Testosterone’s reputation for being abused by bodybuilders and athletes and promoting aggressive behaviour frequently eclipses its more critical role in wellbeing and its function in fostering good health.
As we all know, testosterone contributes to what “makes a man a man”, and it is essential to healthy development and reproductive function. It also continues to be critical throughout the lifespan in preserving health and influencing factors important in the quality of life, such as energy, drive, mental capacity, and mood.
Testosterone decreases with age and environmental factors
Testosterone levels fall with age, on average, about 1-2% per year; The Massachusetts Male Aging Study found a 23% decline in free testosterone for each decade.1
Additionally, recent research tracking men through 1987-2004 indicates that testosterone levels are falling at increasing rates beyond what can be explained by age alone.2 This reduction may be due to several factors, including rising obesity rates and the widespread exposure to the hormone-disrupting effects from the many chemicals in our industrialized environment.
Between ages 43 and 70 men can lose, on average, 2 inches in height, 15% of bone density and 10-20 pounds of muscle. These are the outward signs; On the inside, blood sugar and insulin rise, and unhealthy cholesterol levels develop as the body coats the organs in visceral fat, causing the arteries begin to thicken and then clog.
The signs and symptoms of falling testosterone are often attributed to “normal aging” - weight gain, loss of energy, and interest in being physically active, thinning skin, declining libido, and erectile function.
If low testosterone is corrected, however, these problems improve.
Although low testosterone is not the sole contributor to these age-related problems, its loss is a significant accelerant.
How blood testing reveals testosterone levels
Testing blood levels is an accurate way to measure testosterone values both as a baseline and as a means of tracking improvement.
The most precise tests are the bioavailable testosterone (BAT) and the free testosterone (FT).
In interpreting testosterone levels, overtly low levels occur in about 12% of men in their 50s and decrease with each decade to about 50% by age 80.3 But if symptoms are present, it’s not necessary to wait until testosterone drops below the normal range.
Optimizing testosterone improves men’s quality of life
Restoring testosterone to the mid to upper end of the range can be achieved through direct replacement of testosterone or indirect hormone boosting; this decision depends on a patient’s age. The most effective approach for men over 50 is testosterone replacement. This can be done with gels or patches where the hormone is absorbed through the skin or by weekly injection.
Lifestyle measures may also boost testosterone levels by about 10%, and this may be enough when the decline in testosterone levels is mild. Dietary changes such as losing weight, eating more protein, less sugar and refined carbohydrates, working out strenuously with heavy weights, and getting a solid night’s sleep may all help.
As with estrogen replacement in women, testosterone optimization works best to offset the physiologic and psychological effects of aging when combined with a healthy lifestyle.
Dr. Maureen Sweeney, Age Management Medicine
Live Young Medical Clinic, Sidney, BC. www.liveyoung.ca
1 Massachusetts Male Aging Study
2 The Journal of Clinical Endocrinology & Metabolism January 1, 2007 vol. 92 no. 1 196-202
3 Harman SM, Metter EJ, Tobin JD, Pearson J, Blackman MR. Longitudinal effects of aging on serum total and free testosterone levels in healthy men. Baltimore Longitudinal Study of Aging. J Clin Endocrinol Metab 2001; 86(2): 724-31.