What’s the straight dope on low testosterone? Lately I’ve been reading a lot about ‘andropause’ and how low testosterone can effect the quality of life in men, usually starting at the age of 40, but sometimes much younger.
The doctor’s I’ve talked to about it are split - it seems. One says that a testosterone level of under 3 (1.75-7.81 Ng/mL) is something to be concerned about and another doctor says that it’s nothing.
As I understand it, low testosterone can be caused by a plethora of things, including over training. If that’s the case, how long until the testosterone level rebounds?
To make my questions clear:
Is low testosterone something to be concerned with?
How ‘low’ is low?
Does over training lower testosterone levels?
If over training does lower testosterone, how long until it rebounds to normal levels?
Bumping, googling:
The Mayo Clinic’s take on andropause: Male menopause: Myth or reality? - Mayo Clinic : Testosterone decreases about 1% a year after age 30. But other factors such as alcohol abuse, depression or thyroid problems can affect levels as well.
NY Times:
The National Institute of Aging says flatly that, "there is scant scientific evidence that this condition, also known as andropause or viropause, exists.” Furthermore, “The Endocrine Society, for example, questions the benefits of testosterone therapy except when administered to counteract a specific malady like delayed puberty or AIDS wasting. The society’s guidelines “recommend against . . . offering testosterone to all older men with low testosterone” barring definitive proof of its efficacy.”
Generally in medicine, it’s a good idea to treat patients and not their ‘numbers’. In other words, generally speaking, lab abnormalities are of more concern if associated with (the expected) symptoms. If someone is asymptomatic, then even if their ‘numbers’ look bad, it’s harder to justify treatment - after all, by definition in an asymptomatic individual, they’re not going to feel any better after being treated. Obviously, this is a principle or guideline and can’t be taken too literally (e.g. even an symptomatic person with very high thyroid levels, or who actually feels especially good notwithstanding those levels, needs treatment. Otherwise, one day, sooner rather than later, they will get into trouble).
So, if someone has low testosterone levels and also has symptoms such as decreased muscle strength, decreased sex drive, or has suffered a bone fracture from minimal trauma, treatment (with testosterone supplements) may well be indicated - it is probably going to help them. OTOH, if they’re asymptomatic, and there is no evidence (say on bone density testing) that their bones are thinning, then it’s not obvious what they have to gain by treatment.
Of course, the principle described above must be modified according to things such as age and any associated medical conditions. For example, the finding of a low testosterone level in an asymptomatic man of 80 years has different implications in a 25-year-old, with the latter bound to get into trouble as the years pass.
And, regardless of whether treatment with testosterone will be in the cards or not, it still may be important to determine the cause of a man’s low testosterone level. Does it reflect a brain tumor? A serious illness elsewhere in the body? So, IMHO, most, maybe all, men with low testosterone levels should have at least a basic workup to look for its cause.
Now, regarding male athletes and low testosterone, that’s a good example of how someone’s ‘numbers’ can be abnormal yet they, themselves, can be quite healthy and asymptomatic. Specifically, low testosterone levels are fairly common in male (endurance) athletes. It’s actually quite uncommon, though, for such athletes to have any symptoms or consequences from the low testosterone levels (unlike the case for female athletes where things like altered menstrual cycles and osteoporosis can arise).
Not that it’s terribly helpful, and certainly not because it’s highly readable (it’s neither), I am linking to an article describing low testosterone levels in a male athlete (pdf). You may find the discussion section on the second-last page of some interest. If nothing else, it alludes to how uncommon symptomatic low testosterone levels are in male athletes despite the finding of low testosterone levels per se being fairly common. Indeed, there are only a very small numbers of papers, this being one, addressing the problem of symptomatic low testosterone levels in male athletes - it’s just not common.
Finally, my guess and assumption is that any man who exercises to the point of lowering his testosterone level, would have it return to normal within a few weeks of ending, or significantly reducing, his exercise regimen.
(btw: in men, “hypogonadism”, as in the link and elsewhere, is essentially synonymous with low testosterone levels)
Over the past 4 years, my results have been between 30 and 50. Dr said he doesnt know how I can function at a physical job. I dont either. I fight my severe weakness and fatigue every day. Ive looked all over the web, and ive seen nobody, or no info, about what to do about those low numbers. I stopped Androgel couple years ago, and when i went to get back on it, she said no, because long ago was diagnosed with sleep apnea. I went there to get Ambien because i couldnt fall asleep. They said i had it, so they could bill my Blue Cross for the machine. I never used it. Anyone k ow what i can do?
Thanks
It’s commonly known that anabolic steroids make basically all men stronger with less body fat. Most men also have greater sex drive. Now, there’s negatives to this - negative psychological changes, heart problems being at the top of the list. The problems probably exceed the benefits in terms of measurable characteristics like, well, lifespan. Any benefits, from being stronger and more confident and maybe getting laid more often aren’t going to be easy to measure in a study on this.
Anyways, there are hundreds of kinda shady clinics where men can legally get steroids prescribed for themselves under a guise of treating this ‘disease’. And to be honest, it’s probably a fun drug to try for a time. But just be aware that it’s basically a recreational drug - there’s no disease you’re getting treated, you’re just juicing like a cheating athlete.
What can you do? Use your friggin machine to help with your apnea. Then go from there. My dad went from a grumpy old man to someone at least tolerable and sociable. My son walks around all day in a stupor because he won’t.
Clomiphene for men encourages the male body to make more testosterone. .
"To understand how clomiphene works, you need to know how the pituitary controls the making of testosterone in the testis. Testosterone is made by Leydig cells in the testis, which I explained in my last post. The pituitary releases a hormone called luteinizing hormone (“LH”) that stimulates the Leydig cells to make testosterone. Testosterone is converted to the female hormone estrogen, (which I also explained in my last post,) and estrogen tells the pituitary to stop making more LH. This kind of negative feedback system is common when it comes to how hormones work. It’s just like a thermostat and heater. As the room gets warmer, the thermostat sends less electricity to the heater. When the room gets colder, the thermostat sends more electricity to the heater.
Clomiphene works by blocking estrogen at the pituitary. The pituitary sees less estrogen, and makes more LH. More LH means that the Leydig cells in the testis make more testosterone.
As I explained in my last post, giving testosterone to a man does just the opposite. The pituitary thinks that the testis is making plenty of testosterone, and LH falls. As a result, the testis stops making testosterone, and the usually high levels of testosterone in the testis fall to the lower level in the blood.
So clomiphene is a way to increase testosterone in the blood and the testis at the same time. It preserves testis size and function while increasing blood testosterone.
Unfortunately, clomiphene is not FDA approved for use in the male. Like most of the medications that we use to treat male fertility, the pharmaceutical company that originally sought approval by the FDA did it for women. Clomiphene is now generic, and it’s unlikely that anyone will pony up the hundreds of millions of dollars necessary to get it approved for the male. That’s the bad news. The good news is that it means that this medication is fairly inexpensive, cheaper than most forms of prescription testosterone. Can a doctor prescribe clomiphene for a man? Yes. It’s “off label”, meaning that it’s not FDA approved for use in men.
As a medication, clomiphene is usually well tolerated by men. In my experience, most patients don’t feel anything as their testosterone rises. Those that do feel an increase in energy, sex drive, and muscle mass, especially if they work out. Very rarely I’ve had patients report that they feel too aggressive, or too angry. Very very rarely (twice in the last 20 years) I’ve had patients report visual changes. That’s worrisome, as the pituitary is near the optic nerve in the brain, and visual changes suggests that the pituitary may be changing in size. Because the skull is a closed space, it’s alarming if anything in the brain changes in size. In the last twenty years, I’ve also had two patients who had breast enlargement (called “gynecomastia”) while using clomiphene. Needless to say, for any of these problematic side effects, the clomiphene is discontinued.
So that’s the story with clomiphene. It can be used in the male, either for fertility or low testosterone levels. It’s an off label prescription drug. It works, and is usually well tolerated by men who take it."
regarding your analogy though, that’s not how thermostats for heaters work. they’re temperature driven on-off switches, not variable resistors or potentiometers.