Low Testosterone?

testabol-depot-200Is testosterone the magic elixir of youth for aging men?  Judging by the number of ads on the Internet for supplements, or even from the number of scientific studies assessing the usefulness of testosterone supplements for everything from muscle development to helping improve symptoms of congestive heart failure, lots of guys think the answer is yes.  But what really constitutes ‘low testosterone’ and how is this related to aging in men?  In this issue of the New England Journal of Medicine, a study attempts to provide some answers: Identification of Late-Onset Hypogonadism in Middle-Aged and Elderly Men.

The study surveyed almost 3400 European men between 40 and 79 years of age. Data was collected on general, sexual, physical and psychological health, and a single blood sample was drawn to measure both total and free testosterone.  Turns out that three symptoms were correlated with low testosterone: reduced numbers of erections in the morning, erectile dysfunction, and reduced sexual desire.  In order to make the diagnosis of ‘hypogonadism’ or low testosterone, both a reduced blood level of the hormone and these symptoms were necessary.  The authors make the point that lots of men may have levels that when assessed alone, appear to be ‘low,’ but are not associated with symptoms.

So now that an objective way to determine whether a man’s testosterone level is problematic exists, what about treatment?  As Rick points out in the podcast, oral testosterone supplements enjoy an unsavory association with liver disease, leaving injections as the only way to supplement the hormone.  All those oral supplements purveyed on the Internet?  Save your money; they can’t reach the bloodstream and so can’t improve matters.  If you’re one of the 5% of older men who may have both symptoms and low blood levels of testosterone, it’s that old risk/benefit analysis to determine if injections are for you.

Others topics in this week’s podcast include racial variations in the gold standard for diabetes diagnosis and management, hemoglobin A1c, in Annals of Internal Medicine, a popular class of high blood pressure medication and cancer risk in Lancet Oncology, and two nonsteroidal anti-inflammatory medications and gastrointestinal bleeding in Lancet.  Until next week, y’all live well.

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Low Testosterone And Youth | Medicine Blog
May 24, 2011 at 11:31 pm

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fred L Mathews August 26, 2011 at 5:54 pm

I am 82 years old. I have low testosterone. It leaves me very tired. I use androgel which helps alot, but the price is $10 per day. Is there any other more natural way and cheaper way to raise my testosterone level? thank you

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Elizabeth Tracey September 4, 2011 at 6:18 am

Hi Fred. I unfortunately can't advise you about other testosterone supplements. I hope your primary care doc can give you some advice. All the best in your search.

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