Questions About Testosterone Therapy in Men
Testosterone therapy is a popular hormone replacement therapy offered here at Living Wellness Medical Center. In this blog post, naturopathic doctors Dr. Khalsa and Dr. Brouwer discuss some common questions from patients concerning testosterone therapy in men.
Question #1: At what ages does testosterone start to decline in men?
Dr. Brouwer: I think a generally accepted age is right around age 40. Also, men that are younger than that and are under tremendous stress can experience a decline in testosterone. However, on average, at around 40 years old, testosterone starts to decline. Unfortunately, many men don’t begin to exhibit symptoms until they’re 50 or 60, but by then, they’ve had many years of low testosterone. The effects of low testosterone will have accumulated in their bodies.
Question #2: What are some of the low testosterone symptoms that you should be on the lookout for?
Dr. Brouwer: A lot of men don’t come in until they start to have some type of sexual dysfunction, like erectile dysfunction or a lack of libido. But the changes that occur far before can be anything from insomnia, aches, pains in their joints, a low exercise tolerance, and not getting as much out of their workouts. Their muscles are weaker than they used to be, and their cardiovascular fitness has decreased. These are the main things that we hear complaints about. Patients often say, “I’m tired,” “I’m exhausted,” and “I’m not interested in life anymore.”
They may feel depressed, and this mood can linger for a long time. But then they are also experiencing issues with their cardiovascular system, where their heart muscle can be weakening. There many reasons to start replacing testosterone and start boosting it while the patient is younger. It is important not to wait until the patient experiences poor erections to address low testosterone.
Question #3: What are the differences between testosterone replacement therapy and steroids used in bodybuilding?
Dr. Brouwer: So, testosterone replacement therapy is a replacement therapy, right? As men age, their testes don’t produce testosterone that well, and they’re missing out on the hormone that’s vital for their proper functioning. Therefore, we’re replacing something that’s missing, or that’s very low. In contrast, using steroids means that you’re using artificial testosterone replacements, a chemical that mimics testosterone. These substances have a very different effect on the body. Steroids are not replacing something natural to the body. They are pushing the body with something fake.
These artificial substances can result in really high testosterone levels that can cause serious side effects, such as road rage. Men can get irritable and aggressive, and their testicles shrink away. There are a lot of really harmful effects of that kind of steroid use; that’s not the case with replacing real testosterone.
Question #4: Often, we hear patients say their labs are “normal.” How does that relate to conventional or optimal lab goals?
Dr. Brouwer: This happens all the time. I get men that come in and are in their 40s or their 50s or 60s and say, “I’m just not feeling like myself. I’m not feeling well. I’m tired. I’m not as strong as I used to be.” They say all those things we talked about before. And they say, “But my doctor says my testosterone is normal.”
Well, there is normal for your age. So when you’re younger, men in their teens, 20s, and 30s, have these really high testosterone levels keeping them strong. But as that starts to decline, the reference range changes per age. In their 20s, there’s a reference range for them that’s the normal range. It’s the same in their 30s, 40s, and so on. Therefore, if you’re in your 50s and have a normal level for your age, that’s much lower than when you were younger and stronger.
So, I don’t want my older men to be necessarily in the normal range for their age. I want them to be at a more normal range for a 30-year-old. And that’s based on all the studies, not just my personal preference. Studies of men using testosterone replacement therapy tell us that those more youthful levels are going to keep them stronger, .
A lot of doctors will just look at the total testosterone. So, there are a couple of ways to look at it, and you can look at the free testosterone (what is available for the cells to use) and total testosterone (where a lot of that is bound up and not available). Just measuring total testosterone doesn’t tell us how much of that is usable by the body. Even so, when a lot of men are under 1,000 in their total testosterone level, they feel symptomatic.
Again, they’re not sleeping well, their energy is poor, so I don’t care what your total is, and I don’t care that you’re “normal” for your age. I want you to be in that optimum range of free testosterone as if you were younger.
If you are interested in testosterone hormone replacement therapy, we can do a free meet and greet with you. Call 480-588-6856 to schedule a FREE brief meet and greet with a naturopathic doctor.
