Founder &
Operations Coordinator
Cieanna Marie, CMT, PRS
Medical Director
Psychiatric Family Nurse Practitioner
Bonnie Velez, DNP, CRNP, PMHNP
The Down Low on Low T
How common is low T?
Low testosterone affects almost 40% of men aged 45 and older. It is difficult to maintain normal testosterone levels, because levels vary throughout the day and are affected by body mass index (BMI), nutrition, alcohol consumption, certain medications, age and illness.
Symptoms of low T
Fatigue ~ Moodiness and irritability ~ Decreased sense of well-being ~ Infertility ~ Depressed mood ~ Difficulties with concentration and memory ~ Loss of muscular strength ~ A decrease in hemoglobin and mild anemia ~ decrease in body hair ~ Thinning of the bones ~ Low sex drive ~ Erectile dysfunction ~ Increased body fat
How common is low T?
Low testosterone affects almost 40% of men aged 45 and older. It is difficult to maintain normal testosterone levels, because levels vary throughout the day and are affected by body mass index (BMI), nutrition, alcohol consumption, certain medications, age and illness.
What causes low T?
As a man ages, the amount of testosterone in his body gradually drops. This natural decline starts after age 30 and continues (about 1% per year) throughout his life. There are many other potential causes of low T including:
​
Injury (trauma, interrupted blood supply to the testes) or infection of the testes (orchitis) ~ Metabolic disorders such as hemochromatosis ~ Pubertal delay ~ Dysfunction or tumors of the pituitary gland ~ Trauma (head injury) ~ Chemotherapy ~ Medications including opioids ~ hormones used to treat prostate cancer ~ steroids (such as prednisone) ~ Mellitus ~ HIV/AIDS ~ Severe primary hypothyroidism ~ Aging ~ Alcohol abuse ~ Cirrhosis of the liver ~ Chronic renal (kidney) failure ~ Inflammatory conditions such as sarcoidosis ~ Radiation exposure or prior surgery of the brain ~ Kallmann syndrome ~ Obstructive sleep apnea ~ Klinefelter syndrome ~ High levels of the milk-producing hormone prolactin ~ Obesity or extreme weight loss ~ Uncontrolled type 2 Diabetes ~ Previous anabolic steroid abuse ~ Congenital defect (present at birth) ~ Estrogen excess (usually from an external or environmental source)
How is low T diagnosed?
Low testosterone is diagnosed by measuring the amount of testosterone in the blood with a blood test. It may take several measurements to determine if a patient has low testosterone, since levels tend to change throughout the day. The highest levels of testosterone are generally in the morning between 8 and 10 in the morning. This is why doctors prefer to measure testosterone levels in the early morning.
What are the benefits of TRT?
-
​​Greater muscle strength and physical performance
-
Increased bone density and protection against osteoporosis
-
Improved mental sharpness
-
Improved mood and sense of well-being
-
Improved sexual function
-
Loss of fat
What are the side effects of TRT?
Swelling in the ankles caused by mild fluid retention ~ Stimulation of the prostate (which can cause difficulty urinating) ~ Worsening of sleep apnea ~ Smaller testes ~ Acne or oily skin ~ Breast enlargement or tenderness
TRT may not be for you if you have:
-
An enlarged prostate resulting in urinary symptoms
-
A lump on their prostate that has not been evaluated
-
A PSA measurement above 4
-
Breast Cancer or Prostate Cancer
-
An elevated hematocrit level (higher-than-normal number of red blood cells)
-
Severe congestive heart failure
-
Obstructive sleep apnea that has not been treated