Low Testosterone Levels Test & Symptoms
Your low testosterone levels test and low testosterone symptoms should be correlated when you’re considering low testosterone treatment. An experienced doctor can help you connect the dots and find the low testosterone test that will help diagnose the cause of your health concern.
Many doctors get confused about low testosterone levels being only related to erectile dysfunction (ED) or low libido (reduced sex drive). Low testosterone is becoming an epidemic – low testosterone epidemic.
Many doctors only do lab tests for total testosterone. There are other important lab tests that should be performed to get the best picture of your testosterone levels, including free testosterone (bio-available testosterone).
In some ways the free testosterone level test is the most important because this is the portion of your total testosterone level that is active. Most of the testosterone in your body is attached to a protein, called sex hormone binding globulin (SHBG) and is inactive.
Other important tests that should be done when checking for low testosterone levels in men include:
- Luteinizing Hormone (LH): LH is the signal from your brain to your testicles. Often times this number will be high in older men. When it is low in younger men we may want to do other tests to further look for the cause of the low testosterone level.
- Estrogen (Estradiol): Estrogen is important to check because many men convert too much of their testosterone to estrogen. When we treat low testosterone levels we always monitor estrogen levels because we want to make sure your estrogen levels stay optimal to reduce potential testosterone therapy side effects.
Testosterone Converts to Estrogen and then feeds back to the brain to reduce Testosterone Production
Low testosterone levels can be tested using blood, urine, or saliva. In men, the most studied method to test for low testosterone levels is blood lab testing. We sometimes use urine testing and never use saliva because we have found it to correlate poorly with symptoms. In our clinic, we use a patented testing method to check your blood total testosterone level while you wait in just 15 minutes. We then typically send your blood to one of the biggest labs in the country (Labcorp) to double check our work.
When we do a low testosterone level test we also want to try and match up your symptoms to your level. It is interesting that not all men with “low testosterone” levels have symptoms of low testosterone and many men with “normal testosterone” levels have many symptoms of low testosterone.
Some men may have “low normal” levels of testosterone and if there are multiple symptoms of low testosterone we may want to consider different treatments to optimize your testosterone levels. Every patient is different and not all our patients even use testosterone to optimize their levels.
“Unfortunately, there are limited data on the effects of testosterone on the quality of life of men with [low testosterone levels], but the information that exists suggests that testosterone can improve the quality of life significantly (to the same level as men with normal testosterone levels) and the more severe the symptoms before treatment, the greater the benefits of testosterone replacement. These promising early results need to be confirmed in more detailed quality of life studies.2″
Low Testosterone Levels Symptoms from the Aging Males Symptoms Questionnaire (AMS)
“The AMS scale showed a convincing ability to measure treatment effects on quality of life across the full range of severity of complaints before therapy. The distribution of complaints of testosterone deficient men before therapy almost returned to normal values after 12 weeks of testosterone treatment.1″
Have you experienced any of the following symptoms?
- Decline in your feeling of general well-being (general sense of wellness)
- Joint pain and muscular ache (lower back pain, joint pain, pain in a limb, general back ache)
- Excessive sweating (unexpected/sudden episodes of sweating, hot flashes)
- Sleep problems (difficulty in falling asleep, restless sleep, waking up early and feeling tired, poor sleep, sleeplessness)
- Increased need for sleep, often feeling tired, the “couch is calling”
- Irritability (feeling aggressive, easily upset about little things, moody)
- Nervousness (inner tension, restlessness, feeling fidgety)
- Anxiety (feeling panicky)
- Physical exhaustion / lacking vitality (general decrease in performance, reduced activity, lacking interest in leisure activities, feeling of getting less done, of achieving less, of having to force oneself to undertake activities)
- Decrease in muscular strength (feeling of weakness, feeling frail)
- Depressive mood (feeling down, sad, on the verge of tears, lack of drive, mood swings, feeling nothing is of any use)
- Feeling that you have passed your peak
- Feeling burnt out, having hit rock-bottom
- Decrease in beard growth
- Decrease in ability/frequency to perform sexually, difficulty ejaculating
- Decrease in the number of morning erections
- Decrease in sexual desire/libido (lacking pleasure in sex, lacking desire for sexual intercourse)
The more symptoms from above that you are experiencing the more likely you have low testosterone levels. There are also other questionnaires that are used to screen for low testosterone levels.
“Physicians should consider screening for low testosterone levels in certain subgroups of depressed men.3″
The Androgen Deficiency in the Aging Male (ADAM) Questionnaire has been shown to be helpful to screen for symptoms of low testosterone levels. Some doctors will only check your testosterone levels if you have multiple low testosterone symptoms. In our experience, if you even think you have one of these symptoms it is worth checking your testosterone levels. Either way at least you know your testosterone level.
Do you have any of these symptoms?
- Do you have a decrease in libido (sex drive)?
- Do you have a lack of energy?
- Do you have a decrease in strength and/or endurance?
- Have you lost height?
- Have you noticed a decreased “enjoyment of life”?
- Are you sad and/or grumpy?
- Are your erections less strong?
- Have you noticed a recent deterioration in your ability to play sports?
- Are you falling asleep after dinner?
- Has there been a recent deterioration in your work performance?
Low testosterone levels can occur at any age and the prevalence of erectile dysfunction (ED) is increasing in men under the age of 40 years old.
“This exploratory analysis showed that one in four patients seeking first medical help for new onset ED was younger than 40 years. Almost half of the young men suffered from severe ED, with comparable rates in older patients. Overall, younger men differed from older individuals in terms of both clinical and sociodemographic parameters.4″
Here are some medical conditions that are known to cause low testosterone levels 5:
- Normal aging
- Pituitary Disorders
- Undescended testicles
- Injury to the testicles
- Mumps orchitis
- Certain Medications and Drugs (including smoking)
- And others
New research published in the Journal of the Aging Male in 2013 found that low testosterone treatment improved frailty in older men with diabetes. Low, frequent doses of testosterone are safest in men with diabetes because it helps reduce the conversion of testosterone to estrogen and improve the testosterone to estrogen ratio. Men with diabetes often convert too much of their testosterone to estrogen.
“This study indicates that low-to-intermediate dose TRT may be safely utilized in LOH patients to ameliorate somatic and psychological frailty symptoms in association with improved anthropometric and glyco metabolic parameters in aging, overweight men with LOH and impaired fasting glucose.6″
Men who are considering treatment for low testosterone levels are often concerned about the effects of low testosterone treatment on fertility. New research is showing that while testosterone treatment may reduce sperm production, within 8 months of discontinuing low testosterone treatment sperm levels are likely to return to normal.
“After withdrawal of androgen therapy, sperm concentration and serum follicle-stimulating hormone level returned to normal range at a median 8.5 months (range: 7-10 months).7″
There are also ways to help maintain your sperm production while being treated for low testosterone levels. There are ways to stimulate sperm production while taking testosterone or after discontinuing testosterone.
“Exogenous testosterone supplementation decreases sperm production. Studies of hormonal contraception indicate that most men have a return of normal sperm production within 1 year after discontinuation. Clomiphene citrate is a safe and effective therapy for men who desire to maintain future potential fertility. Although less frequently used in the general population, hCG therapy with or without testosterone supplementation represents an alternative treatment.8″
Our experienced physicians can help you optimize your testosterone and estrogen levels and help you maintain your natural testosterone and sperm production. Every patient is different and we individualize every treatment. The first step is getting checked for low testosterone levels and meeting with a doctor to discuss your options.
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1. Aging Males’ Symptoms scale: a standardized instrument for the practice. Heinemann LA. J Endocrinol Invest. 2005;28(11 Suppl Proceedings):34-8.
2. Testosterone and men’s quality of life. Moncada I. Aging Male. 2006 Dec;9(4):189-93.
3. The Effect of Testosterone Levels on Mood in Men: A Review. Johnson JM, Nachtigall LB, Stern TA. Psychosomatics. 2013 Sep 6. pii: S0033-3182(13)00133-3. doi: 10.1016/j.psym.2013.06.018. [Epub ahead of print]
4. One patient out of four with newly diagnosed erectile dysfunction is a young man–worrisome picture from the everyday clinical practice. Capogrosso P, Colicchia M, Ventimiglia E, Castagna G, Clementi MC, Suardi N, Castiglione F, Briganti A, Cantiello F, Damiano R, Montorsi F, Salonia A. J Sex Med. 2013 Jul;10(7):1833-41. doi: 10.1111/jsm.12179. Epub 2013 May 7.
6. Low-intermediate dose testosterone replacement therapy by different pharmaceutical preparations improves frailty score in elderly hypogonadal hyperglycaemic patients. Strollo F, Strollo G, Morè M, Magni P, Macchi C, Masini MA, Carucci I, Celotti F, Ruscica M, Gentile S. Aging Male. 2013 Jun;16(2):33-7. doi: 10.3109/13685538.2013.773305. Epub 2013 Mar 21.
7. Reversible infertility associated with testosterone therapy for symptomatic hypogonadism in infertile couple.
Bang JK, Lim JJ, Choi J, Won HJ, Yoon TK, Hong JY, Park DS, Song SH. Department of Urology, CHA Gangnam Medical Center, CHA University, 566 Nonhyeon-ro, Gangnam-gu, Seoul 135-913, Korea. Yonsei Med J. 2013 May 1;54(3):702-6. doi: 10.3349/ymj.2013.54.3.702.
8. Crosnoe LE, Grober E, Ohl D, Kim ED. 2013. Exogenous testosterone: a preventable cause of male infertility. Translational Andrology and Urology; Vol 2, No 2 (June 2013)
*There is no guarantee of specific results, your results can vary. We offer a money-back guarantee for patients, if they experience no results.