Content Approved by Dr Fotinos | Male Excel Blog Apr 16, 2020 6:17:24 AM 20 min read

What is Testosterone Replacement Therapy?

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Why Is Testosterone So Important to Men?

Feeling sluggish, no energy, can’t be bothered to eat right and go for that run? These symptoms could be a sign that something isn’t quite right. Sleep apnea, low thyroid, and low testosterone are all contenders to a problem that could possibly just get worse.  If you lack the zest you used to have, then you are more likely to make bad lifestyle choices, have that extra beer, have that extra-large burger, and skip the gym. All decisions that further down the road may cause significant health problems, such as high cholesterol and diabetes.

Testosterone is the primary male hormone and plays a hugely important role in the development of many organs, including the male sexual organs, prostate, muscle, bone, and hair. Testosterone is produced in both men and women, but the role it plays in male development is crucial. Testosterone kick starts all the male characteristics in the womb, particularly the development of the penis and testicles. Then later in life, during puberty – the development of a deeper voice and pubic and facial hair.

There are times during your life when testosterone production peaks, particularly as you develop from a boy to a man, but often later in life, testosterone production slows. 20% of men over 60 have what is commonly called “Low T,” and around 30% in their 70’s to 80s.

What are the Symptoms of “Low T”?

If you are suffering any of the following symptoms, you may be suffering from low testosterone and be a good candidate for therapy.

  • Mental Fog: Cognitive function, notably memory decline with age.
  • Decreased Sex Drive: Many men experience a decreased libido as they get older – this is normal. However, because T is so vital in maintaining libido, if you suffer a drastic fall in sex drive, this could well be caused by “Low T,” and therapy could be the answer.
  • Erectile Dysfunction: T does help fire up your sex drive and also assists in the process of getting and keeping an erection. T helps your body to produce Nitric oxide, which in turn kick starts a chemical chain reaction that enables you to get hard and stay hard.
  • Low Semen Production: Semen is the substance that sperm is carried in and helps get your swimmers to where they need to be. Many men suffering from Low T report a decrease in volume during ejaculation.
  • Hair Loss: Hair loss may, of course, be hereditary, but because T plays a role in hair production if levels are low, you may experience hair loss and not exclusively from your head.
  • Tiredness: A common symptom of low T is a lack of energy and extreme fatigue. If you can’t be bothered to exercise and feel tired all the time, even after a great night’s sleep. Then low T may well be the problem.
  • Increased body fat: One symptom can be a noticeable increase in body fat.
  • Gynecomastia (Man Boobs/Moobs) This occurs when there is an imbalance between T and estrogen (the primary female hormone). This causes the body to develop more female traits, such as breasts.
  • Loss of muscle: T plays a huge part in building muscles. Not necessarily the strength or function but the general mass of your muscles. Many men report that after TRT (Testosterone Replacement Therapy) a notable increase in muscle mass and a decrease in body fat.
  • Shrinking testicles: This can be caused by other medical issues, but low T can play a part. Because the body needs testosterone to develop these organs, low levels could mean smaller than average tackle down below.
  • Anemia: Doctors have discovered that when prescribing T gel to anemic men that their blood count improved. Symptoms of anemia can be problematic such as dizziness, rapid heart rate, and problems sleeping.

Why is Low Testosterone a Problem?

Low T (male hypogonadism) is more common in older men, but younger guys can also experience “Low T” symptoms. These are often caused by lifestyle choices or illness. If you suffer from “Low T” long-term, it can have serious effects on the body. For example, very low levels can cause a weakness in your bones, commonly known as osteoporosis. Low testosterone has also been linked to longevity. To put it simply, men with testosterone levels that fall below the normal range often die earlier than those with normal levels.

What Causes Low Testosterone?

Lifestyle factors include

  • Being obese or overweight causes testosterone levels to nosedive
  • Too much alcohol, especially alcohol abuse, damages the liver, thwarting testosterone production
  • Using illegal drugs
  • Lack of quality sleep
  • High blood pressure
  • High cholesterol

There are also medical conditions that can cause low Testosterone, such as:

  • Treatment for cancer such as radiation and chemotherapy
  • Diabetes
  • Liver disease
  • Hypothalamic or pituitary disease or cancer
  • Injuries to the testicles
  • Inherited conditions such as Down syndrome, amongst others

How is “Low T” Diagnosed?

Testing for this condition is done with a simple blood test, and the medical provider assesses any symptoms you may have. Your levels do fluctuate during the day but are usually highest in the morning, so this is the best time to do the test. The normal range is between 300 ng/dL (nanograms per deciliter) to 1000 ng/dL, so anything below 300 and you could be experiencing symptoms of “Low T”.

As with any hormone therapy, unless you have a proper diagnosis from a qualified medical provider (who knows what they are doing), you may be throwing your money into the wind. This is why we always suggest speaking to a professional before self-diagnosis.

Can you Diagnose Low Testosterone With an Online Assessment?

There are companies that now offer online HRT assessments. Usually, a questionnaire will be used to find out the likelihood of you having low T. It is important to note that you should always choose a company that insists on a medical assessment in person at an approved clinic as well.

There is no way a proper assessment can safely be made purely online. Consultations will ensure patient safety and allow the medical provider to assess you on an individual basis. The best way to test T levels is via a blood test. These can now be done via the post with a simple finger prick test that you can mail to the lab and then discuss with your medical provider in the consultation. They will also offer quarterly testing over a year to see how you have progressed and adjust the treatment plan accordingly.

How Is Low Testosterone Treated?

Testosterone Replacement Therapy (TRT) is commonly used to help people with abnormally low testosterone levels. Decreased body mass, lower sex drive, and fatigue are all common symptoms. Testosterone medication is often prescribed in pills, patches, creams, or injections to increase the levels back to normal.

You will often see companies selling what is known as 'Bio-identical' testosterone. This is simply 'manmade' testosterone that is chemically very similar to that produced in the human body.

Testosterone Injections

Testosterone injections are one of the more common forms of TRT.  Testosterone cypionate is commonly injected into the gluteal muscle every 2-4 weeks. It can be administered yourself after being shown the ropes by a nurse or your doctor. The dosage depends on varying factors that will be carefully diagnosed by a medical provider using blood tests and often a medical questionnaire to assess your suitability for treatment.

Here at Male Excel, the typical dosage range from 0.10mg - 0.25mg daily. We offer a daily dose using a tiny subcutaneous needle into your fat layer instead of painful injections into the muscle. This is to avoid a spike in testosterone. It is far better to have a steady supply rather than a large dose all at once. The thought of giving yourself an injection often puts people off this treatment, but in reality, it is pretty painless, and once you have done it once, it's pretty straightforward.

Testosterone Lipoderm Cream

Testosterone Lipoderm cream is applied to the skin to administer testosterone into your system. It is used to treat hypogonadism and increase testosterone levels in your body. Typical dosage range from 0.25 ml – 4 ml per day and is delivered in the groin area. With all testosterone creams, certain precautions are vital to ensure cross-contamination doesn't occur.

Topical Testosterone creams can cause side effects in women, children, and even pets who accidentally come into contact with it. In children, side effects can be serious and include early-onset puberty, aggressiveness, enlarged genitals, excessive hair growth, and acne. And in women, it is particularly dangerous during pregnancy, where it can cause birth defects.

However, by using the correct precautions, these risks can be eradicated.

  • Do not allow the treated area to come into contact with other people
  • Cover the treated area 20 minutes after application
  • Don't allow others to touch clothes or bedding which has come into contact with creams
  • Don't stoke animals after application
  • Wash hands thoroughly after application

Should I Use Testosterone Cream or Injections?

Which option is best for you is a tricky question to answer because there is no definitive answer. As with any medication, there may be side effects. With bioidentical hormones like those Male Excel prescribe, these are usually very few and far between. We also often find guys prefer creams (which are even better for reducing cholesterol). Typically testosterone can be injected once a week, twice a week, or daily but let's face it; injections won't be for everybody. It can be painful for several days after and can give you a spike in testosterone, diminishing over time until the next dose.

If a smaller dose is injected either daily or every other day, this can help avoid this issue and provide more consistent levels. For overweight men, injections can trigger the body to convert testosterone into estradiol which can cause sore nipples and swelling in the surrounding areas.

Creams can provide high levels of testosterone in an easy-to-apply form, but here are important transference issues, as discussed earlier. You will have to avoid sexual contact if you have applied the cream less than 4 hours ago, especially if applied in the groin area, as many doctors suggest. You also must make sure you wash your hands thoroughly after each application.

Absorption of the cream also varies from person to person, some will have excellent levels whilst others won't. So ongoing testing is vital to ensure the best results. For those who have poor absorption, injections will be the obvious alternative for treatment.

Does an Underactive Thyroid Affect Testosterone Levels?

Low Testosterone is a commonly diagnosed condition, well documented in the media, and well recognized amongst the male population. However, often men who have been diagnosed with Low T may be suffering from a thyroid problem that has been ignored.

The thyroid produces some of the most important hormones in the human body, triiodothyronine (T3) and thyroxine (T4) which help regulate your metabolism and give you energy.  Low thyroid function often leads to an imbalance in important hormone levels vital to usable testosterone in your system. So we strongly advise thyroid treatment working in tandem with testosterone.

With an underactive thyroid, your body produces less of the protein ‘Sex hormone-binding globulin' (SHBG), which transports bioavailable (useable) testosterone around your body, therefore confusing many a diagnosis with Low T as opposed to an under-active thyroid.

A low thyroid level can also affect male fertility. It can increase the size of the testicles, decreasing the number (sperm count) and life span (motility) of the sperm produced. So undiagnosed, this can directly reduce your chances of having children.

How Do You Treat Low Thyroid? (Underactive Thyroid)

The usual treatment for an underactive thyroid is a drug called Levothyroxine which is a synthetic version of the thyroid hormone T4, which the body transforms into the active T3 hormone. However, desiccated thyroid is a natural product that contains T4, T3, small amounts of T1, T2, as well as iodine and calcitonin. Some claim that because of its natural origin, desiccated thyroid mimics real thyroid hormone production much more closely.

Testosterone improves muscle mass

Do I need Testosterone Replacement Therapy?

If you have read this article and the symptoms seem familiar, certainly you may benefit from a test and hormone therapy. The important factor is getting the best advice and treatment and then ensuring regular testing to make sure things are progressing well. Testosterone therapy is proven beneficial to those who do suffer from Low T. Many men nowadays wish to attain optimum levels, which can have a hugely beneficial impact on their life as a whole.  Increased muscle mass, better erections, more energy, improved weight loss, better concentration, better mood, longer life.......what's not to love?

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.