Editor’s note: This is part of a series of articles focused on health issues men need to talk about with their primary care physicians.
You’re a middle-aged man who has prided yourself on your vitality and sexual prowess but lately, you’ve been feeling fatigued, have a lower sex drive and are losing your muscle tone.
Frankly, it’s got you depressed.
Then you learn of a “miracle gel” that can boost your testosterone, or T level. It sounds too good to be true and that makes it a major frustration for endocrinologists like Dr. Michael Sheehan, Marshfield Clinic.
It sounds so easy
“Those TV or Internet ads make it seem so easy,” he said. “You get some testosterone and you’ll feel like a 22-year-old superstar again. Men are referred to me with a preconceived notion that they’ll get testosterone therapy but suspected low T levels are more complex to evaluate and manage.”
Sheehan said doctors may struggle to determine whether symptoms are truly related to T level. Sometimes the low T levels can be caused by a disorder of the pituitary gland, which regulates the amount of T level your body makes. These levels can also be caused by using narcotic pain relievers, sleep apnea or other factors.
Most cases are not definitive
“I would say in 80 percent of suspected low T patients referred to me, the T level is ambiguous or not definitive. They might be just on the edge of normal or low,” he said. A normal level for a middle-aged man is 185 to 540; if you have a level of less than 125, Sheehan will usually blame the T level for most of your symptoms.
But let’s say you have a level of 200 with the same symptoms. Then, it is possible your symptoms may be coming from another unrelated condition.
It may not be low T
“It’s important to realize minor abnormalities of T levels may not be causing significant symptoms, so we need to be sure,” he said. “That’s why in such cases I usually perform a comprehensive evaluation that does not focus just on T level.”
“I understand nobody likes to start feeling older. But we know T levels do decline with age and an 80-year-old man shouldn’t have the same T level as a 30-year-old man.”
To see an endocrinologist, you must be referred by a primary care physician.