Guide To Low Testosterone: Symptoms, Dangers, & Causes

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low-testosterone

Testosterone is a very important hormone to help both men and women maintain proper health and performance. That’s why low testosterone can be so devastating and cause so many problems. In this comprehensive guide, you will learn about low testosterone along with common symptoms, dangers, and causes.

What Is Testosterone?

Testosterone is a steroid hormone responsible for the growth and development of male sex organs and maintenance of secondary sexual characteristics.1 It also influences mood, memory, metabolism, bone density, energy, and ability to burn fat and build muscle. Signals from the brain release testosterone from the testicles. In women, testosterone is produced in the ovaries as well as the adrenal glands. Testosterone binds to receptors inside the body’s cells where it exerts its effects.

What Are The Symptoms Of Low Testosterone?

Symptoms of low testosterone include decreased sex drive, erectile dysfunction, infertility, gynecomastia (enlarged breasts in men), impaired masculinization, decreased muscle mass, and increased body fat (especially abdominal fat), reductions in body and facial hair, and osteoporosis (low bone density). In addition, men with low testosterone report levels of anger, confusion, depression, and fatigue that are significantly higher than those reported by men with normal testosterone levels.

It is important to note that many of these symptoms are nonspecific, meaning they can be caused by things other than low testosterone. Therefore, if you are experiencing any of these symptoms, it is important to get a full evaluation by a knowledgeable healthcare professional. For example, low testosterone can cause erectile dysfunction, but so can vascular disease and unrecognized diabetes, both of which can be fatal.

What Are The Dangers Of Low Testosterone?

There is mounting evidence that low testosterone may predict other serious medical conditions, and that men with low testosterone have a greater chance of dying prematurely than men with higher levels.
A large research study published in the very highly-respected medical journal Circulation demonstrated an inverse relationship between blood testosterone levels and mortality from cardiovascular disease and “all causes.”2 Another study concluded that “testosterone insufficiency in older men is associated with increased risk of death over the following 20 year independent of multiple risk factors and several preexisting health conditions.”3

Additionally, there is a connection between low testosterone and sleep apnea (a condition in which a person essentially stops breathing during sleep) and diabetes. Low testosterone can even be used as a predictor of the development if prediabetes and diabetes.4

What Are The Causes Of Low Testosterone?

There can be several causes of low testosterone, which include:

  1. Aging: Testosterone levels tend to decrease as men get older. However, while a mild decline may be a natural part of aging, clinically low levels are generally associated with other illnesses.
  2. Having children: Fathers of newborns tend to show decreases in testosterone. One school of thought says this drop helps fathers be better caretakers. Other people argue the drop is secondary to the lack of sleep, poor eating habits, fat gain and stress associated with raising children. As of now there is no clear answer.
  3. Other medical conditions: Diabetes and sleep apnea, as mentioned above, are known to be associated with low testosterone. Treating sleep apnea will often dramatically raise testosterone levels, but the jury is still out on whether diabetes contributes to low testosterone or low testosterone increases the risk for diabetes. It is clear, however, that raising testosterone is helpful in lowering blood sugar.
  4. Environment: Two large studies have demonstrated that men today have significantly lower levels of testosterone than men in the past.5 6 This effect seems to be independent of health and lifestyle factors such as smoking and obesity. In one study, there was a 22% drop from 1987 to 2004. It is very possible that environmental factors such as pesticides and other toxins are at least partially responsible for this phenomenon.
  5. Lifestyle factors: Poor sleep and nutrition, high stress, excess body fat, and lack of exercise can all decrease testosterone. Opioid pain medications, like Vicoden and Percocet, lower testosterone. Marijuana can acutely lower testosterone, though it appears that chronic users do not have lower testosterone than non-users. There may be some sort of adaptation that occurs with regular use, though how this happens is not currently known.

What Is A Low vs. Optimal Testosterone Level?

Traditional medicine defines low testosterone (or hypogonadism) as a blood level less than 300 ng/dl. Thus, many doctors will only treat if the level is less than 300. A person with symptoms of low testosterone and a level of 350 will often be refused treatment. However, there are alternative medical practitioners who believe that anyone with less than a “healthy” level of testosterone should be treated. What constitutes a healthy level is not currently defined, but these practitioners often aim for levels above 700, and maybe even higher with a younger patient who “should” have levels even above that. As with all medical treatments, there is a risk to benefit ratio and it is up to the patient and his doctor to decide whether the benefits outweigh the risks.

What Are The Benefits Of Raising Low Testosterone?

Elevating testosterone, either by medicine, supplementation, or lifestyle modification brings numerous benefits.7 These include improving energy and mood, decreasing body fat and increasing muscle mass, increasing done density, increasing sex drive and erectile function and improving insulin sensitivity. Also, as noted above, it appears that men with higher testosterone levels live longer.

What Are The Risks Of Raising Low Testosterone?

The most troublesome potential risk of raising testosterone levels, and this relates primarily to medical replacement therapy, is that a silent prostate cancer may be “fed and unmasked” by supplying outside testosterone. Other risks include worsening of cholesterol, increased red blood cell counts and enlargement of the prostate. The connection between prostate issues and testosterone replacement therapy is not overly clear, and different research studies often yield conflicting results. Again, it is important to weight risks versus benefits when deciding on testosterone replacement therapy.

How Do You Raise Low Testosterone?

A combination of optimizing body composition, reducing stress, consistent exercise, and a focus on eating whole foods can help raise low testosterone levels. Other effective methods may include supplementation and medical hormone replacement.

For more information, check out 5 Scientifically Proven Ways To Increase Testosterone Levels.

Show 7 footnotes

  1. Secondary sexual characteristics include voice deepening, body and facial hair, increased muscle mass and decreased body fat percentage as compared to females and increased sweat and oil secretion.
  2. Khaw, KT, Dowsett, M, Folkerd, E, Bingham, S, Wareham, N, Luben, R, Welch, A, Day, N. Endogenous Testosterone and Mortality Due To All Causes, Cardiovascular Disease, and Cancer In Men. Epidemiology. Nov 2007. 116; 2694-2701.
  3. Laughlin, G, Barrett-Connor, E, Bergstrom, J. Low Sreum Testosterone and Mortality in Older Men. Endocrine Care: JCEM. Oct 2007.
  4. Laaksonen, D, Niskanen, L, Punnonen, K, Nyyssonen, K, Tuomainene, T, Valkonen, Salonen, R, Salonen, J. Testosterone and Sex Hormone – Binding Globulin Predict the Metabolic Syndrome and Diabetes in Middle Aged Men. ADA. Diabetes Care May 2004 vol. 27no. 5 1036-1041.
  5. Travison, T, Aruajo, A, O’Donnell, Kupelian, V, McKinlay, J. A Population-Level Decline in Serum Testosterone Levels in American Men. The Journal of Clinical Endocrinology & Metabolism. Jan 2007 vol. 92 no. 1196-202.
  6. Testosterone replacement has great potential to help a lot of people, but there has to be caution. The serious side effects of the synthetic replacement in the normal middle aged and older population are serious — increased risk of deep venous thrombosis, pulmonary embolism and sudden death. These side effects are rare, but can be deadly. Be sure to consult your physician prior to taking any kind of testosterone therapy.

Author

  • Charlie Seltzer, MD

    Charlie is board-certified in Obesity Medicine and certified by the ACSM as a Clinical Exercise Specialist. He is the owner and medical director of Lean4Life, a medical practice focused on weight loss and body composition. He lost over 70lbs with small, sustainable changes, which is the foundation of his practice.

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