Has your man been a bit moody lately? Is he feeling more tired and sluggish?
Not as motivated as he once was? Not as strong in the bedroom?
If this is how things are, there is a real chance that he needs to have his testosterone checked. In much the same way that estrogen makes a woman, it is testosterone that makes a man.
Men have significantly higher levels of testosterone in circulation than females. When those levels falter, the guys really feel it and it manifests physically, mentally, and emotionally.
Here are five tips to help you better understand how this manly hormone functions, and the appropriate workup he needs today.
1) Low testosterone is not just a concern of middle-aged men.
While it is true that levels tend to decline after about 25-30 years old, actual low levels can occur at any age. Men in their early 20s and 30s can be at risk for low levels, especially if they have type 1 or type 2 diabetes, autoimmune diseases, and/or testicular failure. A low level is considered less than 300 ng/dL total testosterone and under 35 pg/mL for free testosterone.
2) The type and timing of testosterone is important.
Testosterone is highest in the morning (hence those morning erections) therefore men should have their blood drawn before 9 a.m. — closer to 8 a.m. is even better.
In addition, it is important to look at both the total and free testosterone levels, in addition to sex hormone-binding globulin. SHBG will bind up excess testosterone (and estrogen) to keep it in check. The higher the SHBG, the lower the testosterone levels.
3) If testosterone over-converts into estrogen, he is at risk.
He can experience mood swings, weight gain, and breast development. This process is called aromatization. It is important that his estrogen is tested as well, especially if he has these symptoms.
4) Some testosterone converts into dihydrotestosterone, or DHT.
DHT is the most potent androgen and if it's too high, it can cause aggression, anger, mood swings, prostate problems, and male pattern baldness. This increase in DHT is due to an enzyme known as 5-alpha reductase.
Elevated 5-alpha reductase is often due to genetics, however there are pharmaceutical and natural options to help. It is important to recognize that testosterone is more than just testosterone by itself, as the bigger picture must be evaluated.
5) Typical symptoms of low testosterone are varied.
Fatigue, low sex drive, erectile dysfunction, low bone mass, loss of lean muscle mass, weight gain, depression, decreased strength, and blood sugar issues ... these are all common but do not have to occur at once.
A man may still have his sex drive but feel moody and unmotivated, or start gaining weight despite exercise and a healthy diet.
Testosterone replacement is tricky as once a man starts, he usually does not stop taking it. So if it's possible, explore other options for raising testosterone such as lowering aromatization and blocking the 5-alpha reductase enzyme.
Taking testosterone can also reduce sperm count, so those looking to become pregnant should definitely talk with their doctors first.
Replacement can include injections, pills, sublingual tablets, creams, gels,or pellets. It may be necessary to try one form for a while before switching to a different form if something is not working. Blood work to check red blood cells and platelets, lipids, liver enzymes, and blood sugar is often required when taking testosterone due to the potential risks.
Not every man is a candidate for testosterone. A full health history, physical, and lab work are usually required before any prescription is given.
If you think your man is at risk, talk with him today, then make an appointment with his health care provider for more information.
Sources:
1) Ibishev, K., Khripun, I., Belousov, I., Cheryni, A., Dzantieva, E., and Kogan, M. Problems of testosterone deficiency and erectile dysfunction in men (literature review)]. Urologiia. 2014 Nov-Dec;(6):104-7.
http://www.unboundmedicine.com/medline/citation/25799738/[Problems_of_testosterone_deficiency_and_erectile_dysfunction_in_men__literature_review_]_
2) Kelly, D. and Jones, T. Testosterone and Obesity. Obes Rev. 2015 May 15. doi: 10.1111/obr.12282. [Epub ahead of print].
http://joe.endocrinology-journals.org/content/217/3/R25.full
3) Sartorius, G., Ly, P., and Handelsman, D. Male sexual function can be maintained without aromatization: randomized placebo-controlled trial of dihydrotestosterone (DHT) in healthy, older men for 24 months. J Sex Med. 2014 Oct;11(10):2562-70. doi: 10.1111/jsm.12550. Epub 2014 Apr 20.
http://www.ncbi.nlm.nih.gov/pubmed/24751323
4) Meridian Valley Lab. (2015). Clinical Significance of 5a-Reductase Activity. Retrieved June 10, 2015.
http://meridianvalleylab.com/clinical-significance-of-5a-reductase
5) A Harvard expert shares his thoughts on testosterone-replacement therapy. Harvard Prostate Knowledge. Retrieved June 10, 2015.
http://www.harvardprostateknowledge.org/a-harvard-expert-shares-his-thoughts-on-testosterone-replacement-therapy
Reviewed June 10, 2015
by Michele Blacksberg RN
Edited by Jody Smith