Low Testosterone (Low-T)

An underproduction of testosterone causes low-T in men and women.

• Testosterone is a hormone required for male development and sexual function and is produced primarily in the testicles.
• Testosterone is responsible for building muscle and bone mass, sperm production, and sex drive.
• Testosterone influences male pattern fat distribution,bone density, and red blood cell production.
• 我n the normal developing male, testosterone peaks during early adulthood. Once you reach age 30, testosterone levels slowly decline by approximately 1% a year. This is a normal part ofaging.

What are normal ranges or levels of testosterone in men?

The low limit of testosterone levels in men is about 300 nanograms per deciliter and the upper normal limit is approximately 1000-1200 ng/dl. A low level needs to be investigated further to distinguish it from normalaging.

• Low testosterone(low-T) is underproduction or lack of production of testosterone in men and women.
• Causes of low-T include chronic medical conditions such asdiabetes, infections,obesity, or other hormonal conditions.
• Symptoms of low-T include:
  • Change insleeppatterns
  • Reduced sex drive (low libido)
  • Sexual dysfunction
  • 我nfertility
  • Emotional changes
  • Decreased strength
  • Weight gain
• Low-T testing includes linking symptoms with testosterone blood levels.
• Treatment options for low-T include different forms oftestosterone replacement therapy.

Some of the conditions that can lead to a low level are:

• Obesity
• Diabetes(type 2)
• Chronic medical conditions (especiallyliverorkidney disease)
• Hormonal disorders
• 我nfections
• Medications (narcotics,chemotherapy)

我t is important to distinguish between a normal decline of testosterone levels and hypogonadism.

Signs and symptoms oflow testosteroneinclude:

1. Change insleeppatterns:insomniaorsleep干扰
2. Physical changes: increased body fat and reduced muscle bulk
3. Sexual changes: reduced sexual desires, sexual dysfunction, orinfertility
4. Emotional changes: decreased motivations,depression
5. Worsening ofsleep apnea
6. Worsening ofcongestive heart failure

尽管睾酮疗法有助于hypogonadism, whether it helps in the reversal or slowing of normal effects ofagingand lower testosterone levels is unclear. Several published research articles have conflicting results and more research is needed to make a final determination about the use of testosterone for healthyagingmales.

The diagnosis of low-T is based on correlating a low blood level (300 ng/dl or below) with symptoms.

Most of the symptoms are very apparent (see previously), but some need to be further investigated (such as lowbone density).

Treatment oflow testosteronein hypogonadism is a fully accepted therapy. Treatment in older men is more controversial. Discuss your testosterone levels, symptoms, and side effects of treatment with your doctor to establish whether you should receive therapy and what form of therapy.

There are several ways that testosterone therapy can be administered:

• Transdermal (skin patch): Usually applied once a day (for example,Androderm). Tends to be clean and easy to apply. There is an available mouth patch that sticks to the upper gums and is applied twice daily.
• Gels: Applied directly to the skin and then absorbed through the skin (for example,AndroGel, andAxiron). Dosing is more difficult although these gels are available in single applications packages or premeasured pumps.
• 我njections: Testosterone can be delivered by direct injection.
• Pellets: Pellets can be implanted into the soft tissue and release the testosterone.

Why no pills? Testosterone is available as a pill but some experts believe long-term oral delivery of testosterone can have negative effects on theliver. These other delivery methods bypass the liver (as they don't involve a pill being absorbed through the stomach/intestine) and go directly into the bloodstream.

• Get enoughsleep
• Keep a healthy weight
• Stay active

以下是可能的副作用和风险of testosterone therapy for the normal aging male:

• Stimulation of growth of the prostate (benign prostatic hypertrophy) and possible growth of existingprostate cancer
• Skin reactions
• Limiting sperm production and shrinkage of testicles
• Overproduction of红细胞(which can contribute to aheart attack)
• Some studies have implicated testosterone in an increase in cardiovascular events.

The definite verdict on testosterone therapy is still out. Testosterone therapy is accepted as a treatment for hypogonadism, a clearly defined medical condition.

我n older adults who have markedly decreased testosterone levels without significant symptoms or who have modestly decreased levels with significant symptoms, testosterone therapy should be considered after a discussion with your doctor about side effects and possible positive effects of therapy.

There is no clear proof that testosterone therapy is helpful in reversing any aspects of natural aging in males.