Testosterone Restoration: Treating a Commonly Undiagnosed Issue -- By Dr. Steven Stevenson
More than a decade ago I found myself unable to pick up my young grandchildren due to weakness and pain in my back. I also experienced several other symptoms, such as significant fatigue, generalized muscle wasting, and decreased libido. I tried exercise and physical therapy without improvement. Ultimately, I discovered that I had low testosterone and was diagnosed with hypogonadism.
Treating this dramatically changed my life.
Hypogonadism is relatively common and can be associated with numerous health issues and mortality. Yet physicians frequently do not screen for low testosterone, even in men with symptoms and risk factors commonly associated with hypogonadism. The good news is that this condition is readily treatable.
A conservative estimate (from a study involving 13.8 million men) is that 34 percent of men between the ages of 45 and 54 have hypogonadism. Testosterone levels continue to drop further with age and by the age of 85 at least 50 percent of men have hypogonadism.
Hypogonadism can cause significant symptoms and has been associated with a 33 percent increase of all-cause mortality in men over 50. Some of the symptoms of low testosterone include significant fatigue, mood changes including depression, decreased cognition, sexual dysfunction including erection weakness, decreased quality of orgasm, and decreased libido. Other signs associated with low testosterone include decreased muscle mass and strength, increased abdominal fat, insulin resistance, osteoporosis, increased prostate size, decreased volume of semen ejaculate, as well as breast enlargement.
Hypogonadism can lead to multiple other issues. Some of the risk factors for developing hypogonadism include aging, chronic opioid use, a body mass index (BMI) of greater than 30, Type 2 Diabetes, obstructive sleep apnea, and hypertension.
Hypogonadism can easily be screened for with a brief questionnaire combined with an early morning lab test for total testosterone and free testosterone levels. If testosterone levels are low (a total value less than 300 and a free testosterone level of less than 6.5), a second early morning lab should be drawn at least one week later. If this is also low and the person has some of the classical symptoms of low testosterone, a diagnosis of hypogonadism can be made.
Hypogonadism can frequently be effectively treated by addressing the underlying causes, which can include poor nutritional status, inadequate activity levels, increased stress and inadequate stress reduction techniques, unhealthy sleep behavior, and exposure to certain environmental toxins. If addressing these measures fails to restore optimal testosterone levels, several options for testosterone replacement therapy can be instituted in the comfort and safety of your home.
To sum things up, hypogonadism is a common disorder in middle-aged and elderly men. It is associated with significant health issues and mortality, has classical signs and symptoms, is easily screened for, and can generally be effectively treated with lifestyle measures and when necessary testosterone replacement therapy. I also know first-hand how treating this common disorder can give someone a more vital and healthy life.
Dr. Steven Stevenson specializes in treating hormonal imbalances in men as well as Functional Medicine at large. You can contact him at our clinic (first appointment is free) at 785/760-0695.