Men who are experiencing symptoms of low testosterone, such as low sex drive, fatigue, weight gain and loss of muscle mass, should take key steps before they begin testosterone replacement therapy, as the treatment has been linked to an increased risk of cardiovascular events and death, doctors warn.
The first step is to have a blood test to check their testosterone levels. The test should be performed twice, each time in the morning between 8 a.m. and 10 a.m., in order to confirm the results. If the tests show low testosterone, the next step is to determine the cause.
“The most common reason for low testosterone in my practice, I find, is obesity,” Dr. Ronald Tamler, an endocrinologist ad clinical director of the Mount Sinai Diabetes Center, told NPR. Fatty tissue, especially on the belly, can cause testosterone to turn into estradiol, a female hormone that curbs testosterone production. By losing weight, men can quickly boost their testosterone levels naturally.
Other causes of low testosterone include diabetes and sleep apnea, which should also be addressed and treated before one undergoes hormone therapy, Tamler said.
Lowering testosterone levels are a natural part of aging, but it can be problem for some men, causing bothersome symptoms. Men who are considering testosterone therapy should discuss the risks with their doctors. Recent studies have linked testosterone supplements, such as AndroGel, Axiron and Testim, to an increased risk of heart attacks, strokes, and death.
Tamler says that the supplement dose should be carefully considered for each patient to be sure it does not cause production of too many red blood cells, which could cause blood clots. Those on testosterone therapy should also be re-evaluated every six months to check red blood cell production, blood pressure and estradiol levels.