Doctors Specializing In The Treatment Of Low T
Low T is often treated by doctors who specialize in the treatment of diseases and conditions of the male sex organs, including:
- UrologistA urologist is a doctor who specializes in the study or treatment of the function and disorders of the male urinary and reproductive systems. Nearly 40 percent of men over the age of 45 have low testosterone, which can be diagnosed using a simple blood test.
- EndocrinologistAn endocrinologist is skilled in the treatment of the endocrine glands and hormones. For men with Low T who are also experiencing fertility issues, your primary care physician or urologist may refer you to a skilled endocrinologist for specialty care.
How Does Bioidentical Hormone Replacement Therapy Help With Low Testosterone
Dr. Taylor offers bioidentical hormone replacement therapy programs to help men experiencing low testosterone. Bioidentical hormones are derived from plant ingredients and have the exact same molecular structure as the hormones your body produces. Bioidentical testosterone replacement is offered through a cream or with pellets that time release 24/7 to best mimic your natural hormone release patterns.What are the benefits of bioidentical hormone replacement therapy for men?Men benefit as much, if not more, than women do from bioidentical hormone therapy.
They can experience:
What Are The Risks Of Testosterone Therapy
A relatively small number of men experience immediate side effects of testosterone treatment, such as acne, disturbed breathing while sleeping, breast swelling or tenderness, or swelling in the ankles. Doctors also watch out for high red blood cell counts, which could increase the risk of clotting.
Men on long-term using forms of testosterone therapy long term appear to have a higher risk of cardiovascular problems, like heart attacks, strokes, and deaths from heart disease. For example, in 2010, researchers halted the Testosterone in Older Men study when early results showed that men on testosterone replacement therapy had noticeably more heart problems. “In older men, theoretical cardiac side effects become a little more immediate,” Dr. Pallais says.
Some physicians also have a lingering concern that testosterone therapy could stimulate the growth of prostate cancer cells. As with the hypothetical cardiac risks, the evidence is mixed. But because prostate cancer is so common, doctors tend to be leery of prescribing testosterone to men who may be at risk.
So, keep risks in mind when considering testosterone therapy or other therapies . “I frequently discourage it, particularly if the man has borderline levels,” Dr. Pallais says.
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Bioidentical Hormones And Your Body
There is confusion over exactly what Bioidentical Hormones are and their use and effect on the body. Bioidentical Hormones are chemically and functionally identical to human hormones and are derived from plants, such as yam or soy. The body has the necessary enzymes to break down and metabolize these hormones.
Bioidentical Hormones are designed to produce the same responses in the body as hormones made by the human body. Restoring and balancing hormones with Bioidentical Hormones is an individualized approach to hormone replacement. Bioidentical Hormones are custom made for each patient at special pharmacies and are available only by physician prescription.
Acp Recommends Against Using Transdermal Patch
The ACP says the yearly cost of TRT in 2016 was just more than $2,000 per patient for the transdermal patch, compared with less than $160 for the intramuscular injection, according to information recorded in the 2016 Medicare Part D Drug Claims data.
Because the injection is much less expensive and clinical benefits are similar, the ACP recommends that when TRT is prescribed, healthcare providers should consider relying primarily on injectable testosterone.
Most men are able to inject the intramuscular formulation at home and do not require a separate clinic or office visit for administration, McLean said in a statement.
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Testosterone And Cardiovascular Health
In a 2015 advisory, the U.S. Food and Drug Administration warned that testosterone use is possibly associated with increased cardiovascular risk and advised physicians to discuss this risk with patients before initiating testosterone therapy.38 This warning came after two observational studies39,40 and a meta-analysis of randomized controlled trials41 showed an increased cardiovascular risk, and the Testosterone in Older Men with Mobility Limitation randomized controlled trial was stopped early because of concerns about a higher incidence of cardiovascular adverse events in the testosterone treatment group.42 However, other meta-analyses did not find an increased cardiovascular risk,43,44 and several other observational studies have appeared to demonstrate decreased cardiovascular risk with testosterone therapy.4548 Additionally, one of the observational studies that showed increased risk was criticized for its statistical analyses,40 and many of the adverse events leading to the early stoppage of the TOM trial were of questionable clinical significance. Although the findings of the TOM trial are concerning, this study enrolled a high-risk population, and its findings may not be generalizable to most men being considered for testosterone therapy.
Testosterone Implants Or Pellets
Testosterone pellets are small plastic pellets that doctors implant under the skin. The implant goes into a personâs upper hip or buttock. The pellets dissolve slowly and can deliver TRT for 3â6 months .
Inserting implants is a minor inpatient surgical procedure. A doctor makes a small cut and then inserts the pellets in the fatty tissue below the skin. They perform the procedure under local anesthesia.
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Testosterone Replacement Therapy Treatment
When you come in to AsandraMD for your Testosterone Replacement treatment, Dr. Asandra will review the results of your blood test with you. He will discuss the treatment and address any questions you may have. If you are a candidate for pellet therapy, Dr. Asandra will make a tiny incision near your hip and insert between 2-10 small pellets, each the size of a grain of rice, under your skin using an instrument called a trocar. The pellets will slowly release Bio-Identical Testosterone over the course of about 3 to 4 months. If you opt for intramuscular injections, Dr. Asandra will administer the testosterone treatment directly into the gluteal muscle. You will need to receive the injection every 10-14 days. You will have routine follow up appointments with Dr. Asandra to monitor your progress and testosterone levels. Your treatment plan will be adjusted, as needed, when you come in for your next appointment for pellet therapy or testosterone injection.
Low Testosterone Causes In Men
As men age, the amount of testosterone in their bodies gradually declines. This natural decline starts after age 25-30 and continues on throughout their lives. Other potential causes of testosterone deficiency include:
- Injury or Infection of the Testicles
- Genetic Abnormalities
- Congenital Conditions like Kallmans Syndrome
- Dysfunction of the Pituitary Gland
- Cancer Treatments Chemotherapy or Radiation
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Take A Cautious Approach
A large, definitive trial for hormone treatment of men is still to come. Until then, here is how to take a cautious approach to testosterone therapy.
Take stock of your health first
Have you considered other reasons why you may be experiencing fatigue, low sex drive, and other symptoms attributable to low testosterone? For example, do you eat a balanced, nutritious diet? Do you exercise regularly? Do you sleep well? Address these factors before turning to hormone replacement therapy for men.
If your sex life is not what it used to be, have you ruled out relationship or psychological issues that could be contributing?
If erectile dysfunction has caused you to suspect “low T” as the culprit, consider that cardiovascular disease can also cause erectile dysfunction.
Get an accurate assessment
Be mindful of unknown risks of testosterone replacement therapy
Approach testosterone therapy with caution if you are at high risk for prostate cancer have severe urinary symptoms from prostate enlargement or have diagnosed heart disease, a previous heart attack, or multiple risk factors for heart problems.
- Ask your doctor to explain the various side effects for the different formulations of testosterone. The different treatments include testosterone injections, gels and patches. Know what to look for if something goes wrong.
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Types Of Injectable Testosterone
As men age their bodies are changing their testosterone levels begin to dwindle, they experience muscle loss, mood swings, and a decrease in sex drive. What if there was a way to fix it? A way to reverse the effects of aging? When it comes to your health, there is almost no right or wrong way to do something if you want to achieve your ideal results. Hormone replacement therapy , like testosterone replacement therapy, might be the answer you are seeking when it comes to your health. It is important to employ a skilled professional to help you determine the best treatment plan and pick out the best form of testosterone to maximize your health goals and the benefits to your quality of life. Below are four types of injectable testosterone replacement therapy. Talk to a health professional about which one is right for you.
Who Is A Candidate
You need to have both low levels of testosteroneless than 300 nanograms per deciliter and several symptoms to get a prescription for TRT. “It is possible to have low levels and not experience symptoms,” says Dr. Hayes. “But if you do not have any of the key symptoms, especially fatigue and sexual dysfunction, which are the most common, it is not recommended you go on TRT given the current uncertainty with regard to long-term safety.”
A simple blood test measures testosterone levels. Several tests are required, as levels can fluctuate daily and be influenced by medication and diet. “In 30% of cases where the first testosterone test is low, levels are normal when the test is repeated,” says Dr. Hayes.
Even if your levels are low and you have several symptoms, TRT is not always the first course of action. “If you can identify the source for declining levels, often you can address that problem and increase low levels naturally,” says Dr. Hayes.
For instance, the No. 1 contributor to falling levels is weight gain. “Weight has a bigger impact on testosterone levels than aging. As weight goes up, testosterone levels go down,” she says. A five-point increase on the body mass index scalefor instance, going from 30 to 35is equivalent to adding 10 years to your age in terms of testosterone levels.
Men also need to understand the limits of TRT, as many envision it as a type of fountain of youth. “Its impact is less than what many men would expect,” says Dr. Hayes.
What Does Testosterone Replacement Therapy Entail
Low testosterone is fairly common but, in many men, it does not produce obvious symptoms. In cases where symptoms are present, fatigue and sexual dysfunction are the most common. Depending on how severe these and other symptoms are, you and your doctor will decide whether treatment is warranted or not. If it is, a treatment called Testosterone Replacement Therapy is an option to consider.
Simply put, Testosterone Replacement Therapy involves supplementing the bodys natural hormone production to bring testosterone levels back into the healthy range. Supplemental hormones can be delivered in one of several ways including the following:
Skin patches are a form of transdermal TRT, and all you have to do is apply a new patch to the arm or upper body once every 24 hours. A similar option comes in the form of gels like Testim® and AndroGel®, which can be applied directly to the skin once a day.
Similar to oral medication, mouth patches or tablets are two other options. The tablet is inserted into the mouth, applied to the upper gums above the incisor twice a day for the continuous release of testosterone into the bloodstream. The last two options involve implanting a hormone-delivering pellet under the skin or injecting testosterone directly into the muscle itself.
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Side Effects Of Testosterone Injections
This type of Testosterone Replacement Therapy is very potent and it can be very effective in some cases.
Injections are not however suitable for all men.
They do carry a risk of some quite nasty side effects the can include:
- Cardiac Problems
Testosterone injections can in some cases offer a fast fix to the problem.
They should only be used by men who have medically diagnosed with extremely low testosterone levels.
They should ideally only be used until levels have returned to baseline normal readings.
You have to remember and consider the chance of some nasty side effects, that could cause some life changing side effects.
Although not so common in Australia, In the US there has been a surge in pop up clinics who offer these types of injections at cheaper cost without the necessary medical diagnosis or guidance.
Naturally these are very risky and I strongly avoid having any testosterone injections unless prescribed by and administered by a medically trained professional doctor.
Who Is Eligible To Receive Testosterone Replacement Therapy
TRT is largely safe for most adult patients who have diagnosed deficiencies. However, there are certain conditions that preclude therapy. They are:
- Active prostate cancer .
- Active breast cancer.
- Untreated sleep apnea.
Some of these conditions may not necessarily contraindicate TRT if they are well-treated and controlled. However, responsible TRT providers will carefully consider any risk factors to determine an individual patients suitability to receive therapy. In the United States, it is illegal for patients without a diagnosed deficiency to receive testosterone.
What Additional Benefits Does Testosterone Therapy
Testosterone can also play a role life expectancy and vitality. Recent studies have indicated that there is a link between low testosterone and shorter life expectancy. Many other factors can be involved in this as well. Doctors know that testosterone is good for overall health and can help with energy. Treating low testosterone can also strengthen a man’s bones and assist to prevent osteoporosis. Some evidence also suggests that testosterone therapy can also help control blood sugar, which is very important for the prevention and management of diabetes.
Testosterone is also tied to heart health. Lower testosterone levels are linked to higher risk of cardiovascular issues. The doctor believes that testosterone therapy can significantly affect a man’s quality of life, including all the sexual benefits, testosterone replacement therapy can improve a man’s mood and energy level while minimizing irritability and anger. For more information, contact the office to schedule a consultation with the doctor.
What Level Is Considered Normal
There is no standard for what normal testosterone levels should be because it varies greatly with age, physiology, and many other factors, from individual to individual. Testosterone levels are the highest when a man is in his early 20s, and it begins to drop after that. By his 50s, his testosterone levels will have dropped to less than half of what it was in his 20s.
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Risks Of Testosterone Therapy
However, there is also evidence of a possible increased risk of heart attack or stroke associated with testosterone use. Experts emphasize that the benefits and risks of long-term testosterone therapy are unknown, because large clinical trials haven’t yet been done.
There are a few health conditions that experts believe testosterone therapy can worsen:
It will be years before large clinical trials bring any answers on the long-term benefits and risks of testosterone therapy. As with any medicine, the decision on whether the possible benefits outweigh any risks is up to you and your doctor.
Prostate Cancer And Lower Urinary Tract Symptoms
Because prostate cancer can be stimulated by testosterone, testosterone therapy is contraindicated in patients with known or suspected prostate cancer. There has long been concern that testosterone therapy may increase the risk of developing prostate cancer and increase the symptoms of benign prostatic hyperplasia. However, several meta-analyses of randomized controlled trials have not shown an increased incidence of prostate cancer.5052 Use of testosterone therapy in men with hypogonadism and previously treated prostate cancer is controversial, with little data to guide treatment decisions in this group.53
Use of supplemental testosterone has been shown to cause a small increase in prostate-specific antigen levels,52 but the significance of this increase is questionable. There also does not appear to be a significant increase in lower urinary tract symptoms with testosterone therapy, although most studies have excluded men with severe lower urinary tract symptoms at baseline.54