What is testosterone and is it safe?
Testosterone is a hormone found in all mammals made in specialized structures called gonads (Leydig cells in testes in men and ovaries in women). Hormones are involved in just about every biological function including growth, immune function, metabolism, sexual reproduction and more. As we age, our levels naturally decline. The decline in testosterone is both a cause of aging and a byproduct of aging. We cannot change our age, but we can enhance or slow some aspects of the aging process within our bodies.
How is low Testosterone checked?
Testosterone is measured with a blood test, consisting of free T (testosterone) and total levels. About 2% of the total level of Testosterone in your blood that is biologically active is free T. The other 98% is bound to sex hormone-binding proteins, making it unavailable for use. Testing only for total T levels is ineffective as free T is what enters the body and does the work leading to symptomatic improvement. At Vallee Health Repair, we take both into consideration!
Why have the number of low Testosterone patients increased dramatically in the last 20 years?
Testosterone levels were higher in the past due to multiple environmental and lifestyle factors. Our society has higher stress levels coupled with decreased physical activity. Our obesity rates are the highest they’ve ever been due to an exorbitant consumption of processed and calorie rich foods. Our society also has higher rates of substance abuse, specifically with alcohol, caffeine, marijuana, and opiates. All of these are known to induce several endocrine changes including lowering testosterone, increasing fatigue, increasing brain fog, and other metabolic changes such as diabetes, etc.
Is Testosterone Replacement Therapy (TRT) safe?
TRT has been studied and used for decades with there being documented health benefits and when used safely, no significant adverse health outcomes reported during clinical studies.
What are some possible side effects of TRT?
- Secondary polycythemia, which is an increase in red blood cell count. If hemoglobin or hematocrit get too high, this can be a potential health problem. We manage this with changing the dosing schedule and sometimes therapeutic phlebotomy (giving blood) is needed.
- A decrease in spermatogenesis and sperm count but is usually reversible after stopping TRT.
- Testicular shrinkage/atrophy. As TRT increases your T, your body slows down production in the testicles. This is easily combated with HCG (human chorionic gonadotropin), which is a naturally occurring hormone which sends a signal to the testicles to make more T. HCG also boosts the follicle stimulating hormone and progesterone, increases ejaculatory volume, and preserves spermatogenesis. There are other agents besides HCG as well
- Mild fluid retention
- Increased body hair
- Mild acne, oily skin and flushing have also been reported in a small minority of patients (less than 6%).
- Breast enlargement
- Increased urination
What happens if I stop therapy?
Your T levels will return to pre-therapy levels. As a provider, I am glad to ease patients down with a 6-week regimen to avoid crashing.