A Cup of Coffee – Is Low Testosterone A Problem in the USA?

Welcome back! Last week, we talked about a rarely diagnosed issue called Alice in Wonderland Syndrome. If you missed that blog and would like to catch up, click here.

Gentlemen, you are not the man your father was, and there’s a reason for that. The National Library of Medicine reported that a study from between 2006 and 2019 among 102,334 male members of a large health organization indicated a significant (p < 0.001) and a prominent trend of age-independent decline in the testosterone levels was recorded during the study period for most age groups. Why is this important? Read on to find out…

What did that report say?

The report states that “Testosterone plays a major role in male reproductive function, including stimulating Sertoli cell function (they make new sperms) and spermatogenesis (the process of developing those sperm), as well as affecting non-reproductive organs such as muscle growth, stimulating bone mineralization (making sure you have strong bones), erythropoiesis (the production of red blood cells), and cognitive function (learning, thinking, reasoning, remembering, problem-solving, decision making, and attention).

In 2020, Urology Times put out an article that also agrees with their summation. They added, “Testosterone deficiency has a prevalence of 10%-40% among adult males, and 20% among AYA (Adolescent and Young Adult) men aged 15-39 years of age”. They go on to say “This is especially worrisome in this young adult age group, as many men feel stigma around having issues with erectile dysfunction and are less likely to seek care. This may ultimately lead to the undertreatment of testosterone deficiency, which can have large ramifications and severe consequences”.

What kind of consequences?

Healthline tells us:

For each year over age 30, the level of testosterone in men starts to slowly dip at a rate of around 1 percent per year. A decrease in testosterone level is a natural result of aging.

Testosterone helps maintain a number of important bodily functions in men, including:

  • sex drive: you won’t want to have sex/or can’t have sex.
  • sperm production: you may not be able to produce children.
  • muscle mass/strength: you may get heavier/gain weight
  • fat distribution: you may see that spare tire around your middle.
  • bone density: your bones may get weak and break easier.
  • red blood cell production: you may become anemic and feel super tired and worn out.
  • physical changes: you may develop breasts, have a decrease in body hair and have hot flashes, similar to women going through menopause.
  • Sleep issues: you may have trouble sleeping which leads to lower energy levels
  • Sleep apnea is a serious medical condition that causes your breathing to stop and start repeatedly while you sleep. It can disrupt your sleep pattern in the process and raise your risk for other complications, like having a stroke.
  • Emotional changes: You may develop depression and feel sad. Some people have trouble with memory and concentration and experience lowered motivation and self-confidence.

In young boys, normal growth can be jeopardized if hypogonadism occurs during puberty.

Problems occur with:

  • muscle development
  • deepening of the voice
  • lack of body hair
  • underdeveloped genitals
  • overly long limbs
  • enlarged breasts (gynecomastia)

Because testosterone affects so many functions, its decrease can bring about significant physical and emotional changes.

How do we resolve this?

Because little is known about why the national testosterone levels are dropping, there is nothing any of us can do to stop it. More studies are needed surrounding this phenomenon. However, there are things that medical doctors can do to increase testosterone once it is found to be too low.

Harvard Medical School reports: If you and your doctor think testosterone replacement therapy is right for you, there are a variety of delivery methods to consider.

It is recommended that you work with your physician, as a treatment for children may be very different than treatment for an adult.

In terms of adult males, they recommend the following:

  • Skin patch. A patch is applied once every 24 hours, in the evening, and releases small amounts of the hormone into the skin.
  • Gels. Topical gels are spread daily onto the skin over both upper arms, shoulders, or thighs. It is important to wash your hands after applying and to cover the treated area with clothing to prevent exposing others to testosterone.
  • Oral therapy. Capsules are swallowed or tablets are attached to your gum or inner cheek twice a day. Testosterone is then absorbed into the bloodstream.
  • Pellets. These are implanted under the skin, usually around the hips or buttocks, and slowly release testosterone. They are replaced every three to six months.
  • Injections. Various formulations are injected every seven to 14 days. Testosterone levels can rise to high levels for a few days after the injection and then slowly come down, which can cause a roller-coaster effect, where mood and energy levels spike before trailing off.

Most men feel improvement in symptoms within four to six weeks of taking testosterone replacement therapy, although changes like increases in muscle mass may take from three to six months.

As always, this blog is not a replacement for sound medical advice. I am not a doctor. Please make an appointment to see your healthcare provider and put a good plan in place that works for you and the needs of your body.

That’s all I have for you this week, dear reader. I’ll see you back here next Wednesday to share another cup of coffee. Until then, be good to yourself and each other.

Mind, Body, Spirit…Osteopathic Doctors treat the whole person, not just the ailment. Is your PCP a DO? Would you like to learn more about Osteopathic Physicians? Click HERE!

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