Quite often I speak with patients who have decreased or absent libido, loss of muscle, expanding waistlines and lack of motivation to workout who go to their doctors to have their testosterone levels checked only to be told “they are normal.” When they meet with me they ask “what level is considered low?” Here is the answer:
There is no total testosterone level in blood that is considered deficient per the Endocrinology literature. If you are symptomatic, then you need testosterone.
Just to be clear, if you suffer from declining libido, decrease frequency of morning erections, erectile dysfunction, loss of drive and competitive edge, fatigue and decreased effectiveness of exercise workouts then you will benefit from using testosterone. I regularly see patients with these symptoms who have total testosterone in the 600-800 range (“normal 350-1197”) and free testosterone levels of 11 (“normal” 5-25). They all go on testosterone and they unanimously feel better.
Let me point something else out to you as well. Look at the “normal” range for testosterone, 350-1197. That is a huge range to justify calling a patient with a level inbetween 350-1197 “normal”. The patient who has a testosterone level of 375 and feels terrible certainly isn’t “normal”. The same can be said for the guy with no libido with a testosterone level of 695 ( a real patient of mine this week). I don’t care what his level is, he needs testosterone.
The above patient was a 54 year old married man who stated he had very little libido. He rarely had morning erections and definitely didn’t have the drive to get to the gym. When I tested his levels he had a total testosterone of 695 and free of 13 (optimal is 30-40). Instead of telling him “your normal” because your labs fall in this huge range, I prescribed him 200mg of testosterone daily. Within the first week he claims there is a noticeable difference in his libido.
Lastly, what is the harm in taking testosterone? If you prescribe it appropriately and monitor levels to make sure they are in the high end of normal for a 20 year old there is no harm. **In fact, all the cardiac literature says the higher a mans levels the less chance he has of dying of all causes, specifically heart attack and stroke. It also reduces body fat, reduces inflammation and improves mood.
In conclusion, if you have symptoms of testosterone deficiency, use the lab values only as a guide to your therapy. Treat yourself until you start feeling better. I promise it will have a huge impact on your health and quality of life.
Dr. Sean Breen is an expert in Anti-Aging, Functional and Regenerative Medicine and specializes in hormone optimization.
** for a review of the medical literature on testosterone visit “Learn About Hormones” on the homepage under “Bio-Identical Hormones and click on testosterone.