Recently, the Endocrine Society issued an updated clinical practice guideline on testosterone therapy in men with hypogonadism. Awareness and attention to men’s health issues have been growing rapidly, but surveys say men are being prescribed testosterone hormone treatment without an appropriate diagnostic workup or monitoring plan.
The Endocrine Society is hoping to address issues, including:
- Avoiding testing and treating healthy men
- Individualizing treatments
- Increasing lab accuracy
These guidelines ring very true at our clinic — it’s how we’ve always done things. We start with a long, initial consult to dive into your medical history. Because, if what we depended on was just the lab work, you’d be in and out the door in five minutes. But, that’s not how we care for our patients.
Today, what we really want to focus on is the importance of knowing your testosterone levels and taking time to make a decision that’s right for you.
Why You Should Know Your Testosterone Levels
Low T has been associated with diabetes, high cholesterol, excess weight, and other metabolic syndromes. It’s unclear if those conditions cause low T or if low T contributes to those conditions (chicken before the egg dilemma).
When your body is fighting off a chronic health issue or infection, it may simply put less effort into testosterone production. But, because we don’t know if it’s the cause or side effect, it’s crucial to know your numbers.
When other health conditions are at play, maybe low testosterone doesn’t sound like a significant risk to you? But, it could contribute to poor long-term health.
Not to mention, low testosterone can affect your:
- Sex drive
- Sperm production
- Muscle strength
- Fat distribution
- Fat density
- Red blood cell production
What Can Cause Low Testosterone
You may experience a drop in testosterone for a few different reasons, including an injury to your testes, a tumor on a hormone-producing gland, stress, or medications like corticosteroids.
However, testosterone levels also just fluctuate naturally. They peak around 8 am and decrease throughout the day with the lowest levels being around 8 pm.
Several things can nudge your levels in either direction. For example, a high-intensity workout can increase testosterone. But tough exercise (coupled with lack of sleep and nutrition) can significantly drop levels. And men who are 40 years and younger will experience more substantial climbs and drops.
How to Prevent Low Testosterone
You can make positive lifestyle changes, including:
- Healthy diet
- Adequate sleep
- Stop smoking
- Manage stress
- Limit alcohol
- Follow your doctor’s advice and management plan
But, do you need a testosterone therapy plan?
Maybe not. In young men, testosterone therapy can prevent natural production from returning. Once you’re on it, you can’t get off it. It may affect your sperm production too. So, there are other ways to treat low T (including the lifestyle changes mentioned above) that won’t decrease your natural ability. Consult your doctor to learn more about those options.
There’s no urgency when deciding if you need treatment. And there’s not a one-size-fits-all solution. We encourage all our patients to book a one-on-one consultation, research the facts, and think about it.
Understanding what’s going on with the physiological processes is important. It can help you make an informed, careful decision.
If you decide testosterone therapy is right for you, follow up with your blood work and keep track of your symptoms. Do you feel better? Do you feel worse? Are you noticing any unusual side effects? Is it helping? Instead of relying on the numbers, check in with your body too.