A man’s ability to maintain adequate testosterone production for wellbeing has become a subject of vast interest. The long list of symptoms attributed to low testosterone condition (often referred to as “low T”) can be vague and nonspecific (e.g. fatigue, weight gain, erectile dysfunction, depression). However, because there are now many testosterone preparations on the market by prescription as well as supplements purported to elevate testosterone level or function, the challenge is to make the correct diagnosis, establish its cause, and recommend appropriate therapy.
It is important to understand whether a man’s symptoms are truly due to low testosterone. For answering that question a battery of laboratory evaluations must be looked at. This will assist the clinician in understanding if the testes (primary cause) or the hypothalamus/pituitary gland (secondary cause) is the main issue to focus on. There are many influences on these glands’ functions such as genetic, medications, tumors, physical trauma, aging and other co-existing diseases (diabetes, thyroid, sleep apnea, infections, just to name a few). All of these need to be evaluated before correct diagnosis can be established. Findings during a comprehensive physical examination will also help differentiate some of these causes.
Once a correct diagnosis is made, then the discussion of risks vs. benefits of therapy is discussed. According to the AACE (American Association of Clinical Endocrinologists) guidelines treating the underlying cause of low testosterone is preferred. If testosterone therapy is agreed upon, then follow up by the medical professional for both positive response and potential side effects is necessary. There are many ways to administer prescribed testosterone, ranging from intramuscular or subcutaneous injections, implantable pellets, topical gels, creams to oral tablets.
For those individuals who choose testosterone injections, teaching instructions for intramuscular injection technique will be given in our office for self-administration and by their family member if preferred. It is not advisable to use over-the-counter supplements; these are not regulated by the FDA and their actual testosterone ingredient or content is uncertain.
As endocrinologists at GDI, we perform comprehensive evaluations that are individualized for low testosterone levels and understand the benefits vs. risks of FDA approved testosterone therapies.