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.
How Is Low Testosterone Diagnosed
If you have signs and symptoms of low testosterone, a healthcare provider will perform a physical exam. Theyll also ask questions about your medical history, medications you take or have taken, smoking history and any symptoms you currently have. Blood tests may be ordered.
To make a diagnosis, a provider will consider your specific signs, symptoms and any blood test results.
Chronic Illness Or Medications And Low Testosterone
An acute illness, such as heart attack or sepsis, can decrease testosterone levels, but the effects typically only last a short while and no treatment is necessary.
A chronic illness, such as diabetes and hypertension, or medications that affect testosterone levels, should be assessed in order to address the decreased testosterone and raise it to normal levels. Some medications that can affect testosterone are:
- Beta blockers, which decrease testosterone and impede arousal by interfering with nerve impulses. Alternative treatments include antihypertensives, such as calcium-channel blockers, that don’t interfere with sexual function.
- H2-receptor antagonists, such as cimetidine and ranitidine , which are used to treat gastrointestinal disorders . Alternative treatments include changes to diet and sleep habits, or trying melatonin at night and during the day, consuming several glasses of water with one tablespoon of apple-cider vinegar and one tablespoon of honey mixed in.
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What Are The Treatments For Low Testosterone In Women
Treatments for low testosterone in women havent been largely studied by medical experts. While doctors know about the effects of excess testosterone in women, the symptoms of too-little testosterone arent as well known. As a result, doctors dont always have the same regimen for treatments related to low testosterone levels.
Doctors may prescribe a medication called Estratest in post-menopausal women. This medicine has both estrogen as well as testosterone in it. However, the testosterone form is a synthetic one and may not be as effective in treating low testosterone.
Doctors can also administer injections of testosterone and medical researchers are currently studying the effects of testosterone patches and pellets implanted in the skin. Some women may also obtain testosterone gel formulations from compounding pharmacies. However, these gels are traditionally used for men that have much higher average testosterone levels than when compared with women.
An over-the-counter option is taking a DHEA supplement. Because DHEA is a precursor to testosterone, the idea is that if someone takes DHEA, they could increase the amount of testosterone in their body. Speak with your doctor before starting a DHEA supplement as treatment for low testosterone.
Having too much testosterone in your body can also cause side effects. Side effects of excess testosterone use in women include:
Treatment Doesn’t Always Work
Many men whom weve given testosterone replacement therapy have seen their symptoms dramatically improve, but about one-third of men who see me dont feel any better after the treatment, Paolone says. Its a little frustrating for guys when theyre looking for a simple, straight-forward fix, and thats why testosterone gets checked so frequently, but unfortunately, its more complicated than that.
If your symptoms dont resolve after treatment, it could be a sign that another condition is to blame.
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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.
Low Testosterone Fast Facts
Low testosterone is linked with many other health problems, such as high blood pressure, high cholesterol, obesity, and diabetes.
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The FDA has approved testosterone therapy for men with low T due to disorders of the testicles, pituitary gland, or brain.
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Fatigue alone is not a reason to get testosterone therapy, despite all the Are you tired? commercials for testosterone drugs.
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A man can develop low T at any age.
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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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Diseases And Conditions That Affect Testosterone
Men can experience a drop in testosterone due to conditions or diseases affecting the:
- Testes direct injury, castration, infection, radiation treatment, chemotherapy, tumors
- Pituitary and hypothalamus glands tumors, medications , HIV/AIDS, certain infections and autoimmune conditions
Genetic diseases, such as Klinefelter syndrome and hemochromatosis can also affect testosterone.
Women may have a testosterone deficiency due to diseases of the pituitary, hypothalamus or adrenal glands, in addition to removal of the ovaries. Estrogen therapy increases sex hormone binding globulin and, like aging men, this reduces the amount of free, active testosterone in the body.
Maintain Ideal Body Weight
This is probably the most important thing a man can do. As belly fat increases, there is an increase in activity of the enzyme aromatase which converts testosterone in the fat cells to estrogen. This reduces testosterone and increases estrogen, which can increase fat deposition in typical female areas and increase the risk of enlargement of the prostate and even prostate cancer. With every one-point drop in your body mass index your testosterone level will increase by approximately 1 point. In fact, management of obesity may prevent declining total testosterone in the aging male.
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Testosterone Therapy For Low Levels
In most cases, men need to have both low levels of testosterone in their blood and several symptoms of low testosterone to go on therapy.
It is possible to have low levels and not experience symptoms. But if you do not have any key symptoms, especially fatigue and sexual dysfunction, which are the most common, it is not recommended you go on the therapy given the uncertainty about long-term safety.
Even if your levels are low and you have symptoms, low-t therapy is not always the first course of action. If your doctor can identify the source for declining levelsfor instance, weight gain or a particular medicationhe or she may first address that problem.
If you and your doctor think testosterone replacement therapy is right for you, there are a variety of delivery methods to consider, as found in the Harvard Special Health Report Men’s Health: Fifty and Forward.
Most men feel improvement in symptoms within four to six weeks of taking testosterone replacement therapy, although changes like increases in muscle mass may take from three to six months.
Top 7 Foods That Boost Testosterone
Did you know the average 100-year-old Okinawan male has much higher levels of testosterone than the average American male who is 30 years younger, and today, low testosterone in males is rapidly growing? There are a few factors, including lifestyle, body weight and not eating enough foods that boost testosterone.
Maintaining the right level of testosterone can be tricky, and Im not just talking to guys here. Healthy women make up to 300 micrograms of testosterone in their ovaries and adrenal glands every day.
Like men, women with low testosterone levels often experience chronic fatigue, a stunt in their libido and a decreased sense of well-being. This truly is a hormone that everyone should keep tabs on.
However, low testosterone in men has especially become a major health issue today, and I will explain why and how you can fix.
If you have low testosterone, like many men do, these testosterone-boosting foods and lifestyle changes will help you overcome it faster.
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What Is A Testosterone Test
In order to know whether testosterone levels are too low, a normal level has to be established. This has been a challenge for clinicians. However, according to a press release from the Endocrine Society in January 2017, results from a recent study have helped to define the normal ranges for testosterone levels in those assigned male at birth: 264916 nanograms per deciliter . This range is for those assigned male at birth between the ages of 19 and 39 years who dont have obesity.
A testosterone test measures the amount of testosterone in your blood. If a doctor wants to test the hormone levels in your blood, theyll most likely specify a time of day for your test. Hormone levels are highest in the morning, so this test is often performed in the morning between 7:00 a.m. and 10:00 a.m. Your doctor may have your levels tested more than once.
Your doctor may ask you to stop taking certain drugs before your test, as they could affect your testosterone levels. Its important to tell your doctor about all medications youre taking. Include both over-the-counter and prescription drugs.
Testosterone home-testing kits are also available from companies such as LetsGetChecked. They use your saliva to test your hormone levels. After taking the test, youll send your sample to a lab for testing.
There may be certain lifestyle changes to help increase testosterone levels, such as adding resistance exercise and losing weight.
Is Low Testosterone Curable
Low testosterone caused by a curable condition, such as obesity, alcoholism, drug use, or hypothyroidism, is curable. Fixing the underlying condition will often if not always bring testosterone levels back to normal. Low testosterone due to age or inherited disorders is not curable but can be managed with testosterone replacement therapy.
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Low Testosterone Symptoms And Risk Factors
Signs of low T are often subtle, and some men may not exhibit symptoms at all. Other men may have a range of symptoms including:
- Lower sex drive
- Depression and other mood changes.
While each of the symptoms above may result from lowered testosterone levels, they may also be normal side effects of aging.
What’s A Normal Testosterone Level
Testosterone is a natural hormone produced primarily in the testicles, and it helps men maintain everything from bone density and body hair to sex drive and sperm production. However, you don’t have to hit a certain number or level to be “a real man,” despite what the constant flow of ads may tell you. What matters is who you are and where you are in your life.
On average, a testosterone level of 3001,000 nanograms per deciliter of blood is normal. Hypogonadism reduced testicular function generally occurs when the total testosterone is less than 300 ng/dL. However, a healthy level for you depends on your age, lifestyle, and bioavailable testosterone level the unbound testosterone your body isn’t using for daily functions.
Unlike many low-T clinics, we calculate bioavailable testosterone by measuring levels of two proteins, sex hormone binding globulin and albumin, that typically bind to testosterone. It’s possible to have a normal total testosterone level and experience low-T symptoms if this balance is off.
Having a normal bioavailable testosterone level tells us your body is making plenty and you likely won’t benefit from testosterone replacement therapy. If your bioavailable testosterone level is low, we can discuss options.
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It Can Affect You In Ways You Don’t Expect
Testosterone levels can influence more than sex drive and sperm count. Testosterone is very important for cellular functioning, so its not just sexual symptoms it can affect your cognitive ability, energy level, strength, vitality, bone health. All of these things can be reduced if someone has low testosterone, Paolone says.
At the same time, it can be easy to mistakenly attribute the conditions vague symptoms including weight gain, difficulty concentrating and fatigue to low testosterone when they could be caused by another health problem, such as depression or sleep apnea, he says.
Testosterone Deficiency: Practical Guidelines For Diagnosis And Treatment
Testosterone deficiency in men is a common but often-missed diagnosis. After confirmation of the diagnosis, exclusion of any reversible causes, or contraindications to the use of testosterone, replacement therapy may be offered. Methods of replacement include injectable testosterone esters, transdermal testosterone , or oral testosterone in the form of testosterone undecanoate. Men receiving testosterone therapy should be followed according to a standardized monitoring plan testosterone levels should be assessed 2 to 3 months after therapy is initiated, followed by annual examinations to assess whether symptoms have improved and whether the patient is experiencing adverse events.
Testosterone can be administered orally, transdermally, or by injection to improve a hypogonadal mans sense of well-being, sexual function, bone density, and muscle strength.
Hypogonadism affects approximately 40% of men aged 45 or older, although less than 5% of these men are actually diagnosed and treated for the condition. Despite some controversy, testosterone therapy has been established as a safe and effective principal treatment for hypogonadism for nearly 70 years.
In the last decade, studies have improved our understanding of hypogonadism and have helped clarify its prevalence and associated comorbid illnesses.
CausesThe principal causes of hypogonadism are testicular failure , pituitary and/or hypothalamic failure , and age-related dysfunction .
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Men Naturally Lose Testosterone As They Age But There Are Low
Testosterone is the hormone that gives men their manliness. Produced by the testicles, it is responsible for male characteristics like a deep voice, muscular build, and facial hair. Testosterone also fosters the production of red blood cells, boosts mood, keeps bones strong, and aids thinking ability. Lack of testosterone, often nicknamed, low-t, can cause unwanted symptoms.
Testosterone levels peak by early adulthood and drop as you ageabout 1% to 2% a year beginning in the 40s. As men reach their 50s and beyond, this may lead to signs and symptoms, such as impotence or changes in sexual desire, depression or anxiety, reduced muscle mass, less energy, weight gain, anemia, and hot flashes. While falling testosterone levels are a normal part of aging, certain conditions can hasten the decline. Low t risk factors include:
- injury or infection
- chemotherapy or radiation treatment for cancer
- medications, especially hormones used to treat prostate cancer and corticosteroid drugs
- chronic illness
Millions of men use testosterone replacement therapy to restore low levels and feel more alert, energetic, mentally sharp, and sexually functional. But it’s not that simple. A man’s general health also affects his testosterone levels. For instance, being overweight, having diabetes or thyroid problems, and taking certain medications, such as glucocorticoids and other steroids, can affect levels. Therefore, simply having low-t levels does not always call for taking extra testosterone.
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
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Which Foods Increase Testosterone The Most
Many foods increase testosterone levels. None of them, however, increase testosterone in clinically significant ways for men with low testosterone. And many foods that people claim raise testosterone, such as pomegranates or milk, instead reduce the symptoms of low testosterone by increasing energy levels, erectile function, muscle strength, and sexual function. The common-sense alternative for men with testosterone deficiency is to eat a balanced diet with nutrient-rich foods.
Don’t Test Just To Test
As awareness of low T has grown, Paolone has seen more patients eager to have their testosterone levels checked simply because they heard they should have it checked. If you feel fine, you dont have to go fishing for low testosterone, he says. We try to direct treatment only to men who are experiencing symptoms.
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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 .
What Tests Will Be Done To Diagnose Low Testosterone
The following tests can help confirm low testosterone and determine the cause:
- Total testosterone level blood test: This test usually requires two sample collections between 8 a.m. and 10 a.m., when testosterone levels should be at their highest. If youre sick or have recently been sick, its important to tell your provider. Acute illness may cause a falsely low result.
- Luteinizing hormone blood test: This test can help determine if the cause of low testosterone is an issue with your pituitary gland.
- Prolactin blood test: High prolactin levels may be a sign of pituitary gland issues or tumors.
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