How common is the low testosterone levels among middle aged men?
"I can tell you that we don't know the answer of that," said Dr. Ramin Artang, Mercy Cardiology. "Each laboratory tests we do has a normal range that is based on thousand of blood tests obtained on general population. But, for testosterone the normal range is based on levels from male subjects ages 17 to 40-years-old.
What about men who are older than 40-years-old? Would a 60-year-old man, who complains he just doesn't have any energy anymore, have low testosterone levels? "Of course," Artang said. "So the problem with this picture is that the normal range is not defined for age groups above 40-years-old."
Many middle-aged men are put on hormone replacement treatment for "Low T". But, many more don't get that same prescription. Are we denying them the fountain of youth? "The fountain of youth is just too good to be true," Artang said. "We thought that of the hormone replacement treatment for women and it turned out to cause some increase risk in heart attacks, strokes, blood clots and cancer. So until further notice there is no such a thing as "fountain of youth" without side effects."
What do you tell patients, who come to you asking for hormone replacement therapy? "I think it is important to use common sense," Artang said. "I am not denying that some people with severe hormone deficiency can benefit from it, but majority of the time, there is a reason for the persons symptoms that needs to be investigated. So if the person is not sleeping well, or has sleep apnea, undiagnosed or poorly controlled diabetes or high blood pressure, does not exercise and eats poorly. The answer of that is not hormone replacement. The answer is probably to address the sleeping issue, diet and exercise."
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