Maintaining the proper level of testosterone is vital for men.
It’s what makes us men. When it gets low, we lose interest in life, our sex drive becomes non-existent, and depression often sets in.
However, the symptoms of low testosterone (Low-T) can often be confounded with other problems:
- Low sex drive
- Erectile dysfunction
- Decreased sense of well-being
- Depressed mood
- Moodiness and irritability
- Loss of muscular strength
- Poor concentration and memory
- Feeling sad or blue
- Decreased energy, motivation, initiative, or self-confidence
- Diminished physical or work performance
- Reduced muscle bulk and increased body fat
So, more testing is usually required to determine if you’re suffering from Low-T.
The first test your doctor will probably administer will be a blood test.
The timing of this test is important. During the day, your hormone levels shift. The hormone cortisol, which suppresses your testosterone level, is at its highest for an hour or so after waking.
Additionally, if your testosterone levels are checked in the middle of the day, you are much more likely to present low testosterone levels because they naturally decline as the day goes on. Therefore, your results may be skewed.
To make this even more complicated, the shift in testosterone levels is not as pronounced in men over 45. If you are over 45, getting your blood drawn until 2 P.M. shouldn’t affect the results.
There are two test results you will get back from your bloodwork: Free Testosterone and Total Testosterone.
Free-T is the testosterone available for the body to use. It is important to know that while you may have plenty of testosterone if it’s not “free,” it’s not available to do its magic.
That means that testing “Total Testosterone” levels is not an accurate way to make a diagnosis.
Anywhere from 40% to 70% of Total Testosterone travels around with a protein called sex hormone binding globulin (SHBG). Total-T is bound so tightly to SHBG that it can’t be released and therefore isn’t available to your cells.
After measuring your testosterone, your doctor must determine if it is in the normal range.
Across the total population of men, the statistical norm for testosterone ranges from about 270 to
1070 nanograms per deciliter (ng/dL).
So, if your Total Testosterone is below 270, that must mean you are deficient, right?
Unfortunately, the definition of “low” depends on the local standards adopted by the doctor and the testing lab. The line at which you cross into “low-T” can be 230, 250, 270, or 300.
To obtain a clear-cut diagnosis —either confirming low-T or ruling it out—work with a physician who understands the complexities of testosterone testing and can interpret the results.
If you have all the symptoms of low-T, but your bloodwork isn’t showing it, then more medical detective work is required.
And unfortunately, not every doctor has studied all the subtleties of male hormone issues.
Sometimes low-T might be hiding behind a high estrogen level.
For men, high estrogen can be just as dangerous to their health as a low-T level, and unless you have a doctor who is aware of this potential problem, it might be missed.
And simply giving a guy testosterone can create other problems.
Some men may experience certain side effects of testosterone supplementation including acne, swelling or tenderness of the breasts, or swelling in the ankles. Doctors also watch for high red blood cell counts, which could mean an increased risk of clotting.
And once you get on testosterone replacement therapy, you may have to utilize it for life.
In short, this is not a simple issue and men need to become properly informed about their most important hormone.