The human body has small structures called glands. These glands produce and release chemical substances called hormones. Hormones transmit signals to organs in the body about essential functions like reproduction, metabolism, and growth.
Testosterone is the primary male sex hormone. It belongs to a group of hormones called androgens. Production of testosterone begins at puberty. It is produced by the male testicles and is responsible for the development of male sexual characteristics.
Production of testosterone decreases as a man gets older. A study by the American Urological Association shows that of every 10 men above the age of 60, 2 have low testosterone.
The symptoms of low testosterone vary. A man is diagnosed with low testosterone, or low T when he has less than 300 ng/dL of testosterone.
The normal level of testosterone is between 300 to 1000 ng/dL. Testosterone levels can be determined by a serum testosterone test.
Causes of low testosterone
Testosterone production drops as a person gets older. You see, testosterone production peaks at the age of 30. After this, it begins to drop. The drop continues at a rate of 1% yearly until the end of the man’s life.
Apart from age, other factors may contribute to low testosterone levels. These include:
- Traumatic injury to the testis. The injury may interrupt the flow of blood to the testes.
- Orchitis: this is an infection of the testes.
- Alcohol abuse
- Hemochromatosis and other metabolic disorders.
- Cirrhosis of the liver
- Acute or chronic health conditions
- Obstructive sleep apnea
- Chronic renal failure
- Certain medications, like steroids and opioids
- Congenital defects
- Untreated type 2 diabetes mellitus.
- Excessive exposure to radiation
- Severe primary hypothyroidism
What are the symptoms of low testosterone?
Low testosterone has a range of symptoms. In many cases, the symptoms experienced depend on the age of the individual. Common symptoms of low testosterone in men include:
Inability to maintain an erection
We’ve known that testosterone is a man’s primary sex hormone. So, it does not only help in the development of the man’s secondary sexual characteristics, but also in achieving an erection, and maintaining one. Apart from causing an erection, testosterone also stimulates the production of nitric oxide.
Nitric oxide is an important molecule in the human body. It starts the series of chemical reactions that result in an erection. People who have low testosterone may find it hard to have an erection before sex.
Baldness/loss of hair
Testosterone is also involved in hair production. Many men start losing their hair when they age. Why? Well, this may not be unconnected with the reducing testosterone levels. Yes, balding may be inherited in some cases, but men with a low level of testosterone could also lose their facial hair and body hair as well.
The role of testosterone in sex drive (libido) cannot be overemphasized. It plays a key role. Some men may start to lose interest in sex as they get older. This may be connected to the decreased testosterone production which is characteristic of old age.
Weakness and fatigue
Low testosterone level is associated with decreased energy levels and fatigue. Consistent tiredness (despite sleeping well) may be a sign of low testosterone. Low testosterone also kills the motivation to exercise.
Thinning of the bones
The medical name for this condition is osteoporosis. Thinning of the bones is more prevalent among women. But that notwithstanding, low testosterone in men can cause thinning of the bones. You see, testosterone helps with bone strengthening. Men with low testosterone levels will experience a drastic reduction in bone mass, followed by an increased risk of fractures.
Loss of muscle mass
Muscle building is close to impossible without testosterone. Men whose testosterone level is on the low side may experience a decreasing muscle mass. According to a 2016 study published in PLoS One, testosterone affects the development of muscle mass.
Mood changes is another symptom of low testosterone in men. Testosterone affects a person’s mental capacity and mood. A 2013 study published in The World Journal of Men’s Health suggests that low serum testosterone level increases the risk of irritability, depression, or a lack of concentration.
A 2017 study published in the Journal of the American Medical Association has shown that low T increases a man’s risk for anemia. In the study, men with low testosterone (who were also anemic), were given testosterone gel. After administration, their blood counts improved. Some symptoms of anemia include dizziness, difficulty concentrating, cramping in the legs, and sleeping disorders.
Other symptoms of low testosterone in men include:
- A decreased sense of well-being
- Difficulty with concentration and memory
- Gynecomastia (development of breast in men)
- Increased body fat.
How is low testosterone diagnosed?
The key to determining a person’s testosterone level is by measuring the concentration of testosterone in his serum. This is what most doctors recommend. But, apart from measuring your blood testosterone level, your doctor will also conduct physical examinations and also take your health history. Physical examination may include:
- Checking for the size of your prostate or any abnormalities in your prostate
- Presence of enlarged breasts
- Body mass index (BMI)
- The size of your testicles
- How much hair you have, as well as your hair pattern and location.
The doctor may also order the following blood tests to help with investigation and diagnosis:
- Total testosterone level
- Blood hemoglobin
- Prolactin level
- Test for luteinizing hormone
Other tests that may be conducted include:
- Chromosome tests (karyotype)
- Imaging of the pituitary gland (MRI)
- Test for estradiol hormone
- Bone density tests
Are there any treatments for low testosterone?
Doctors treat testosterone deficiency with testosterone therapy. Once the therapy starts, it goes on for life.
If you are diabetic, and also testosterone deficient, then you should first be treated for diabetes or other underlying illnesses.
For men who may be obese, losing weight and living a healthy life can improve your condition, and give your testosterone level a boost.