It often starts with unexplained fatigue, low energy and poor mental focus. These can be signs that a man's testosterone levels are below normal. Sufferers may also experience decreased muscle tone despite regular physical activity or sexual symptoms like decreased libido and desire.
These were the symptoms plaguing Mike Sisk, prompting him to open the first Low T Center in Southlake in 2010 after several doctors failed to diagnose him.
"He [Sisk] knew guys in their late 30s and 40s don't like to go to doctors" offices," explains Bill Reilly, M.D., chief medical director of all 31 Low T Centers, including several in the DFW area. "So he came up with the unique concept for the diagnosis and treatment of low testosterone in men where it would not feel like a doctor's visit at all."
If a man suspects that he has low T, a blood test will show if his numbers fall within normal range (test before 10 a.m. for the most accuracy). Supplementation options range from gels and pellets to patches and injections.
"Low T is definitely becoming a bigger player in men's health right now," explains Clark Meador, D.O., of Baylor Family Medicine Southwest. "Testosterone numbers can range from 300 to around 1,000. That's a large range of normal. If they are under 300, they may benefit from supplementation with testosterone."
However, a blood test alone is not sufficient for diagnosis. A full evaluation by a physician to understand family history and the patient's symptoms is important.
"I have men who say, "Please check my testosterone levels because I have erectile dysfunction and loss of desire." But testosterone is often not the problem," says Odilon Alvarado, M.D., at Texas Health Harris Methodist Hospital Fort Worth. Issues like diabetes, thyroid imbalance, stress, depression and pharmaceutical side effects must be ruled out. "If I were in my 40s, a little bit overweight, and I didn't want to take testosterone, the first thing I would do is try to lose the gut. Fat cells around the abdomen cause more estrogen production."
Any patient undergoing testosterone therapy should also be monitored by his physician.
"We set our protocols up so that they receive a shot every seven days," says Reilly. "That way we can maintain a good level of testosterone and keep an eye on how they are doing so we can adjust their dose according to their symptoms and watch for side effects."
Side effects of therapy may include enlarged prostate and increased red blood cell production, among others. So knowing your cholesterol, prostate and blood count levels is essential.
"It is important to have a physician that you respect," suggests Dr. Meador. "I want to take care of the whole person and look at all the things that are going on, not just the number. They need to know the risks, side effects and benefits of treating and not treating with testosterone."
