In order to understand Low T, its causes and how it can affect your health, we need to discuss how your body produces T, controls its levels and what functions of the body it affects.
Testosterone Production, Malfunction & Treatment
Testosterone is produced by the testicles in a man, or the ovaries in a woman, in response to stimulatory hormones called gonadotropins. The stimulator of T release by the gonads, comes from the Pituitary gland at the base of the brain, and is called Luteinizing Hormone, or LH. This is the same stimulator hormone whether in man or woman, but it was identified first in women.
A feedback system is present in the pituitary of both genders whereby it senses and regulates the blood levels of T by putting out more or less LH. Therefore, Low T at its most basic level results from either a malfunction of regulation by the Pituitary, or in the man, a malfunction in production by the Testicles.
Pituitary malfunctions that cause Low T can result from benign tumor growths in the Pituitary called adenomas, and are diagnosed by high blood levels of a hormone called Prolactin, which then call for follow up study with a Pituitary MRI scan. Other men develop Pituitary malfunction resulting in Low Testosterone due to brain trauma, chronic use of narcotic pain medication, sleep disorders such as sleep apnea, viral illnesses, congenital (present from birth) pituitary malfunction, or the use of Anabolic (body building) steroids for athletics.
Low T and Fertility
Testicular malfunctions that cause Low T can result from anatomic conditions that are also related to low sperm counts such as Varicocele (varicose veins of the testicles), Cryptorchidism (failure of the testicles to descend from abdomen to scrotum within first year of life), and Congenital, Traumatic or Infection related Atrophy (shrinkage) of the testicles. In other cases, the individual may have a genetically determined, age related tendency toward reduced T production. This is often the case in men with fertility problems such as low sperm count.
Diagnosis and Treatment for Low Testosterone Levels
Low T is diagnosed on the basis of blood testing for serum Testosterone levels, and correlating those levels with the individual’s age, signs and symptoms.
Laboratory standards give a wide range of low to high normal values (ie 300 ng/dl to 1000 ng/dl). Intuitively, and correctly, low end of normal correlates with older adult men while the high end of normal correlates with younger adult men.
It is critical that the doctor assisting you in your process of diagnosis and treatment has a detailed knowledge of age related normal levels. Dr. Buch, and an increasing number of experts in this field, have begun to suggest proactive evaluation of every man’s T levels at 5 year intervals beginning at age 20, so that treatment can be directed when needed to achieving normal levels for each individual, rather than counting on industry established age related norms.
Understanding Your Testosterone Levels
Testosterone levels have been measured in the morning when they are typically at their highest level of the day. When one of the major complaints of a man with Low T is that he runs out of energy in the mid-afternoon, why shouldn’t the new standard be to check levels in the mid to late afternoon?
At LowTguru, we are constantly questioning the conventional wisdom of “group-think” and of the so called experts who try to make these issues much more complicated than they need to be. Our goal is to educate our clients with a solid knowledge of Andrology as it applies directly to control of their own Health and Wellness.