Low testosterone, or “low T,” is gaining more awareness as the controversy over its exact nature and proper treatment gains traction as well.
According to U.S. News and World Report, low testosterone is a serious medical condition that affects 6% of adult men. However, patients should be wary of certain purported “treatments” that some claim are harmful.
Low testosterone is simply defined as having an unusually low level of the hormone, which would be considered lower than 250 to 300 nanograms per deciliter (ng/dl). Such levels indicate the patient is at risk for serious medical ailments such as lowered libido, decreased strength and energy, increased body fat levels, sleep problems, depression, and osteoporosis. There are also reports of a causal correlation between low T and lowered life expectancy.
However, medical experts warn patients to do research before jumping on certain treatments, especially those advertised on TV as of late. Doctors that specialize in treating low T hold the opinion that the condition and treatments for it are considerably complex and need further clinical study.
“There’s been a lot of confusion,” said Dr. Abraham Morgentaler, a urologist at Beth Israel Deaconess Medical Center in Boston and the director of Men’s Health Boston. “Testosterone replacement therapy can help relieve symptoms in a lot of these men. It’s not perfect, but I don’t think men with symptoms should be scared off a therapy that’s working for them after reading news reports that it may cause heart attacks.”
The reports Dr. Morgentaler referred to are four recent medical studies which have suggested a link between a common treatment for low T, testosterone replacement therapy, and an increased risk of heart disease. Last year, Dr. Morgentaler and other medical experts conducted an extensive medical review of dozens of studies covering the use of testosterone replacement therapy for low T patients. Of all the reviewed studies, only four were critical of the treatment — and of those, two had “serious methodological limitations.”
In addition, other studies have suggested that there is no such link. Some have even stated that low T patients who leave their condition untreated actually face a higher risk of heart disease than those who do seek treatment.
“Low testosterone has significant impact on quality of life for a man. Low T impacts mental focus, energy, libido, and overall mood, some men to the point of depression,” says Kevin Meuret of Low T Institute. “When Low T goes un-diagnosed or untreated, the changes are noticed by everyone- weight gain around the waist, grumpiness, fatigue, and sluggish mental state. Changes in body composition as there is a loss of lean body mass, there is an increased risk of cardiovascular disease as well as risk factors for type 2 diabetes.”
Still, testosterone replacement therapy, like nearly all medical treatments, comes with potential risks. One 2010 study Dr. Morgentaler reviewed reported that of the 209 participants, 23 suffered a heart attack (some of them fatal) in the testosterone group as opposed to just five in the placebo, or control, group.
“There needs to be a bigger trial of cardiovascular risks with testosterone therapy to get the full answers,” he said.
Regardless, doctors recommend that men who notice fatigue, lowered libido, and other low testosterone symptoms should a blood test to determine whether testosterone replacement therapy is necessary.
“The controversy starts to bubble when a man has a level of around 250 ng/dL without any clear reason to explain his low levels,” said Dr. Brand Anawalt, chief of medicine at the University of Washington Medical Center and chair of the Endocrine Society’s Hormone Health Network. “In general, I tell men that the benefits of treatment are much smaller when levels are closer to normal.”
He goes on to recommend treatment, however, for patients with 150 ng/dL of testosterone or lower.