When it comes to testosterone, lots of patients arrive at their initial appointment with me bearing a similar story:
They’ve gone to see their primary care doctor, saying they have suspicions that their testosterone is low because of this or that symptom. Maybe it’s dampened libido, or lack of energy. Maybe they just don’t feel like themselves anymore, or they have trouble sleeping deeply. Their doctor runs a a standard testosterone test and comes back with the result: It’s normal.
To Age Management doctors such as myself, “normal” isn’t enough. Just because someone’s numbers are in the normal lab range, that doesn’t mean they have an adequate amount of testosterone. That’s because what’s “normal” is based on the average population, which, unfortunately, in our country, is a largely unhealthy population.
I optimize hormones to ranges that are associated with the best quality of life, consistent with people who feel at their best. These aren’t “normal” people; they’re people who have plenty of energy, healthy libido, clear heads, and who are resistant to disease. Maybe even more importantly, I optimize levels to those associated with the best health outcomes: meaning the lowest risk of heart disease, cancer, diabetes, Alzheimer’s disease, osteoporosis, stroke, and so on.
But it’s not just unhealthy or normal people who need to have their testosterone levels boosted.
Even if you eat well, exercise properly, sleep eight hours a night, and de-stress every day…you’ll still experience declining testosterone levels as you age. That’s because everyone experiences age-related hormonal decline. When it comes to testosterone, that means the cells that make testosterone in your body are dying off or declining in function, and/or the enzymes that convert less active forms of hormones into more active ones, are becoming less robust with age.
At The Body Well, we do extensive testing for testosterone levels (as well as other key hormones), and work with patients to reach optimal levels with lifestyle factors and testosterone replacement therapy.
One way we boost testosterone, particularly in men, is by using human chorionic gonadotropin, or hCG. hCG is mainly reserved for younger men, who still have an adequate number of cells that produce testosterone in their body. It stimulates the body’s own testosterone production, and also serves to support sperm production, so fertility is preserved.
In both men and women, we can give an injectable testosterone or cream. We prescribe bioidentical testosterone, meaning that the molecular makeup of the hormones we prescribe is equivalent to the molecules the body uses.
Compare this to non-bioidentical testosterone, which may work on the testosterone receptor, but they don’t act in the same way because they’re not similar in composition. These so-called synthetic hormones and their abuse are what has led to misconceptions about testosterone replacement therapy.
For example, non-bioidentical oral testosterone was shown to cause liver problems. It’s not used anymore, but the problematic side effects linger in cultural memory.
Overuse of testosterone leads to all sorts of problems: Overgrowth of cardiac tissues, acne, aggression, and so on. And then there’s the entire host of illegal steroids sometimes used in bodybuilding and athletic communities. These are nothing like legally prescribed bioidentical testosterone, but they — along with their side effects — get falsely lumped in with it. That’s why people sometimes think of the “roided out” bodybuilder (losing his hair, easily enraged, covered in pimples, etc) when they think of testosterone.
When testosterone is properly administered, it does not encourage gynecomastia (enlargement of breast tissue in boys and men) or aggression. Instead, it stimulates hair growth on the scalp, restores energy, evens out moods, and more.
That’s why it’s important to see an Age Management practitioner every step along the way in investigating and working with your testosterone levels – from your first tests to administering supplements.
This is the final entry in a series of easy-to-read, brief posts on testosterone from Dr. Mike Carragher. Thanks for reading, and be well!