When I first started my private practice, my focus was mainly on medical aesthetics and external beauty, skincare and products to enhance beauty. After 8 years, now it have evolved more into lifestyle, where I also delve into optimizing my patient's systems so that the body functions the best. Because what is the point of looking beautiful, if you feel like crap and you gain weight excessively for no reason? I myself face similar dilemma trying to keep my weight checked, to the point that I start studying more on hormones and internal body processes and metabolic pathways. And after awhile, everything seems to make sense.
A very interesting problem nowadays is how a lot of men in their prime are not in optimum health that you find young men having testosterone deficiency symptoms. The factors contributing to this dilemma is mainly stress levels, diet and lack of physical exercise that causes the testosterone levels to decline and slowly leads to weight gain, low mood, low energy and depression. Another issue that a lot of men have is the aromatization of testosterone into oestrogen by an enzyme called Aromatase. This then leads to the formation of gynaecomastia or also dubbed man-boobs and the collection of fats around the stomach pot belly area. This conversion leads to a reduced amount of available testosterone in the body leading to symptoms of deficiency. So basically that growing tummy is not a good thing boys, you better start thinking of losing it. Recent studies have also shown that men with reduced testosterone levels have higher mortality risk. So its not just about getting that 6 packs, but it is also to ensure then men live longer.
Last July I attended a conference on men focusing on hypogonadism or low testosterone and erectile dysfunction. It was a real eye opener. Thank you Bayer for the kind invitation. Our speakers were well experienced andrologist from Malaysia and Singapore who were very informative and entertaining. Andrologist are doctors who specialize in male sexual and urinary problems. I learnt so much on testosterone in that two days that a lot of the things I was studying made more sense.
Most doctors believe that as long as the testosterone levels are within range, it is normal. However, more and more studies have shown that there is an age relation to the level, where it peaks highest in the adolescent stage up to 1200ng/dl at 18 years old and slowly declines over the years with an average of 1.6% decline per year. The range given by the labs is so huge i.e. from 270ng/dl - 1070ng/dl. A few community studies have shown the averages based on age groups which can also be used as a rough guide. The best way is to look at the symptoms and signs and correlate clinically.
Possible symptoms of Testosterone deficiency:
1. Psychological symptoms
- Irritability
- Nervousness
- Anxiety
- Depressive Disorders
- Memory Disturbances
- Lack of Concentration
- Mood changes
2. Somatic Symptoms
- Muscle Pain
- Joint Pain
- Excessive sweating
- Sleep disturbance
- Muscle strength and muscle mass decline
- Hot flushes
- Cardiovascular disease
- Increase body weight
- Increased visceral body fat
- Testicular atrophy
- Osteopenia
- Chronic fatigue
- Anaemia
3. Sexual Symptoms
- Low libido or sexual interest
- Reduced number of morning erections
- Delayed ejaculations
- Impotency
These symptoms can be reduced by increasing testosterone levels in men to what they require. You see, not everyone function well on the same level. It really depends on the individual. Just like how our body built are not the same. In the past, the testosterone range was determined by subjects between the ages of 20-80 years old. Nowadays, there is a more age specific range based on the general well being of the man, whether or not they have metabolic issues like diabetes or cardiovascular problems.
But it is not as easy as just supplementing testosterone as what most men believe. There are many factors to consider such as age, and cause of low testosterone and whether future offsprings are considered. Long-term testosterone therapy causes the Leydig cells to stop producing sperm in 91% of cases. Hence, we should weigh the pros and cons of treatment. The best is always to consult your anti-ageing or lifestyle practitioner properly to give you the best options based on your age, and future expectations. Furthermore, too much testosterone has been proven to increase aggression in men, with a higher tendency for them to drink, smoke and engage in high risk sexual behaviours. Therefore, careful planning and monitoring is required to ensure optimized treatment. I'll explain more about treatment options in another blog entry.
For more information or for appointments feel free to contact us at drmmclinic@gmail.com or +60129660852.
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