There has been a great deal of interest recently in low testosterone in men. Low T is a real problem that affects millions of men. It used to be written off as just getting ‘older’,’ or ‘winding down.’ It was pretty much ignored until recently. Everyone is familiar with the female hormone decline menopause, but not the male hormone decline, andropause. We now know that male testosterone levels begin to decrease in the 30s (1% per year)! We also know that these low testosterone levels can be boosted to more youthful levels. The good news is that the word is out about low testosterone and it is easy to test and treat!
Simply, testosterone is the hormone that make a man a ‘man.’ It has profound effects throughout the body from the muscles to the brain. It drives a man’s libido and erections as well as his mental sharpness and ambition. It also increases muscle and bone mass as well as stamina and strength. In adult men, the majority of testosterone is produced in the testicles, with a small amount from the adrenal glands. The production of testosterone is regulated by the brain and pituitary gland. Most of the testosterone in the blood is bound by proteins and only a small ‘free’ amount is available to enter cells.
It is believed that the production of testosterone by the testicles begins to diminish in mid-life. This leads to the gradual decline of testosterone levels. It is also felt that the binding proteins in blood increase with age, making less free testosterone available.
Low testosterone effects can include decreased libido and absence of morning erections and erectile dysfunction, forgetfulness, lack of ambition, cloudy thinking, loss of muscle mass and stamina, bone loss, night sweats, elevated cholesterol, thinning and rapid aging. These symptoms can be caused by many other things, but if you have some or all of them, low testosterone may be the problem.
The standard way of checking low testosterone levels is by a blood test. However as we previously mentioned, most testosterone in the blood is bound to protein and not available to the tissues. So blood tests cannot tell us the actual amount of testosterone in the cells where it is needed. Salivary testing offers the ability to look at free testosterone levels. The amount of testosterone in the saliva gives us a pretty good idea of the amount of active testosterone available to your tissues.
The good thing is that there are many testosterone treatments available for testosterone replacement therapy. Weight loss, stress management, exercise and good nutrition will all increase testosterone levels. However, when testosterone levels are really low, hormone replacement therapy may be required. There are many over the counter testosterone boosters available. These testosterone supplements have many unknown ingredients that can cause unpredictable changes in testosterone levels and side effects.
There are now many prescription testosterone creams, gels, patches, pill and shots available. Commonly used testosterone cypionate or depo testosterone, is effective but tends to overdose and results in spikes of testosterone levels. It is best to look for bioidentical testosterone, which is closest to what your body actually makes. The other key is to use just the amount necessary to restore normal testosterone levels. This will require retesting as well as dose adjustments. Blood work is also required to check for any side effects (especially PSA and blood count). The goal is to restore testosterone to normal physiologic levels. Trying to increase testosterone past normal levels can lead to serious side effects and has not been shown to improve men’s health.
Yes! Not only do testosterone levels decrease with age, but men also suffer declines in other hormones. it is also important to maintain appropriate levels of estrogen, progesterone, DHEA and cortisol. Salivary testing can simultaneously measure all of these hormones. With age, levels of progesterone and estrogen fall leading to an estrogen dominant state. Estrogen increases testosterone protein binding and increases prostate growth and cardiovascular disease. So it’s just not about testosterone. Balancing of all these hormones is critical for the best results. Click here to read more about other hormones besides testosterone.
So why accept the gradual decline in your testosterone levels? Why not return them to your youthful levels when you were strong and virile. Lawrence Broder MD is an expert at low testosterone treatment and bioidentical hormone replacement. Contact us for your free consultation at one of our 5 Low T Centers to start your journey to better health today.