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Low Testosterone? Ask Yourself These 10 Questions

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By Dr. Ron Kline, M.D.
Medical Director, Renewal Medical Centers of North Texas

Talk Testosterone to Me

Testosterone levels drop in all men as they age. Some men who suspect their levels are low are proactive and come to my office for tests; others, however, seem too embarrassed to voice their concerns. As common as it is to have low testosterone levels, I wish people felt more comfortable discussing this issue openly. My goal is to educate people about testosterone, the role it plays and the treatments available if levels are low. 

So, what exactly is testosterone?

Most people know testosterone is the major male hormone.  It’s a word some people toss around lightly to describe “maleness”. It’s also a word commonly associated with muscle building. But there’s so much more to it. 

Classified as an androgenic agent, testosterone is a steroid hormone produced primarily in the testicles. And yes, it controls all the primary and secondary characteristics associated with being male. The most obvious of these characteristics are bigger bones and muscles, body and facial hair and deeper voices.

A more subtle effect is its involvement in the sex drive for both men and women. Some people are not aware women produce testosterone too, just in smaller amounts than men. Without this hormone, there is no fuel to spark the sexual fire.

What causes low testosterone?

Mostly aging.  Levels peak in the 20’s and 30’s, then gradually fall. Did you know that on average, men lose about 10% of their testosterone every decade? As this change is gradual, most men are not aware the levels are declining. Unless, that is, they think to compare themselves now to how they felt in earlier years.

Excess weight confounds the situation. Within the fat cells in the abdominal wall, what some of us call a ”spare tire”, is an enzyme called aromatase. Aromatase converts testosterone to estradiol, a female hormone.  Men need a low level of estradiol to stimulate the libido. But too much estradiol leads to the growth of fat in the abdomen and chest. Some people unkindly refer to these fatty areas as “man boobs”.  As more fat accumulates, more testosterone converts to estrogen. It becomes a vicious cycle.

There are additional factors that also lead to low testosterone levels. For example, injuries and illnesses that involve the testicles can cause low levels.

low testosterone symptoms

How do I know if I have low testosterone?

A blood test that evaluates both total and free testosterone is the easiest way to determine your levels. The free testosterone is the active form. You need to know, however, that a wide range exists in what’s considered a “normal” level, depending on the lab. Anywhere from 200 to 1000 ng/dl is labeled as within the normal range. As a result, though your report shows a “normal”  level, your subjective assessment of how you feel figures into how you interpret the results. It’s a good idea to check levels too since this hormone affects your sex drive. 

So, ask yourself the following questions:

  1. Have you lost interest in sex?
  2. Have you lost interest in work or hobbies?
  3. Do you feel burned out?
  4. Is it harder to keep focused?
  5. Have you gained weight or lost muscle size and strength?
  6. Is exercise or physical activity more difficult?
  7. How is your strength and endurance?
  8. Do you doze off at work or in the evening?
  9. Is it difficult to sleep?
  10. Are your erections less strong than they used to be?

“Yes” answers to to many of these questions indicates you may have symptoms of low testosterone in spite of a testosterone blood level that comes back within what’s considered a “normal” range.

What can I do about my low testosterone levels?

The good news is low testosterone is a problem that is correctable.  You do not have to live the rest of your life with low testosterone symptoms.

LIfestyle Choices

For those who are overweight, it helps if you lose the fat stored around your abdomen. Also, exercise causes a temporary rise in testosterone levels after activity. Additional lifestyle changes such as healthier food choices, fewer alcoholic beverages, and quitting smoking improve testosterone levels too.

Vitamins and supplements

Vitamins and supplements also help with testosterone production. For example, we know vitamin D3, zinc and DHEA may increase levels. A note about over the counter testosterone boosters currently available: these products have variable effects on testosterone production.

Testosterone replacement therapy (TRT)

TRT is available in several different forms such as topical agents, oral medication, injections and pellets. All are prescription medications that require physician supervision. Engage your doctor in a conversation about the pros and cons of each before you make a decision. You want to also confirm your physician is knowledgeable about testosterone replacement therapies before you seek injections or pellets. Self-treatment often leads to serious consequences.

Here’s some additional information about each of these therapies. Topical creams and gels rely on absorption of the testosterone through the skin and studies show varied effects on testosterone levels. There are some new oral medications on the market that demonstrate positive results. Injections that use several different varieties of testosterone used for replacement therapy, are safe and effective when used in the recommended amounts. Too  much, however, may cause problems with liver damage, acne breakouts, and  ”roid rage.” Bio-identical hormone pellets, purified forms of the hormone inserted under the skin of the buttocks, are effective and safe for testosterone therapy, and last for 3 to 6 months.

The Bottom Line

Testosterone replacement can  positively affect your life if prescribed properly and monitored by a trained physician. In my practice, I personally see the many benefits of treatment to the health and overall wellbeing routinely. Don’t simply dismiss low testosterone symptoms as something you need to accept, because today’s treatments are available, safe and effective for many.


dr ron klineDr. Ronald Kline graduated with his M.D. from the University of Texas Medical Branch, then completed both his general surgery residency and a colon and rectal surgery fellowship at Baylor University Medical Center in Dallas. He is certified by the American Board of Colon and Rectal Surgery.  Additionally, he is a Fellow of both the American College of Surgeons and the American Society of Colon and Rectal Surgeons.

Dr. Kline received his certification in age management medicine from the Cenegenics Institute. This training led him to incorporate hormone replacement therapy into his practice. He saw the effects hormone replacement provided in all aspects of the patient’s life, especially sexual health. From there, he looked for additional methods to improve and enhance sexual performance, which in turn brought him to Renewal Medical Centers and the innovative therapy for improving men’s sexual health.

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Disclosure: The information contained in this article is not intended as a substitute for medical advice. Please consult your doctor if you experience medical issues related to erectile dysfunction.

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