Testosterone In The Body: Free T Vs Total T
In men, most testosterone is made by the testes through a complex series of biochemical reactionsâwhich convert cholesterol into testosterone .
Testosterone molecules are then secreted directly into the bloodstreamâwhere many of them soon bind to other molecules known as sex hormone binding globulin, or SHBG . Other testosterone molecules bind to albuminâan important type of blood protein.
How To Lower Testosterone In Women
What lowers testosterone in women? If you’re looking for natural ways to increase testosterone, it can help to know that several herbs and other plant-based foods may be able to naturally decrease T levels in women:
- Licorice â The root of a legume plant native to the Middle East , licorice may lower testosterone levels when taken daily.
- Green tea â Aside from being an all-around delicious tea, green tea may also be able to block testosterone from turning into a hormone called DHT â which is similar to testosterone but has much stronger effects on the body.
- Spearmint â Often consumed in tea form, spearmint may decrease levels of free testosterone in the bloodstream.
Also, keep in mind that if you’re experiencing high testosterone, it’s a good idea to talk with your healthcare provider to learn what their recommendation is.
Fatigue And Difficulty Concentrating
Healthy levels of testosterone help you feel energizedlike you can conquer the world. One of the biggest complaints among men with low testosterone levels, however, is that they feel tired and unfocused a lot of the time no matter how much they sleep. Fatigue that lasts for weeks and cant be explained by stress or extreme activity is always something you should tell your doctor about.
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What Is The Average Testosterone Level By Age
Although you can clearly see this information on the T levels by age chart above, lets just see what the average total T levels by age are:
Age and Average Total Testosterone
- 25 to 34 617
- 35 to 44 668
- 45 to 54 606
- 55 to 64 562
- 65 to 74 524
- 75 to 84 471
- 85 to 100 376
And to put things into perspective, the normal testosterone range is considered to be between 300 and 1000 ng/dl, according to the FDA.
- Also read: What are the normal testosterone levels in men?
Anything below the 300 mark is viewed as low testosterone as thats where the symptoms become more prominent.
Regardless, its normal to expect your T levels to drop as you get older as evident from the chart above.
Appendix D: Testosterone Therapy And The Risk Of Major Adverse Cardiac Events
Given the conflicting nature of the evidence, the Panel cannot definitively state that there is an association between testosterone therapy and subsequent MACE events nor can it be stated definitely that testosterone therapy is associated with reduced incidence of MACE. However, the FDA added a warning to testosterone product labeling after reviewing five observational studies and two meta-analyses of RCTs that examined the effects of testosterone therapy on MACE. Two of the trials and one meta-analysis pointed to an increased risk of cardiovascular events,363, 364, 366 two revealed no cardiovascular risk,233, 367 and one was neutral with respect to risk.373 The Corona meta-analysis,372 which showed that there was no increased risk of cardiovascular events, was not officially reviewed but was taken into consideration in the final analysis. Although the committee reviewing the evidence concluded that there was not enough data to definitively state that testosterone therapy posed a significant cardiovascular risk, the FDA nonetheless required testosterone product manufacturers to add information to the labeling about a possible increased risk of myocardial infarction and cerebrovascular accidents in patients using testosterone therapy.
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Testosterone Levels In Postmenopausal Women
Female hormone imbalance is relatively common, especially once menopause strikes. At this time, the ovaries no longer produce crucial chemicals that the body needs. These hormones are still required throughout life to maintain strong bones and muscles, support brain and heart functions, and keep an active libido.
The list of female hormones produced by the ovaries includes:
While the adrenal glands still help out with testosterone and progesterone production in later years, the amount supplied is extremely small. The biggest issue that we see is an end to normal estrogen levels when the body converts excess testosterone into estradiol. This causes an imbalance that leads to a condition called estrogen dominance where estrogen is now unopposed by progesterone and testosterone because their levels have declined. Estrogen dominance leads to weight gain, which further increases testosterone to estrogen conversion.
Here is how to tell if a woman has high estrogen and low testosterone and progesterone after menopause:
What Is Free Testosterone
And the rest of your testosteroneâthe unbound testosterone? This testosterone isâquite appropriatelyâtermed âfree testosterone,â or free T, because it isnât attached to other molecules. Because they donât attach to other proteins, this type of bioavailable testosterone can be used up by the body. Your body actively uses free T molecules since they are at liberty to enter the bodyâs cellsâunimpeded by SHBG or albuminâto carry out their function as signaling molecules that regulate metabolism and other cellular functions.
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Treatment Of Testosterone Deficiency
Guideline Statement 22
22. Clinicians should adjust testosterone therapy dosing to achieve a total testosterone level in the middle tertile of the normal reference range.
The Panel recognizes that it might be difficult to achieve an on-treatment total testosterone level in such a narrow range in every patient, especially those using IM testosterone however, the suggested range aims to limit the over-treatment of testosterone deficient men who have had physiologically lifelong total testosterone levels in the lower range of normal, while minimizing the under-treatment of men who have had physiologically lifelong total testosterone levels in the upper range of normal. For men with on-treatment testosterone levels that fall below the suggested target range but who have on-treatment amelioration of symptoms, up-titration may be considered in an effort to achieve symptom abolition. For men with on-treatment testosterone levels that fall below the suggested target range but who experience complete resolution of symptoms, there is no need to titrate dosing. For the patients with no or minimal symptoms associated with low testosterone levels, but rather the presence of signs , clinicians are encouraged to aim for on-treatment total testosterone levels in the 450-600 ng/dL target range and re-evaluate the patients’ signs at an appropriate time point after reaching the therapeutic range.
Guideline Statement 23
Guideline Statement 24
What Causes Testosterone Deficiency
Testosterone deficiency can be caused by normal ageing. However, there are many other different causes of testosterone deficiency. Some causes of testosterone deficiency can be inherited. Testosterone deficiency may be present at birth or it may develop later in life.
Being significantly overweight or obese at any age may be linked to testosterone deficiency.
Temporary testosterone deficiency may be caused by a physical illness, surgery or emotional stress. The testosterone level will go back to normal once the underlying problem has been treated.
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What Happens To The Body If Testosterone Levels Are Low
Did you know that the human body produces several different hormones that play important roles in various bodily functions? Without them, digestion, blood circulation, growth, reproduction, memory, and other bodily processes would not be possible.
In men, one of these essential hormones is known as testosterone. Primarily produced in the testicles, testosterone is a type of anabolic steroid hormone that facilitates the development of the male reproductive tissues and the secondary male sexual characteristics. Because of how integral it is in the growth and development of men from the fetal stage to old age, it is regarded as the primary male sex hormone.
Signs You May Have A Testosterone Deficiency
Testosterone production declines naturally as men age, but sometimes levels drop abnormally low. Whats more, it can occur earlier than you think. Did you know that 25% of men over age 30 and close to 40% of men over age 45 have testosterone deficiency? That number goes up significantly for men over age 65.
Inadequate testosterone levels can have a major impact on your physical health, mental health, and overall quality of life. The good news is testosterone replacement therapy can restore your levels to normal and improve your symptoms.
If you suspect your testosterone levels are off, TRT specialist Gordon Hart can perform a simple blood test to determine your levels. At Balance Hormone Center in Norman, Oklahoma, Hart treats men with hormonal imbalances using bioidentical hormones that mimic the ones your body produces. Many men report feeling better within weeks of initiating treatment. If you have any of the following eight warning signs, you may have low testosterone.
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Whats The Best Method For Testing Your T Levels
Blood tests are undoubtedly the most reliable and accurate for checking your testosterone levels.
They will give you the most accurate representation of how much free, total and SHBG-bound testosterone is flowing through your veins.
Nonetheless, these are the 3 most widespread methods for testing your T:
Now, something worth keeping in mind when you do decide to go for a blood test is that testosterone levels peak during early morning hours.
And more specifically your testosterone is at its max during 7-10 AM!
So for a more accurate reading, your best bet would be to get tested during this time window.
Testosterone Therapy For Low Levels
In most cases, men need to have both low levels of testosterone in their blood and several symptoms of low testosterone to go on therapy.
It is possible to have low levels and not experience symptoms. But if you do not have any key symptoms, especially fatigue and sexual dysfunction, which are the most common, it is not recommended you go on the therapy given the uncertainty about long-term safety.
Even if your levels are low and you have symptoms, low-t therapy is not always the first course of action. If your doctor can identify the source for declining levelsfor instance, weight gain or a particular medicationhe or she may first address that problem.
If you and your doctor think testosterone replacement therapy is right for you, there are a variety of delivery methods to consider, as found in the Harvard Special Health Report Men’s Health: Fifty and Forward.
Most men feel improvement in symptoms within four to six weeks of taking testosterone replacement therapy, although changes like increases in muscle mass may take from three to six months.
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Should Men With Symptoms Of Low Testosterone But Without Hypogonadism Be Prescribed Testosterone Therapy
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Healthy men who complain of symptoms of low testosterone but without hypogonadism should not be routinely prescribed testosterone therapy.
The definition of male hypogonadism varies, with different experts/societies/labs having different reference ranges for total testosterone. Generally, most experts would agree that a total testosterone level less than 250 ng/dL is considered low, whereas some experts endorse a higher level of around 350 ng/dL as the lower limit of normal. There are also additional ways of assessing for testosterone status beyond measuring total testosterone: free testosterone or bioavailable testosterone can also be measured. Each test has its own set of positives and negatives ultimately, clinicians need to order the testing which they feel is most appropriate for a particular patient.
The symptoms of low testosterone are rather vague and non-specific and can be related to many other health conditions, such as obstructive sleep apnea, overweight or obesity, or a sedentary lifestyle. Evaluation of symptoms such as fatigue may note borderline-low testosterone values, and in a minority of cases, a trial of testosterone therapy may be considered, depending on the results of the overall evaluation. However, this should generally be an exception to the rule, rather than the rule.
Can You Have Too Much Testosterone
Its common to write off-road rage or men otherwise behaving badly as a sign of increased testosterone production. However, there are no studies that link male behavior to increased testosterone production. It simply isnt a common occurrence for men to have too much naturally-produced testosterone hormone.
Testosterone is produced when the brain signals the pituitary gland, which is located at the base of the brain, to make more of this hormone. Then the pituitary sends a signal to the testes to produce more testosterone. Its a feedback loop that regulates chemical production. If testosterone is too high, the feedback loop slows down.
Problems can occur, however, if men are using anabolic steroids or supplementing their bodys natural production with more testosterone. This usually happens when men are seeking greater muscle mass or better athletic performance. If the body has too much testosterone, the side effects can be severe, including:
- High blood pressure and cholesterol
- Increased risk of blood clots
- Increased risk of heart attack
- Liver disease
- Mood swings
The right levels of testosterone play an important role in your health, no matter your gender. Checking your testosterone level is as simple as having a blood test from your doctor.
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What Causes Low Testosterone
Having low testosterone isnt something most men talk about. It certainly isnt the topic of most adult conversations, despite the fact that 4 to 5 million men experience this issue. While testosterone in men begins to decline after age 30, younger men, teenagers, children, and even babies can suffer the symptoms of low testosterone.
What is testosterone? How can you know if your body isnt making enough? What causes low testosterone and are there treatments available to help with this condition?
Recovering Fertility After Testosterone Therapy
Regaining fertility is not guaranteed, but it is possible for some patients depending on their age and duration of testosterone use. The first step is to end any testosterone therapy and get baseline lab tests to know where your levels truly are. Often, we find that the patient’s LH production has been suppressed. In those cases, the next task is to increase it. Most patients start with Clomid. If that isn’t sufficient, we may consider hCG injections.
In rare cases when neither therapy works, we can consider increasing the FSH level as well with injections of the FSH substitute hMG. This drug is more expensive, and success is not guaranteed.
If you are concerned about low-T symptoms, or if you’ve tried therapies that didn’t work, talk with your primary care doctor or urologist. Feeling better starts with a conversation about your needs, goals, and lifestyle. Personalized care from a board-certified urologist or male fertility expert is the healthiest way to get there.
To visit with a men’s reproductive health specialist, call orrequest an appointment online.
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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.
The Common Warning Signs Of Low T
Testosterone is a sex hormone, but that doesnt mean that low levels only affect your life in the bedroom. However, sexual issues are the most easily identifiable warning signs, so lets start with those:
Lowered sex drive – A sudden lack of interest in sexual activity often signals low T.
Fewer spontaneous erections – During puberty, you may remember getting frequent erections, sometimes for no discernible reason. Fewer spontaneous erections may be a sign to get your T-levels tested.
Erectile dysfunction – If you’re having trouble becoming aroused with your partner, you should talk to a doctor about getting tested.
Infertility – If you and your partner are trying to get pregnant with no success, low testosterone counts could be the source of the problem.
Low semen volume – Men with higher testosterone counts produce more semen and vice versa. If you’ve noticed a decline in your semen production, consider getting your T-levels checked.
The majority of men who suffer from low T get tested as a result of sexual issues. However, there are a few other symptoms of low T which could be confused with the natural aging process:
Hair loss – Hair loss is a natural byproduct of aging for many men, but occasionally it is a result of low testosterone. A loss of facial hair is an especially urgent warning sign.
Bone mass loss – Testosterone helps to keep your bones strong. If youre suffering from low T, youre at a heightened risk of developing osteoporosis later in life.
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