Testosterone deficiency and replacement

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It’s amazing how an ad that runs on TV generates medical questions.  Such is the case for the “do you have Low-T?” commercial.  In that spot the fellow looks fat, tired and doesn’t have a romantic bone in his body.  As is true with any commercial, however, it is important to separate the facts from the hype.

Testosterone levels generally drop as a man ages.  Usually this is a very slow process, and the resultant effects are often not readily apparent.  Every man has a different rate of decline, and many men are not bothered by this normal decrease in hormone levels.  Symptoms of low testosterone usually include fatigue, depression, decreased libido, loss of strength, obesity and/or a general loss of interest in everyday activities, among other complaints.  Usually the decline is directly due to lower production of testosterone from the testicles, but occasionally the problem indirectly arises from a portion of the brain known as the pituitary gland.  In this case, the signaling hormone(s) from the gland is/are low, inadequately stimulating the testicles to produce normal levels of testosterone.

Your physician will perform a history and examination as well as order labwork to determine the cause of your symptoms.  If your testosterone level is low, additional labs and possibly an MRI of the head will be ordered to help determine the reason.  Testosterone replacement, usually through gel, shot or patch, can be helpful at alleviating many of the symptoms, but there are risks involved.  Testosterone replacement can increase the incidence of prostate cancer, high blood pressure, blood fat (triglyceride) elevation, heart attack and stroke, and routine check ups and labwork are very important when using this therapy…..Richard R Samuel, MD     Family Practice and Urgent Care   Hayden, ID  USA 

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