So, You Think You Have Low T? We Need to Talk…

“Low T” means Low Testosterone levels. Low T is the latest health epidemic to affect American men, at least according to the multiple, million-dollar advertising campaigns you see on TV, hear on the radio and see in the glossy magazines.

Guys, Have you been wondering if you have low T? You are not alone. Let’s talk frankly about this, you and I…

So, you think you have low T? “Low T” means Low Testosterone levels. Low T is the latest health epidemic to affect American men, at least according to the multiple, million-dollar advertising campaigns you see on TV, hear on the radio and see in the glossy magazines. Don’t believe everything you hear on TV or from Dr Google. Take it from me, a board-certified specialist in Reproductive Endocrinology and Infertility with decades of experience, you do not have low T. Yes, I am talking about you! The guy sitting in my office who is tired and stressed and not sleeping well and whose libido is just not what it was when he was younger and did not have a mortgage and a crazy boss. You want to feel better and taking a pill, or a shot or some gel sounds like a good idea. What could be the harm?First of all, why do you think you have low T? Low energy and low libido could be caused by hundreds of things and Low T is not in the top 10 causes. Stress, lack of sleep, an bad diet, those extra 20 pounds, smoking, lack of exercise….Is it possible these things might have something to do with you not feeling at your best?

I am sitting here discussing your symptoms with you and you are growing a beard as we speak. You are not having problems with erection or ejaculation and you and your partner are here to see me because you are trying to have a baby. You complained to your family doctor about being tired a few months ago and you were given a prescription for testosterone gel or testosterone shots. Or some guys at the gym got you some “stuff” – anabolic steroids to help you build up your muscles, raise your energy level.

Well, guess what, testosterone will shut your testicles down. For some reason the people that are giving out testosterone like it is a multivitamin forgot to tell you that taking testosterone tells your testicles that they can take a break. They don’t need to do their normal job of making testosterone because there is already a lot of testosterone around. The problem is when the testicles stop producing testosterone, they stop producing sperm as well. The testicles actually will physically shrink in size with testosterone treatment. Theoretically, once you stop the testosterone the testicles should resume normal function, normal size and normal sperm production but some men can permanently damage their testicles if they take enough testosterone for long enough. Some men will be come completely azoospermic (no sperm at all, zero, nada, nothing).

So….what am I saying? That perhaps you could try eating a healthy diet, losing those extra pounds, getting some regular exercise, getting 7 to 8 hours of sleep at night, quitting smoking and maybe have just one glass of wine or beer with dinner instead of the bottle or the six pack. Perhaps you just might start feeling a lot less tired and a lot healthier. These things will actually help you live longer and you will feel better – more energy, more sex drive, even a little happier and more confident. All good things, right?

If these things still do not work or you can’t grow a beard, your muscles are shrinking or you are having consistent problems with getting or maintaining an erection (everyone has a bad day once in awhile), then see a specialist about possible Low T. An excellent medical endocrinologist can diagnose this issue and treat you without having a negative impact upon your fertility and should be able to optimize your fertility. Low testosterone levels are consistently below 200 ng/dL in the am. Many men can drop below these levels throughout the day and still have normal production, so checking a single level is not enough. You need a full evaluation by a board certified medical endocrinologist, not just one blood test with your family doctor. A good urologist can evaluate an isolated erectile dysfunction problem. Most cases of erectile dysfunction are not due to low T.

If you really have low T and are trying to conceive, then your doctor should be able to raise your testosterone level without using testosterone, to maintain sperm production. A medical endocrinologist has the training to accurately evaluate and treat true low T safely and effectively without harming sperm production.

Low T is not an epidemic and treating low T with testosterone will stop sperm production in its tracks. Make sure you get expert advice and think about finishing your family before taking this very potent and potentially destructive hormone.

Copyright Serena H. Chen, MD 2015