Men Should Check Their Testosterone Levels by Age 30, Urologist Says

Men should know their testosterone levels by age 30 to prevent health issues like weight gain and muscle loss, says top urologist

Gabby Landsverk
Oct 11, 2022, 12:31 PM

This article is a repost which originally appeared on INSIDER.

Edited for content. The opinions expressed in this article may not reflect the opinions of this site’s editors, staff or members.

Early testing can help identify low testosterone.

‧ Low testosterone levels can cause side effects ranging from low libido and mood to muscle loss.

‧ A urologist said more men should get tested so their doctors can see how their hormone levels change over time.

‧ There is some evidence that higher testosterone levels may prevent illness like prostate cancer, not increase the risk.

Testosterone is a crucial hormone for men’s health, and a top urologist says more men should know their levels earlier in life.

Low testosterone can cause loss of energy, muscle, and libido, and can contribute to chronic illnesses such as heart disease, diabetes, and obesity, according to research.

But diagnosing low testosterone can be tricky, because natural testosterone levels can vary.

If you don’t already know your baseline, and you start experiencing these symptoms, you may not be able to trust the results of a testosterone test, said Dr. Ananias C. Diokno, former chief medical officer and chair of urology at Beaumont Hospital, Royal Oak.

“If you ask men what their testosterone levels are, they’ll scratch their heads. They don’t know and doctors aren’t testing for this. You should know what your level is by the time you hit 30 to 35,” Diokno told Insider.

What we think of as ‘normal’ testosterone, and why it’s not a perfect barometer

Testing for low testosterone is simple, using a blood test.

In healthy men, testosterone levels can range between 260 nanograms per deciliter (ng/dL) and more than 900 ng/dL, depending on age.

Low testosterone is typically defined as less than 250-300 ng/dL, according to the Cleveland Clinic.

However, since natural testosterone levels can vary widely, Diokno said many men can be misdiagnosed for hormone deficiencies.

For example, a person with testosterone levels of 400 or 500 ng/dL won’t be diagnosed with low testosterone because it’s higher than the defined standard, but if his initial levels were 700 or higher, the drop is significant and may warrant treatment.

“Many practitioners close their minds. Someone may be having symptoms but according to the guidelines, does not have low testosterone. It’s frustrating among men and among doctors who can’t help them,” Diokno said.

One solution is more routine hormone testing so men can establish what a healthy baseline looks like for them, similar to other markers of health like cholesterol, blood pressure, and blood sugar, Diokno said.

Low testosterone can cause low energy, low libido, and loss of muscle

Over time, men’s testosterone levels dwindle as a common side effect of aging. However, younger men can also have low testosterone, causing them to experience similar symptoms to much older men.

Telltale symptoms of low testosterone can be mental, physical, and emotional, including:

‧ Decreased sex drive

‧ Brain fog

‧ Depression and mood changes

‧ Fatigue

‧ Difficulty building or maintaining muscle

“The lower the testosterone, the more symptoms,” Diokno said.

Testosterone therapy may not be as risky as previously believed

For men who have had sudden dips in hormone levels, testosterone therapy can help restore quality of life, energy, and libido, Diokno said.

Previously, testosterone therapy has been carefully regulated, in part because high testosterone has been linked to a higher risk of prostate cancer in some studies.

Diokno said the opposite may be true, according to some observational studies, and healthy testosterone levels may protect prostate health.

Loss of muscle linked to low testosterone can cause other problems, too, including a decreased metabolism that can lead to weight gain and associated health issues.

Available evidence suggests that testosterone therapy, done correctly and with medical supervision, is a safe and effective way to raise hormone levels, and more research is needed to see who could benefit, Diokno said.

“It’s a Pandora’s Box, I think there are many questions that are still unanswered,” he said.

How to Increase Testosterone: A Guide

Medically Reviewed By Kelly Wood, MD
— Written By Dr Christopher Oseh Updated on August 15, 2022

This article is a repost which originally appeared on healthgrades.

Edited for content. The opinions expressed in this article may not reflect the opinions of this site’s editors, staff or members.

Our Takeaways:

· Testosterone controls a number of physiological functions in adult males.

· Older males typically experience a reduction in testosterone levels due to a number of factors.

· There are many ways to naturally increase testosterone levels.

There are different interventions to increase testosterone. Testosterone naturally reduces in males as they grow older. Individuals with low testosterone may notice symptoms such as decreased sexual drive and unusual tiredness.

Read on to learn more about the treatment methods and natural remedies that could boost your blood testosterone level.

What is testosterone?

Testosterone is a male sex hormone produced in the testis — the male reproductive organ. Testosterone binds to albumin and sex hormone binding globulin as it circulates in the blood, while some exist in an unbound form. Regulatory hormones in the pituitary gland regulate the production of testosterone.

Testosterone production starts from the seventh week of gestation in a male embryo. The amount gradually rises and helps in the development of the male genitals in utero. A few months after birth, the blood concentration of testosterone in male infants drops and peaks again at puberty.

The liver, prostate, and reproductive tissues contain an enzyme called 5α reductase, which converts testosterone to its metabolite — dihydrotestosterone.

Testosterone and dihydrotestosterone are responsible for the development of male sexual characteristics.

Testosterone controls physiologic functions in adult males, such as:

‧ sexual drive
‧ muscular tone
‧ sperm production
‧ red blood cells

Adult males may notice a decline in these functions when their testosterone level drops.

What are the symptoms of low testosterone in males?

Symptoms of low testosterone levels are nonspecific. However, if you have low testosterone, sexual and nonsexual symptoms may manifest.

Here are some sexual symptoms you could notice:

‧ decreased sexual desire or libido
‧ reduced frequency or rigidity of nocturnal erections
‧ erectile dysfunction

Nonsexual symptoms include:

‧ unexplained fatigue
‧ decreased energy
‧ difficulty concentrating
‧ decreased sense of well-being
‧ depressed mood

These symptoms alone are not adequate to diagnose low testosterone. Your doctor will typically conduct a physical examination and order some investigations to identify the possible causes of low testosterone levels.

Low testosterone causes vary depending on the age of the individual. For instance, genetic and acquired conditions that affect the testis may lead to low testosterone levels in young males.

In addition to medical conditions affecting the testis, older males typically experience a natural reduction in blood testosterone. This is due to the gradual decline in regulatory hormones that influence testosterone production.

The combination of your clinical history and investigation findings is essential in diagnosing low testosterone.

However, if you experience any of these symptoms, contact your doctor.

How can doctors help increase testosterone?

After confirmation of low testosterone, your doctor will typically initiate a treatment called testosterone replacement therapy (TRT). TRT involves administering testosterone medication to boost testosterone concentration in your blood.

Testosterone medication exists in various preparations. Your doctor will generally carry out a clinical assessment to identify the most effective type of medication for your individual needs, best formulation, or route of delivery for you.

Oral testosterone replacement therapy

This type of medication involves the oral intake of testosterone capsules to boost the blood testosterone level. However, as a result of low absorption and liver toxicity, doctors do not typically prescribe testosterone capsules to individuals with low testosterone.

Buccal testosterone replacement therapy

Buccal testosterone preparations have adhesive features that enable adhesion to the gums in the mouth. After dissolving in the gums, the blood vessels in the gums absorb the medication. This allows the medication to bypass the liver and the gastrointestinal tract.

Because of the above characteristics, buccal testosterone formulations are generally more tolerable than oral capsules.

Nasal testosterone replacement therapy

This form of TRT involves self-administering nasal pumps to administer intranasal testosterone gel into the nasal cavity. The blood vessels in the nasal mucous membrane absorb the nasal gel into the systemic circulation. Some individuals who use Intranasal testosterone may have side effects, such as:

‧ sinusitis
‧ nasal discomfort
‧ rhinitis
‧ nose bleeds

If you use intranasal testosterone and you experience any of these symptoms, contact your doctor.

Intramuscular testosterone replacement therapy

This type of medication entails injecting oil suspensions of testosterone into the muscles. Your doctor may prescribe long-acting intramuscular testosterone preparations for weekly injections. This ensures convenience and also improves compliance and adherence to therapy.

Transdermal testosterone replacement therapy

This form of TRT involves administering transdermal testosterone gels or patches over the skin. Your doctor will typically apply transdermal patches or gels on the skin where the blood vessels absorb it.

These areas generally include:

‧ surfaces of your abdomen
‧ upper arm
‧ thigh

To reduce the onset of local skin irritations, rotate the skin area where you apply the transdermal gels or patches.

Contraindications to testosterone replacement therapy

Though testosterone replacement therapy is effective, it is not suitable for some individuals. Some contraindications to TRT include:

‧ hematocrit above 48%
‧ prostate cancer
‧ uncontrolled heart failure
‧ a recent episode of myocardial infarction or cerebrovascular accident
‧ untreated obstructive sleep apnea
‧ fertility planning in males
‧ elevated PSA above 4 ng/mL

How can you naturally increase testosterone?

A 2018 study showed that eating foods rich in specific vitamins and minerals can maintain testosterone. However, it may not be possible to increase it without medical intervention. Here are some foods and supplements that can support the blood testosterone level.

Natural cocoa products

Natural cocoa products such as cocoa powder contain flavonoids — plant-based antioxidants with potent anti-inflammatory properties. These flavonoids promote the formation of steroids required for testosterone production and support the testicular cells.

A few studies reveal that flavonoids facilitate the process of testosterone production in the testis.

Magnesium-rich foods

A 2011 study suggested that magnesium increases insulin-like growth factor 1, which stimulates the process essential for testosterone formation. Intake of some fruits such as avocados or leafy vegetables, which are sources of magnesium, may maintain your testosterone level.

Selenium foods

Animal and human studies of selenium demonstrate its potential benefits and support in the male reproductive system. Selenium has strong antioxidant properties that promote male fertility. However, more clinical studies are essential to show its potential benefits in humans.

Herbal extracts

Certain herbs may support the production of testosterone. A 2020 research review revealed that some leaf and root herbal extracts positively affected testosterone concentrations in male study respondents.

However, as a result of dosage variations and safety concerns, further studies are critical in establishing the efficacy of these herbal extracts.

Reduce alcohol intake

Frequent consumption of alcohol adversely impacts testosterone production in multiple ways. Firstly, a high intake of alcohol disrupts the balance in the pituitary hormones that regulate testosterone production.

Also, a high concentration of alcohol in the blood may cause damage to the testosterone-producing glands and cells in the testis.

Studies with male rats showed that chronic alcohol intake negatively impacted their overall fertility and the structures in their reproductive tracts.

Therefore, reducing your quantity and frequency of alcohol intake can have a positive reproductive health impact.

Summary

Testosterone is a male steroid hormone produced in the testis. In older males, blood testosterone levels typically drop naturally. However, young adult males may have low testosterone levels if they have medical conditions that damage the testosterone-secreting glands in the testis.

You may notice symptoms of low testosterone levels such as decreased sexual desire or libido, erectile dysfunction, unexplained fatigue, and reduced energy.

Even though intake of certain fruits like natural cocoa products or some herbal extracts may maintain testosterone levels, testosterone replacement therapies are typically the most effective treatment for low testosterone.

Contact your doctor for clinical evaluation and to discuss the most appropriate TRT intervention for you.

Sources:

1. Cohen, J., et al. (2020). Low testosterone in adolescents & young adults. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6966696/
2. Emanuele, M. A., et al. (n.d). Alcohol and the male reproductive system. https://pubs.niaaa.nih.gov/publications/arh25-4/282-287.htm
3. Hu, T-Y., et al. (2018). Testosterone-associated dietary pattern predicts low testosterone levels and hypogonadism. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6266690/
4. Maggio, M., et al. (2011). Magnesium and anabolic hormones in older men. https://onlinelibrary.wiley.com/doi/10.1111/j.1365-2605.2011.01193.x
5. Martin, L. J., et al. (2020). Improvement of testicular steroidogenesis using flavonoids and isoflavonoids for prevention of late-onset male hypogonadism. https://www.mdpi.com/2076-3921/9/3/237
6. McBride, J. A., et al. (2015). Testosterone deficiency in the aging male. https://journals.sagepub.com/doi/10.1177/1756287215612961
7. Shoskes, J. J., et al. (2016). Pharmacology of testosterone replacement therapy preparations. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5182226/
8. Smith, S. J., et al. (2020). Examining the effects of herbs on testosterone concentrations in men: A systematic review. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8166567/
9. Testosterone and aging: Clinical research and directions. (2004). https://www.ncbi.nlm.nih.gov/books/NBK216164/
10. Qazi, I. H., et al. (2019). Role of selenium and selenoproteins in male reproductive function: A review of past and present evidences. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6719970/

 

Men’s health: Employers must tackle low testosterone levels

by Helen Lake

Low testosterone is sapping the energy levels of two million men in the UK. Helen Lake discusses some of the issues and misconceptions surrounding low testosterone, as well as outlining the actions that employers can take to support their staff who are suffering with this hard-to-spot condition.

27th Jul 2022

This article is a repost which originally appeared on HRZone.

Edited for content. The opinions expressed in this article may not reflect the opinions of this site’s editors, staff or members.

Our Takeaways:

· A large percentage of men suffer from emotional concerns in silence.

· 40% of men aged 45 or older have clinically low levels of testosterone.

· Testosterone Replacement Therapy (TRT) should be considered a tactic of last resort for men with hormonal issues.

It’s estimated that around two million men in Britain suffer from low testosterone levels, making it a very real issue for a large proportion of the UK workforce.

For those working men suffering with it, symptoms can include low energy levels, poor concentration, memory loss and side effects that are often misdiagnosed as depression. Longer term, men living with a testosterone deficiency are more susceptible to serious health issues including cardiac arrest, infertility and osteoporosis.

Recent research by Peppy found that 39% of employees experience disruption due to men waiting until a health problem becomes severe before talking to their HR team.

With low testosterone impacting a man’s general wellbeing, as well as his performance at work – increasingly, there are calls for greater workplace support and awareness around male testosterone deficiency.

Men’s Health Awareness Week recently took place, but we shouldn’t only focus on men’s health during this time. At any point in the year, organisations should examine what can be done to raise the bar for men’s health, including their ‘t-levels’.

Who is impacted by low testosterone?

The research also revealed that an estimated 40% of men aged 45 and older have low testosterone. But, since this is an issue unique to men, it’s likely that the true figures are much higher than are reported.

Testosterone is the male hormone produced that boosts bone strength, powers sex drive, and helps to maintain muscle mass.

An estimated 40% of men aged 45 and older have low testosterone, with the true figure thought to be much higher.

It is mostly produced in the testicles, with production rising rapidly during puberty, triggering a whole host of teenage side-effects in young males and peaking around the 20s.

Levels begin to decline naturally in men by around 2% a year from their mid-30s. By their 40s, the more common symptoms – such as mood swings, low energy, loss of muscle mass, and poor concentration – are more likely to occur.

The imbalance of such a crucial part of a man’s hormonal make-up can have wide-ranging implications, both for him and his workplace.

A wide range of symptoms

While concerns around the impact menopause can have upon women in the workforce have taken deserved precedence in recent years, the issue of low testosterone in men of a working age is a cause for increasing concern among medical professionals.

And it should be for employers, too.

The ‘andropause’, as it’s been dubbed, may not present with as severe a set of symptoms as those experienced by some women during menopause, but the gradual decline in testosterone levels can have a devastating impact on the long-term health of men.

At the heart of the problem, is the fact that low testosterone isn’t always correctly diagnosed. Symptoms are commonly attributed to ‘working too hard’ or just getting older, and are often mistaken for depression – or else not identified at all.

The gradual decline in testosterone levels can have a devastating impact on the long-term health of men.

The symptoms of low testosterone vary between individuals. In some cases, low levels of testosterone do not appear to cause many symptoms for reasons that are not clear.

Impacts on men’s mental health and emotional wellbeing include poor sleep quality, mood swings and irritability – making it an issue employees and employers need to be aware of. Erectile dysfunction is another common sign, but is often viewed as an embarrassing issue that contributes to men suffering in silence.

In more severe cases, a decline in testosterone can affect sperm count and cause men to grow ‘moobs’ or man boobs, due to changes in the body’s fat distribution. The knock-on effect of low testosterone can therefore impact body image, self-confidence, and even family plans.

Most cases are caused by ageing, or through being overweight or type 2 diabetes – both of which are prevalent in the male population of the UK. In addition, low levels of testosterone can affect younger men as a result of stress, lack of sleep, poor diet and lack of exercise.

The impact on male mental health

For many men, low testosterone levels are the real culprit for that general feeling of low mood and exhaustion that so many experience.

But, when men are half as likely as women to visit their GP, many go years if not decades experiencing high levels of fatigue and decreased energy levels without finding out that it is hormone related and treatable.

In the UK today, one in eight men struggle with a common mental health problem such as anxiety or depression, and this is likely to be higher than is officially recorded. One in three men also attribute poor mental health to their job, making this a serious issue for workplaces.

In the UK today, one in eight men struggle with a common mental health problem such as anxiety or depression.

Directly or indirectly, the impact low testosterone levels can have on a man’s health and lifestyle – from loss of libido, to weight gain, to lack of quality sleep, to low mood – is very likely to trickle through to their mental and emotional wellbeing.

For organisations committed to improving their male workforce’s mental health, tackling testosterone must become part of the conversation.

How workplaces can tackle the problem

At present, accessing specific support is difficult for men suffering with low testosterone. Tests are only available on the NHS to those with severe symptoms, and these people must firstly have made an appointment with the GP and made it through the system, just in order to be diagnosed with low testosterone.

Workplaces are uniquely placed to give employees the practical and emotional support they need – and this starts with raising awareness.

Employees of all genders, ages and life stages should be made aware of the signs, symptoms and risks of low testosterone, so they know what to look out for in themselves, their colleagues and even their partners. Providing resources in the workplace for improved physical and mental health for employees should also be a priority.

Organisations should make the pathway to support as easy to access as possible by giving employees access to specialist men’s health support, including highly-trained urology specialist nurses, as well as nutritionists and fitness experts. Crucially for men, support should be available remotely and entirely confidentially to maximise uptake.

The help provided should include access to at-home hormone tests and personalised, expert advice on how to treat the side-effects of low testosterone.

Testosterone replacement therapy (TRT) should always be the last resort.

There is no ‘quick fix’ when it comes to low testosterone levels. Simple lifestyle changes like diet, exercise, sleep and work-life-balance can have a miraculous impact on an individual’s testosterone levels and should be explored first.

Testosterone replacement therapy (TRT) should always be the last resort, with any potential underlying medical cause excluded.

Leading employers are transforming men’s health

Forward-thinking employers and their employees are already reaping the rewards of connecting their people to a team of real, human experts.

With the right tools at their fingertips, individuals from leading consultancy firms, high street retailers and law firms are able to work alongside nutritionists, personal trainers, urology specialists and mental health experts – building the habits that can help to restore healthy testosterone levels.

Because eliminating the unwanted effects of low testosterone won’t just benefit the individual, but their workplace as well.

With the right holistic support and wellbeing initiatives, employees can spot the signs, identify the causes and take immediate, practical steps towards rebalancing their hormone levels, enabling them to bring their best selves to work each day.