Testosterone is the predominant male sex hormone produced in the testicles, and to a lesser degree in the adrenal glands. A man’s testosterone levels peak in his late teens and early 20s, then start declining around age 30. While most men experience a slow decline, some have a harsh dip that resembles a downward health spiral. While low T (and hormone imbalances in general) are a common problem, there are still a few misconceptions about this condition and how to treat it.
Dr. Rohn Rigby is a Family Medicine Doctor with extensive training in metabolic syndromes, hormone health, and weight management. He oversees Ogden Clinic’s Medical Weight Loss department. In this article, he helps dispel myths regarding hormone therapies and low testosterone to set the facts straight.
Myth: Low testosterone only affects a man's sex drive.
Fact: While decreased sex drive is one symptom of low testosterone, low T can also cause chronic fatigue, feeling older than your age, irritability, and some physical symptoms including:
Reduced body and facial hair
Loss of muscle mass
Low libido, impotence, small testicles, reduced sperm count and infertility
Increased breast size
Loss of body hair
Increased risk of fracture (brittle bones)
Poor concentration and/or depression
Myth: Testosterone loss is mainly caused by age.
Fact: Age is the most common reason why testosterone decreases, but it can have many other causes. Autoimmune diseases, metabolic disorders, drug use, obesity, type 2 diabetes, hypothyroidism, testicular injury, certain infections, and other factors can lower testosterone.
“Another interesting reason why testosterone can decline is using it off-label or without a prescription,” says Dr. Rigby. “If you are buying/taking testosterone without a doctors’ supervision, it could signal to your body that you’re making enough. In turn, your body will stop producing adequate amounts later in life,” he adds, stating that it’s important to have a doctors’ supervision for any type of hormone therapy.
Myth: Annual bloodwork will tell if your testosterone is low.
Fact: Not necessarily, says Dr. Rigby. Testosterone travels through your blood in two ways:
Attached to the proteins albumin and sex hormone binding globulin (SHBG)
Free, or not attached to any proteins
“You may need to order a total testosterone test to see the full picture; a blood draw during your annual physical may not capture free testosterone,” says Dr. Rigby. “I always tell my patients they’re their own best advocate. If your provider doesn’t mention a total testosterone panel, ask them if it’s possible to take one.”
Myth: TRT is a “silver bullet”.
Fact: “We need to think of our body as a system of systems,” says Dr. Rigby. “There are hormone-balancing things we can do daily which will improve a lot of things at once such as joint pain, lethargy, and even depression.”
Hormone therapy has tremendous benefits for those who need it, but it’s not the only thing patients should focus on. Dr. Rigby encourages patients to support healthy testosterone levels by:
Getting enough quality sleep
Eating enough protein, healthy fat, and fiber
Incorporating movement strength training and walking regularly
Limiting alcohol and avoiding smoking
Getting daily sunlight exposure whenever possible
“But if you are struggling to get up, feeling lethargic, or have body aches, you should definitely get in to see a doctor.” Lifestyle modifications paired with hormone therapy will carry the long-term benefits of keeping men healthy and energized enough to keep up good habits.
Myth: You can handle testosterone treatment on your own.
Fact: The idea that you can treat low T on your own can have dangerous side effects. Testosterone supplements are easy to find online, but these unfounded treatments should be avoided. Testosterone medications and therapies are controlled substances that should only be prescribed by a physician.
Excessive use of testosterone medications can lead to enlarged breasts, high blood pressure, and an increased risk for blood clots. It’s also important that a medical professional look into other conditions that may be causing a decrease in testosterone so that you can be sure that your treatment plan is the best course of action.
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Dr. Rohn Rigby works in Layton, Utah. His Medical Weight Loss Clinic is a 2023 Best of Northern Utah winner of The Standard Examiner’s Readers’ Choice Awards. Dr. Rigby enjoys managing diabetes/pre-diabetes, metabolic syndromes, thyroid/hormone regulation, and weight loss. Schedule a consultation with Dr. Rigby and his team here.
