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Low testosterone in Men

Low testosterone 

Upto 20-30 % of men can develop low testosterone as they age. In most people it will decline approximately 1 % per year after age 30 but does so faster in certain men. Here we will discuss age related reduction of serum testosterone levels. It should be noted that other medical conditions can also lead to secondary low testosterone, which is not a subject of discussion here. 

Symptoms of low testosterone levels can include 

-reduction in stamina

-poor sleep, 

-reduced muscle strength and bone density

-mood changes, 

 -memory changes 

-diminished libido and performance. 

Sexual dysfunction is currently the only justifiable symptom for which testosterone replacement therapy can be prescribed as per ACP guidance. Remaining symptoms should be managed by lifestyle modification whenever possible. There are concerns with regards to association of testosterone replacement therapy with heart health and prostate health. These possible associations are currently under investigation.

The blood test itself should be a fasting blood test checking for free testosterone levels done before 11 AM. If levels are low, this should be repeated in four weeks time along with other tests to differentiate between primary and secondary causes.

  

Falling testosterone levels can be related to

-obesity

-metabolic syndrome

-low nutritional status 

-drug / alcohol use. 

 

Lifestyle approach to increasing serum free testosterone levels include:

-Reduce weight, particularly around the waist

-Exercise more, particularly weight lifting and muscle building exercises

-Sleep well

-Reduce stress

-Avoid excessive consumption of alcohol and any drugs. 

-Ensure adequate amounts of Vitamin D3

 


INFORMATION & DISCLAIMER: 

I obtained my primary medical education from India and post graduate MD in Family Medicine from the United Kingdom. After working in National Health Service, England for 15 years, I moved to  Canada five years ago.  As a Family Physician, I consider my speciality as engaging patients, interpreting medical information for them, guiding them through their health journey, promoting wise health choices and encouraging early detection and management of disease. 

The information on this blog is accurate as per time of publishing. Scientific information and evidence changes dynamically and my opinions would change accordingly. 

The recommendations on this blog are not prescriptions and any patients considering these should consult with a physician to check if these are applicable to their unique situation.
 
Physician websites I commonly use for reference include 

 
Patient reference websites I commonly recommend to patients include
 

 
 
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Patient confidentiality must be upheld at all times and any patients wishing to discuss specific medical scenarios on social media are requested to do so anonymously in 'third party' sense. 

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