This blog is not to be used for medical advice. Please discuss any symptoms, or concerns with your primary care provider.
How do you know if you have low testosterone?
The current hype on testosterone has all of us questioning our testosterone levels. The truth is the symptoms of low T are so vague they can fit many other conditions. One way to know for sure if your testosterone is low is to have your healthcare provider run some labs to find out. While they are running labs you should also ask that they check your thyroid and also make sure you aren’t anemic, as these can mimic low testosterone.
Both of the medical conditions mentioned above can cause fatigue and weakness like low testosterone. Depending on the severity of the symptoms will determine how bad your condition currently is. Many people walk around with these medical problems and never find out because they think it is just part of getting older, working too much, or not getting enough sleep at night.
Two other conditions not mentioned that you should make sure you don’t have before considering low testosterone are sleep apnea or depression. These are two overlooked problems as possible causes.
Many of us snore at night which isn’t abnormal unless our snoring is keeping us from getting enough oxygen to our brain. When this happens we tend to wake up as sleepy as we were when we went to bed. We find ourselves unable to stay awake when watching tv, reading, and if bad enough falling asleep during conversations. Once again overworking, getting older, or staying up too late gets the blame.
Depression doesn’t always mean rolling up in a ball and crying about everything. Everyone reacts slightly differently to depression. Some of us may feel sad, while others may feel very irritable and snappy (usually at those closest to us). One common factor with depression is the feeling of wanting to be left alone and just wanting to rest, feeling tired is a regular complaint.
Something most of us didn’t know
It isn’t advised to start on testosterone as let’s see if it makes me feel better while we wait for the test results. Starting testosterone therapy and then stopping will cause hypogonadism which is like having rebound low testosterone during recovery of the pituitary-testicular axis. This means that when you start testosterone your body says “oh great, they are getting it from somewhere else I can take a break”. Then with the sudden withdrawal of therapy, the body takes a bit of time to realize the testosterone isn’t coming like it was. The body then kicks in the production line to restart testosterone. Like with most production lines the finished product may take a while to get because of all the other steps. So during this phase, you may feel worse than you did. Your next thought will be I must need testosterone because I wasn’t feeling this bad when I was on it. Sadly this isn’t always the case.
Risks of testosterone
While we wait for our lab results, what are some things we need to know before starting replacement therapy? If you have problems with your prostate such as a slow start to your urine stream, weak urine stream, or feeling like you’re not completely emptying your bladder testosterone replacement can make this worse. If you have a history of prostate cancer or family history testosterone can increase the risks. It is speculated prostate cancer feeds off testosterone making it worse. If you do have a history as mentioned above it is advised to have your provider check your PSA (prostate-specific antigen) before starting and again at 6 months, then yearly.
Erythrocytosis is a common issue with testosterone replacement. This condition is an overproduction of red blood cells. This in itself isn’t bad but what it can cause is. When you have too many blood cells in your circulatory system it’s like having too many cars on the road, but unlike cars, if the blood doesn’t have enough room to move it runs the risk of clotting. These clots can turn into pulmonary embolisms, heart attacks, and strokes. Smoking can increase your risk for these.
Testosterone can also cause shrinkage of the testes if not used correctly. This is due to the lack of work gonads have to put out because most of the work is being done for them. Acne and oily skin can also be more prevalent.
Benefits
We have discussed the cons but what about the pros? When our testosterone is low the main symptoms are fatigue, decreased focus, low libido, and erectile dysfunction. When we begin therapy and are at the therapeutic range it is safe to say that many or all of these symptoms will resolve or dramatically improve. Another benefit that we most likely won’t appreciate until we are older is increased bone strength and decreased risk for osteoporosis.
What causes low testosterone
Some of the causes aren’t able to be changed. Such as testicle trauma, infection, hormone disorder, pituitary gland disease, or cancer. Many preventable causes will give you the ability to review your lifestyle, make changes, and possibly improve your situation without any further treatment
Two common medications that cause low testosterone are opiates and corticosteroids. Short-term use of either medication isn’t going to affect testosterone. Chronic use of these medications disrupts the endocrine mechanisms which slow the production of testosterone. Alcohol and drug use can also lower testosterone. Much like medication, alcohol and drugs impair the way the brain’s hormones function disrupting testosterone production. Lack of sleep can also be a cause of decreased testosterone. This doesn’t affect you if it happens every once in a while, but levels have dropped with just one week of sleep deprivation. As the above, it is due to hormone disruption. When we don’t get enough sleep our bodies will compensate by producing cortisol which will interfere with production. Stress falls into the same category as sleep due to the body’s compensation methods with the production of the cortisol hormone.
Odd discovery
We all know that cigarette smoking is bad for our health. Smoking is linked to COPD, cancer vascular disease, and hypertension. Oddly enough smoking has been found to raise testosterone levels. It is not recommended to take up smoking to boost your testosterone, the risks aren’t worth the benefit.
How do they replace testosterone?
Testosterone replacement can be done with multiple methods, but which one would be considered the best? Which one will give you the most bang for your buck?
Let’s talk about the easiest method and yet the least effective, oral testosterone. This testosterone would be a great option for those who don’t find the other options appealing. The oral route isn’t the most effective because it is metabolized so quickly. This makes it very difficult to maintain normal testosterone concentrations. So while this one may be the easiest it would probably not give the desired effects.
Another option would be testosterone Gels. These Gels are used daily and if used properly therapeutic testosterone levels can be reached in as little as a month. This one sounds pretty simple, just apply to arms, shoulders, or under your arms. If the gel comes in contact with children it can cause increased anxiety, aggression, early puberty, stunted growth, and abnormal hair growth. If it comes into contact with women it can cause unusual hair growth, and increased acne. So setback is the extra time you need to take to assure the safety of those around you. Once applying the gel you must let it completely dry before putting on a shirt or coming into contact with others. Another setback is skin irritation, most of the time it is minor and not bothersome.
Patches are another option if the extra steps of gels sound troublesome. You can apply patches to your skin and change it every 24 hours. Like the others, there are some setbacks. Patches aren’t available in all countries, but they are in the United States. One-third of men who use the patches are unable to continue this therapy due to severe skin rash.
Weekly or bi-weekly testosterone injections are yet another option. The major setback is the mode of delivery, some men do not like the thought of getting a shot. On a positive note, injections allow for weekly to bi-weekly treatments. Injections have lower costs and are more convenient.
Extra long-acting testosterone injections can also be taken. After the first two doses, injections can then be given every 10 to 14 weeks. There are several deterrents, one being the higher cost. Another is the fact you have to see your provider to have this administered. Last is of course it’s an injection and if you don’t like needles this may not be an option you want to choose.
How can I boost my testosterone without therapy?
The first thing most of us are looking for is an easy fix. What better way to get a quick fix than just buying a supplement that will give you everything you’re looking for. If you do enough research from reputable sites you will discover that most supplements promise more than they can deliver. This doesn’t necessarily mean it doesn’t boost your testosterone, but it may not make the difference you are looking for and the expense you are out for the supplement. Most supplements are not FDA regulated which allows the seller to promise things that have no research to back the claims.
If you lead a sedentary lifestyle an easy way to naturally boost your testosterone is to increase your activity. A low-activity lifestyle doesn’t require much testosterone so your gonads decrease the production to save resources and energy. Once you begin an exercise routine your body’s demand for testosterone increases causing an increase in production naturally.
Certain foods also provide your body with the necessary building blocks so your body can increase your testosterone. Healthy fats like avocados, eggs, and fatty fish like tuna, salmon, and sardines provide a great source of vitamin D, boron, zinc, and omega-3 fatty acids.
Foods high in magnesium like dark leafy greens help prevent oxidative stress to help maintain normal testosterone levels. Cherries and pomegranates are high in flavonoid antioxidants which are thought to protect testosterone-producing cells.
Summary
When looking into testosterone replacement be sure to check for other problems that can mimic low testosterone levels. Don’t start testosterone replacement unless you need it. You may feel worse when you stop. There are side effects to taking testosterone, most of them are most prevalent in those who don’t use it correctly. There are multiple testosterone replacement therapies out there, find the one that will best suit you. Do some research before starting a supplement (preferably not just reading the seller’s website) if it isn’t FDA approved they can promise you the moon without any proof. Proper diet and exercise can improve testosterone levels naturally making you feel better and saving you money in the long run.