Testosterone: Low T Or Not Low T, That is the Question


By now you have probably heard about testosterone replacement or “low T” from a few different sources. You may be wondering if this is something legitimate or just a new fad with a bunch of marketing hype. The truth is that testosterone deficiency is a real condition that benefits from real treatment. Some have called it andropause and even “Man-o-pause”. This refers to the progressive decline of testosterone levels in adult males, as well as certain other deficiency states. For decades it was written off as just a normal part of aging. A growing awareness of this common condition and the benefits of treatment has evolved in recent years. Hypogonadism, another term referring to low testosterone, affects approximately 39% of men over the age of 45. The likelihood of developing this condition increases with age. Men with low testosterone may experience problems with erectile function, decreased libido (desire for sex), increased body fat, decreased muscle mass, decreased energy, frequent fatigue, and depression. Many of these symptoms can be easy to miss if they are attributed to just getting older. Some of these symptoms can lead to or worsen the other symptoms. The decreased energy and easier fatigability makes it more difficult to keep up with physical fitness. This would in turn lead to decreased muscle mass and increased body fat. The negative impact on body image, as well as the diminished sexual performance can further injure a man’s self esteem and add to depression. The depression that develops from this condition can be significant and is one of the common reasons why men would come in to seek diagnosis and treatment. Other medical conditions that are frequently associated with hypogonadism include high blood pressure, high cholesterol, diabetes, obesity, and chronic opioid (pain pill) usage. A man that has most or all of these symptoms would truly be considered the epitome of poor health. This is all very treatable though and many treatment options do exist.

Treatment starts with a thorough assessment and diagnosis. There are a number of different causes of low testosterone and these must be investigated. This is usually done with a blood test. Once the diagnosis has been made and the degree of deficiency has been determined, the focus shifts to restoring the levels back well into the normal range. In most cases testosterone is replaced directly in any number of different forms. The most common form of replacement is a gel that is rubbed onto the skin of the arms or shoulders each day. This form is very convenient but has a limited capacity to raise testosterone levels as compared to other forms. The gel form also has more hair loss as a side effect. Patches can also be used, which have the same benefits and drawbacks as the gel. Bi-monthly or weekly injections have a much greater capacity to raise testosterone levels, have less hair loss as a potential side effect, and can easily be dosed up or down as needed, based on what is clinically indicated. Implantable pellets also have a greater capacity to raise testosterone levels, have less hair loss as a potential side effect, but cannot be quite as easily dosed up or down as compared to injections. Oral forms can be toxic to the liver and are not recommended. When testosterone is restored, it should be done to an appropriate level within the normal range. When a man’s testosterone level is restored, the benefits are significant. Energy improves and depression can be greatly relieved. Strength and stamina improve. The ability to put on muscle and recover from strenuous workouts improves. Body fat, especially around the abdomen, decreases. Libido and erectile function improve greatly. These benefits can all be further enhanced when combined with positive lifestyle changes. A healthy diet and regular vigorous exercise will boost each of the beneficial effects of restored testosterone. The greatly increased capacity for physical training makes doing this much easier. The net result of all of this is a man who looks and feels much younger and more virile.

The benefits of treating hypogonadism outweigh the risks in most cases. Treatment is relatively simple and safe when done as prescribed, after a proper evaluation. This is one of the critical differences between testosterone replacement and steroid use. Steroid use typically pushes blood levels far beyond the range of normal, to levels that are not safe and wrought with risks of major complications. The goal of proper replacement is to safely relieve the symptoms of low testosterone by restoring levels back towards the upper range of normal, but not to the point where complications are more likely to emerge. Overall happiness and quality of life will improve when testosterone replacement is done properly in a specialized setting. The Men’s Health Program at the Delray Center for Healing is one such setting that is specialized in meeting the clinical needs of individuals with low testosterone.   Raul J Rodriguez MD is the medical director of the Men’s Health Program at the Delray Center for Healing, a program created to meet the needs of active men throughout the life cycle. 

Delray Center For Healing 403 SE 1st Street, Delray Beach, FL 33483 www.delraycenter.com • 888-699-5679