Should I Use Testosterone Replacement Therapy?

Do you feel like something is missing when it comes to your health and fitness? Maybe your performance in sports or at the gym is suffering; you can’t seem to think clearly; or you’ve been dealing with poor sexual function. If you’re a man over the age of 40 or 50, you could have low testosterone.

Why Testosterone Replacement Therapy?

Low testosterone levels are a symptom of the aging process, and in turn contribute to other signs and symptoms of aging. These include falling sex drive, erectile dysfunction, poor energy levels, increased body fat, and loss of muscle strength and bone mass. By the seventies, around 30% of men have testosterone levels in the male hypogonadism range, a severe enough deficiency to warrant a clinical diagnosis. It really isn’t about vanity. Loss of bone mass increases your risk of dangerous fractures later in life, while impaired cognition (as subjective or mild cognitive impairment) may progress to dementia. Low testosterone has also been linked to metabolic syndrome and type II diabetes, which may be partly why the “beer gut” appears in middle age. What’s more, some studies have found an association between low testosterone and all-cause mortality.

What Testosterone Can Do

Testosterone Replacement Therapy (TRT) aims to restore testosterone levels to that of healthy young men, in order to help prevent illness and reduce disability. The mid-lower range of young men should be the aim. It can be administered as pills, including dissolvable preparations; injections or cream (transdermal administration). You must first get a blood test to see if it may be the solution for you. Levels over 500ng/dL don’t need treatment, while men with levels under 300ng/dL typically benefit from testosterone replacement. If your levels are in the grey area, then measuring free testosterone can determine if you need testosterone therapy. The cost of TRT depends on your location; the brand, or if there’s a generic version available; and the administration method. It is usually between $20 to $1,000 per month.

Men of all ages have shown increases in bone mineral density with TRT in clinical studies. While low testosterone levels  result in an increased risk of osteoporosis, restoring normal levels can bring bone density out of the fracture threshold. This benefit is caused by an increase in bone-building activity, and a decrease in bone breakdown. However, you’re probably noticing muscle loss much more than any bone degeneration. Even elderly men given TRT show increases in muscle mass (around two kilograms in one trial), along with improved hand grip strength. Up for beating your son or younger colleague at arm wrestling again?

On a more serious note, testosterone deficiency predicts age-related decline in memory. In the Baltimore Longitudinal Study of Aging, each 10-unit increase in testosterone was linked to a 26% lower risk of Alzheimer’s disease. As for clinical trials, even short-term testosterone treatment was found to partly restore cognitive functions in older men. These include verbal fluency, spatial cognition and working memory. Men with mild cognitive impairment and Alzheimer’s disease have shown improved memory and constructional ability with intramuscular testosterone injections.

The Importance Of Follow-Up Care

While TRT has many potential benefits, there are also possible side effects. These include worsening of sleep apnea or benign prostatic hyperplasia (BPH); heart failure or excessive red blood cell counts. However, there is no conclusive evidence that it increases your prostate cancer risk or leads to BPH. It is recommended that you keep up regular appointments with your urologist and general practitioner.

Overall, failing testosterone production has significant and often dangerous impacts on men’s health. if you feel like you’re in a mid-life crisis of the health kind, getting your testosterone levels tested is worthwhile. Your future self may even thank you for it.

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