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A 49-year-old male asked:

How significant is low testosterone in a 49 year old male? i am generally in good health but over the last year have been having problems with fatigue, memory, concentration, at at times libido. i thought it could be low t level after some internet resear

3 doctor answers8 doctors weighed in
Dr. Heidi Fowler
Psychiatry 26 years experience
Hi. : Hi. I will leave most of your question for urologists to answer. I am a psychiatrist. I just wanted to let you know that I have treated several men who had low libido, poor energy level, low motivation levels, anxiety, depression, weight gain and marked irritability. The men were treated by specialists for low testosterone and low and behold, their psychiatric conditions virtually resolved.
Dr. Alvin Lin
Geriatrics 31 years experience
Your : Your urologist is correct in that most dietary supplements don't have much evidence to support their marketing claims. Worse, they're manufactured w/o 3rd party oversight to insure safety. Regardless, testosterone tends to peak in the morning and reach a low in the afternoon. There also tends to be quite a bit of day-to-day variation. As such, i wouldn't rely on two values drawn at different times of the day. It's also not clear to me whether you used the same laboratory both times (which is important). You also didn't mention the reference range of the laboratory used which would be helpful in interpreting your results as opposed to just blindly comparing to some values tossed around on the internet. The point is that there's a wide range of what's normal for men of any age. Therefore, the goal for replacement/supplementation isn't a numeric value but rather a clinical response, at least in my practice. Working backwards, I am therefore also willing to consider replacement/supplementation based upon clinical symptoms such as yours, assuming that we've taken care of everything else. In other words, before jumping to your urologist, did you get evaluated by your family physician for your complaints? There are many other conditions that can present similar to hypogonadism and it would be a shame to whitewash them with testosterone. Don't forget that testosterone is not without side effects and/or harm so it's use must be closely monitored. One last thought - while you mentioned your age, you didn't mention whether you're interested in future fertility or not. If father more children is in the plans, then you want to stay away from testosterone replacement products which would tend to shut down sperm production. Instead, you'd need to consider something like HCG or Clomiphene to increase testosterone & sperm production. Finally, growth hormone is a totally different animal than testosterone. You take growth hormone only if it's needed, not to correct hypogonadism. And vice versa. Think gasoline & diesel. Both are perfectly good fuels, just like hgh & testosterone are excellent performance enhancing drugs. But you don't put diesel into a gasoline engine, nor gasoline into a diesel engine, and hope the car runs. Likewise, taking testosterone won't solve growth hormone deficiency and growth hormone won't treat hypogonadism. Hope this helps!
Dr. Scott Shapiro
Anti-Aging Medicine 36 years experience
If it matters to you: and is affecting your lifestyle, it IS significant. Low T can be easily treated and has literally changed the lives of many of my patients. Remember, your doc should not ONLY look at lab values, but look at them coupled with your SYMPTOMS. You should also have your thyroid checked as thyroid problems can sometimes mimic other hormonal imbalances. more info at www.doctorscotts.com.

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Last updated Oct 4, 2016

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