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On June 12, 2010, in Hormones, MEDICAL FACTS, by Dr. Tuchinsky

The Supreme Hormone.

Testosterone is a magnificent hormone. It is the hormone of energy, desire, and ambition. (Of course it has a dark side to it as well, being responsible when present in excessive quantities for aggression and promiscuity). Both men and women depend on testosterone for their bodies to function well, however men require it in the amounts that are hundred-fold higher than women. I have already touched on testosterone deficiency in women in the post about birth control, and  now I would like to focus on testosterone deficiency in men. On one hand testosterone is often abused by young  athletes and bodybuilders who push their testosterone from normal to supra- normal levels to improve muscle mass and performance. This is unhealthy for the body and can cause serious medical problems. On other hand, there are plenty of men out there who have low testosterone but may never even find out about it. Decreased testosterone in men (medically known as hypogonadism) is more prevalent than most people think. Over the last few decades, testing older men for testosterone deficiency has become more widespread.

The Replacement.

Testosterone replacement is also part of the commercial anti-aging therapies. The group that is most often ignored in diagnosis of testosterone deficiency is men in their 20s-40s who may have subtle decrease in their  testosterone level. The range for testosterone is wide (200-900)  and younger men should test toward the higher end of the spectrum. I believe that it is even more important to test for “free testosterone”, rather than customary total level, which is the biologically active form of the hormone. Sometimes the total testosterone appears misleadingly normal while the active form is low due to increased binding to serum protein. It should be noted that mild testosterone deficiency often presents only with decreased sexual drive and low energy.  The amount of body hair, testicular size and erection may often not be affected at this level. I recommend checking testosterone for every man who complains of persistent fatigue and/or low sex drive.

Causes of Low Testosterone.

There are many reasons for testosterone deficiency: medications, chronic illness, pituitary disease, obesity, liver problems. However, often there is no good explanation at all  that can be found –particularly in the mild cases. Perhaps, one day the multiple endocrine disruptors that are present in our environment will be implicated as a cause or perhaps it is just the genetic “draw of luck” for some.

Therapy Options.

There are many treatment options on the market, including biweekly injections, gels and patches. There is also implantable form of testosterone pellets. Some experts, however, recommend using drugs to stimulate testosterone production such as beta-HCG (the hormone produced in pregnancy) and clomiphene (the female fertility drug) to boost the production of testosterone, rather than replace it with an artificially synthesized hormone. This approach is particularly preferred for younger men, given that replacement of natural testosterone would suppress their testicular function and that in turn may result in infertility. Fortunately, this  is usually reversible upon discontinuation of the drug but it may take a long time. Many men with low testosterone who have had their levels raised to normal, feel as if  their lives “have been shifted back into full gear” and report better satisfaction at work and personal lives.  READ MORE

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