The simple fact is that both males and females need testosterone for a normal healthy life. As we become ill or age, our natural levels of testosterone drop. This results in depression, fatigue, loss of vigor, increases body fat and many other symptoms.
Unfortunately, the early pioneers of testosterone research were never taken seriously. The use of steroids by athletes was considered “unfair” and cast into a league of “cheating.” Early interest was overshadowed by the myths of “roid rage,” early death and many other side effects and myths.
Not until as recent as 2010, did the acceptable prescribing and managing of testosterone become more widely accepted. But, even today, many of the old myths still exist about TRT (testosterone replacement therapy). These myths cast a doubt by many physicians and the use of TRT.
The medical testing of testosterone to establish “low T” is also still currently an issue filled with debate. Which test are the most appropriate and what are the correct serum levels, are still hot topics of seminars across the world. Physicians are often learning from those very athletes who were considered “cheaters” and learning about their own success and failures.
Why is this topic important if you are 24 years old? Consider that 14 million men are estimated to have low T in the US. Those stats are based on old data that the scientific community can’t agree on, so the number is believed to be triple that amount.
Most of the data shows that men and women over the age of 50 tested showed that over 60% have low T. Since our economy is paying for the aging population, it is important that we keep older adults independent and in the best health possible.
To best understand the facts about testosterone, it is important to gather what facts we do know. The anterior pituitary gland is responsible for the production of gonadotropins like SHBG (Sex-Hormone Binding Globule) which stimulates FSH (Follicle Stimulating Hormone) and LH (Luteinizing Hormone), which then stimulate the testicles in the male and the ovaries in the female to produce testosterone. The adrenals make some testosterone, but not usually more than 10%.
It would make sense that you could simply test the blood and determine some hormone levels and supplement and correct any deficiencies; however, it isn’t that simple. Since the body has a significant feedback on the pituitary, many factors effect testosterone production. Welcome to the world of physical chemistry, a subject that most physicians failed at in medical school.
When most people don’t understand a topic, they often make up myths to cover their lack of knowledge and unfortunately doctors are no different. This is why you will still hear physicians say, “If you take testosterone, it will cause prostate cancer.” Nothing could be further from the truth. Consider how many strength and physique athletes who use testosterone and their prevalence of prostate cancer is the lower when compared to the sedentary population.
Simple testing of testosterone levels doesn’t work, since the levels are set too low for total T and there is a huge misunderstanding about free T. Some older individuals have no symptoms of low T, but their blood test show they have a lower testosterone than the normal 300 level as suggested by the literature. This is because they have more free testosterone.
Testosterone is about 98% bound in our blood stream to (60%) Sex Hormone-Binding Globulin (SHBG) and (38%) albumin binding. As we age, the later or “free” testosterone is less. The key is that you need more free testosterone to feel better. Less than 2% of testosterone is free and this gets worse as you get older.
Problems with low T can be primary from the testicals and secondary, which is related to the actual organs that help control the hormone production. It is difficult to determine the true cause of low T to begin the best treatment. Simply pouring T into the system doesn’t fix the problem in all individuals. Careful review is necessary to determine the right method of TRT.
This is why just blood test alone is not the only answer for determining the correct approach to TRT. Testosterone is determined best, not just by blood test or symptoms, but in the case presentation of each individual. A patient must have the appropriate symptoms to establish the need for TRT. Symptoms can be overlapping towards many other conditions, so a careful history and full exam is also needed.
Symptoms of “low T” are simple; loss of mojo (the desire to start any task, not just sexual), loss of energy, loss of sex drive, loss of functional erections, loss of quality of sleep, loss of thought patterns, loss of lean mass, low HDL and high LDL, and overall lowered activity level.
Other factors that cause low T are chronic illness, past history of mumps, HIV, alcoholism, hyperthyroidism, diabetes, high fat diets, smoking, marijuana, high estrogen levels, Propecia and Rogaine, chronic drug usage (recreational and prescription) and aging primarily. Several studies have shown that specific hair regrowth drugs actually increase total testosterone, lower free T and result in a lower overall lean body mass.
Once proper testing and supplementation occur, the balancing act of testosterone to estrogen begins, but typically the patient has a marked improvement almost overnight.
The benefits of testosterone is seen with stimulating blood cells, prevents cancers, builds leans muscle mass, lowers body fat, improves brain function and mood, increases sex drive, helps with healing tissues, prevents Alzheimer’s disease, improves kidney function, prevents osteoporosis/heart disease/stroke, improved thinking and cognitive memory.
So the benefits of TRT are still in the early stages, but now that mainstream medicine is starting to document the positive effects, it is important to stop listening to myths and get the facts.
Yours in Health!
Columbus Chiropractic Center Director