There is a slew of misinformation out there, and unfortunately, it is coming from both extremes of the Low T debate. Some would have you believe that hypogonadism (the medical term for Low T) is completely made up, despite the mountains of literature and research that proves otherwise. The opposite end of the spectrum espouses the notion that every person, regardless of pre-treatment levels and symptoms experienced, will benefit from boosting their T levels even if into the supraphysiologic or “super human” range.
Testosterone Therapy: Sorting Fact From Falsehood
1. Everyone can use more testosterone.
One of the most common misconceptions about testosterone therapy is that anyone can undergo treatment and benefit from increased testosterone levels. This is definitely not the case, as treatment of individuals without low testosterone can result in many negative side effects. Treatment is only recommended in those individuals with symptoms attributable to Low T and verified testosterone deficiency.
2. Testosterone therapy can result in prostate cancer.
Currently medical practice recommends that therapy not be initiated in patients with active, treated, or dormant prostate cancer. Prostate cancers do grow more aggressively in the presence of higher testosterone levels. Also, a drop in testosterone can be an indicator of the return or onset of prostate cancer, especially in patients who have undergone radiation therapy. As of yet, however, no scientific evidence has proven an increase in the frequency of prostate cancer in men on testosterone replacement therapy (TRT).
3. Like menopause, all men will experience andropause.
As men age, hormone levels will change, however not all men will experience low testosterone. While it is biologically normal for women to lose estrogen production almost entirely, the natural decrease in men’s production of testosterone should be gradual and slight. Assuming a mid-normal level of 750 ng/dL or so at age 30, when men should start to lose 1% of T production per year, the average person should not reach sub-normal levels until close to 70 years of age.
4. Testosterone therapy is illegal.
Unlike illegal abuse of steroids, testosterone therapy is legal and an important and effective treatment for low testosterone. TRT is most often covered by insurance. It should only be undertaken after appropriate testing and under the care of a medical professional. If testosterone is taken without a prescription, then yes, it is illegal.
5. Testosterone therapy causes aggression.
Excessively high, abuse levels of testosterone are tied to aggression and “roid rage” in some individuals. Properly monitored testosterone therapy will not lead to stratospherically high testosterone levels when under the care of an ethical medical professional. Depression, mood swings and irritability are all symptoms of low testosterone, present in some individuals, and in fact, treatment can create improvements in mood and reduced irritability.
6. Higher testosterone causes baldness.
According to Harvard trained physician, Dr. Andrew Morgantaler, baldness has more to do with your genes than with your testosterone levels. Therefore, you do not have to worry about trading your hairline for higher energy levels, and increased muscle mass.
7. Testosterone gels are the only way to treat Low T.
Your provider should evaluate your treatment and lifestyle needs before making decisions on your treatment plan. Gels and other topical agents are widespread, but many find that they fall short of the promised results. They must be applied to bare, dry skin daily, can’t be allowed to rub off on others, and over 30% of men don’t absorb enough to achieve the desired impact. Pellets which are implanted under the skin every 3-4 months are also available, but most of these are not FDA approved and they send you levels soaring for the first month while they plummet over the next 2-3 leaving you “barely normal” by the time of you next treatment.
The Best Approach to Testosterone Replacement Therapy (TRT)
As with virtue, balance lies in the middle. The goal of therapy should be to take low levels, associated with negative symptoms, and make them normal; not “barely normal”, not double or triple normal, but normal. The best approach is one that uses the lowest effective dose that keeps you consistently in the “mid-normal range”.
This style of treatment allows patients to stay above borderline low levels, which often are still associated with unwanted symptoms while keeping you out of the borderline high range that increases your risks of side effects. Call us today to schedule an appointment! Testosterone therapy must be managed carefully and consistently, the way your body would if it didn’t need our help.