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It’s a fact of nature: testosterone levels in men decline as they get older. On average, a man’s level of this hormone peaks around age thirty and then begins to drop gradually. After age 40, levels decline by about 1.6 percent per year thereafter. That’s not a cause for gloom and doom as some commercials or men’s magazines will have you believe. In fact, many men fare quite well as their testosterone levels get lower.
However, men also should not become complacent about their declining T levels either. It’s a good idea to ask your doctor to check your T levels. A simple blood test is all it takes.
What does testosterone do?
During puberty, testosterone is the hormone that promotes the maturity of male sex organs, facial and other body hair growth, deepening voice, increasing sex drive, and denser muscle development. Throughout a man’s life testosterone plays a role in regulating sex drive, bone mass, red blood cell and sperm production, body fat distribution, erection firmness, and muscle strength, mass, and tone.
A small amount of testosterone is transformed into a form of estrogen called estradiol. As men get older and testosterone levels decline, they also produce less estradiol.
Testosterone levels rise and fall during the day. Levels are typically highest in the morning, which is when some men experience the most interest in sex.
What are some signs and symptoms of declining testosterone levels?
The signs and symptoms of declining testosterone can include things like an increase in abdominal fat, weight gain, reduction in muscle tone and strength, loss of body hair, lower sex drive, fatigue, anemia, hair loss, decline in bone density, mood changes, poor memory, erectile dysfunction, and low sperm count. Every man responds differently to his falling numbers because numerous factors are involved, including lifestyle habits (e.g., diet, exercise, sleep, stress, smoking, drug use, weight), current health status, genetics, and what is considered normal testosterone for him.
Is there a magic testosterone level below which men begin to experience noticeable signs of low T?
No. A normal, healthy testosterone level varies from man to man. Ten men with the same testosterone levels can all be at different levels of body fat, muscle strength, sex drive, and so on. A low testosterone number for you may be normal for someone else. Experts have not reached a consensus on what constitutes low testosterone.
Generally, the so-called normal range of testosterone in males is about 270 to 1,070 ng/dL, with an average level of 679 ng/dL. Some researchers, however, suggest that the healthiest testosterone levels are between 400 and 600 ng/dL.
Are testosterone supplements and testosterone replacement therapy the same thing?
No. Testosterone supplements typically are over-the-counter products that contain ingredients designed to prompt an increase in testosterone levels. They usually contain herbal or other natural ingredients (e.g., nutrients, amino acids) that can have an impact on testosterone levels. Because they are not prescription medications, testosterone supplements are not regulated by the Food and Drug Administration as drugs are. Therefore, you should look for reputable manufacturers of testosterone supplements.
Testosterone replacement therapy (TRT) consists of the hormone delivered to the body as an injection, transdermal patch, mouth patch, or gel. TRT has been approved by the Food and Drug Administration for use in men who have symptoms of low testosterone and who have verifiable low blood levels of the hormone, or hypogonadism. It is not approved for use in men who have low testosterone because of aging.
Does testosterone replacement therapy have any side effects?
Yes. Those side effects may include:
- Decline in sperm count, which can cause infertility
- Higher risk of heart attack and stroke
- Increase in breast tissue (man boobs)
- Testicle shrinkage
- Increased risk of blood clots
- Acne and oily skin
- Unwanted hair growth
- Enlarged prostate
- Abnormal rise in red blood cells (erthrocytosis)
In addition to these side effects, men who have certain medical conditions should talk to their doctor before starting testosterone replacement therapy. Those conditions include obstructive sleep apnea, severe urinary tract symptoms that are associated with an enlarged prostate (benign prostatic hyperplasia), elevated red blood cell counts, or severe congestive heart failure.
Besides aging, what else causes a decline in testosterone?
Several situations can cause testosterone levels to drop, either permanently or temporarily. They include:
- Treatment for cancer
- Injury to the testicles
- Presence of HIV or AIDS
- Testicular tumors
- Pituitary disorders
- Inflammatory conditions such as sarcoidosis or tuberculosis
- Rigorous exercise (temporary decline)
- Insufficient sleep
- Too much sugar in your diet
- Poor stress management
- Exposure to environmental toxins, including food additives and chemicals in personal care and household cleaning products
What ingredients should I look for in a testosterone supplement?
You want a supplement that provides organic ingredients, has no added fillers, and is formulated to help restore testosterone to more natural levels. Among the natural herbs and nutrients that have been shown to have an impact on testosterone levels are beta-sitosterol, boron, fenugreek, green tea extract, magnesium, saw palmetto, stinging nettle, tongkat ali, Tribulus terrestris, vitamin D, and zinc. Look for a testosterone supplement that contains as many of these ingredients as possible.
What can I do to enhance the benefits of a testosterone supplement?
Although a high-quality testosterone supplement can greatly support testosterone levels, certain lifestyle habits can enhance the benefits. They include focusing on an all-natural food diet, getting sufficient sleep (your body needs sleep to produce testosterone), manage stress, limit alcohol, lose weight if overweight, don’t smoke, participate in both aerobic and anaerobic exercise several times a week, and avoid exposure to environmental toxins, including food additives and chemicals in personal care and household products.
Davis CP. High and low testosterone levels in men. MedicineNet 2019 Mar 29
MacGill M. Why do we need testosterone? MedicalNewsToday 2019 Feb 6
Tsujimura K. The relationship between testosterone deficiency and men’s health. World Journal of Men’s Health 2013 Aug; 31(2): 126-35