Testosterone 101, Part 2.
Low Testosterone Levels: A Natural, But Optional Problem
What’s so bad about low testosterone levels? Aren’t low hormone levels a natural part of aging?
It’s true that testosterone declines gradually as we age. But just because this is a normal part of aging, that doesn’t mean we shouldn’t support our bodies along the way. The endocrine system (the system of glands that produces hormones) is one of the few systems Western medicine doesn’t regularly treat the decline of. When your heart or bones start to decline with age, a doctor will readily treat you for it. But if your hormones start declining, it’s dismissed as “natural.” Age Management medicine was developed partially in response to this huge blind spot in medical practice.
Low testosterone levels (or “low T“) have been implicated in many disease processes: from heart attacks to osteoporosis. Low T can lead to muscle loss, which will lead to increased body fat. The consequence? Basically all the biggest killers of Americans: obesity, heart disease, diabetes, cancer, and so on.
What are the signs of low T?
Testosterone levels don’t just plummet at once. There’s a slow decline to varying degrees in various individuals. Symptoms will often show up gradually. The most common signs of testosterone deficiency are:
- lack of motivation
- low energy
- loss of libido
- sleep disturbances
- loss of erectile function (attaining or maintaining erections, decrease in firmness)
- muscle weakness
- mental changes like depression or irritabilty
Of course, these may be symptoms of other conditions, or of some other underlying factors and low T. For example, if someone is experiencing fatigue, maybe 50% of the fatigue is caused by lack of testosterone, while other factors might be problems with thyroid, diet, and so on. That means you you can’t just assume low T is the only issue, even if the symptoms are there.
When I see patients, I try to put their symptoms in context by looking at the whole person. So it takes a bit of problem solving.
How does an Age Management physician check for low T?
The best way to see if a person is low in testosterone is to do a simple blood test. Unfortunately, many doctors who aren’t Age Management specialists only check for total testosterone. That means they do a test to check the total of all testosterone in your body. This can give a false picture of testosterone levels, because some of your testosterone is bound to proteins in your body, and unavailable for use.
I can have two patients with the same levels of total testosterone, but very different symptoms and qualities of life. That’s why I check total testosterone and levels of free testosterone, meaning the testosterone that is unbound and biologically available for use by your body. It’s important to ask, “How much testosterone does this person have in their body?” But it’s equally important to ask, “How much testosterone does this person have access to?”
This is the second in a series of easy-to-read, brief posts on testosterone from Dr. Mike Carragher.
Next up: How do I boost my testosterone when it’s low?