Are my testosterone levels too low?

You’ve probably seen countless ads and commercials promising that testosterone supplements are the key to solving fatigue, low libido, weight gain, and more. But how common is low testosterone—also known as “low-T”? And should you really be talking to your doctor about it? Let’s break it down with information from the Cleveland Clinic.

What Is Low Testosterone? Low testosterone occurs when the testicles (specifically, the Leydig cells) don’t produce enough testosterone—the hormone responsible for many key functions in the male body. While testosterone levels naturally decline with age, a significant drop can lead to symptoms that affect daily life.

What does testosterone do? Testosterone stimulates the development of male characteristics and is essential for sperm production. In men, testosterone helps maintain and develop sex organs and genitalia, muscle mass, adequate levels of red blood cells, bone density, sense of well-being, sexual function, and reproductive function.

What are the symptoms of low testosterone? They can vary considerably, particularly by age.
• Reduced sex drive
• Erectile dysfunction
• Loss of armpit or pubic hair
• Shrinking testicles
• Low sperm count or infertility
• Hot flashes
• Depressed mood
• Increased body fat
• Enlarged breast tissue
• Decreased muscle strength and mass
• Difficulty with concentration and memory

How common is low testosterone? It’s difficult for researchers to estimate how common low testosterone is since different studies have different definitions for low testosterone. Data suggest that about 2% of men may have low testosterone. And other studies have estimated that more than 8% of men aged 50 to 79 years have low testosterone.

Are there side effects from taking testosterone? Yes. Potential common side effects include acne, worsening breathing problems while sleeping, breast and ankle swelling, an increase in the size of the prostate, increased risk of heart disease, increase risk of blood clots, and a reduction in the body naturally producing testosterone leading to infertility.
Treating underlying conditions may clear up symptoms: According to Cleveland Clinic, low testosterone is common among people living with some common chronic conditions. “Chronic illnesses can keep your brain from sending out the right signals to tell your testicles to make more testosterone,” Dr. Pantalone explains. “For a lot of people, controlling their underlying condition can boost their testosterone levels without additional treatments.” A few of the conditions commonly associated with low testosterone are: Alcohol use disorder, Anemia, Diabetes, Obesity (BMI of 30 or higher) and Sleep Apnea.
In some cases, properly managing these conditions can increase your testosterone to a normal range and reduce your symptoms. For people with sleep apnea, that means being compliant with your CPAP therapy. For people with a BMI (body mass index) higher than 30, it can mean losing weight through diet or exercise.

What if I get tested, and don’t have low testosterone, but still have symptoms?
Given the likelihood of men having low testosterone is generally very low, there are many reasons men can experience depressed mood, increase in body fat, increase in fatigue, difficulties with concentration and memory. The first place to start is with the things you can control like nutrition intake, physical movement and getting needed sleep. Foods or drinks with sugar, saturated fat, and high sodium foods can cause depression symptoms, increase in body fat and inflammation, and increase joint pain and fatigue. Daily physical activity will boost endorphins (the feel-good hormones), help to manage insulin resistance-which can cause fatigue, and maintain muscle mass-which will help with body weight. Getting 7-8 hours of sleep daily can also help with fatigue and weight loss.

Here is a checklist to feeling better:
• Eat 5 cups of vegetables daily
• Consume about 1 gram of protein per kg of body weight
• Get 7–8 hours of quality sleep per night
• Do 30 minutes of moderate activity daily (e.g., walking, biking)
• Strength train 2x per week
• Drink 99 oz. of water per day
• Limit caffeine to under 200 mg per day
• Stop eating 2–3 hours before bedtime

Other causes might be at play as well, like low Thyroid hormone levels (weight, fatigue, erectile disfunction) or heart disease, diabetes or high blood pressure (erectile disfunction, fatigue). If you find yourself already doing the things on the ‘feeling better’ checklist above on a regular basis but still have symptoms, talk with your doctor about other causes.

Sources: Cleveland Clinic, Harvard Health Publishing, Mayo Clinic

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