Friday, December 1, 2023

How Low Testosterone Is Treated

What Is The Best Natural Supplement For Low Testosterone

Patient Education Video: Low Testosterone

Fenugreek and ashwagandha, a principal botanical in Ayurvedic medicine, are frequently singled out as effective testosterone boosters. Ashwagandha has been shown to slightly raise testosterone levels in saliva. This may be due to its ability to lower stress and cortisol levels in the body, both of which reduce testosterone levels. Fenugreek supplementation has been associated with higher scores on self-assessment questionnaires related to low testosterone. No supplement has been shown to increase testosterone at a clinically significant level for people with low testosterone.

The Link Between Low T And Ed

Studies have looked at how often people with ED also have low testosterone. Unfortunately, the results of the different studies are all very different. Some studies showed that as few as 4% of people with ED also had low testosterone. Others showed that up to 25% of people with ED also had low testosterone. And a lot of studies showed numbers in between.

These differences might be because some studies tended to involve older participants. Or, some studies may have included more people with other medical problems. Lots of factors can affect a studys results.

So, is there a link between low testosterone and erectile dysfunction? Yes, probably. People with ED may also have low testosterone, but that doesnt necessarily mean that the low testosterone is the cause of the ED.

Getting The Best Care For Low

If youve been diagnosed with low testosterone and are taking or about to start testosterone replacement therapy, you may want to pause and examine your options.

On one hand, you could receive standard androgen medications from your primary care physician. They will prescribe a standard dose and help you monitor side effects. But this doctor may not have the full range of experience and training in hormone imbalances and therapies. In other words, you may not receive the highest quality care possible.

You may be better off seeking testosterone replacement therapy from a qualified expert in hormone health. At BodyLogicMD, our expert practitioners are committed to delivering integrative care that takes the whole person into account. They will perform extensive testing to determine your hormone needs, prescribe fully customizable medication regimens for your symptoms, and help you reach optimal wellness through consistent monitoring and careful adjustment throughout the treatment process. They will also listen to your individual concerns and ensure that your treatment plan works for you.

If youre looking to start testosterone replacement therapy under the care of the nations best hormone practitioners, consider partnering with BodyLogicMD.

Disclaimer: These statements have not been evaluated by the Food and Drug Administration. All content on this website is for informational purposes only. The content is not intended diagnose, treat, cure or prevent diseases.

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Does Testosterone Replacement Therapy Work

Theres conflicting evidence regarding the benefits of male testosterone therapy for age-related declines in testosterone, according to a 2017 clinical review.

Some studies show improvement in ED in older men, while others dont. Theres no evidence that testosterone therapy improves ED in men with normal testosterone levels.

Testosterone therapy does appear to increase bone density in the lumbar spine in middle-aged men with testosterone deficiency.

It also consistently increases lean mass while decreasing fat mass, but the effect sizes are small.

Low Testosterone Treatment Options


When a particular cause has been identified for low testosterone, treatment will generally focus on the underlying condition, which could involve surgery, medications, or lifestyle changes. For men who have low testosterone directly caused by underproduction of hormones or testosterone, the most common treatment is testosterone replacement therapy.

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Treating Low Testosterone Levels

In addition to lifestyle changes and increased exercise, there are a few other options available to you that can help boost the amount of testosterone in your body. A few of these options have been proven in clinical trials. Others may claim to increase testosterone level but dont always provide substantial evidence to back up their claims.

Of course, if youre concerned about you testosterone levels, its a good idea to share your concerns with a doctor. Theyll be able to verify your T levels and help build a treatment plan. Here are just a few of the most common ways to treat low testosterone levels.

Some types of herbal supplements claim to be testosterone boosters. The makers of these products claim that the ingredients help to increase levels of testosterone.

However, there isnt enough research to support their effectiveness, and these products have ingredients that support their claims.

In fact, a 2020 study tested 50 supplements advertised as testosterone boosting and libido improving. The researchers found that less than 25 percent of them had data to support their claims, based on their ingredients. Moreover, 10 percent of the supplements tested contained ingredients that have a negative effect on testosterone, according to the study.

You may find there are more natural steps that may help to boost your testosterone level.

Some foods may play a role in helping your body moderate your testosterone levels.

  • fluid retainment
  • symptoms of depression

How Do I Take Testosterone Replacement Therapy

TRT comes in several different forms. Each has pros and cons.

Patches. These are easy to apply. But patches can cause skin rashes and may have to be applied more than once a day.

Gels. You rub gels into the skin daily. They are convenient to use. But you have to be careful that no one comes into contact with the treated area for several hours after you’ve applied it. Otherwise they could get testosterone in their system. A nasal gel is now available that eliminates the risk of exposure to others.

Buccal patch. You put this on your upper gum twice a day. These patches are convenient but can cause irritation or gum disease.

Injections. Injections are given anywhere from 2 to 10 weeks apart. They are inexpensive compared to other treatments. But injections may not provide steady benefits. Your testosterone levels will go back down between doses.

Subcutaneous pellets. Your doctor inserts these under your skin every 3 to 6 months. They are very convenient once they’re put in, but they require minor surgery for each dose.

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Avoid Medications That Lower Testosterone

Many drugs and medications reduce testosterone. Some, like opioids and anabolic steroids, greatly reduce the bodys production of testosterone. Corticoid steroids and taking too many NSAIDs contribute to reduced testosterone levels. Some drugs, like caffeine, actually may increase serum testosterone in men, but they also contribute to stress and interfere with sleep. Several over the counter, testosterone boosters/supplements may actually decrease testosterone production and can result in infertility.

How To Treat Low Testosterone

Testosterone: Myths & Facts

Treatment for low testosterone primarily involves testosterone replacement therapy : the administration of synthetic formulations of this hormone. There are several kinds as well as several ways to administer them. These include:

  • Injections: A common approach involves injections of testosterone formulations, such as Depo-Testosterone or Delatestryl every two weeks. Aveed is a longer-acting option, requiring administration once every six weeks.
  • Transdermal: Transdermal gels, such as Testim or AndroGel, are applied on the skin daily, providing a more sustained release of testosterone. Androderm patches are another TRT option.
  • Nasal and buccal: Testosterone formulations are also available via a nasal spray, Natesto, strips placed under the tongue, sold as Andriol.
  • Pellets: Testopel is a pellet thatâs implanted beneath the skin in the buttocks, abdomen, and thigh. These need to be replaced every three to six months.
  • Oral: Jatenzo is an oral form of testosterone that has been approved to be taken once or twice daily with food.

Additionally, treating the underlying conditions and diseases and adjusting medications can restore testosterone levels. Managing obesity by improving your diet, getting good sleep, and incorporating exercise, may also be a means of taking on hypogonadism.

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Which Drugs Help To Increase Testosterone Production

Estrogen blockers are used to increase testosterone production. An alternative to testosterone replacement, estrogen blockers are used in young men with low testosterone and older men with age-related low testosterone. For young men, estrogen blockers dont reduce fertility in the same way as testosterone replacement. For older men, estrogen blockers are used when they arent candidates for testosterone because of heart disease or prostate cancer.

Treating Low Testosterone Symptoms

If your low testosterone levels are the result of an underlying medical condition or lifestyle factor, then at least part of your treatment plan will be treating the original condition.

It may be possible in these cases to have testosterone levels return to normal levels after treatment or lifestyle change. This is not always an option, unfortunately. In these cases, your healthcare provider may recommend treatment such as testosterone replacement therapy .

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Should All Men Be Tested For Low T

Men who are otherwise healthy dont need to be screened, according to guidelines released in 2018 by the Endocrine Society, an organization made up of endocrinologists.

The American Urological Association, made up of urologists, also issued guidelines in 2018. These advise doctors to think about measuring testosterone in patients who meet any of the following criteria:

  • unexplained anemia

  • pituitary issues

  • chronic corticosteroid use

The guidelines state testing should be considered in these situations even without symptoms of low T.

We are not recommending general screening of the population, Dr. Mezitis says. The test can be expensive. It varies, but he cites costs of around $100.

How Will My Doctor Treat Low Testosterone

Low Testosterone Replacement Therapy

If youre experiencing symptoms of low testosterone, your healthcare provider will run a blood test to check your testosterone levels.

Symptoms of low T can include:

A testosterone number less than about 250 nanograms per deciliter is considered low. But a number isnt necessarily something that needs treatment. Treatment for low testosterone isnt recommended unless you have low numbers and symptoms of low T.

People should not be treated for low numbers and no symptoms or symptoms but no low number. The two really need to go together, Dr. Pantalone stresses.

If you show symptoms and your testosterone levels are indeed low, your healthcare provider will likely recommend lifestyle changes, testosterone therapy and additional testing.

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What Are The Symptoms Of Low Testosterone

Often men will come to my office complaining that they have erectile dysfunction and are feeling excessively fatigued, weaker or depressed. Another major complaint is a marked decrease in their sexual desire.

Other symptoms may include insomnia, weight gain, reduced muscle mass and strength, heart problems, osteoporosis and difficulty concentrating. The problem is that many of these same symptoms can also be signs of other health issues.

For instance, your chronic fatigue and lack of energy could be caused by depression instead of low testosterone levels. Thats why its important to undergo a physical exam and testosterone evaluation first. If your testosterone isnt low, your doctor may determine that low T isnt really the issue at hand.

The Side Effects And Risks Of Trt

Like any medication, testosterone replacement therapy can come with a few side effects. And while generally considered a safe treatment, there may be health risks that make TRT inappropriate for some men. Youll want to discuss these possible outcomes extensively with your hormone practitioner before deciding whether or not hormone replacement therapy is right for you.

Some of the common side effects associated with TRT include:

  • Oily skin and/or acne
  • Lower sperm count and decreased testicle size
  • Fluid retention
  • Increased red blood cell count

If you have problems with your liver, kidneys, or prostate, or if you are currently trying to have children, testosterone replacement therapy may not be the best choice. Discuss these risks with your physician. Although the most recent research indicates there may not be a connection between TRT and prostate cancer, its still very important that you report your complete medical history before starting hormone therapy. Studies also indicate that TRT could reduce the risk of heart attack, stroke, and mortality by all causesbut testosterone has previously been associated with an increased risk of cardiac events including heart attack. Men with heart conditions or clotting disorders should consult with a cardiologist prior to starting hormone therapy.

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What Is Considered Low Testosterone

For a healthcare practitioner, low testosterone is not a number. It is a combination of lower than normal testosterone levels in the blood accompanied by significant physical symptoms such as reduced muscle strength, physical performance, energy levels, sexual desire, erectile function, and other symptoms.

Path To Improved Health

TRT was a MISTAKE (3 years on Testosterone)

Low T can affect your physical and mental behavior. Talk to your doctor if you have symptoms, such as:

  • trouble sleeping
  • trouble focusing

The symptoms listed here can be caused by health issues besides low T. Your doctor will likely perform a physical exam and review your lifestyle to determine the problem. In addition, they may run a blood test to check your levels. Men usually have between 300 and 1,000 nanograms of testosterone per deciliter . If your test results show a low level, you may need to increase the hormone. This can be done naturally.

Testosterone replacement therapy is most common. This involves using man-made hormones. There are several forms that your doctor can prescribe. They include gel, a patch, or an injection. TRT is not an option for men who have certain health issues, including prostate or breast cancer. TRT also may not help men who have low T due to advanced age.

TRT often is done in combination with other lifestyle changes. These changes promote overall good health. If you are obese, you should lose weight. You can do this by eating better and getting more exercise. Aim to get 7 to 8 hours of sleep each night. Try to control your stress levels. This allows your body to focus its energy on testosterone production.

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What Are The Treatment Options For Low Testosterone

There are several treatment options for low testosterone, and medications arent always necessary. Changing certain lifestyle factors, such as exercising, reducing stress, improving sleep and improving dietary habits, will help significantly. Many people benefit from losing weight or getting a sleep study and using a CPAP machine, which delivers steady air through a hose connected to a mask or nosepiece to help you sleep.

Others may find benefit from hormone therapy using testosterone gels, patches, injections, pellets or alternative hormone medications. The majority of low T patients use injections for treatment. Injections are typically performed weekly or twice weekly to keep levels stable.

Testosterone gels are usually applied to the chest, upper arms, underarms or inner thigh once a day.

Pellets are placed under the skin during an office visit and re-done every three to five months. Theres also an oral option, but this medication is newer and often not covered by insurance.

Risk factors for all testosterone therapy include: elevation in red blood cell count, elevation in estrogen, acne, skin reactions, testicular atrophy, blood clots and cardiovascular risk.

Id encourage all men to a see a doctor if they think they may have low T symptoms. This is a real medical issue that can safely be helped by a primary care physician, an endocrinologist or a urology provider to improve quality of life.

Low Testosterone Fast Facts

Low testosterone is linked with many other health problems, such as high blood pressure, high cholesterol, obesity, and diabetes.

  • The FDA has approved testosterone therapy for men with low T due to disorders of the testicles, pituitary gland, or brain.

  • Fatigue alone is not a reason to get testosterone therapy, despite all the Are you tired? commercials for testosterone drugs.

  • A man can develop low T at any age.

  • Low testosterone can affect mood, energy levels, fertility, and other aspects of a mans life.

Dr. Eleswarapu has no disclosures. Dr. Mezitis has no disclosures.

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What Is The Best Medication For Low Testosterone

The medical community itself cannot fully agree on what the best medication or treatment for low testosterone. For now, the most widely used medical intervention for low testosterone is testosterone replacement.

Best medications for low testosterone
Drug name
1, 1 mg tablet daily Joint pain, high blood pressure, nausea

Many of the standard dosages above are from the U.S. Food and Drug Administration . Dosage is determined by your healthcare provider based on your medical condition, response to treatment, age, and weight. Other possible side effects exist.

Difficulty Achieving And Maintaining An Erection

Testosterone Replacement Therapy in Tucson: Testosterone Therapy Options

Testosterone aids in achieving and maintaining an erection. It tells brain receptors to produce nitric oxide, which is a molecule that helps trigger a series of chemical reactions necessary for an erection to occur.

When testosterone levels are too low, you may have difficulty achieving an erection before sex or having spontaneous erections, such as during sleep.

However, research is inconclusive on whether testosterone replacement therapy can successfully treat erectile dysfunction. In a 2016 review of studies that looked at the benefit of testosterone in men with erection difficulties, showed no improvement with testosterone treatment.

Other health conditions can often cause erectile difficulties. These include:

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Risks: Who Should Not Take Testosterone

Testosterone replacement therapy may cause the prostate to grow. Therefore, if a person has early prostate cancer, there is concern that testosterone may stimulate the cancer’s growth.

People who have prostate cancer are advised not take testosterone replacement therapy. It is important for all males considering testosterone replacement therapy to speak to their healthcare providers and undergo prostate screening before starting this therapy.

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