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February 12, 2011

Testosterone Deficiency Is Not Healthy

Man and testosterone deficiencyTestosterone is more than a muscle and sex hormone. And, testosterone deficiency or low testosterone is more common than you might think.

Testosterone provides health benefits for the entire the body. Testosterone and other hormones hook up to receptors on our cells. This hook-up is like a key and lock mechanism. When testosterone hooks up with a receptor it “unlocks the door” and triggers that cell into action.

There are testosterone receptors on our cells throughout the body. In fact, the heart has the highest concentration of receptors and the brain the second highest concentration. This may explain why the incidence of heart disease goes up once men pass into middle age and testosterone levels drop. Testosterone deficiency is also associated with mood swings, lack of concentration and focus, declining memory, and depression as the brain suffers from a lack testosterone stimulation.

Signs and Symptoms of Testosterone Deficiency

  • Decreased libido and sexual performance
  • Decreased lean body mass and muscular strength
  • Decreased energy/stamina/well-being
  • Increased body fat
  • Impaired glucose (blood sugar) utilization
  • Increased total and LDL cholesterol
  • Decreased wound and tissue healing
  • Decreased bone density
  • Elevated blood pressure
  • Tendency towards depression and mood disorders
  • Decreased skin tone
  • Increased tendon and joint degeneration

Individuals with testosterone levels in the upper part of the reference range seemed to be protected against Alzheimer’s disease.

Testosterone facilitates production of nitric oxide, which is a potent vasodilator (relaxes and opens blood vessels). This is one of the mechanisms by which testosterone improves erectile dysfunction. Testosterone also stimulates production of endothelial progenitor cells, which repair the inner lining of blood vessels. Testosterone’s effects on blood vessels probably explain why men with testosterone levels in the upper third of the reference range suffer from less heart disease.

Diagnosing Testosterone Deficiency

Testosterone deficiency is a clinical diagnosis and should not be made, or not made, solely on testosterone levels. What a normal or healthy level is varies from man to man. Testosterone level reference ranges are determined purely by statistical methods, which do not necessarily correlate to healthy or optimal levels.  Studies looking at heart disease, cancer, and all cause mortality have shown that men with testosterone levels in the upper third of the reference range (many times inappropriately referred to as the normal range) fare better in avoiding chronic disease, but also enjoying a higher quality of life than those men who have levels in the bottom third of the reference range.

Since the reference range for total testosterone levels is typically 300 ng/dl to 1,000 ng/dl, based on these studies it would appear that a healthy or optimal levels is above 700 ng/dl, or the upper third of the range. It should be noted that some do not experience symptoms at levels below 700 ng/dl. If there’s any question whether or not a man’s symptoms are related to testosterone deficiency testosterone replacement treatment could be prescribed on a trial basis (for 3 to 6 months) to see if the symptoms improve.

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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. Read more about Dr. Joe Jacko

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