by Dr. John Neustadt

Testosterone is the major sex and anabolic hormone in men. Testosterone orchestrates the normal development and function of the genitals, is crucial for building stronger bones, creating muscle and increasing strength, facial and body hair. Testosterone increases sex drive, promotes fat burning, is required for memory and heart health, and is involved in producing red blood cells and sperm.  In other words, it’s crucial for feeling our best. That’s why getting your testosterone tested is so important. 

Testosterone increases in boys during puberty and then begins to slowly decline in men around 40 years old, at a rate of about 1% a year. By age 80, more than 50% of men will have low testosterone. Studies show that 38% of the men going to doctors have low testosterone.

As men age the natural decrease in testosterone is called andropause, which, like menopause in women, can cause uncomfortable symptoms, decreased quality of life and increase the risk of certain diseases like heart disease and osteoporosis. Recent research, however, shows that many more men, and at younger ages, are at risk for low testosterone (low T). 

Testosterone levels are steadily falling in American men. Scientists first noticed this in 2007, when a study of over 1500 men reported a decline in testosterone levels between 1987 and 2004 that could not be attributed to age, weight, illness or lifestyle. Other studies since then have confirmed the trend. This decline is in addition to the steady, slow loss of testosterone that inevitably occurs with aging, putting more men than ever at risk.

While there is still a lot to learn about why men’s testosterone is declining at younger and younger ages, one potential cause researchers point to is the massive increases in toxic chemicals in our environment. Many of these chemicals are endocrine disruptors that block and interfere with hormones. 

Whatever the causes, a decline in healthy testosterone causes or contributes to lots of problems:

• Anemia
• Cardiovascular disease
• Chronic obstructive pulmonary disease (COPD)
• Chronic kidney disease (CKD)
• Decreased memory 
• Decreased motivation
• Decreased self-confidence 
• Depression
• Diabetes
• Erectile dysfunction 
• Fatigue
• Frailty
• Infertility 
• Insomnia
• Irritability
• Lethargy
• Low sperm counts
• Memory loss
• Muscle loss (sarcopenia) 
• Obesity
• Osteoporosis
• Weakness

Since testosterone is so important, and since symptoms of deficiency are not always obvious, it’s important to get your testosterone checked. Testing is important for tracking levels over time and should particularly be considered if your experiencing any of the following issues.

When Your Memory Isn’t As Sharp As It Used To Be

Memory lapses happen to us all, but as we age the frequency can increase. We might misplace our keys, forget where we parked the car in a large parking lot, and find our ability to retrieve information—such as names, phone numbers, or appointment times—takes longer. Memory, attention, language and spatial skills all decline as we age. Low testosterone levels can contribute to this memory impairment. 

This is not surprising when we consider that receptors for male hormones are found in the regions in the brain involved in memory and learning. Low levels of testosterone in healthy older men have been correlated with poor performance on some cognitive tests. Testosterone might even help protect the brain from Alzheimer’s disease, since it can inhibit the protein, b-amyloid, that forms the plaques commonly found in Alzheimer’s disease. Higher levels of free testosterone in men have been correlated with better spatial abilities and better memory, particularly as we age.

When You’re Feeling Blue All-Day Long

Depression can be insidious, seeping into all aspects of life. You drag yourself out of bed in the morning. You force yourself to exercise. Little tasks feel like big chores. Life just doesn’t seem as exciting anymore, colors don’t seem as vivid, and you don’t look forward to work or play like you used to. Sometimes these symptoms of depression can linked to mildly decreased testosterone. Improvement in mood, a feeling of well-being and ability to concentrate has been shown with testosterone supplementation.

When You Want To Do All You Can To Protect Your Heart 

According to the Centers for Disease Control, over 700,000 Americans have a heart attack each year, and over 600,000 Americans die of heart disease annually. Testosterone supplementation can have a beneficial effect on the heart. When men who were low in testosterone were supplemented for one year, their total cholesterol and low-density lipoprotein cholesterol (LDL or the ‘bad’ cholesterol) decreased significantly. Low testosterone levels have been linked to metabolic syndrome, diabetes, hypertension and heart attacks. Testosterone replacement therapy has been shown to improve myocardial ischemia in men with coronary artery disease. Myocardial ischemia occurs when blood flow to your heart is reduced, preventing the heart muscle from receiving enough oxygen. Testosterone therapy also improves the ability to exercise in those with heart failure.

When Sex Just Isn’t What It Used To Be

Loss of libido and inability to sustain an erection are stressful for men, since most men define their masculinity in large part by their sexual drive and capacity. If sex starts to feel like a chore more than a pleasure, if erections are more difficult to maintain, then low testosterone may be a cause. Testosterone therapy significantly improves erections, libido and sexual function in men with low testosterone.

When You’re Struggling with Insomnia

While there are many reasons for insomnia, low testosterone is an important cause, especially as men age. Getting your testosterone tested can help you determine if that may be an underlying factor. For other potential reasons for insomnia and what you can do about it, read my blog, Your Checklist to Beat Insomnia and take Sleep Relief.

Testing Testosterone

Testosterone can be found in both a free form and its bound form. Therefore, when you get your testosterone checked, make sure to test your total and free testosterone. About 1-2% of testosterone is free, biologically active testosterone, and this fraction has the most potent biological activity. The remainder of testosterone is bound to proteins. Total testosterone measures both free and bound testosterone for a complete picture. If you have Low T, your doctor can discuss with you whether testosterone replacement therapy is right for you. Additionally, weight bearing exercise and losing weight if you’re overweight, have also been shown to increase testosterone.

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