Low testosterone is a real problem, but few actually have it

Posted by Dr. Michael White, Updated on October 24th, 2015
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Low testosterone, or hypogonadism, is a legitimate health problem. Men who have it can suffer a variety of conditions, from low energy and sex drive to depression, weight gain and even bone loss.

But chances are, you don't have this problem, and neither do many of the men you know.

The best evidence is that only about 2 percent of the U.S. male population ages 40 to 79 are below the minimum T threshold.

That hasn't prevented a wave of interest in testosterone-replacement therapy. At the top of the hierarchy, there are the prescription-only gels and injections that replace the diminished hormone with synthetic testosterone. At the other, much more dubious, end of the spectrum are the dozens of over-the-counter supplements that purport to help the body boost its own T-levels naturally.

"It's just a bunch of nonsense," Dr. Ellis Levin said of the supplements. He's chief of endocrinology, diabetes and metabolism at the University of California-Irvine's School of Medicine, and he said those products aren't FDA-approved, nor are they generally tested to see how well they work. "So people can claim whatever they want, and nobody will hold them to the truth."

Often, when a user does find a benefit, it's a placebo effect that dissipates over time, he said.

The supplements, with names like Manimal, HexaTest and High T, often make bold claims in advertising and marketing. Andro400, which has a mailing address in Ventura, Calif., says on its website that its capsules are "powered by testosterone," which can have a variety of therapeutic properties, including the ability to "melt" body fat. Elsewhere on the exclamation-point-filled home page are slogans like "Get back your enthusiasm, motivation and zest for life!" ... "Recharge your energy, strength, stamina and sports performance!" ... "Enhance sexual performance and bring back romance!" One 60-pill bottle costs $39.95.

Several possible factors

Is it true that men produce less testosterone as they age? Generally, yes. But that might not mean much. And there are other factors that can bring the level of hormone down, including injury, illness, obesity and heavy use of marijuana and opiates.

A 2012 study found that men who were married tended to have less precipitous drops, possibly owing to being happier or having more sex. However, a 2011 study said new dads can see their levels drop faster than non-dads, an effect possibly caused by the body's need to nurture a child outweighing the need to perform historically macho tasks, like fighting a rival suitor.

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