Low T or hypogonadism has been a recent star in the media. Often low testosterone is defined by two morning measurements below 300 with symptoms. This is very blurry line however as ‘normal’ values are averages and the overall level can vary person to person, by age, and many other factors. Sometimes special testing is done to calculate the ‘Free’ or available testosterone. It’s recent popularity is because testosterone is involved in many desirable attributes: lean muscle mass, energy level, libido, sugar cholesterol metabolism, and even perhaps longevity.
Since testosterone is involved in so many aspects of our body a true low level can manifest in many ways. These can also vary by the age of the person and interact with other medical issues. Low testosterone can be especially detrimental in diabetics because of testosterones help in sugar metabolism and fat burning. Most commonly men will report symptoms related to lower energy and decreased libido.
The short answer is we don’t know. I believe it is beneficial to treat people experiencing symptoms from low testosterone. However we still often find unexpected things when we given medicines long term that may have a ripple effect in other areas of our health. Some recent studies have questioned whether treating with testosterone could cause an increased risk of heart disease. There may be some unclear risks at this time but a more clear answer is likely several years away.
Giving testosterone alone in men who need it will usually give noticeable beneficial effects when monitored and adjusted to a good level. Many men do feel that they have gotten their energy back and are able to be more active. The amount of change often depends on where they start and what activities they are doing with the treatment. But we are still all aging and even with all the testosterone in the world we will not be able to run and work out like we did in high school.
Like many things with health, increased fat is a cycle that can make it easier to make more fat. Obese males often have lower levels of testosterone which is bad because testosterone is what helps maintain a lean body. Fat (especially abdominal fat) can convert testosterone to estrogens, lowering overall testosterone and increasing estrogen which can promote more fat accumulation.
I personally believe testosterone is an important aspect in evaluating and treating mens health. This is something that I get routinely and monitor during the program. Many men in the program actually normalize their testosterone without any medication as they improve their health. Some may require and short or longer term monitored administration to give their system a boost as they are losing weight.