At T Off Your Health, we have created a treatment system that closely regulates patients testosterone levels. Having and maintaining healthy levels of testosterone is our goal for each patient. Too much and too little of the hormone can have negative effects on males health. This being said, our treatment program is designed with our patients optimal health in mind.
The Perils of Too Much Testosterone
Having too much naturally-occurring testosterone is not a common problem among men. That may surprise you given what people might consider obvious evidence of testosterone excess: road rage, fighting among fathers at Little League games and sexual promiscuity.
Part of this may be due to the difficulty defining “normal” testosterone levels and “normal” behavior. Blood levels of testosterone vary dramatically over time and even during the course of a day. In addition, what may seem like a symptom of testosterone excess (see below) may actually be unrelated to this hormone.
In fact, most of what we know about abnormally high testosterone levels in men comes from athletes who use anabolic steroids, testosterone or related hormones to increase muscle mass and athletic performance.
Problems associated with abnormally high testosterone levels in men include:
- Low sperm counts, shrinking of the testicles and impotence (seems odd, doesn’t it?)
- Heart muscle damage and increased risk of heart attack
- Prostate enlargement with difficulty urinating
- Liver disease
- Fluid retention with swelling of the legs and feet
- Weight gain, perhaps related in part to increased appetite
- High blood pressure and cholesterol
- Increased muscle mass
- Increased risk of blood clots
- Stunted growth in adolescents
- Uncharacteristically aggressive behavior (although not well studied or clearly proven)
- Mood swings, euphoria, irritability, impaired judgment, delusions
Too Little Testosterone
In recent years, researchers (and pharmaceutical companies) have focused on the effects of testosterone deficiency, especially among men. In fact, as men age, testosterone levels drop very gradually, about 1% to 2% each year — unlike the relatively rapid drop in estrogen that causes menopause. The testes produces less testosterone, there are fewer signals from the pituitary telling the testes to make testosterone, and a protein (called sex hormone binding globulin (SHBG) increases with age. All of this reduces the active (free) form of testosterone in the body. More than a third of men over age 45 may have reduced levels of testosterone than might be considered normal (though, as mentioned, defining optimal levels of testosterone is tricky and somewhat controversial).
Symptoms of testosterone deficiency in adult men include:
- Reduced body and facial hair
- Loss of muscle mass
- Low libido, impotence, small testicles, reduced sperm count and infertility
- Increased breast size
- Hot flashes
- Irritability, poor concentration and depression
- Loss of body hair
- Brittle bones and an increased risk of fracture
Some men who have a testosterone deficiency have symptoms or conditions related to their low testosterone that will improve when they take testosterone replacement. For example, a man with osteoporosis and low testosterone can increase bone strength and reduce his fracture risk with testosterone replacement.
Diseases and Conditions That Affect Testosterone
Men can experience a drop in testosterone due to conditions or diseases affecting the:
- Testes – direct injury, castration, infection, radiation treatment, chemotherapy, tumors
- Pituitary and hypothalamus glands – tumors, medications (especially steroids, morphine or related drugs and major tranquilizers, such as haloperidol), HIV/AIDS, certain infections and autoimmune conditions
Genetic diseases, such as Klinefelter syndrome (in which a man has an extra x-chromosome) and hemochromatosis (in which an abnormal gene causes excessive iron to accumulate throughout the body, including the pituitary gland) can also affect testosterone.
Women may have a testosterone deficiency due to diseases of the pituitary, hypothalamus or adrenal glands, in addition to removal of the ovaries. Estrogen therapy increases sex hormone binding globulin and, like aging men, this reduces the amount of free, active testosterone in the body.
Currently, testosterone therapy is approved primarily for the treatment of delayed male puberty, low production of testosterone (whether due to failure of the testes, pituitary or hypothalamus function) and certain inoperable female breast cancers.
However, it is quite possible that testosterone treatment can improve symptoms in men with significantly low levels of active (free) testosterone, such as:
- Generalized weakness
- Low energy
- Disabling frailty
- Problems with sexual function
- Problems with cognition.
However, many men with normal testosterone levels have similar symptoms so a direct connection between testosterone levels and symptoms is not always clear. As a result, there is some controversy about which men should be treated with supplemental testosterone.
People with normal testosterone levels are sometimes treated with testosterone at the recommendation of their doctors or they obtain the medication on their own. Some have recommended it as a “remedy” for aging. For example, a study from Harvard Medical School in 2003 found that even among men who started out with normal testosterone results noted loss of fat, increased muscle mass, better mood, and less anxiety when receiving testosterone therapy. Similar observations have been noted among women. However, the risks and side effects of taking testosterone when the body is already making enough still discourages widespread use.
The Bottom Line
Testosterone is so much more than its reputation would suggest. Men and women need the proper amount of testosterone to develop and function normally. However, the optimal amount of testosterone is far from clear.
Checking testosterone levels is as easy as having a blood test. The difficult part is interpreting the result. Levels vary over the course of the day. A single low level may be meaningless in the absence of symptoms, especially if it was normal at another time. We need more research to know when to measure testosterone, how best to respond to the results and when it’s worthwhile to accept the risks of treatment.
Information sited from Harvard Health https://www.health.harvard.edu/drugs-and-medications/testosterone–what-it-does-and-doesnt-do