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EITHER WE'RE IN a low-T epidemic or an epidemic of falling for persuasive ads. Testosterone-replacement prescriptions have soared as ads for the therapy have become widespread, and it's widely discussed in forums like Reddit and on social media. So you've got to be wondering—especially if you’re tired or losing muscle, have ED, can’t concentrate, feel irritable, or just never feel all that great—could T therapy really help? Here's how to find out:
Get Your Testosterone Level Tested
Sounds obvious, but as many as a quarter of men receiving T therapy do it blindly—that is, they start a regimen without testing whether they actually have low T. Supplementation won’t help if your T levels are normal. In fact, “it will turn off your own production,” says Bradley Anawalt, M.D., chief of medicine at the University of Washington Medical Center. “The pituitary recognizes there’s plenty of testosterone in the blood and stops producing hormones that stimulate the testicles to make more.”
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To be sure, get a fasting testosterone test at your doctors, preferably in the morning, when the hormone’s levels peak. Repeat the test at least once, with the second a day or more after the first. Two low morning readings indicate testosterone deficiency. Readings can vary from day to day and even hour to hour, and they can be lower if you’re sick. So don’t test when you’re under the weather.
If you go to a lab yourself for a test, ask if that test has been validated and certified by the CDC. This ensures that the results are standardized.
Cancel Out Other Causes
If your levels are a little low, don’t just blame it on your age. Poor health is more likely to cause low T than the other way around. If your levels are right around 300 ng/dL, which is on the cusp of being low, and you have symptoms, “look first at other conditions,” Dr. Anawalt says. Medications like opioids lower testosterone. Problems with the testicles or the pituitary gland—or both—can prevent your body from producing enough T. Far more common than either of these: extra pounds. “If you’re overweight and lose 7 percent of your body weight, testosterone could increase 10 to 15 percent, which would put you squarely in the normal range,” Dr. Anawalt says.
Weigh the Risks
You don’t want testosterone therapy if you do want kids: In healthy men, it can make the pituitary shut down sperm production. Possible side effects of T therapy also include an increased risk of sleep apnea, blood clots, and prostate cancer.
Then Pull the Trigger
Your doc still may write you an Rx. In men with verifiably deficient levels—generally below 300 ng/dL—and low-T symptoms (fatigue, decreased sex drive), replacement can ratchet up desire, sexual activity, physical function, and vitality. But not this weekend: It takes three to six months for supplemental testosterone to have an effect.
Find out more about who's taking testosterone now and why here.
Richard Laliberte is an award-winning veteran health journalist and former senior writer at Men's Health who writes for some of the nation's best-known magazines, blogs for WeightWatchers.com, and has authored several books.
