Okay, so you've read the title to this article and I know what you're thinking; only old men have low testosterone levels. And you're not old, right? After all, you exercise, eat right and take your supplements. Heck, you look younger than most guys your age. If you're a male over 40 and you haven't had your hormones checked in a while, pick up the phone and call your doctor now! Fact: Starting at about age 30, testosterone levels drop by about 10 percent every decade. To many of you, that may not sound like a big deal, so allow me to re-phrase that thought. By the time you reach 80 years of age, your androgen levels are similar to that of a pre-pubescent boy! (I bet that got your attention!). Whether or not you live to 80 years of age is irrelevant. Your quality of life can be greatly diminished by the age of 40-55 if your testosterone levels are lower than normal.
I've been practicing nutrition for the last several years and I am amazed at the number of men whom comment on their low energy and lack of motivation. It's almost as if these guys would rather go home and sit on the couch than spend quality time with family or exercise. They spend most of their time going through the motions with out any emotion and have lost their sense of well-being! After making positive changes to their eating program, exercising regularly and taking vitamins and minerals, there were no improvements in how they felt. In addition to that, some couldn't lose body fat no matter how hard they tried. When asked about previous blood work, I was surprised to learn how many men have never had their testosterone levels checked. Even more shocking, many of them have not had any blood work done in years! For most of these men, after sending them to have a simple test done, we found that the root of their semi-depression like state was due to low levels of testosterone.
This concept of male andropause isn't new; it's been around since the 40's. For years, we've heard of women entering a stage of "life change" and now boys, it's time to join the club! All kidding aside, there are many similarities amongst men and women as their hormone levels decline. Unfortunately, men don't have a clear-cut "bench-mark" such as the cessation of menstruation to mark this transition. Andropause is often misdiagnosed because most physicians don't think of low testosterone levels as causing depression like symptoms. But because this transition happens at a time of life when men begin to question their accomplishments and direction in life, it's difficult to pinpoint exactly when the hormonal changes occur. In addition to that, it is also very hard to predict who will experience the symptoms, what age the symptoms will appear, and to top it off, every symptom can vary between men! Typical symptoms of low testosterone levels include: decreased muscle mass and/or loss of muscle strength, increased upper and central body fat, problems sleeping, feeling irritable or angry, loss of drive at work, nervousness, problems with memory and concentration, indecisiveness, lower self-confidence. In addition to these symptoms, studies show that a decline in testosterone can actually put you at risk for other health problems like heart disease, osteoporosis, and prostate cancer!
Testosterone is a hormone that helps to build muscle and is essential for normal sexual behavior. Therefore, many men begin to notice a decrease in lean body mass, strength and less interest in sexual activities. Testosterone also affects many metabolic activities such as production of blood cells in the bone marrow, bone density, lipid metabolism, carbohydrate metabolism, liver function and prostate gland growth. When there is less testosterone available to do its work, these body functions suffer. Every man will experience a decline of testosterone as they age and some men's levels dip lower than others. There are many things that can contribute to a decrease in male hormones such as, psychological stress, alcohol, injuries or surgery, medications, obesity and simply aging.
If you're having the symptoms associated with low testosterone, talk to your doctor. You can get your testosterone levels tested. It's a simple blood test. It is important that serum testosterone, free testosterone and PSA (yes, PSA) be tested to accurately determine whether or not you need treatment. Try to get tested in the morning, when the testes release more testosterone. If you are not over 40 years of age or don't feel as though you are experiencing symptoms of andropause, get tested anyway. A baseline number can be valuable for future tests to monitor changes in hormone levels.
In many instances, testosterone replacement in men with andropause can be highly effective and beneficial. Usually, a total blood serum testosterone level less than 400 nanograms per deciliter require treatment. A free testosterone level below 6.0 picograms per milliliter can also trigger symptoms. With testosterone therapy, one's attitude improves, reinforcing self-esteem and self-confidence at work, as well as an increased energy at home and in social activities. Most men will feel more vigorous, experience improved energy levels, mood, concentration, libido, and an overall sense of well-being. These effects are usually noted within 3 to 6 weeks.
Talk to your doctor to find out if testosterone replacement therapy (TRT) is right for you. Here are the forms of TRT to consider:
· Injections. Injections are given either every week or every two to three weeks. You or your doctor must administer these injections. Symptoms of low testosterone may fluctuate because it creates abnormal highs and lows in hormone levels. Injections are best for those who do not absorb the hormone via the skin.
· Gel/Cream. These are applied daily to the skin on the shoulders, upper arms, and abdomen. It's easy to use, and you maintain a balanced amount of testosterone in your body. In some men, the testosterone doesn't get absorbed well through the skin and the injections are required.
· Oral Androgens. These medications are not metabolized into testosterone, but act on androgen receptors. These are used for patients with bleeding disorders or those who are intolerant to injections. These are rarely used and have the potential to damage the liver.
Of course, with any hormone replacement therapy, there may be side effects. Some may include: increased acne, increased body hair growth, breast tenderness, a rise in hemoglobin levels above normal ranges and increased muscle mass. Your doctor will monitor liver function and will monitor your blood to achieve your ideal level.
Before you start taking TRT be sure to get a PSA test, a digital rectal exam, and have your hemoglobin levels tested. Once you begin treatment, visit your doctor to see if the TRT is working for you. It will take about 1-2 months for the hormone levels to change. Approximately every 6 months visit your doctor to get testosterone levels measured again. Your doctor will most likely draw blood to test hemoglobin levels and perform another physical exam.
Individuals who have had breast cancer (in males) and/or prostate cancer are not candidates for hormone replacement therapy. And in some cases testosterone replacement therapy may not be right for those with the following conditions: liver disease, heart or blood vessel disease, enlarged prostate, kidney disease or diabetes. If you feel as though you are "not quite the man you use to be", get your levels checked. Just keep in mind that while normal levels of serum testosterone usually run between 260 and 850 if your levels are within the low but normal range and you suffer from the clinical symptoms you may benefit from hormone replacement.
For those of you who are in the Houston area, I would recommend two doctors who specialize in male andropause: Dr. Richard LeConey 713-807-1000 (www.antiageinstitute.com) and Dr. Arlette Pharo 713-802-1177 (www.awakenhealth.com)
