Michael Aziz, MD
Primary Care Physician & Internist located in Midtown East, New York, NY
Low Testosterone Treatment Q & A
What is Testosterone (T)?
Testosterone is the male sex hormone that makes you a man and gives you; your masculinity. It is a minor hormone, meaning it is not needed for survival, but you will feel lousy and miserable if your level is low. Low testosterone levels can also shorten your life.
What’s a “Normal” Testosterone Level?
When you go to get tested for testosterone, the lab will often show you what’s considered the “normal” range among patients who have tested with that particular lab. It’s called the “reference range.” Here’s the problem. The reference range consists of a wide variety of men who tested with that specific lab; 80-year-old men and 20-year-old men; obese men and superfit men; men with a pituitary gland problem and men with a normal gland.
For example, Quest lab shows a reference range of 300 – 800 ng/dl (nanograms per deciliter) for total testosterone levels. According to this reference range, a 20-year-old with a level of total testosterone of 300 ng/dl will fall within the normal range, when in fact, his levels are very low for his age. He may suffer from many low testosterone symptoms even though he may be told by less informed doctors that his levels are normal according to the lab reference!
To explain this better for you, let's take an example of a 50-year-old woman in menopause, her sex hormones (estrogen and progesterone) are non-existent. She has hot flashes, feels depressed, and gaining weight. she goes to her doctor who may be not experienced in anti-aging and may tell her; that her sex hormones are normal!!! Are they? Yes, they are normal for a 50-year-old woman in menopause. But how do they compare to a 20-year-old woman with normal sex hormones and who is full of vitality!
The same facts apply to men. The fact that reference ranges don’t break patients down by age or health status explains why a 25-year-old man can go to his doctor with the symptoms of low T, only to be told that his T levels are fine because they’re within the “normal” range. Your levels are normal by the lab reference age, but they are really low.
Factors that accelerate the decline of testosterone include:
- excess weight, especially abdominal obesity
- illness, disease, and stressful events
- smoking and all forms of tobacco consumption
- drug or alcohol abuse
- depression or mental illness
- reduced sexual activity
What You Should Know About Low Testosterone
Between the ages of 25 and 50, men’s testosterone levels tend to decrease by approximately 10% per decade, yielding over a 50% reduction by the time they reach their 60s. Because it is such a slow decline, men’s responses vary very widely. Many of these subtle symptoms men simply identify as normal aging.
Symptoms of testosterone deficiency tend to fall into one of four categories: physical, cardiovascular, mental, or sexual, with some of them overlapping. For example, feeling too weak or tired to engage in sex could be related to impaired cardiovascular health, feelings of insecurity, and decreased libido, all of which may be related to a testosterone deficiency.
Symptoms Associated with Low Testosterone
• Balding head
• Reduced body hair
• Decreased muscle mass, with increased body fat
• Reduced strength
• Reduced stamina
• Feeling weak or tired
• Decreased testicle size
• Enlarged prostate
• Urinary discomfort and/or difficulty
• Increased abdominal fat, increasing risk of heart attack
• Increased insulin, cholesterol, and triglyceride levels
• Elevated blood pressure
• Diminished coronary artery elasticity
• Weakening of the heart muscle
• Moodiness, irritability, insecurity
• Inner unrest
• Lack of concentration
• Memory failures
• Reduced intellect and critical thinking
• Decreased sex drive and arousal
• Reduced organ sensitivity or pleasure
• Fewer orgasms
• Erectile dysfunction
One of the most troubling symptoms men encounter as they age is an enlarged prostate. The prostate gland goes through a second growth spurt as men reach their 40s, 50s, or 60s, often resulting in benign prostatic hyperplasia (BPH). As the prostate grows, it pushes on the bladder and urethra, causing mild to severe urinary discomforts such as increased frequency of urination, especially at night, difficulty initiating urination, decreased urinary force, and the sensation of a full bladder, even after urinating.
Current medical research indicates that low testosterone levels may be associated with BPH, especially when coupled with elevated estrogen hormone levels.
No amount of testosterone will help you if your cortisol level is high. This is because cortisol and testosterone compete with one another. Dr. Aziz uses a variety of techniques to lower cortisol such as natural herbs and ashwagandha. Once this is done, he can start your testosterone replacement therapy. The earlier that a testosterone imbalance is detected and treated, the better. Testosterone Replacement Therapy (TRT) supplements can provide symptom relief while delaying other age-related declines.
The testosterone treatments available today—such as oral capsules, sublingual lozenges, injectables, patches, creams, and gels—can be quite effective and easy to use, with minimal side effects. The benefits they offer include:
• improved energy and overall well-being
• increased strength and stamina
• enhanced mood and self-esteem
• improved concentration and memory
• enhanced libido and sexual function
If you decide to pursue hormone therapy, be aware of the difference between conventional hormone therapies and natural hormone supplements. Hormones in some conventional hormone therapy are not identical to human hormones. Natural hormones are those that are biochemically identical to the hormones found in your body. As such, their effects on the body are the same as the effects of the hormones they are supplementing.
Dr. Aziz only uses bio-identical hormones. We use pellets. We use Testim, Androgel, testosterone cypionate, and long-acting testosterone undecanoate also known as Aveed.
Dr. Michael Aziz's presentation at the American Academy of Anti-Aging Medicine in Las Vegas, 2009
Read Dr. Aziz Aziz health column in Life Extension magazine
Call Dr. Aziz for a Consultation Today to Get your Vitality Back (212)906-9111
Major Insurance Plans Accepted
Dr. Aziz accepts most major insurance plans.
Words from our patients
"Dr. Michael is very caring and has helped me with my menopause symptoms with some natural hormones that my gynecologist did not even bring up."
“I have been a patient with Dr. Aziz for few years. He has always been very caring, and never rushed me. I will always recommend him to my friends and family.”