The Truth About Low T
Experts agree on at least one thing: After age 30, every man’s testosterone drops about 1 percent a year, according to Ranjith Ramasamy, a urologist at Baylor College of Medicine in Houston. Being overweight or obese, as well as having type 2 diabetes, may drag your levels down even lower.
But what is a healthy T level for an older man? Doctors can’t agree. Many laboratories use wildly varying reference numbers based on the average testosterone levels of young men, anywhere from 300 to 900 nanograms per deciliter.
Meanwhile, some symptom lists virtually guarantee that any middle-aged man will self-diagnose low T. Several websites that promote testosterone replacement feature a 10-question self-quiz. Answer yes to just three you’re grumpy now and then, you don’t have the strength you used to have, and you sometimes fall asleep after dinner and you could have low T. “These complaints may have nothing to do with testosterone,” says Woloshin.
Things Men Need To Know About Low Testosterone Treatments
Are you a shadow of who you used to be? Is your sex drive abysmal? Would your wife instantly be more attracted to you if your testosterone levels were higher? This is what ads hyping Low T testosterone replacement therapy are prompting men to consider.
The villain: low testosterone, or Low T, a phrase employed by clinics selling their cure, complete with improved mood, energy levels, libido, erectile function and vitality.
These are targeted toward a specific audience, and that audience is men in their forties and up who are concerned about the potential effects of low testosterone, said Dr. Karan Shukla, of Novant Health Randolph Family Medicine in Charlotte. They market it as an easy fix when, in fact, it may not be so easy to fix. By the same token, there may be much easier solutions, Shukla added.
Heres what men should really know about testosterone levels and growing older.
Does Low Testosterone Cause Infertility
Low testosterone does not cause infertility. Sperm production is actually stimulated by hormones other than testosterone. Testosterone is required for sperm production, but the level in the testes where sperm are produced is many times higher than in the blood. Even men with low or borderline T levels may have sufficient T levels for sperm production.
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You Could Lose Your Hair
Fan of rocking those hipster haircuts? Well, that could quickly change if you start using testosterone injections. Why?
When you increase your bodys testosterone levels through injections, youll simultaneously increase the amount of test thats converted into dihydrotestosterone . And guess what? DHT has been linked to hair loss in both men and women.
Sure, its a super anabolic compound, but DHT chokes the life out of your hair follicles, eventually killing them so they dont grow back.
You can use shampoos or ointments like Regaine, but thats a surface solution that doesnt show the best results. Those test injections are the problem. Do you really want to lose sleep over the amount of hair youre not seeing anymore?
Speaking of losing sleep
Will Testosterone Really Cure Everything
Low energy? Get some T! No libido? Get T! Overweight. T will fix it! Youve heard the ads, but are they true? Dr. Alex Pastuszak explains everything you need to know about testosterone therapy and whether its right for you.
This content was originally created for audio. Some elements such as tone, sound effects, and music can be hard to translate to text. As such, the following is a summary of the episode and has been edited for clarity. For the full experience, we encourage you to subscribe and listen it’s more fun that way.
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Low Testosterone And Erectile Dysfunction
Although testosterone certainly plays a role in your sexual function as a whole, the idea that its a common cause of erectile dysfunction doesnt appear to be true.
Hormones like testosterone are vital for healthy sexual desire. However, erectile dysfunction is primarily a vascular issue, not a hormonal one.
Erections develop due to a combination of factors, including sexual stimulation and the effects of blood flow into the tissue of your penis.
When youre sexually aroused, the nerves inside your brain and around your penis cause the muscles that control blood flow into your penis to relax, allowing blood to flow into the pairs of erectile tissue called the corpora cavernosa.
As blood flows into this tissue, a fibrous membrane called the tunica albuginea contracts and seals the blood inside your penis, resulting in an erection.
This process takes place in reverse after you reach orgasm and ejaculate, with blood flowing out from your penis and the erection disappearing.
While low testosterone levels may affect your level of sexual arousal — an issue that might be linked to ED if you feel little or no desire for sex — they dont appear to be responsible for any changes in blood flow to your penis.
Though researchers still dont fully understand the precise relationship between testosterone and erectile dysfunction, they generally agree on two things.
The first is that you dont need to have normal testosterone levels to get or keep an erection during sex.
Recognizing The Signs Of Low Testosterone
When your body starts producing less testosterone, its common to notice a lower sex drive and difficulty getting or maintaining an erection. But low testosterone can cause additional issues that include:
- Weight gain
- Hair loss, both on your body and face
- Lack of energy and endurance
- Fatigue
- Loss of muscle mass and bone density
- Problems falling and staying asleep
- Emotional changes, like irritability and depression
- Memory issues and difficulty focusing
When you have less than 300 nanograms of testosterone per deciliter or symptoms affecting your quality of life, Dr. Kelly might recommend hormone therapy.
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Monitoring Managing And Follow
Both sets of guidelines stress the importance of monitoring T levels during treatment to make sure the hormone falls within a desired range and to check the status of other health conditions such as sex, heart and bone health.
While the number of men using testosterone has increased, its concerning that about 20 to 25 percent of men who go on testosterone never get their levels double checked before treatment, and a percentage of men who go on testosterone who dont get their levels checked at all while theyre on the treatment, says Dr. Mulhall.
There are a number of health reasons to monitor testosterone treatments. For example, low testosterone is a risk factor for cardiovascular events, but giving a patient testosterone cannot be said to definitively raise or lower the risk for cardiovascular issues, Dr. Mulhall says.
While testosterone replacement therapy does not cause prostate cancer, Dr. Bhasin notes that increasing testosterone could raise PSA levels, which may lead to an increased risk for prostate cancer, particularly in the 30% of men over 70 years of age who may have with an early stage prostate that has not yet become detectable.4
One important goal of monitoring testosterone levels is to minimize the risk of unnecessary biopsies, he adds.
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Treatment of low testosterone in hypogonadism is a fully accepted therapy. Treatment in older men is more controversial. Discuss your testosterone levels, symptoms, and side effects of treatment with your doctor to establish whether you should receive therapy and what form of therapy.
There are several ways that testosterone therapy can be administered:
- Transdermal : Usually applied once a day . Tends to be clean and easy to apply. There is an available mouth patch that sticks to the upper gums and is applied twice daily.
- Gels: Applied directly to the skin and then absorbed through the skin . Dosing is more difficult although these gels are available in single applications packages or premeasured pumps.
- Injections: Testosterone can be delivered by direct injection.
- Pellets: Pellets can be implanted into the soft tissue and release the testosterone.
Why no pills? Testosterone is available as a pill but some experts believe long-term oral delivery of testosterone can have negative effects on the liver. These other delivery methods bypass the liver and go directly into the blood stream.
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Low Testosterone Produces Erectile Dysfunction
Testosterone levels are directly linked to a mans ability to achieve and maintain an erection.
For men who are experiencing either infrequent or recurring impotency, low testosterone could be the source of these issues. One of the most common catalysts that launches men into impotency is external pressure and stress.
Men who work in high-stress jobs or are engaged in periods of prolonged interpersonal tension often find themselves confronted with short-term impotency. This is due in large part to the shift of hormone production taking place in the brain.
During periods of perceived stress, the body produces exaggerated levels of cortisol, which, in turn, reduces sexual desire and counterbalances testosterone.
Fortunately, impotency caused by stress is considered to be a short-term malady and should dissipate as men return to normal lifestyles. For those are who are unable to return to their normal functional lifestyle, it may be worth discussing these problems with a psychologist or certified sex therapist in order to confront these issues in a non-confrontational environment.
Many men have found that these problems quickly disappear when an effort is made to actively reduce daily stress levels.
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Nerve Pain Or Numbness
Testosterone and its derivatives, such as DHT, have recently been demonstrated to repair damage to nerves in the peripheral nervous system, which are not part of the brain or spinal cord,” Dr. Butcher explains. “This damage could be from diabetes, chemotherapy, physical injury, and chronic nerve pain. Research published in the March 2014 Journal of Endocrinology examined testosterones role in mitigating nerve damage. Researchers concluded that testosterone or its metabolites could play a role in treating neuropathy to prevent numbness and pain.
If you have a condition such as diabetes and you find your nerve pain and numbness getting worse, talk with your doctor about the possibility that you may also have low testosterone.
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It Can Be Caused By Other Health Issues
The relationship between low testosterone and weight can go both ways: low levels of testosterone can cause weight gain, and being overweight can also cause your testosterone levels to drop. Diabetes, HIV, kidney disease/renal insufficiency, and injuries to the testicles from chemotherapy or radiation can also lower testosterone levels.
Myth #: Only Older Men Experience Low Testosterone
Actually, this health problem does not discriminate by age. Low testosterone can affect any man, Dr. Guise said. It is not just a disease of older men.
How do you know if you have low testosterone? The first priority is getting a diagnosis, Dr. Guise said. Its important that your physician not only evaluate your symptoms, but also order blood tests to check various hormone levels.
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What Is A Dangerously Low Testosterone Level
The progressive decline in a mans testosterone levels that occurs from about the age of 30 on is typically responsible for a corresponding decline in his energy, stamina, strength, and sexual vitality. But what is a dangerously low testosterone level for any man to have developed? Does having Low T levels automatically lead you down the path to being confronted by more serious health issues?
If there is one thing that doctors and medical researchers have learned about a mans testosterone production it is that every individual has their own unique hormonal chemistry. The ranges that have been clinically determined to be the norm for men at particular stages of adulthood are approximations of what normal testosterone levels should be. It is possible for a man to have levels that are lower than the norm for his age group and not be bothered by Low T symptoms yet it is also possible for some men within the low end of the normal range to experience a number of undesirable symptoms related to having Low T levels for him.
Yet living with Low T is more than just living with its symptoms it also has a detrimental effect on the optimal function of your bodys systems and organs. This is where some of the dangerous aspects of having this disorder are hiding and if you are unaware of future health damage that low testosterone levels can cause, it can come at you later in the form of a very unwelcome medical event.
What Are Androgens?
What Causes High Female Testosterone Levels
- Ever come across the acronym âPCOSâ? It stands for Polycystic Ovary Syndrome, and itâs a hormonal disorder that can fill your blood with too much testosterone.
- Steroid use and abuse can hike up your testosterone levels and hormone levels of other androgens .
- Adrenal disorders can also be at fault for high T levels. These disorders are genetic and often found at birth or during puberty.
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The Dangers Of Low Testosterone
Much of what you associate with men, in terms of general appearance, is because of testosterone. During puberty, this hormone helps build muscle, deepens a mans voice, and boosts the size of his sex organs. Throughout life, testosterone is the hormone that drives libido and keeps muscles and bones healthy. Testosterone levels are highest at the tail end of puberty , but typically remain at high levels until around age 30.
After 30, most men experience a gradual decline in testosterone. Many men notice that this correlates with a loss of sexual desire, which is totally normal. Sometimes, however, testosterone levels drop too low. This can reduce your bones strength and muscle mass, exacerbate sexual issues, and lead to a host of health issues. Low testosterone can be dangerous if not treated.
Do you think you have low testosterone? Put your health first with Woodstock Family Practice & Urgent Care and James Y. Lee, DO. Dr. Lee is a mens health expert hell work with the rest of our team to make sure you get the care you deserve to be the best man you can be.
Should All Men Be Tested For Low T
Men who are otherwise healthy don’t need to be screened, according to guidelines released in 2018 by the Endocrine Society, an organization made up of endocrinologists.
The American Urological Association, made up of urologists, also issued guidelines in 2018. These advise doctors to think about measuring testosterone in patients who meet any of the following criteria:
- unexplained anemia
- exposure to chemotherapy or testicular radiation
- those with HIV/AIDS
- pituitary issues
- chronic corticosteroid use
The guidelines state testing should be considered in these situations even without symptoms of low T.
“We are not recommending general screening of the population,” Dr. Mezitis says. The test can be expensive. It varies, but he cites costs of around $100.
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Can Low Testosterone Be Treated
Men with low T levels and symptoms of low T can consider treatment. Men with low T can be treated with medicine through shots, gels, patches, or implantable pellets. There are advantages and disadvantages to each type of treatment. Recently, the number of men receiving T treatment in the United States has increased significantly. Medications for low testosterone are now marketed directly to patients in the media.
The Most Common Symptoms Of Low Testosterone
As a man, testosterone plays a key role in your health and wellbeing. Its responsible for most of your male secondary sex characteristics, including your voice, facial hair growth, muscle strength and bone structure.
It also plays a key role in your sexual function. Testosterone is vital for proper sperm production, and as an adolescent, its involved in many aspects of your male sexual development.
Below, weve shared 12 common physical and mental symptoms that are used to diagnose low testosterone in men.
Because testosterone is a hormone with several functions, low levels can often result in multiple symptoms.
If youve noticed any of the symptoms below, its important to talk to your healthcare provider about getting a blood test to check your testosterone levels.
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Let Me Briefly Discuss Sex Hormone
In both men and women, SHBG is the protein that carries the sex hormones testosterone and oestrogen. Only the testosterone and oestrogen that is not bound to SHBG is biologically active.
If testosterone levels stay the same and SHBG rises, there is less biologically active testosterone and a guy can not feel well. So, when a man has testosterone checked, they should also have SHBG checked at the same time.
For those thyroid patients who have to use T3 replacement, this sometimes may drive SHBG up. Multi-dosing using the dosage management process in the Recovering with T3 book helps because the process arrives at an effective T3 dosage with low individual T3 doses and low total levels of T3.
If SHBG is still an issue then there are multiple approaches.
Some patients have said that the use of milk thistle can sometimes bring SHBG down. Stinging nettle root extract in capsules can really help to lower SHBG. Stinging nettle root comes in 250 mg and 500 mg capsules and the dosing typically is done 2-3 times per day over the day.
There is also a drug called Danazol that can be used in low doses as an off-label approach to reducing SHBG . Danazol supposedly cuts SHBG in half within 6-8 weeks.
Note: Danazol is a prescription drug and its use to reduce SHBG is an off label application. Danazol should only be considered under the supervision of a knowledgeable physician.