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Grumpy Old Men…or Low T?

Clifton Sheets, MD July 8, 2011Uncategorized

Perhaps you have seen the ads on TV that ask “Could it be low T?”. Low T refers to low testosterone, the predominant male sex hormone. Average testosterone levels for all ages have declined 15% since 1984. No one is sure why, but the trend is worrisome.

Testosterone decline begins in men in their 30’s and progressively declines during the following decades. Since the decline is slow, many men don’t realize that there is something wrong with how they feel. They just assume that what they are feeling are the effects of getting older.
Testosterone is produced by the testicles and circulates throughout the body. There are testosterone receptors in the brain, heart, and many other tissues.

Cell phones and laptop computers emit electromagnetic radiation that can reduce testosterone levels when held in close proximity to the testicles. Therefore men should not carry their cell phones in their front pockets and should not use laptop computers directly on their laps.

Low testosterone levels reduce libido, or sex drive, and make it more difficult for a man to achieve and maintain an erection. Research has shown that testosterone deficiency has other more serious consequences. Low testosterone has been shown to increase the risk of heart attacks, diabetes, hypertension, and cognitive decline.

Testosterone dilates coronary arteries and as such improves blood flow to the heart and cardiac output. Testosterone lowers inflammation, cholesterol and abdominal obesity. After one year of replacement therapy, the average male loses 6 pounds of fat and replaces it with 6 pounds of lean muscle. Testosterone therapy has also been shown to reduce depression. It has also been shown to increase memory in men with Alzheimer’s disease. Men with low T are grumpy! Replacing the T can make them happier and better able to deal with stress.

Testosterone levels are easily determined using simple blood tests. Testosterone is tightly bound by a circulating protein called Sex Hormone Binding Globulin (SHBG). The testosterone bound by SHBG is unavailable to be used by the body and is thus inactive. Blood tests for total testosterone do not take into account the amount of SHBG bound (unavailable) testosterone. If SHBG is not measured and accounted for a serum testosterone level may appear “normal” when in fact it is quite low. Since SHBG generally increases with age, men are more likely to appear to have normal levels in their 50’s and 60’s when in fact they would qualify for and benefit from replacement therapy.

Testosterone replacement is inexpensive and generally covered by insurance. Testosterone can be given by injection or topically with a cream or gel. Men can be trained to give these shots to themselves. Testosterone therapy lowers sperm count and should not be used by men who desire to have children. In addition, testosterone therapy can increase blood thickness, cause acne, worsen sleep apnea, convert to estrogen and di-hydro testosterone (DHT). All of these side effects are manageable

If you think you may have low T, be sure to see your doctor and have your levels, including SHBG tested. If you do not have a doctor and would like to be evaluated for low T, we would be happy to evaluate you. Simply fill out the new patient form on our website, and someone will contact you to set up your consultation.

For additional information I recommend the excellent book “Testosterone for Life” by Harvard Urologist Abraham Morgentaler, MD. It is available on Amazon.com for about $12.

Disclaimer: My blog posts on the Prime Care website are meant for informational purposes only and are not intended to be considered as medical advice or as a diagnostic tool. Seek prompt medical attention if you have health concerns.