April 10, 2012

Low Testosterone Symptoms

Women and men are different. Right?  Women are more open and willing to discuss their health while men are not, and that’s particularly true when it comes to hormones and sexual health. Men are a bit reluctant to discuss their loss of manhood. But just like women, men too suffer from waning hormone levels. While in women the symptoms can be quite dramatic and come on suddenly, in men the symptoms of low hormones, and specifically low testosterone symptoms can be quite subtle and come on more gradually.

In the following video Abraham Morgentaler, MD speaks about low testosterone symptoms.  Dr Morgentaler is an urologist and associate clinical professor at the Harvard Medical School.  He has conducted extensive research on testosterone and is author of the book Testosterone for Life.  (Testosterone for Life is available through Amazon from this site.  Scroll to the bottom or go to “Products” navigation button to book reviews).

Do any of these low testosterne symptoms or findings affect you?  You’re not alone, but fortunately there is help. Below is a summary of symptoms of low testosterone.  Low T is sometimes called andropause or male menopause.

Summary of Low Testosterone Symptoms

  • Low sexual desire or libido
  • Erectile dysfunction
  • Diminished orgasmic intensity
  • Decreased genital sensitivity
  • Low energy
  • Loss of muscle mass/increased fat mass
  • Decreased physical performance
  • Decreased bone density
  • Lack of mental focus and concentration
  • Irritability and mood swings
  • Indecisiveness
You can see there are several low testosterone symptoms.

CAUTION: Blood Tests Alone Are Not Enough to Diagnose Low Testosterone

That’s an important CAUTION – even doctors are not aware that blood tests alone are not enough to diagnose low T.  Dr. Morgentaler further states, “Testosterone deficiency is a clinical syndrome, not a biochemical diagnosis, that has a characteristic set of symptoms and signs, and it is associated with serum levels of androgens (testosterone) below that seen in healthy young men.  Blood tests alone are not enough to make the diagnosis.”

Too often, though, physicians rely solely on blood tests to determine to diagnose low T rather than taking into account low testosterone symptoms.  Laboratory tests are reported along with a reference range.  Many times the reference range is referred to mistakenly as the “normal range”, but this is inaccurate.  The reference range, in the case of testosterone and the other hormones, is based purely on statistical methods.  The range does not reflect or suggest what a healthy or “normal”  level is.  All a testosterone level does is tell you your levels are right now, that doesn’t mean that the level is a healthy level even if it is within the reference range.

Reference ranges are usually determined by measuring levels in many individuals.  The mean value is identified, and the low-end and high-end of the range are established at 2 standard deviations from the mean.   This means that at any point only two and half percent of males can have low testosterone if reference ranges alone are used (yet nearly every male over age 60 experience symptoms consistent with low testosterone).   The usual range for testosterone in adult males is 300 ng/ml to 1,000 ng/ml, regardless of age.  Some men function well with levels in the 400 ng/ml range, but some men require higher levels to avoid symptoms.

There’s a huge difference between having a testosterone level of 300 ng/dl and no symptoms, and having a level of 300 ng/dl with symptoms.  The person with no symptoms may have always had testosterone levels towards the lower end of the range.   So that is “normal” for him.  But, the man with symptoms most likely had higher testosterone levels when he was younger.  So a level of 300 ng/dl is low for him.

Population based studies have found that men who have testosterone levels in the upper third of the reference range suffer less heart disease and cancer than men who have testosterone levels on the lower third of the reference range.  So having a level in the reference range is not good enough. A healthy or optimal level for most men is in the upper third of the reference range.  This is important for you to recognize, as well as your physician. Testosterone levels in this range are rarely associated with low testosterone symptoms.

We think it is wise for a male to have his testosterone and other hormone levels measured in his early 30s when he feels good and is healthy.  This will establish that man’s healthy, or “normal” level.  This then provides a target level to guide future treatment when that male becomes older and develops low testosterone symptoms.

See related articles, “Testosterone Deficiency“, “Low Testosterone Levels“, and “Testosterone Therapy“.

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Dr. Joe Jacko

Dr. Joe is board certified in internal medicine and sports medicine with additional training in hormone replacement therapy and regenerative medicine. He has trained or practiced at leading institutions including the Hughston Clinic, Cooper Clinic, Steadman-Hawkins Clinic of the Carolinas, and Cenegenics. He currently practices in Columbus, Ohio at Grandview Primary Care. Read more about Dr. Joe Jacko

  1. Prescribed testosterone boosters have been linked to severe side effects including heart attack, stroke, pulmonary embolism, coronary artery disease, and death. According to a 2013 study published in the Journal of the American Medical Association, men who use testosterone boosting drugs were 30% more likely to have a potentially fatal heart attack or stroke during a three-year period than men who have low testosterone and didn’t take supplements.

    1. In 80 years only 4 studies have showed a potential increase in heart disease related to testosterone use. All 4 have significant study flaws. Attached is a letter from the Androgen Study Group headed by Abraham Morgentaler, the leading expert on testosterone use in the US, asking JAMA to retract that misleading article you refer to.

      In fact 29 professional organizations have asked JAMA to retract the article. The study had many flaws including the inclusion of 10% women in an all male study.

      Also observational studies have shown that men with testosterone levels are at lower risk of heart disease and cancer than men with lower levels of testosterone.

      I hope you find this helpful in expanding your knowledge of testosterone replacement therapy.


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