Testosterone is the male sex hormone , just as estrogen and progesterone are the primary female sex hormones.
Although women do indeed have (and at some point,need) testosterone, this article will focus mainly on men.
But yes,I’ll give you women the “skinny” on it too. In men, testosterone is the main hormone produced in the testicles and secreted by the testes.
The major effects of testosterone are:
- Promotes libido, aggressiveness, and sexual desire
- Stimulates the growth of certain organs
- Promotes protein anabolism, that is, the use of protein to build muscle, skin and bone, and mitigates against protein catabolism, or breakdown
- Stimulates sperm production
- Nourishes all the tissue of the male urinary and reproductive systems
- Regulates the production of prostaglandins, which (all research point to) seems to keep prostate growth under control.
The effects of testosterone are most pronounced during puberty. It brings on the enlarged larynx, thicker vocal cords, new body hair, increased muscle mass and increased oil-glad secretion by the skin commonly associated with puberty.
After puberty, levels of testosterone drop gradually in men, with profound effects on physical health and well being and particularly on mood and libido.
Some males suffer when their bodies produce insufficient levels of testosterone, resulting in a condition called hypogonadism.
Hypogonadism can be caused by ailments of the testes, such as testicular injury or infection, Klinefelter’s syndrome (a chromosomal abnormality), and/or from disorders of the pituitary and hypothalamus glands.
It can also be caused by getting knocked in the noggin and occasionally by a benign pituitary adenoma that generally knocks down human growth hormone production too.
Some telltale signs of hypogonadism (“Low-T”)are:
Fatigue and the feeling of low energy all day
Loss of sex drive
Erectile dysfunction or inability to maintain an erection
Disturbances of sleep including needing help falling asleep and staying asleep.
- Depressed mood
- Aches and pains in the joints
- Osteoporosis if it goes on for a while
- Loss of weight due to muscle mass loss
- Absence or regression of secondary sexual characteristics, such as muscle development, deep voice, and hair distribution on the chest and face….again if for a while.
My experience as an Anti-aging doctor:
After treating men with “low-T” for a number of years now what I find to be universal is fatigue that isn’t an adrenal fatigue pattern,meaning fluctuating all day. Instead, my low-T patients have a chronically low level of energy, and “just feel pooped” all day.
By the time they get to me many have been self medicating the fatigue with lots of coffee and energy drinks and have actually put themselves INTO adrenal fatigue, and I find myself treating both things at the same time quite often.
- Often men are a bit depressed, but this happens with everyone who is fatigued and sleep deprived.
- Speaking of sleep, “my men” tell me they awake “unrefreshed”….that’s another universal complaint.
- The ones who are used to weight training are not making gains and are instead putting on “fat pounds.”
- I can spot it a mile away.
- What is a shame is when they have been “undertreated” or not treated at all and the low T has caused heart disease and other issues like prostate enlargement.
- Low T is also linked to prostate cancer, NOT the other way around-meaning let’s quell rumors that testosterone replacement CAUSES prostate cancer-it does NOT.
Testosterone and heart disease:
While I’m on the topic of the benefits of having a NORMAL testosterone level,let me assure those of you who read ONE poorly done study which purported to show that testosterone actually increased the incidence of heart disease that nothing could be farther from the truth.
In fact, hundreds of studies since the 50’s show that it helps PREVENT heart disease. Just lately there was yet another positive study and it was done with men who had existing heart disease.
In a recent study, researchers studied 755 male patients, 58-78 years of age, who all had severe coronary artery disease.
They were separated into three different groups, receiving varied doses of testosterone, administered intravenously or by gel.
At the end of the first year, 64 patients who weren’t taking any testosterone supplements had serious adverse cardiovascular events.
Only 12 who were taking medium doses of testosterone and 9 who were taking high doses did. (Going to my theory of maintenance of a NORMAL T level for all men).
At the end of 3 years, 125 patients who had not received testosterone therapy suffered severe cardiovascular events, whereas only 38 medium-dose and 22 high-patients did.
Patients who were given testosterone as part of their follow-up treatment did much better than patients who had not been given testosterone supplementation.
The non-testosterone-therapy patients were 80 percent more likely to suffer an adverse event.
This new study confirms the findings of a previous study from the same researchers which found that testosterone therapy did not increase the risk of experiencing a heart attack or stroke for men with low testosterone levels and no prior history of heart disease.
Testosterone production is affected by a number of external factors, such as illness, medications, psychological state, obesity, exercise, and lifestyle (smoking and excessive alcohol intake).
Factors such as reduced activity, nutritional deficiency, diabetes, and deficiency in human growth hormone levels can also contribute to lower levels.
So can (and this is common) recreational use of testosterone for muscle building when men are in their “skinny”-want-to-impress-girls stage.
There can be a permanent interruption of the pituitary-testicular axis with “unresponsive testes” after normal dosing for only a few months time.
Testosterone and your prostate:
Numerous studies have linked low-T to both prostatic hypertrophy and prostate cancer.
What should my level be?
It is a shame that men see their primary care doctors who might draw a T and a “free T” if asked, but then,they fall WAY short in interpretation and treatment.
They look at the right hand column and tell men with a total T of 3oo that “it’s normal” and a “Free T” of 8…well that’s normal too, if you look at the Labcorp labslip. I’m using Labcorp numbers here, guys.
You want to have a “Free T” of 12 or more. It really doesn’t matter all that much what your total T is because approximatly 700 ng/ml is where you want to be, but if your SHBG (sex hormone binding globulin) is high, your actual available “T” will be less than reflected in Total and Free T.
This is why you need a real Anti-aging doctor, NOT a family practitioner to handle your hormones.
What’s the best form of treatment?
- Glad you asked because the gels out there do NOT get men the levels they need the great majority of the time.
- I can have the right strength of topical creams compounded for patients but the problem with them is hair interferes with absorption, you have to stand shirtless for a good 20 minutes to let it dry…and you can transfer it to partners, kids and pets easily.
- It also becomes a hassle for most. In fact, most men ask to switch to a once weekly injectable after the first month of using a cream.
I have testosterone compounded in the very thinnest oil and patients use the very smallest needles so no one is “needle adverse” after the first shot-usually in the buttocks,but sometimes in the thigh.
There are several brands of injectable testosterones “out there” but I choose testosterone cypionate because after one biochemical “cleavage” it is considered one of the most bioidentical hormones we use. In other words,it acts on your tissues the identical way your own testosterone would.
What about pellets?
Pellets generally last 3 months. They are used for men and women.
The PROBLEM with them is that it’s like a 3 BEARS book.
The first month the T releases “too high”, 2nd month “just right”, 3rd month” too low.
So men, especially, have ups and downs of energy and the whole nine yards. There is a surgical fee and doctors make some GOOD $ with pellets. I’m not going to say that’s why they’re rather popular but I will say I’M not doing pellets on anyone!
Other benes for men and women:
Normal testosterone levels are good for brain health, bone health and libido for women of course, too.
And by the way,NOOOOO replacement of testosterone to NORMAL not sky-high levels will not make anyone “get aggressive.”
What if I am discovered to have low T and want kids?
You need a sperm count and if you are lucky enough to have a normal one, you need to deep freeze your sperm.
If your count is low, we can try to amp it up with clomid and HCG and then try again.
If we’re lucky you’ll have a decent count or a “combinable count” and you can freeze your sperm then.
Do NOT get right on T if I’m talking about you because exogenous T will then NUKE your chances.
What if I have E.D. and my T is normal?
- Actually low-T is less of a cause of E.D. than is diabetes or vascular disease.
- You need a thorough check-up and lab testing.
- Don’t fret.
- If you are seeing a good boarded A4M doc like me we can treat high blood sugar with integratives and even reverse some placquing.
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