Table of Contents
What is Testosterone?
Testosterone is a hormone found in both men and women, as well as other animals. Testosterone starts to increase during puberty. In men, testosterone is primarily produced in the testicles, whereas in women it is mainly produced by the ovaries though at a much smaller rate. Women produce about 1/10th to 1/20th the amount of testosterone as men.
In men, testosterone is the primary male sex hormone. It handles the development of the prostate and testes, as well as sperm production. Other characteristics such as libido (sex drive), bone and muscle mass, voice pitch, and body hair are also affected by testosterone. Testosterone levels can even affect a man’s mood.
What is Low Testosterone?
On average, men have between 300 - 1000 ng/dl (nanograms per deciliter of blood) whereas normal levels for women are between 15 and 70 ng/dl. Low testosterone (Low-T) or hypogonadism in men is diagnosed when a man’s total testosterone levels fall under 300 ng/dl. Testosterone levels in men peak around the age of 20 before declining as they age. A 1% decrease year on year considered normal in middle-aged men.
What Causes Low Testosterone in Men?
A publication from Boston University School of Medicine states that between 4 and 5 million men in the United States are affected by male hypogonadism. Almost 40% of men aged 45 and older.
After the age of 30, testosterone will begin to decline but low testosterone in young men can be a result of many factors. The causes of low-T can be separated into three categories: primary, secondary, and tertiary hypogonadism.
Primary Causes of Low Testosterone
Primary types of low testosterone refer to the under-activity of the testes, as these are the main producer of testosterone in men. Common causes of this under-activity include:
- • Physical injury or trauma to the testicle - Though both testicles need to be injured to affect testosterone levels
- • Ageing - Testosterone levels naturally lower as men get older
- • Chemotherapy or radiation - Cancer treatment can damage testicles
- • Diseases such as mumps - Mumps can cause the testicles to swell, injuring the testicles
- • Surgical removal - Most of the time when one testicle is removed the remaining testicle will produce enough testosterone to compensate, but with the removal of both a man is no longer able to produce testosterone
- • Undescended testicles - If the testicles fail to descend from the abdomen before birth it can cause a testosterone deficiency
- • Hemochromatosis - Too much iron in the blood can cause testicle failure or damage the pituitary gland
- • Klinefelter's syndrome - A condition in which a male is born with an XXY sex chromosome rather than an XY, leading to lower testosterone levels as a result of the underdevelopment of typically male characteristics
Secondary and Tertiary Causes of Low Testosterone
Secondary types of low testosterone are caused by damage to the pituitary gland, whereas tertiary types are caused by damage to the hypothalamus. The pituitary gland regulates the production of testosterone produced by the testes amongst other hormones while the hypothalamus regulates the pituitary gland.
Most causes for secondary and tertiary low-t are the same, and both may be affected at the same time.
- • Diseases such as HIV/AIDs, sarcoidosis, and tuberculosis - These can cause inflammation in either of the glands
- • Pituitary disorders - These can be caused by drug abuse and kidney failure
- • Medication - Anabolic steroids and opioid pain meds can affect the function of the pituitary gland and hypothalamus
- • Ageing - Your body’s response to hormones can change as you get older
- • Tumours - Tumours associated with the pituitary gland or hypothalamus can cause malformations or affect blood flow
What else can cause low Testosterone?
Certain causes don’t fit well into the above categories. Obesity, especially. Fat cells convert testosterone to estrogen, lowering testosterone levels as well as reducing globulin levels. Globulin is a protein that carries testosterone in the blood.
Symptoms of Low Testosterone
Many side effects that occur as a result of low testosterone are often subtle. If any of these common symptoms sound familiar then it might be worth a visit to your doctor.
- • Reduced sexual function - Including a reduced sex drive, fewer erections, and infertility
- • Physical changes - Increased body fat, decreased muscle mass, getting tired more easily, hair loss and tender breasts can all be signs of low-T
- • Insomnia - Low testosterone can affect your sleeping pattern in a number of ways
- • Emotional changes - Feeling sad or depressed, as well as lowered self-confidence or motivation
How to Know If You Have Low Testosterone
If you’re worried about having low-T, then it’s best to schedule an appointment with your doctor. Your doctor will be able to do a simple blood test to determine your testosterone levels. If the results come back confirming low testosterone levels, then more tests may be taken to understand why. This will determine the course of action for your treatment.
Low Testosterone Tests
Your testosterone levels fluctuate throughout the day but are highest in the morning. Your doctor will want to schedule an early appointment to test your hormone levels.
At-home kits are also available that will test the levels of testosterone in your saliva. You take a swab of your own saliva, before posting it to the lab for testing. You usually receive your results a few days later, though it’s best to take these results with a pinch of salt as expert opinions on this method are mixed.
How to Treat and Increase Low Testosterone
There are some lifestyle changes that you can make today that will increase your testosterone levels. Eating a balanced diet, exercising, and getting plenty of sleep would be a great place to start
Natural treatments for Low Testosterone
- • Exercise - Resistance training such as weight lifting, and high-intensity training (HIT) are the best types of exercise to improve testosterone levels short and long term
- • Diet - Eating a balanced diet will certainly help, but certain foods like ginger, pomegranate, fish oil and onions have all been seen to increase testosterone in men
- • Sleep - Not only is a good night’s sleep beneficial for your general health, but a lack of sleep can also lower testosterone levels
- • Remove stress and get out in the sun - The vitamin D you get from sunlight may boost testosterone while cortisol that is elevated when we get stressed negatively affects testosterone production
Medical Treatments for Low Testosterone
- • Testosterone gel - Applied to different areas of the body, these treatments are very effective in raising testosterone
- • Supplements - D-Aspartic acid, vitamin D, ginger, and zinc amongst others can boost testosterone
- • Other patches, injections and tablets are also available
When should you seek a doctor about Low Testosterone?
Even if lowering testosterone is a normal part of ageing, it still may not be the easiest thing to discuss with your doctor. If it is having a negative effect on your quality of life though, it must be done. If you’re concerned at all about having low-T then it’s best to schedule an appointment whenever you can fit it in and discuss your symptoms.
Doctors are not there to judge and will treat it the same as any other health problem that needs addressing.