What is testosterone?
Testosterone is the primary male hormone or androgen that is produced in the testicles.  Although testosterone is generally referred to as a sex hormone, testosterone actually governs several areas within the body including a man's development from birth onward with responsibility for everything from determining gender, through pubertal changes and male potency (libido & sexual functioning), to the partitioning of bodily muscle and fat distribution.

As testosterone levels continued to decline, men develop other symptoms of low testosterone or medical problems, including:
  • Loss of muscle or difficulty gaining muscle

  • Bone thinning

  • Loss of facial or body hair

  • Growing breasts (also called “gynecomastia”)

  • Low sperm count or infertility

  • Low Bone Mineral density

 Men older than 60 might have testosterone replacement therapy if:

  • More than 1 blood test shows very low testosterone

  • They have symptoms of low testosterone that bother them

  • The symptoms of low testosterone are not caused by another disease or condition that doctors can treat 

  • Older men who have testosterone replacement therapy need regular screening tests for prostate cancer. 

What are the symptoms of low testosterone?
The symptoms of low testosterone are different depending on how long a man has had low Testosterone. 


At first, the symptoms of low testosterone:

  • Feel tired, especially at the end of the day

  • Decreased exercise endurance

  • Have little or no interest in sex (also called “low libido”)

  • Decreased erections or absence of morning erections

  • Feel sad, down, or depressed

  • Mood irritability

  • Weight gain

What are the normal levels of testosterone?
Normal testosterone levels range between 350ng/dl and 1,000ng/dl however there is a variation between normal testosterone levels and optimal  testosterone levels.  Optimal testosterone levels are actually 700ng/dl and 1,100ng/dl but they also vary according to age.  

What is low testosterone in men?
Low testosterone is exactly what it says.  It is when the body makes too little testosterone. As men age, testosterone levels begin to decline.  In fact, in males, peak testosterone levels are achieved by the age of 20 after which they plateau and then  slowly begin to decline through the years.  In some males, testosterone levels can decline more rapidly.  When the levels of testosterone get too low, that is when the symptoms of low testosterone develop.  The medical term for this is “androgen deficiency,” but what is exactly the range in which low testosterone is diagnosed?  Unfortunately, this number is variable.  As a general rule, a testosterone level greater than 500 is considered healthy.  This does not mean that you cannot have symptoms of low testosterone with these levels. The symptoms of low testosterone do not necessarily correlate with the levels of total testosterone but more so with the levels of free testosterone.  Free testosterone is the testosterone that is actually available to work in the body as the rest is tied up to a protein.  as the levels of free testosterone drop below 15, the symptoms of low testosterone begin to develop. 
 

Can low testosterone in men be treated?
Low testosterone can be treated with testosterone replacement therapy, which comes in shots, patches, gels, and tablets you put on your gums. But low testosterone is not always treated, especially in men older than 60. That’s because it’s normal for testosterone to drop in men as they age. In fact, normal aging causes some of the same changes that happen in men with low testosterone, such as less energy or interest in sex.

How do you diagnose low testosterone?
Low testosterone is diagnosed with a combination of test.  The first test is quite simple and straight forward.  You simply fill out a simple survey or questionnaire that determines whether or not you have symptoms that could be attributed to low testosterone levels.  Once the presence of these symptoms are confirmed, your doctor might order some blood work to confirm the diagnosis of low testosterone.  These test include total testosterone levels as well as free testosterone levels.  Follicle-stimulating hormone (FSH) and Luteinizing hormone (LH) are also typically ordered to ensure that proper testicular stimulation is present and that the lack of testosterone production is secondary to decreased testosterone production rather than decreased testicular stimulation

If I have these symptoms, should I see a doctor or nurse?
Yes, if you have symptoms of low testosterone, see your doctor or nurse. There are many things that can cause those symptoms. Your doctor or nurse can try to find out what might be causing them. A blood test can show whether you have low Testosterone, but you might not need that test if something else is causing your symptoms.

What causes low Testosterone in men?

Low testosterone in men can be caused by:

  1. Normal aging

  2. Injury or infection affecting the testicles (which make most of the testosterone in men)

  3. Certain treatments for cancer, including radiation, chemotherapy, and hormone therapy for prostate cancer

  4. Disorders that affect the pituitary gland, a gland at the base of the brain that controls all hormone-producing organs

  5. Other medical problems, such as liver and kidney disease, obesity, diabetes, and AIDS

  6. Other rare genetic problems 

 Men older than 60 might have testosterone replacement therapy if:

  1. More than 1 blood test shows very low testosterone

  2. They have symptoms of low testosterone that bother them

  3. The symptoms of low testosterone are not caused by another disease or condition that doctors can treat 

Older men who have testosterone replacement therapy need regular screening tests for prostate cancer. 

 

 Low Testosterone

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