We recommend that elderly men with symptoms of hypogonadism and a total testosterone level <300 ng/dl should be started on testosterone replacement.
Testosterone replacement is likely beneficial in healthy older subjects with significant hypogonadism. Testosterone replacement in individuals with borderline low or low-normal testosterone levels is yet to be proven effective and may not outweigh the risks.
Diagnostic Tests
Men older than age 65 should have a testosterone level of about 300–450 ng/dL. Testosterone levels below 300 affect approximately 40 percent of men older than age 45, including 2 out of 10 men over 60, 3 out of 10 men over 70, and 3 out of 10 men over 80 years old.
Testosterone treatment of older hypogonadal men is associated with a low frequency of adverse events (4–9). The adverse effects of testosterone treatment include acne, erythrocytosis, growth of metastatic prostate cancer, reduced sperm production, and increased risk of detecting subclinical prostate cancer (ref.
Treating normal aging with testosterone therapy is not advisable. If you don't have a medical condition that's contributing to your decline in testosterone levels, your doctor might suggest natural ways to boost testosterone, such as losing weight and increasing muscle mass through resistance exercise.
If you have benign prostate disease.
The Endocrine Society also warns against taking testosterone if you have severe urinary tract symptoms caused by an enlarged prostate or if your doctor finds a lump on your prostate gland during a digital rectal exam.
Other possible risks include worsening symptoms of benign prostatic hypertrophy, liver toxicity, hyperviscosity, erythrocytosis, worsening untreated sleep apnea or severe heart failure. Despite this controversy, testosterone supplementation in the United States has increased substantially over the past several years.
Testosterone does decline with age, so an 80-year-old will have an average value of around 13 nmol/L (350 to 400 ng/dL), but its drop with age is not as dramatic. For a 40-year-old, the average value is 16 nmol/L (450--500 ng/dL).
Men can start experiencing low testosterone (T) levels in their 50s. Men start losing about one to two percent of testosterone per year once they hit their 30s, so by the time they hit their 50s and 60s, they may start experiencing signs of low T levels. However, even men in their 30s can suffer from low testosterone.
However, testosterone also comes at a cost: it accelerates aging, disease risk and reduces lifespan. Despite this, testosterone therapies are being touted everywhere, from magazines, to TV, online and by new startups with a financial incentive to downplay the long-term effects.
Low Testosterone can Occur Because of Aging or an Underlying Condition. While getting older is generally the main cause of low testosterone in many men, low T levels can also be a symptom of other underlying conditions or comorbidities. According to the Asian Journal of Andrology, these conditions may include: Obesity.
Pregnant women should also be very careful to avoid TRT gel. TRT is a life-long treatment. If you stop taking it, your testosterone levels will drop. Some men with low-T decide not to be treated.
It's expected for peak testosterone levels to arrive in a man's teenage years—around 18 or 19—before it starts to decline. But the human body can start producing testosterone even during infancy as it's responsible for the development of the male reproductive system.
As men age, the level of the male hormone testosterone usually drops. Some older men have levels far below what is normal for a young adult male. Doctors sometimes prescribe hormone treatment for such men to combat challenges they may have with sexual function, bone fractures, and other symptoms.
Testosterone levels are measured through blood tests. Most doctors agree that a “normal” reading falls anywhere between 300 to 1,000 nanograms per deciliter (ng/dL). About 40% of men over age 45 will have levels that come in below that range.
You can check testosterone levels with an at-home test or at a clinic. The Everlywell test uses a small, finger prick blood sample that you collect at home. You then mail the sample to a lab and get your results online.
Testosterone replacement therapy often gives positive result for erectile function. Testosterone replacement therapy can achieve the desired results, either by itself or in conjunction with medications for erectile dysfunction.
Any prescription for Testosterone has to be for therapeutic purposes. Doctors prescribing is ultimately sanctioned by The Australian Health Practitioner Regulation Agency (AHPRA).
However, growing evidence indicates that testosterone, even at levels observed in aging men, can have adverse consequences on cardiovascular-renal function.