The Truth About Testosterone

Over the past couple of decades, testosterone, often referred to as T, has become the hot topic in men’s health. Low T clinics seem to be as common as coffee shops, and every day there seems to be a new online business that wants to sell you testosterone. And lots of men have been buying in. The number of men taking testosterone prescriptions has risen sharply, especially among younger men.  

The Testosterone Therapy Hype: What’s Real and What’s Not

If you’re not already taking exogenous testosterone (from outside the body, as opposed to the endogenous testosterone your body produces), then you probably know someone who is. You have probably been bombarded with ads promising testosterone will cure every ailment or short-coming you might feel: low energy, lack of motivation, low libido, too little muscle and too much fat on your body, and the list goes on. According to the hype, it seems testosterone is the magic bullet you’ve been looking for, the one thing that will transform you into the man you want to be.

But can testosterone really do all that?  Is it the fountain of youth, or overhyped modern-day snake oil? Like most things, the truth is a bit more complicated.  Read on to find out how to figure out if testosterone is right for you.

How Testosterone Works in the Male Body

First, some basics. Testosterone is a hormone, which means it’s produced someplace in the body, then gets sent out into circulation to do its magic somewhere else in the body. In the case of testosterone, it is produced primarily in the testicles in males, and in the ovaries and adrenal glands in females. Yes, both males and females need testosterone. It’s just that testosterone is a more dominant hormone in males. 

Free Testosterone vs. Bound Testosterone: Why It Matters

Once it’s made, testosterone floats around in the bloodstream to travel to other tissues. But testosterone can’t just travel by itself; it needs to be bound to a carrier protein. The primary transporter of testosterone is called sex-hormone binding globulin or SHBG. Think of SHBG like a car. Testosterone has to get into the car to travel to work. But here’s the thing, it can’t do any work while it’s sitting in the car. 

Testosterone can only act on its target tissues when it is not bound to SHBG. The testosterone that is not bound to protein, and thus able to have an effect on its target tissue, is called free testosterone. For most men, only about 2% of their total testosterone is free testosterone.

Testosterone Testing: Why Accurate Results Are Essential

If you’ve ever had your total testosterone measured, the result was all the testosterone in your blood stream at the time the sample was collected, both the bound testosterone and the free testosterone. It is possible to measure the free testosterone as well, and I always measure it for my patients so we can get an accurate idea of how much testosterone is actually active in the body. In fact, all of the testing we do is carefully considered and comprehensive, to give you the best path forward to improve your health.

Low Testosterone Symptoms Can Affect Your Whole Body

So where are these target tissues that testosterone is affecting? Well, basically everywhere.  Nearly every tissue in the body has receptors for testosterone. For example, skin, heart, bone, brain, muscles and fat tissue all have testosterone receptors. That’s why low testosterone can make you feel so terrible. It’s not just one thing that’s affected; it’s your whole body and even your mind and emotions. 

Low energy, low libido, erectile dysfunction, lower muscle and higher fat, and depressed mood can all be symptoms of low testosterone. Trouble is, there are lots of other things that can cause the same symptoms. That’s why it’s important to work with a doctor who will take the time to figure out what’s best for you.  

The Health Risks of Untreated Low Testosterone

But not only does low testosterone make you feel terrible, it can also negatively affect your health and longevity. Low testosterone can set you up for poor bone health, leading to increased risk of breaking bones as you age.  It can also increase your risk for heart disease, metabolic disorders like obesity and diabetes, neurological diseases like dementia, and even certain types of cancer.  

Why Testosterone Levels Are Declining in Men

So yeah, it’s important to maintain healthy and balanced testosterone levels. And low testosterone seems to be more common now than it used to be, especially among younger men. If you have low testosterone, raising it to a healthy level can be life-changing, and sometimes that means taking exogenous testosterone. 

How to Find the Right Doctor for Testosterone Therapy

If you’re thinking about getting your levels checked, or if you have already, I’d suggest you make sure the doctor you’re working with knows about male hormones and knows what to check and when. Because it’s not just as simple as checking a testosterone level and prescribing testosterone. 

Testosterone levels can change a lot day to day and even at different times of day, and there are different tests that a lab might use to measure testosterone, so you need to make sure you’re getting the right test and it’s being done in the right way. 

Low Testosterone Can Signal an Underlying Health Issue

What’s more, low testosterone can be a sign of something else going on, and it could be potentially serious. Things like genetic mutations, testicular injury, iron storage diseases, or even a brain tumor can cause low testosterone. If your testosterone results come back low, you should know if you need to consider a potentially serious cause.  

Testosterone Therapy Options: More Than Just Injections

You also want to make sure whoever you’re seeing isn’t just trying to sell you testosterone, but will work with you to balance your hormones in the way that’s best for you.  Sometimes that means exogenous testosterone, such as creams you put on your skin, injections, or pills, but sometimes there are other ways to boost testosterone.  Make sure you know your options.  

Understanding Testosterone Therapy Risks and Benefits

If you do choose to take exogenous testosterone, you should know that it is incredibly safe.  But you should also be aware of the risks and side effects. If your doctor isn’t willing to discuss those risks and side effects with you, you might want to find someone else to help you balance your hormones. 

In other words, before you start taking prescription testosterone–potentially for the rest of your life–you should be sure you really need it and you should know what you’re getting into. And if you ever want to come off of testosterone, it’s important to do it in the right way to minimize symptoms.

A Thoughtful and Safe Approach to Hormone Health

At B1, we are experts in helping men balance their hormones.  We always do so in the context of your overall health and well-being, after a thorough discussion of your goals and of the risks, benefits, and alternatives available. If you have questions about your testosterone levels, feel free to get in touch.