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Do I Have Low Testosterone?

Do I Have Low Testosterone?

By Mike Kocsis | 7 minutes read | Last updated: January 21, 2024
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  • Medically Reviewed by Dr. George Touliatos

    Evidence Based Research

    Testes produce testosterone after receiving signals from the brain. This hormone gives men characteristics that make them manly such as facial hair and a deep voice. In addition, it also fosters body fat distribution, red blood cell formation and muscle development.

    Testosterone levels increase during early adulthood, but they start dropping after age 30. While the reduction in testosterone levels is a normal part of ageing, and all men experience it, certain conditions like an injury to testicles can speed up the process. Lack of testosterone causes symptoms that can affect your health and social life.  

    Millions of men use testosterone replacement therapy (TRT) to reduce low T symptoms. TRT has many proven benefits, but it is not for all. Therefore, doctors first evaluate a patient’s condition and prescribe TRT only if they are the right TRT candidate.

    This article will inform you what exactly low T is, how to tell you if have it, and what you can do to relieve its unwanted symptoms. 

     

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    What does low T mean?

    Healthy testosterone levels in men range from 300 to 1,000 nanograms per deciliter (ng/dL). If your testosterone levels are below 300 ng/dL, you have low testosterone, nicknamed low T. 

    The hypothalamic–pituitary–gonadal (HPG) axis is responsible for the production and release of testosterone. Hypothalamus secretes gonadotropin-releasing hormone (GnRH) to stimulate the pituitary gland located in the brain. This gland secretes luteinising hormone (LH) and follicle-stimulating hormone (FSH) that collectively stimulate the testes to produce testosterone.

    Disturbance in the HPG axis results in low T. It can happen when any of the HPG organs – hypothalamus, pituitary gland, and testes – fail to function normally. Some men are born with low T, while others acquire it.

    Alternative names

    Low T is known by many other names, including male hypogonadism, testosterone deficiency, late-onset hypogonadism, male menopause, and andropause.

     

    How many men have low T?

    Low T affects millions of men every year. It is difficult to give the exact number of people having this condition because different studies use different definitions of low T.

    According to the American Urological Association, 40% of men older than 45 years have low testosterone levels. However, not all of them have low T symptoms. They appear gradually and become more prominent after 60.

     

    Do I have low T?

    One of the most common ways doctors diagnose a problem is to check patients’ symptoms. Hence, if you think you have low T, your doctor will first ask you to explain what you feel or what made you think that you have this condition.

    Men with low T experience the following symptoms.

     

    Your doctor will also do a physical examination to look for low T signs. If your symptoms indicate you lack testosterone, they will ask you to have the following tests to diagnose low T and its cause.

    • Total serum testosterone test: This test will tell you how much total testosterone your serum has. Total testosterone is the sum of free testosterone (active testosterone) and bound or unavailable testosterone.
    • LH test: It is done to check whether your pituitary gland is producing enough LH.
    • Prolactin test: Prolactin is another hormone secreted by the pituitary. Its high levels indicate pituitary problems.

    They may also ask you to have the following tests.

    • FSH test: Again, FSH is produced by the pituitary and stimulates the testes to form testosterone. Its levels are checked to ensure the pituitary is producing enough FSH.
    • Thyroid hormone test: It measures thyroid hormone levels. An abnormality in their level can disturb testosterone production.
    • Estradiol hormone test: It measures estradiol levels (a kind of oestrogen – female sex hormone). It is done if you have enlarged breasts.
    • MRI: Magnetic resonance imaging (MRI) is performed to locate problems with the pituitary gland.

     

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    Who is at risk of developing low T?

    Anyone can have this problem at any time in their lives. However, certain conditions make you more susceptible to testosterone deficiency. These are:

    • Obesity
    • HIV
    • Type 2 diabetes
    • Metabolic disorders
    • Chronic liver or kidney disease
    • Infections
    • Heart failure

     

    Options to increase your testosterone

    It is possible for low-T men to not experience any symptoms. In such cases, doctors usually do not prescribe treatments like Testosterone Replacement Therapy (TRT). Even if you have symptoms, they may choose natural ways to increase it depending on what is causing the problem.

    TRT

    As the name indicates, TRT is used to increase testosterone levels in men who naturally have testosterone deficiency. Testosterone was first synthesised in 1935 and approved for medical use in 1939. Over the years, scientists have developed different forms of testosterone that vary from each other based on their delivery method.

     

    Common forms of TRT are:

    Testosterone gels or creams: It is one of the most popular forms of TRT because of its convenience. You apply the gel with clean, dry hands on your thighs, upper arms, or shoulders according to your doctor’s instructions. Cover the area with a cloth to prevent exposing others to testosterone.

    Testosterone injections: They are administered once every 7 or 14 days. Your testosterone levels will spike right after getting an injection, and they will drop gradually, which can cause mood swings.

    Testosterone pellets: They are installed under the skin every 3 to 6 months. They provide a consistent testosterone dosage for 3 to 6 months.

    Testosterone patches: They are applied to the skin once a day. They provide a small testosterone dose throughout the day.

    Testosterone tablets: Different doses of testosterone are available in the form of capsules or tablets. You may have to take them multiple times a day.

    You should study them thoroughly and choose the one that best fits your lifestyle, budget, and health condition.

     

    Alternative options

    The following alternative treatments may boost your testosterone levels if they have declined due to a minor issue such as weight gain, alcohol consumption, medication, etc.

    Get proper sleep: Lack of sleep can increase your cortisol (a stress hormone) levels and cause hormonal abnormalities.

    Maintain a healthy weight: Fat cells produce aromatase, an enzyme that converts testosterone into oestrogen. That is why overweight men usually have low testosterone levels and high oestrogen levels.

    Avoid stress: Stress hormones can block testosterone’s effect on different body parts. Therefore, you should avoid stress or try relaxation exercises.

    Reduce alcohol consumption: Excessive alcohol consumption can convert your testosterone into oestrogen, causing a hormonal imbalance.

    Make exercise a part of your lifestyle: Weightlifting helps increase muscle mass, eventually boosting testosterone production. You should move your body regularly to maintain a healthy weight and good physique.

     

    Possible side effects of TRT

    TRT produces certain side effects, such as:

    • Fluid retention
    • Acne
    • Oily skin
    • Breast tenderness
    • Gynecomastia
    • Testicle shrinkage
    • Low sperm count
    • Infertility
    • High red blood cell count
    • Increase in prostate-specific antigen

    You may be able to avoid some side effects by taking precautionary steps on time. Contact your doctor if your side effects keep on worsening. They may readjust your dose to reduce side effects.

     

    Prognosis of low T

    Low T can or cannot be cured depending on its cause. Consistent TRT can help maintain testosterone levels and reduce unwanted symptoms. TRT is a lifelong procedure. Your testosterone levels will stay high as long as you keep taking testosterone. They will drop again when you stop TRT.

    The mortality rate is comparatively high in low T men compared to men with normal testosterone levels. You should discuss your condition with your doctor to get timely treatment.

     

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    Takeaway

    Men can develop low T at any time in their lives. Your doctor will use your symptoms and testosterone level tests to diagnose this problem. He/she may run a few other tests to identify the cause of the problem.

    TRT is usually prescribed to boost serum testosterone levels in hypogonadal men. You can take testosterone in different forms, such as injections, creams, or skin patches, depending on what you find the most convenient.

    Once you start taking testosterone, you may notice an improvement in your muscle mass, body fat, bone density, sex drive, and mood. Despite all these benefits, TRT may not be suitable for some people. Contact a qualified healthcare provider to determine what you should do to fix your low testosterone levels.  

     

    References/Further reading/Bibliography/Scientific studies

    Morgentaler, A., Zitzmann, M., Traish, A.M., Fox, A.W., Jones, T.H., Maggi, M., Arver, S., Aversa, A., Chan, J.C., Dobs, A.S. and Hackett, G.I., 2016, July. Fundamental concepts regarding testosterone deficiency and treatment: international expert consensus resolutions. In Mayo Clinic Proceedings (Vol. 91, No. 7, pp. 881-896). Elsevier.

    Swerdloff, R.S. and Wang, C., 1993. Androgen deficiency and aging in men. Western journal of medicine159(5), p.579.

    Ng Tang Fui, M., Prendergast, L.A., Dupuis, P., Raval, M., Strauss, B.J., Zajac, J.D. and Grossmann, M., 2016. Effects of testosterone treatment on body fat and lean mass in obese men on a hypocaloric diet: a randomised controlled trial. BMC medicine14, pp.1-11.

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    Evidence Based Research

    This article has been researched and written based on scientific evidence and fact sheets that have then been crossed checked by our team of doctors and subject matter experts.

    References, sources and studies used alongside our own in-house research have been cited below, most of which contain external clickable links to reviewed scientific paper that contain date stamped evidence.

    Our team of healthcare experts and GMC registered doctors are licensed to UK GMC standards. We strive to provide you with the latest evidence based, researched articles that are unbiased, honest and provide you with accurate insights, statistics and helpful information on the discussed topic to ensure you gain a better understanding of the subject. You can read more about our Editorial Process by clicking here.

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    About the Author: Mike Kocsis

    Mike KocsisMike Kocsis has an MBA with a focus on healthcare administration and is an entrepreneur and medical case manager for Balance My Hormones Ltd which offers medical services in the UK and Europe. Mike has over 20 years of experience in the healthcare sector, much of that working with people who have hormone imbalances. Mike has appeared on podcasts and radio and is an expert speaker on the subject of hormone imbalance. He specialises in Testosterone Replacement Therapy (TRT) and Hormone Replacement Therapy (HRT) and has helped thousands of people suffering from hormone imbalances recover and regain control of their lives. You can follow him on LinkedIn and on the Balance My Hormones YouTube Channel.

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