What is Low Testosterone?
All men are different, and testosterone levels vary greatly. The American Urology Association defines low testosterone as less than 300 nanograms (ng) of the hormone per deciliter (dl) of blood. Testosterone is responsible for all sorts of bodily functions, and when levels start to drop, men may begin to experience symptoms. On average, from around 30-35 years old, a man's testosterone levels fall between 1 and 2 percent each year.
This decline is normal, and no one knows precisely why this happens. However, some scientists and doctors believe that we live longer than we are 'designed' to live due to advances in medicine and all aspects of healthcare. A few hundred years ago, men would be lucky to reach the age of 40; however, nowadays, men can live to 80, 90, even 100 years old – we simply live longer than ever before. It was no problem for a man to peak in their 20s, reproduce, raise their kids, and die all in a 40-year period. Nowadays, things are very different.
In men, testosterone helps maintain and develop:
- Sexual organs
- Muscle mass
- Red blood cell levels
- Bone density
- Sexual and reproductive function
- Hair, both on the body and head
Is Decreased Testosterone Common in Men?
As previously discussed, testosterone levels start to decrease from around the age of 30 onwards, and it is perfectly normal for men by the time they reach middle age to see signs of reduced levels. Some studies suggest that up to 40% of men over the age of 45 have low testosterone levels, not all of whom will experience any symptoms. Levels are also affected by body mass index, general health, alcohol consumption, age, illness, and smoking.
What Causes Testosterone Levels to Drop?
Many factors can affect testosterone levels, from getting older to diseases and hereditary conditions. Some things are within your control, while some are not. A healthy lifestyle, eating well, not drinking too much alcohol, and getting plenty of sleep and exercise will help maintain 'normal' levels in younger men. However, the natural decline is unavoidable without treatment to maintain optimum levels.
There are many potential causes for a decline in testosterone levels.
- Testicular trauma, viral or bacterial infection (orchitis)
- Chemotherapy for cancer
- Hemochromatosis (blood disorder)
- Pituitary gland tumors or disorders
- Thyroid disorders
- Certain Medications (Opioids, chemotherapy medication, some antidepressants, and others)
- Alcohol abuse
- Cirrhosis of the liver
- Kidney failure
- HIV / AIDS
- Type 2 diabetes
- Autoimmune disease
- Kallman syndrome
- Klinefelter syndrome
- Undescended testicles
- Lack of Sleep
- Previous anabolic steroid abuse
Primary hypogonadism is a disorder where your testicles are not producing enough testosterone. The testicles are still receiving messages from the brain and thyroid but cannot produce enough or any hormone. This condition can be hereditary and caused by illness or damage to the organs involved in adults and children alike.
- Undescended testicles are where the testes don't descend from the abdomen before a baby is born. It is usually treatable in early childhood, which can affect testosterone levels in the future.
- Klinefelter's syndrome is a condition where men are born with an extra X chromosome. Often this can go wholly undiagnosed and only becomes apparent in later life. A girl usually has XX chromosomes and a boy XY; with Klinefelter's syndrome, a baby boy has XXY. Interestingly X is not exclusively a female chromosome and is present in both sexes. It is the Y that makes you a boy. Boys and men with this syndrome are still genetically 'male.' This condition can cause problems, particularly with testosterone production, fertility, blood disorders, weak bones, lupus, male breast cancer, an underactive thyroid, and other issues. Testosterone replacement therapy is the standard option because it can significantly reduce symptoms and the long-term effect of many of these issues.
- Hemochromatosis is a condition that causes the body to absorb too much iron from your food leading to far too high iron levels in the blood. This disorder can be hugely problematic because your body has no natural way to remove this excess. The iron builds up in your liver, heart, pancreas, and joints. Men with this disorder often have low testosterone levels, which is correctable with testosterone replacement treatment.
- Physical injury and damage, which affects both testicles, can affect testosterone production. Diseases such as mumps, cancer as well as cancer treatments can affect testosterone production.
Secondary hypogonadism accounts for 75% of cases. It is most often related to neuroendocrine issues where disease disrupts the interaction between the nervous system and endocrine system or obesity, medication, and other illnesses. Secondary hypogonadism is not caused directly by damage to the testicles. It is problems in the pituitary gland or hypothalamus that cause hormone production issues.
The Pituitary gland and hypothalamus send signals to the testicles, triggering testosterone production. There are quite a few disorders and diseases that can cause secondary hypogonadism, from normal aging to HIV and AIDs. Testosterone replacement therapy can help alleviate the symptoms of many of these.
- Inflammatory diseases such as tuberculosis can alter the pituitary gland and hypothalamus function.
- Pituitary issues caused by drugs, kidney failure, or small tumors
- Kallmann syndrome, present from birth, this disorder affects men and women and in men has the symptoms of hypogonadism along with a complete lack of sense of smell.
- HIV/AIDS. Men with HIV or AIDS are far more likely to suffer from hypogonadism.
- Aging: Men produce less testosterone when they reach 35-40, which drops every year.
- Obesity: Fat, especially visceral fat, causes testosterone levels to decline. Obesity may indicate a thyroid issue, but hypogonadism is incredibly common in obese men.
- Medications: Some medications cause testosterone levels to decline, including (not exclusively) opiates, certain antidepressants, chemotherapy drugs, Spironolactone (Aldactone), and Cimetidine (Tagamet)
- Recurring illnesses: Cancer, Chronic obstructive pulmonary disease, diabetes, vascular disease, and even sleep apnea can affect testosterone levels.
Thyroid Directly Affects Testosterone Levels
Thyroid hormones have over 200 beneficial effects and are present in every cell in your body. Your metabolism, heart function, bone growth, cell renewal, oxygen consumption, neural growth in the brain, muscle contractions, sexual appetite, weight, and more, are all affected by this critical hormone.
Many HRT clinics ignore that thyroid hormones directly affect other hormones in the body. It is common for men to have hypothyroidism, where the thyroid produces insufficient hormones T3 and T4. If your body produces low levels of these hormones, it reduces how much free (available) testosterone is in your blood.
Most testosterone in the bloodstream attaches to one of two proteins: albumin and sex hormone-binding globulin (SHBG). Free and albumin-bound testosterone remains readily available for use by your body. Low thyroid will reduce your free testosterone levels.
Hormone replacement therapy that includes desiccated thyroid tablets will ensure that thyroid hormones and testosterone work together to maximum effect.
What are the Optimum Testosterone Levels?
Testosterone replacement therapy could be considered essential for men over 40. TRT is used to restore levels to within the top 25% of 'normal.' We aim to get patients into the 800-1100 bracket. Most men will start to notice benefits in the 600-700 range.
It is essential to remember that every patient is different; testing your testosterone levels are only part of the story. Any doctor who understands TRT will take the blood readings as only half the picture. At Male Excel, we look at the patient's symptoms as the primary indicator of a testosterone deficiency.
- A drop in energy
- Memory Fog, Lack of Focus, and Concentration
- Lack of Libido and Erection Problems
- Sleep disturbance
- Weight gain
- Inability to gain muscle
Because all men' feel' the effects of testosterone deficiency differently, it is vital to look closely at the symptoms and then the blood test. Only then can our doctors create a bespoke treatment plan for each patient.
Put Yourself to the Test
If you feel any of the symptoms described above, it's well worth purchasing your at-home blood test and then booking your free consultation with one of our expert medical providers to follow up. Our simple at-home finger-prick test unlocks valuable information about your hormone health. With a detailed analysis at our CLIA-certified diagnostic labs, we’re here to help you stay healthy and active now and in the years ahead.
Disclaimer: The information provided on this page is not a substitute for professional medical advice, diagnosis, or treatment. If you have any questions or concerns about your health, please consult a doctor.