Testosterone Therapy
What is testosterone?
Testosterone is the primary male hormone and is responsible for the normal growth and development of the male sex organs, bone density, muscle mass, and is vitally important for health and well-being in men. Testosterone is produced in the testes, the reproductive glands that also produce sperm. It is also produced in smaller quantities within a woman’s ovaries. It contributes to fertility, sex drive, red blood cell production, muscle mass, fat distribution and mood.
What are normal levels?
Current accepted normal testosterone levels range between 350 ng/dL and 1,100 ng/dL. Normal physiology allows the brain and the testes to work together to keep testosterone in this range. Normal testosterone levels in healthy women range between 15ng/dL to 70ng/dL.
*Low testosterone is predictive of the development of diabetes and cardiovascular disease. It is also associated with higher mortality.
What is TRT?
Testosterone Replacement Therapy is the practice of diagnosing an individual with hypogonadism or androgen deficiency and replacing low levels of testosterone with injections, gels, or creams. It is exactly as described, replacement therapy. At our clinic, we prescribe injection therapy or creams to treat low testosterone in eligible patients.
What is the purpose of TRT? Why do something rather than nothing?
The goal and purpose of TRT is to alleviate symptoms of testosterone deficiency in men and to encourage optimal physical and psychological well being and health by elevating testosterone levels. This improves quality and function in life.
What are benefits of replacement therapy?
Benefits of Testosterone Replacement Therapy vary based upon initial symptoms and other factors, but patients can expect:
- Increased energy
- Relieves mental fog.
-Decreased irritability and depression
- Increased muscle mass and strength
- Improved sexual desire
- Higher motivation
- Decreased body fat (best results received along with healthy diet and exercise routine)
-improvement in erectile function
How to determine if I have low testosterone?
To evaluate testosterone levels, we will collect blood specimen with our lab partners, the results will be completed within a few days. If your total or free testosterone are not within the optimal range, you may be a candidate for treatment. Determining whether a patient is the right candidate for testosterone therapy is evaluated by the medical professionals in communication with the patient.
Will Testosterone Therapy help me exercise?
Yes, absolutely! Exercise is crucial for health, muscle preservation and growth, and quality of life. Testosterone will work with you and allow you to get off the couch and get moving.
Testosterone will influence exercise performance. Healthy testosterone levels can lead to increased stamina, endurance, and strength. This will make it easier to exercise and burn fat. A priority is to create the habit of regular resistance training. Resistance training, such as weight lifting, will stimulate skeletal muscle hypertrophy (muscle size). Gaining and maintaining skeletal muscle mass is vital for staying strong throughout your life. Not only will muscle keep you stronger, it also improves insulin sensitivity, facilitates serum glucose disposal, and glycogen storage. These mechanisms lead to ideal metabolic environment and greatly reduces risk of diabetes.
*skeletal muscle is the most health promoting tissue in the body.
What are advantages of testosterone injections versus other methods?
The best method of testosterone delivery will be discussed between you and your provider. Testosterone injections and high potency creams are both very effective at increasing testosterone levels. The decision comes down to individual preference.
Obesity and Testosterone Therapy.
Obesity is involved in several metabolic diseases including diabetes type II, heart disease, fatty liver disease, and high blood pressure. Additionally, hypogonadism can be caused by obesity in men. A condition known as MOSH (male obesity secondary hypogonadism). Fat tissue contains abundant amounts of the enzyme aromatase. Aromatase converts testosterone to estradiol. Excess estradiol is detected by receptors within the brain that communicates with pituitary gland leading to cessation of LH (luteinizing hormone), which is the main signaling hormone that tells the testes to produce testosterone. If luteinizing hormone is not present, testosterone production is stopped.
Weight loss and body fat reduction is needed to correct MOSH. Testosterone Therapy can give these men the energy to start exercising and practicing healthy lifestyle habits to lose body fat and maintain lower body weight.
*Estradiol is not 'bad', it is needed in men and women to be healthy. However, too much estradiol, and in combination with low testosterone, does lead to very negative symptoms. Both estradiol and testosterone need to be present for best quality of life and function.
Why is my testosterone low?
Causes of testosterone deficiency fall under two categories, these included primary (disorder/damage with testicles) and secondary (disorder/malfunction of signal from brain to testes). This can be evaluated with baseline lab findings. Dropping testosterone levels as a man ages is normal but if we want to elevate our quality of life, mood, and physicality then we want to replace and optimize our level.
*One thing that is a bit of a mystery is why younger men's testosterone levels are dropping in comparison to previous generations. This most likely has multiple factors contributing such as environment exposure (microplastics, BPH), lifestyle (sedentary men that are not very active), inadequate sleep, chronic stress, and nutritional deficiencies (poor diet choices).
Another cause of secondary hypogonadism seen in younger men is either obesity related or repeated head trauma (common in soldiers, police men, firefighters).
How does the process work?
We provide a convenient way to evaluate and treat low testosterone by way of virtual visits. Contact us today to start an initial consultation and simple blood test. If the results of you blood test reveal low testosterone levels, we will discuss your individual treatment options.
What about estrogen?
Estrogens are vitally important players in many physiologic functions in men and women. In men estrogen has a part in bone mineral density, cardiovascular health, endothelial function (responsible for nitric oxide production within arterial system), spermatogenesis, cognition, mood, and sexual function including erection and libido. Estradiol also appears to prevent fat gain and fat distribution. Estradiol is a metabolite of testosterone. To achieve a higher quality of life, estradiol is an important component.
How can I increase my Testosterone level without TRT?
Ways to increase testosterone levels:
- Lose body fat, target less than 20%
- Perform regular high intensity resistance training.
- Change your diet and include green vegetables, lean meats, eggs, fruits, whole grains.
- Build as much muscle as possible
- Prioritize your sleep.
- Get tested for sleep apnea and treat it if necessary.
- Stop smoking.
- Stop using marijuana regularly.
- Stop using opiates.
How long does it take for TRT to work?
The symptoms of testosterone deficiency resolve on different timelines. Some men feel better in weeks, while others take months. Understand that this is a marathon, not a sprint. It is a process that is expected to take time. Major benefits of TRT will be noticed over months and years, not days or weeks. If a patient has been suffering from testosterone deficiency for years, it isn’t reasonable to expect an overnight fix.
If I don't treat low testosterone what will happen?
It is expected that your testosterone levels will continue to decline as you age and your current symptoms will continue to become more noticeable.