How do you know if you have low testosterone? If you’re a man in his 30s who could use a bit more vitality despite eating healthy food and exercising regularly, you might want to check out your testosterone level.
Having low testosterone levels among the young male population is not uncommon. It is said that around 13 million American men suffer from this deficiency. It covers 1 in every four above the age of 30, with a global prevalence between 10% and 40%.
Sure, it’s not a topic men openly discuss, even among their closest friends. But being aware of its symptoms will help you address them more accurately when they occur.
So, should low testosterone be a cause for concern? When do you consult your doctor? How do you know if you have low testosterone? And if you do, is it treatable?
Before you rattle off even more panic questions in your head, we will explain the answers and other relevant information in this article.
Note that any statements indicated herein should NOT be treated as medical advice. If you think you are experiencing any of the symptoms discussed in this article, please seek the professional opinion of a licensed physician.
What Is Testosterone?
Testosterone is the hormone that makes men, well, men. It sculpts a man’s body, increasing muscle mass and bone strength, and molds the male mind during libido, risk-taking, and pursuing status.
Interestingly, this male hormone is also present in women and is produced by their ovaries and other locations, albeit in small quantities. Women have more testosterone circulating in their blood than estrogen at any given time; hence, it is also a very important hormone for them.
Note that the impact of this molecule begins in utero and affects us all in many ways.
Having too much of it in men could be perceived as a social poison, deciding acts of aggression. Too little or low testosterone is not good either, which will be the focus of our discussion.
How Men Benefit From Testosterone
Testosterone plays a major role in developing male sexual traits like erectile function, sperm production, and libido or sex drive.
According to the American Urological Association (AUA), a healthy level of testosterone in the bloodstream for men would range from 300 to 1000 nanograms per deciliter. For women, it is anywhere between 15 and 70 ng/dl.
During puberty, masculine features such as facial beard, body hair, voice deepening, and genital transformation emerge in male teens, some of which, like acne, are undesirable.
It all begins in the hypothalamus, which determines the amount of testosterone that needs to be put out. This will then be picked up by the testicles, the main testosterone producer, followed by the pituitary and adrenal glands.
Aside from the sexual aspects, testosterone also dictates muscle mass, bone density, fat metabolism, heart health, and certain behavioral traits like competitiveness. Just like collagen, testosterone is inversely proportional with age; it declines in amount as a man grows older.
How Do You Know If You Have Low Testosterone
So, how do you know if you have low testosterone? Although what would be considered healthy or normal testosterone levels for men will still depend on factors such as age, thyroid function, and protein status, they should be at least 300 nanograms per deciliter but not more than 1,000 ng/dl.
Testosterone starts to be produced as early as during infancy; it is responsible for the development of the reproductive system. At this time, the testosterone level would be anywhere between 75 and 400 ng/dl.
In males, testosterone reaches its peak (up to 1200 ng/dl) during their teenage years and early adulthood, where traits that define their manhood are maturing. Their voice starts to deepen, facial and body hair grows, and their bone structure becomes more masculine, among other physical changes.
Reasons For Low Testosterone/Risk Factors
Age contributes to one’s low testosterone, beginning to manifest in men above 30 years old and lasting throughout the rest of their adulthood. From this point on, you can expect your testosterone to decline each year slightly.
Outside the norm, having low testosterone is referred to as hypogonadism which happens when the sex glands (testes) cannot produce a sufficient amount of testosterone for normal functioning. This condition may occur at a young age, even at birth.
So, what causes hypogonadism? A testicle injury brings about primary hypogonadism or an issue such as undescended testicles. The other is secondary hypogonadism, which traces the issue in the pituitary gland and hypothalamus. It also includes pituitary medications, aging, and type 2 diabetes.
Another probable reason is genetic. Many studies that have been conducted on low testosterone being hereditary seem to corroborate its validity. Scientists were able to identify several genetic markers for low testosterone.
Men with at least three of these markers are almost seven times more likely to suffer from this condition. Likewise, those with genetically acquired disorders such as Klinefelter syndrome, Noonan syndrome, and Ambiguous genitalia can also have low T.
Non-Genetic Factors
- Orchiectomy surgery (testicle removal due to cancer)
- Chemotherapy
- Radiation therapy
- Chronic obstructive lung disease
- Low thyroid function
- Pituitary gland-related condition
- Autoimmune disease
- Infection
- Delayed puberty
- HIV/ AIDS
- Erectile dysfunction
- Stress
- Depression
- Sleep disorders like sleep apnea
- Overtraining syndrome (stress from overexercising)
- Chronic liver or kidney disease
- Alcohol use
- Use of antidepressants, narcotics, or pain medications
Men with low testosterone levels risk developing other health issues or are interchangeably connected with others, like diabetes, obesity, osteoporosis, and heart disease.
Studies have also shown that those with low T are likely to have a metabolic syndrome where the person experiences high levels of cholesterol, blood pressure, and blood sugar. Furthermore, these conditions, in turn, would increase your risk of strokes and heart disease.
Symptoms Of Low Testosterone Levels Or Testosterone Deficiency (TD)
Testosterone is a key component in men’s libido, muscle mass, and overall energy. It even plays an important role in the circulatory system by encouraging the bone marrow to churn out red blood cells.
Most men hardly notice the decline in their testosterone level because it happens slowly. How do you know if you have low testosterone? The following are the primary symptoms:
Fatigue
Since testosterone is connected with energy levels, men with low T can get tired easily. At the same time, they may experience difficulty concentrating on their tasks. If these scenarios persist for weeks and don’t have an obvious explanation, such as a strenuous activity; best to consult your doctor, who can test you for low testosterone.
Decreased Libido
Note that testosterone is not the sole factor for a man’s sex drive. Hence, some men can maintain their sexual desire even with fairly low testosterone levels, while others who fall within a normal range can experience a decline. However, if your testosterone is significantly low, it’s almost certain that it will impact your ability to have satisfying sex.
Mood Swings
Low T is also associated with erratic moods, feelings of depression, and irritability. That’s because testosterone also influences emotions. A study has found that high testosterone and low cortisone levels are related to increased anger. Conversely, low testosterone can make a man feel depressed or have no desire to participate in activities he usually enjoys.
Low Muscle Mass
When you have low T, muscle wasting may occur where your existing muscles shrink, losing strength and bulk. Typically, testosterone binds with androgen receptors located in the muscular cells. So if you don’t get sufficient testosterone, it will be difficult to maintain the muscle fibers, causing them to waste away gradually.
Erectile Dysfunction
Speaking of decreased sex drive, erectile dysfunction is another related symptom of low T. Erection is dependent on androgen. Still, men do not need a normal testosterone level to get one.
However, lacking T can impact their ability to masturbate because having adequate testosterone amounts often fuel sexual fantasies. It also affects the central nervous system, which gets stimulated during an erection. The spinal nerves connected to the blood vessels in turn, help sustain it.
More men have symptomatic low testosterone than those who don’t manifest symptoms. Unfortunately, the numbers are on the rise based on several research projections. Nonetheless, having discernible health issues can be an advantage because it will prompt you to seek treatment or a solution.
Other effects of low testosterone in men that need to be checked by a doctor include hair loss, osteoporosis, infertility, increased body fat, sleep disturbances, and hot flashes. Yes, even men can have the latter, but it typically happens to those who have undergone chemotherapy and have almost depleted their testosterone.
Gynecomastia, or an increase in breast tissue in men, is also a symptom for some. In any case, you should go to your healthcare provider to check if your symptoms are being caused by low T.
Diagnosis And Testing Of Low Testosterone In Males
If you are exhibiting any symptoms of low testosterone that cannot be explained, it’s time to get a diagnosis of your condition. Early detection, especially in boys, is crucial to avoid delaying puberty, which should occur by age 14 at the latest.
Addressing the problem sooner can provide timely protection from osteoporosis and other debilitating illnesses in adult males.
During diagnosis, you will undergo testing of your blood testosterone level, preferably in the morning between 7 and 10 am, during which testosterone is at its highest count. The healthcare professional will collect a small amount of blood from a vein in your arm using a needle.
Two samples taken at different times will be extracted for this purpose. If you are sick with a fever or cold, you must postpone your testing until you’re well.
Your doctor will also conduct a physical exam to determine if your physical attributes, such as muscle mass, testes size, enlarged breasts, pubic hair, etc, are consistent with your age group. He/ she may also need to know if you’re suffering or have experienced the following:
- Metabolic syndrome
- BMI
- Headaches
- Changes in the visual field
- Any head trauma, injury, or surgery
- Loss of smell
- Diseases and conditions linked to low T
- Mumps after adolescence
- Usage history of anabolic steroids, opiates, glucocorticoids, chemotherapy, radiation therapy
- Inexplicable anemia
- Stroke or heart attack
If the results from your blood testosterone level test yield a lower value than 300 ng/dl, your healthcare provider may require additional tests to check possible causes of your low T as listed below:
Luteinizing Hormone (LH) Levels Test
This type of hormone testing determines the potential cause of your low T. LH is responsible for making testosterone in the testes. The LH test checks your LH levels alongside your Follicle-Stimulating Hormone (FSH), both of which are manufactured by the pituitary gland. Low LH results in men could mean that your low T is due to the presence of a pituitary or hypothalamus disorder.
Prolactin Levels Test
Prolactin is a type of hormone made by the pituitary gland responsible for breast tissue development, lactation, and other bodily processes. Higher prolactin may mean you have a benign gland tumor called a prolactinoma. On the other hand, a low-level result can equate to hypopituitarism, where the pituitary gland is not working within its normal capacity.
Hemoglobin Levels Test
Hemoglobin is a red blood cell protein to which oxygen attaches while being distributed to the body tissues. When your testosterone is low, usually your blood hemoglobin is as well. But your doctor will also check the presence of other contributing factors, such as smoking, sleep apnea, and climate altitude, to determine the real cause of a low hemoglobin count.
Pituitary MRI
For men with low LH results, a pituitary MRI will sometimes be recommended as a diagnostic tool for hypogonadotropic low T, which is caused by an existing pituitary or hypothalamus condition.
Low Testosterone Treatments
Low testosterone can impact one’s regular body functions, leading to a lowered sex drive, decreased muscle, mood swings, and erectile dysfunction. High-quality testosterone supplements like zinc, vitamin B6, fenugreek, etc., are available as non-prescription and can help boost testosterone.
For those with abnormally low testosterone, corroborated by blood testosterone levels testing in males, testosterone therapy or testosterone replacement therapy is recommended, especially if you’ve had your testicles removed or are born with Klinefelter syndrome.
Testosterone Therapy (TT)
TT can be helpful for more extreme forms of low testosterone. You must note that this therapy can come with significant risks and potential adverse effects. These include heart disease and stroke, to name a few.
Your doctor will consider your medical history and other pertinent information you have provided during your consultations. Thus, testosterone therapy is not to be used lightly. And it is not recommended for all men suffering from low T. Nonetheless, its possible benefits are normalized blood testosterone levels, increased sex drive, improved mood, and cognition, etc.
5 Ways Of Administering TT
Transdermal Patch
Treatment is delivered through a patch (sometimes gel or cream) directly applied to the skin, ideally around the same time but at different spots daily.
Injection
The frequency of this type of TT administration will vary from weekly to monthly. The injection is directed under the skin or straight into the muscle for a quick-acting response. Meanwhile, the long-acting treatment is given to the gluteal muscle. One such example is Depo-Testosterone.
Buccal
A tablet-form steroid hormone is placed above the incisor tooth and alternated on both sides of the mouth. You should hold it firmly in place during the specified dosing interval.
Intranasal
The intranasal route comes in gel form and is typically taken thrice daily. To apply, a pump is directed into the nostril to squirt the gel, and it must be held in for at least 1 hour without blowing your nose.
Time-Released Pellets
Small testosterone pellets are implanted under the skin via an incision. They are expected to last for four months before repeating the procedure.
Potential Side Effects Of TT Administration
Most medical interventions and treatments will almost always have some risk during their delivery; TT is no exception. Those who receive their testosterone transdermally may encounter several adverse effects on the skin site, such as redness, itchiness, rashes, and back pain.
This method is also transferable to others if they come into contact with an exposed skin site, children being particularly more vulnerable. Some patients may also develop a serious allergic reaction to the long-acting injection. Bruising, swelling, and blood clotting were observed on the implant site with testosterone pellets.
Post Treatment
Testosterone therapy aims primarily to increase your testosterone levels after a prescribed period of treatment. Your doctor will closely monitor you for any signs or symptoms indicating an improved condition from three to six months. After which, he/ she may require you to undergo routine checkups once or twice a year.
In addition, your doctor will likely recommend you observe proper diet and exercise, which would be not only beneficial for weight management but also for maintaining your normal testosterone levels.
For cases where the testosterone has achieved normal values, but the patient continues to suffer from symptoms, the attending physician may decide to cease the TT and determine other causes to address them properly.
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