800 ng/dL optimised

• Free T: 100–190 pg/mL optimised

• Oestradiol: 20–35 pg/mL optimised

• Cortisol: 10–20 µg/dL morning optimised

Do not chase maximum numbers. Chase the right pattern:

Good free testosterone, balanced oestradiol, healthy SHBG, normal prolactin, strong thyroid function, and a cortisol rhythm that lets you perform by day and recover by night.

And as always: use this for education and optimisation. If anything is out of range or symptoms are significant, review it with a qualified physician/doctor or endocrinologist.