The 411 on Low Testosterone and Testosterone Replacement Therapy.

Dr. Melissa Loseke
By Dr. Melissa Loseke

Are my symptoms caused by low testosterone?

Testosterone - a vital hormone to men; it is responsible for a man’s appearance, masculinization, and sexual development.  Testosterone is primarily produced by the testes and is also responsible for sperm production, sex drive or libido, and muscle and bone growth and strength.  And it is on the decline in men of all ages. 

While testosterone levels naturally decline as men age, on average 1-2% every year after the age of 30, most men become symptomatic with a blood level around 500 ng/dL.  But you don’t have to accept and suffer through your symptoms or blame them on life.  Research shows that one in four men over the age of 30 has low testosterone.  While aging is often the blame for low testosterone, it isn’t the only cause of low testosterone.  There are many lifestyle factors, medications, chronic health conditions as well as a history of injury or trauma that can contribute to the decline in levels.  And often it can be a combination of several factors contributing to the decrease, and ultimately symptoms.  

Causes of Low Testosterone

  • Testicular injury or trauma
  • Chronic Medical Conditions including diabetes, liver or kidney disease, cardiovascular disease including high blood pressure and elevated cholesterol
  • Medications such as asthma inhalers, antidepressants, and antihistamines
  • Obesity
  • Alcohol, drug, or tobacco abuse
  • Pituitary gland malfunction
  • Stress
  • Previous chemotherapy or radiation for treatment of cancer
  • Poor sleep
  • History of head trauma

Low levels in men can lead to a variety of symptoms, many of which are often attributed to stress or “life.”  These symptoms are vague and many men attribute them to “I’m just getting older.”  But it’s time to stop blaming life and aging, and investigate if there is a cause for your symptoms.  Determine if there is a reason making you feel like each day is a struggle to just get through and less like yourself.  Testing is simple and easy and takes just a couple of days to know the results.  

Symptoms of Low Testosterone

  • Fatigue or lack of motivation
  • Poor sleep
  • Obesity or difficulty losing weight
  • Brain fog, lack of focus or concentration
  • Lack of sexual desire
  • Erection concerns 
  • Muscle weakness
  • Joint pain
  • Loss of body hair
  • Increase in moodiness and crabby
  • Anxiety or depression

Many men fail to seek treatment because symptoms are vague and easily blamed elsewhere, they can start early and decline slowly, and often can be attributed to other factors.  But more commonly, it is not knowing where to go or who to trust to seek answers with so much information everywhere on low testosterone.  Many men have discussed their symptoms or specifically inquired about testosterone with their primary care provider, only to be told their levels are “normal.”  It is important to understand that “normal” doesn’t equal optimal.  The normal range for testosterone is broad and variable depending on the lab.  “Normal” can be as low as 250 ng/dL and as high as 1100 ng/dl.  As mentioned, most men will begin to experience symptoms, or an increase in noticeable symptoms, when testosterone falls to around 500 ng/dL. Everyone has a level where they feel their best and the lower your testosterone gets, the farther from that ideal, the greater or worse your symptoms.  Testosterone is commonly tested with a simple blood draw in conjunction with several other blood tests or markers to assess overall health.  The key to treatment is understanding what your goals are, what YOU want to accomplish, what it takes for you to feel like you again.  You should also have a detailed conversation about your medical and social/lifestyle history, medications, and physical exam.  So just because your testosterone result came back “normal” at 280 ng/dL, does not make it optimal for you and the life you want to live.  

So, what are your options to treat low testosterone if you find yourself checking the box on many of the symptoms and laboratory results show low testosterone?  There are many testosterone treatments including creams or gels, patches, injections, and pellet therapy.  While there’s not a superior option, some methods are better than others.  Most practitioners specializing in replacement therapy generally offer injection therapy and pellet therapy as the best options.  Creams, gels, and patches often don’t increase testosterone levels significantly enough or consistently for patients to experience improvement in their symptoms.  Plus they come with a host of concerns such as transfer to others and the inconvenience of rubbing in a cream and waiting for it to absorb or getting a patch to stay on.  It is important to understand that not all injections and not all pellets are created equal.  There are better formulations that exist, better dosing schedules, and side effects from each to monitor for, hence the importance of receiving care from a provider with extensive training in testosterone replacement.  Your treatment plan should be designed specifically for you and your goals.  It is important to understand that often testosterone alone isn’t always the magic answer.  To optimize your goals, we may need to address lifestyle habits, diet, and exercise, or additional therapies as well as managing any chronic medical conditions.  

Besides improving your symptoms and feeling more youthful and energized, there are additional benefits to optimizing your testosterone levels.  With testosterone replacement, not only can your personal relationships such as with your significant other, children, extended family, and friends improve but often work balance increases.  You can increase your bone density reducing your risk of fractures and other injuries.  And as you continue to age, your risk of Alzheimer’s disease substantially decreases with memory and cognition remaining sharp.  

Now is the time to get your life back and start living the way you envision.  Call today or schedule your consultation online with our expertly trained hormone specialists to get your comprehensive treatment plan based on your goals, your health, your labs, and your symptoms.

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