A dose of testosterone might not cure what ails you

Posted by Dr. Michael White, Updated on January 5th, 2018
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A middle-age man goes to see his doctor, complaining of a host of vague symptoms: He's lethargic, somewhat depressed and feeling a little anxious about his manliness.

Could he just need a boost of testosterone, the vital sex hormone produced by the testicles?

These days, watching commercials from drug companies might lead you to believe that testosterone replacement could be just what you need, but researchers say it's unclear whether the issues associated with aging -- decreased sex drive, less energy, reduced muscle mass -- are the result of low testosterone or other factors.

Often equated with youth, vigor and strength, testosterone is responsible for the development of the penis and testes; it also helps build muscle and bone density, maintain adequate levels of red blood cells and helps keeps men confident and vibrant.

But as men age, the amount of testosterone in the body gradually declines. After age 30, a decline of about 1% a year begins and continues throughout the rest of a man's life.

There's substantial debate over whether decreasing testosterone levels need to be treated. Most experts say testosterone is about as effective as anti-wrinkle face cream in reversing the effects of aging.

Test results are hit or miss: Blood tests for testosterone are so unreliable that the federal Centers for Disease Control and Prevention has launched the Hormone Standardization Project to improve the accuracy and standardization of the lab data.

Nor can doctors diagnose a condition using a single measurement, because lab results vary and levels of testosterone tend to fluctuate throughout the day.

The meaning of "low" and "normal" levels is unclear. "Normal" testosterone levels for any age are more than 300 nanograms per deciliter. But the healthy range is large and spans between 250 and 1,100 nanograms per deciliter, said Neil Goodman of the American Association of Clinical Endocrinologists.

"In general, if it's under 200, the guy really has a problem that needs to be worked on," said Goodman, a professor of medicine at the University of Miami. "It's the 200 to 300 range where no one can agree whether the symptoms are related to testosterone."

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A dose of testosterone might not cure what ails you

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