By Chris Iliades, MD | Medically reviewed by Cynthia Haines, MD for everydayhealth.com
Most men don’t need to worry about dangerously low testosterone, but you should know the symptoms. Find out about really low T and its warning signs.
As if erectile dysfunction weren’t enough to worry about, low testosterone weighs on the minds of many men. Throughout your life, testosterone plays an important role in regulating sexual, mental, and physical health. That’s why low testosterone, or low T as it’s called, can cause common symptoms like erectile dysfunction (ED), low libido, depression, and low energy. The good news in all of this is that very low testosterone is very unlikely, and certain signs will let you know when testing and possible treatment are needed.
How Low Can Testosterone Go?
Unlike women, who have a rapid decline in estrogen at menopause, men may experience a gradual decline in testosterone. Studies show that about 20 percent of men have low T in their sixties and about 50 percent have low T in their eighties. In younger men, low T may be caused by common problems like obesity, diabetes, and stress. Altogether, low T may affect up to 5 million American men.
“The lower your testosterone goes, the more likely you are to have the common symptoms like low energy and low libido,” says Daniel Shoskes, MD, a urologist at the Glickman Urological & Kidney Institute at the Cleveland Clinic in Ohio. “A deep reduction can cause less common symptoms like anemia, osteoporosis, depression, and confusion. But the idea that healthy men’s testosterone levels need to be monitored to prevent these symptoms is probably nonsense.”
Malignant Melanoma Med
Get the Facts on Advanced Melanoma
& a Treatment Option that May Help.
When symptoms indicate that you may have a low T problem, a simple test can help make the diagnosis. A morning blood test is the best way to measure testosterone. “There is a very wide range of normal, and testosterone levels change during the day,” says Dr. Shoskes. The normal range is anywhere from 300 to 800 nanograms per deciliter (ng/dL). You would not be considered to have low T unless you had a number below 300.
Dangerously low testosterone levels may occur under certain conditions. One example is treatment for prostate cancer. Because prostate cancer can be fueled by testosterone, doctors may use treatments to block testosterone in advanced cases. This is called androgen deprivation therapy (ADT).
One example of ADT is surgical removal of the testicles. This will drop testosterone levels by more than 90 percent in 24 hours. Another way to block testosterone is with drugs. In a study published in the journal Clinical Genitourinary Cancer, researchers looked at the testosterone levels of men being treated for prostate cancer with an ADT drug after six months. Of 153 men, 25 were found to have a testosterone level less than 20 ng/dL.
At these lowest levels of testosterone, low T symptoms may include:
Complete loss of libido
Tender and enlarged breasts
When to Talk With Your Doctor About Low T
If you’re an otherwise healthy adult man, you’re not likely to experience dangerously low testosterone. But you should talk with your doctor if you have ongoing symptoms of low T.
A review article in the BC Medical Journal suggests that your doctor might consider a blood test to diagnose low T if you have persistent symptoms that include:
Mood changes such as irritability or sadness
Loss of interest in sex
Loss of morning erections or other erection problems
Low energy and easy fatigue
Loss of muscle strength or bulk
Very low testosterone is very unlikely and you probably do not need to worry about it. But if you have persistent symptoms of falling testosterone levels, talk with your doctor about low T. Diagnosing low T early may help prevent more serious low T symptoms later on.