One of the current buzz phrases in advertisements and articles directed at men is “low T,” meaning “low testosterone.” Men are being asked to take a personal inventory of specific signs and symptoms and talk to their doctor if they have indications of low testosterone. What’s so important about low testosterone? What are the symptoms of low testosterone? Do you have low testosterone, and if you do, what should you do about it?
Why is testosterone important
Testosterone is the hallmark male sex hormone, the one that makes men feel and look like men. Truth be told, women have testosterone as well, although at levels much lower than those of men. Testosterone is responsible for a man’s masculine characteristics, from a lower register voice to body hair and muscle development. Proper testosterone production helps increase bone density, prompts the testes to produce sperm, and is the kick in the pants when it comes to sex drive and sexual behavior.
Therefore, men who have low testosterone can expect to experience effects that have an impact on all the positive factors associated with the hormone. Levels of testosterone decline naturally in men starting around age 30 to 40 and drop by about 1 percent per year. However, those small decreases in testosterone do not mean men will automatically experience symptoms of low testosterone (see “Symptoms of Low Testosterone” below). Low testosterone is typically defined as 300 nanograms per deciliter or lower, although this figure varies by age.
Causes of low testosterone
According to Gary Wittert, MD, professor of medicine at the University of Adelaide in Australia, “Declining testosterone levels are not an inevitable part of the aging process, as many people think.” At the Endocrine Society’s 94th Annual Meeting in Houston in June 2012, he explained that “Testosterone changes are largely explained by smoking behavior and changes in health status, particularly obesity and depression.”
Wittert and his research team based their conclusions on results of a five-year study that evaluated testosterone levels in 1,382 men ranging in age from 35 to 80 years. They found that while testosterone levels decreased by less than 1 percent yearly, certain factors were associated with lower testosterone levels at five years when compared with those at the beginning of the study. Those factors included obesity, stopping smoking (although the authors stressed that stopping provided “huge” benefits), and depression.
We’re not saying age doesn’t play some role in a lower testosterone level, since the hormone does decline with age. However, while it’s considered normal for older men to have less sex drive, having no libido is not normal.
Other causes of low testosterone may include having type 2 diabetes, thyroid disease, chronic kidney diseases, long-term endurance exercise, use of certain drugs (e.g., long-term use of marijuana, anabolic steroids, opiates), injury to the testicles, excessive alcohol use, and chemotherapy or radiation therapy for cancer, which may damage cells in the testes.
Symptoms of low testosterone
If you experience symptoms of low testosterone, it will be up to your doctor to determine the cause. Those symptoms may include loss of sex drive, erectile dysfunction, lack of energy, fatigue, mood swings, loss of bone density (increasing a man’s risk of developing osteoporosis), infertility, hair loss, increased body fat, and reduced muscle mass.
Many men experience minimal symptoms associated with a gradually declining testosterone level and feel no need to seek treatment or make lifestyle changes, such as exercising more or losing weight, to manage symptoms. Others, however, need more help. If you are experiencing symptoms and want to do something about them, see your doctor.
Diagnosing and treating low testosterone
Determining your testosterone level is easy enough: a simple blood test will provide information to guide you and your doctor on a treatment course. If your testosterone level is not abnormally low, then your doctor will likely conduct other tests to uncover the cause of your symptoms. If the hormone level is low, then you can discuss possible treatment options.
Some men opt for testosterone replacement therapy while others turn to natural ways to raise their testosterone levels. Let’s look at replacement therapy first.
Testosterone replacement therapy may cause side effects, so men who are considering this approach should undergo a physical examination before starting therapy, including a digital rectal examination, cholesterol and triglyceride testing, PSA test, liver function tests, and cardiac function tests. These tests should be repeated regularly, typically every 3 to 6 months, while testosterone therapy continues. Possible side effects of testosterone therapy include formation of blood clots, breast enlargement, sleep apnea, elevated PSA levels, liver toxicity, and urinary tract blockage.
To minimize the possibility of side effects, the safest ways to receive testosterone are:
- Subcutaneous implant (Testopel), which delivers constant levels of the hormone over a 3 to 4 month period
- Topical gel (e.g., Androgel, Fortesta) that is applied daily to the shoulders, thigh, or underarms
- Transdermal patch, which is applied daily to either the arm, back or upper buttocks
Raising testosterone levels naturally may be a bit more challenging, but there are additional health benefits that go along with the higher hormone levels. The lifestyle changes include:
- Have more sex. Engaging in more frequent sexual activity can boost testosterone levels.
- Exercise regularly in short bursts. You can achieve a better increase in testosterone levels if you participate in intense but short sessions of exercise rather than prolonged endurance activity, such as long-distance running.
- Lose weight. Excess fat and weight is associated with high estrogen levels, which reduces testosterone. Drop the weight and raise the testosterone.
- Minimize alcohol use. Maximum alcohol intake for men is two drinks per day, but less is better.
- Manage stress. Daily stress management benefits not only testosterone levels but overall health.
- Avoid a high-protein, low-carb diet. The Atkins diet approach can bring down testosterone levels. That’s because high levels of protein in the blood can reduce the amount of testosterone the testes produce.
- Consider supplements. Some natural supplements have been shown to support better testosterone levels and boost libido, including carnitine, fenugreek, and pomegranate, among others.
Lear more about natural ways to boost testosterone as you age with our “30-Day Natural Testosterone Boosting Plan”
Read more in our Low T Health Center.
Endocrine Society. “Declining testosterone levels in men not part of normal aging.” ScienceDaily. ScienceDaily, 23 June 2012.