Living With Low Testosterone

Testosterone is the key sex hormone that is responsible for primary and secondary sexual characteristics in males. According to careful estimates, approximately one-third men are believed to have low testosterone levels that may or may not be symptomatic. The clinical diagnosis of low testosterone levels is made if your serum levels drops below the normal T-concentration i.e. 300- 1000 ng/dL (1).

Symptoms Of Low Testosterone

As discussed previously, low testosterone levels are not always symptomatic, which often delays the diagnosis. Most men seek medical help when low testosterone levels impair libido or sex drive. However, it is imperative to mention that chronic low testosterone levels impact almost all the biological tissues (from muscles to brain). Some notable symptoms include:

• Sexual symptoms: Erectile dysfunction, poor sex drive, infertility (since testosterone stimulates the production of sperms) and low volume of ejaculate/semen (1).
• Physical symptoms: Loss of bone-mineral density, bone pains, anemia, loss of hair, poor metabolism that is often associated with weight gain and fat deposition (1)
• Psychological symptoms: Depression, anxiety, mood swings. According to a study reported in the Journal of Clinical Psychiatry (3), investigates suggested that males with low testosterone levels are twice as likely to experience a depressive illness within a period of 2-years of onset of T-deficiency.
• Miscellaneous: Difficulty in sleeping (insomnia), urinary problems, persistent fatigue and low energy levels

What Are Some Common Causes Of Low Testosterone Levels?

• Physiological aging: Advancing age is associated with a decline in the activity and productivity of all biological tissues including endocrine glands. According to a new report published in the Journals of Gerontology Series (1

• ), investigators suggested that testosterone levels progressively decline in men after 30 years of age. Consequently, at 60 years of age, more than 20% men are testosterone-deficient and approximately 50% men at 80 years of age have low T- levels.
• Type 2 Diabetes: According to a study reported in the Journal of Clinical Endocrinology & Metabolism (2), investigators suggested that more than 43% men suffering from type 2 diabetes have clinically low testosterone levels. The pathophysiology revolves around insulin resistance and endocrinological imbalance.
• Thyroid dysfunction: Besides insulin, an imbalance in the metabolism of thyroid hormone and other endocrine hormones can also cause/ deteriorate testosterone deficiency.

Low testosterone levels are not always due to physiological aging. Other notable causes include:

• Damage to testicles
• Chronic exposure to radiations or chemotherapy
• Pituitary damage or hypothalamus disease
• Steroid abuse

Living With Low Testosterone Levels

It is always a good idea to speak to a primary care provider in order to learn what is causing your symptoms. If your symptoms are severe and testosterone levels are significantly low, your doctor may consider hormone replacement therapy to address your symptoms. According to an observational study conducted by Molly M. Shores (4) and associates, it was concluded that testosterone replacement in men with clinically low T-levels can significantly reduce the mortality risk besides improving the quality of life.

In addition, you should consider the following to restore optimal hormonal balance:

• Make sure to maintain a healthy sleeping pattern. It has been observed that poor sleeping habits can elevate stress hormone levels which in turn negatively affects testosterone release.
• Adopt moderate physical activity (especially aerobic training) as exercise stimulates the release of testosterone.
• If you are involved in a steady romantic relationship, it is very important to communicate with your partner (especially if you are experiencing a decline in sex drive). You can also consider testosterone replacement options.
• Men who experience erectile dysfunction secondary to low testosterone levels (or independent of testosterone concentration) should speak to their doctor regarding a pharmacological agent (to strictly address erectile function).
• Impaired concentration, foggy brain and anxiety can often make it difficult for men with low testosterone levels to focus on their day-to-day tasks. All such individuals should focus on natural remedies instead of caffeinated beverages or alcohol to address their neurological functions.

References

1. Kenny, A. M., Prestwood, K. M., Gruman, C. A., Marcello, K. M., & Raisz, L. G. (2001). Effects of transdermal testosterone on bone and muscle in older men with low bioavailable testosterone levels. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 56(5), M266-M272.

2. Grossmann, M., Thomas, M. C., Panagiotopoulos, S., Sharpe, K., MacIsaac, R. J., Clarke, S., ... & Jerums, G. (2008). Low testosterone levels are common and associated with insulin resistance in men with diabetes. The journal of clinical endocrinology & metabolism, 93(5), 1834-1840.

3. Shores, M. M., Moceri, V. M., Sloan, K. L., & Kivlahan, D. R. (2005). Low testosterone levels predict incident depressive illness in older men: effects of age and medical morbidity. The Journal of clinical psychiatry, 66(1), 1-478.

4. Shores, M. M., Smith, N. L., Forsberg, C. W., Anawalt, B. D., & Matsumoto, A. M. (2012). Testosterone treatment and mortality in men with low testosterone levels. The Journal of Clinical Endocrinology & Metabolism, 97(6), 2050-2058.