Understanding Low Testosterone and How It Affects Men’s Health

What Causes Low Testosterone?

The testosterone hormone is secreted by the testes, which means it’s a part of the endocrine system. If a man is diagnosed with hypogonadism, it means they’re experiencing a blend of low testosterone along with a potential for a number of other bothersome symptoms.

Men with low testosterone are more likely to later develop diabetes. Testosterone helps the body’s tissues take up more blood sugar in response to insulin. Men with low testosterone more often have insulin resistance: they need to produce more insulin to keep blood sugar normal. Studies show that around 30-50% of men with Type 2 Diabetes have low testosterone.

Additionally, obesity and low testosterone have a close association with each other. Obese men are more likely to have low testosterone. And males with very low testosterone are also more likely to become obese.

Fat cells metabolize testosterone to estrogen and lower their levels. Also, obesity reduces levels of sex hormone binding globulin (SHBG), a protein that carries testosterone in the blood. Less SHBG translates to less free testosterone.

Losing weight through a healthy diet and exercise can increase testosterone levels. 

At the age of 40, men’s testosterone levels start to decline by around 1% with every passing year. Testosterone levels can be checked with the help of simple blood tests. The key is doing these tests consistently.

Treating Low Testosterone

One of the primary ways to combat low testosterone is through testosterone replacement therapy. This can help men improve their sex drive, muscle mass, bone health, and even their red blood cell count. If other health complications are causing low testosterone, it’s advised to focus on those before pursuing replacement therapy.  

At Texas Diabetes and Endocrinology, we provide the following treatments for low testosterone:

  • Skin patches
  • Gels
  • Injections
  • Nasal spray

For more information about treatments for low testosterone, contact us here. And don’t forget to follow on Facebook and Instagram.

Austin TypeOneNation Summit

Dr. Tira Chaicha-Brom, MD ECNU, of Texas Diabetes and Endocrinology, has joined a panel of experts who will be discussing Type 1 diabetes (T1D) and pregnancy at the upcoming Austin TypeOneNation Summit on Sunday, March 1, 2020.  

This educational conference is a great opportunity for those living with T1D, parents, caregivers, siblings and anyone interested in learning more about T1D. Topics include advancements in the treatment of T1D,  T1D and pregnancy and will showcase learning tracks for children and teens as well. Please join Dr. Chaicha-Brom at this important event.

Learn more and register today at bit.ly/TON2020

POLYCYSTIC OVARIAN SYNDROME

Do you have irregular periods? There are several reasons for missing periods, but one of the most common reasons is PCOS, polycystic ovarian syndrome.  

Symptoms of PCOS include:

  • Missing periods (usually having less than 9 periods per year)
  • Excess testosterone on blood work or on exam (excess hair growth, acne)
  • Ovarian cysts

PCOS is a diagnosis of exclusion so other diseases like thyroid or other hormone problems should be ruled out before making the diagnosis of PCOS.  The diagnosis is based on symptoms, laboratory findings, and sometimes imaging studies.

The risk of having PCOS is that it can be associated with diabetes or insulin resistance, sleep apnea, cardiovascular disease, weight issues, uterine cancer, infertility, and sleep apnea.

The cause of PCOS is unknown and treatment involves controlling the symptoms.  A healthy lifestyle with weight loss can oftentimes improve symptoms and prevent associated medical complications.  Birth control pills are typically used to help regulate periods and can sometimes decrease facial hair or acne. Metformin is another medication that is typically used to help control the blood sugar.

When a woman has regular periods, this is a good indication that her hormones are appropriate. 

You should let your healthcare provider know if you have irregular periods or excess hair growth or acne in order to do a proper evaluation.

The following references:

https://www.hormone.org/diseases-and-conditions/polycystic-ovary-syndrome

PCOSChallenge.com

What is the pituitary?

The pituitary is a hormone-producing gland that sits just beneath the base of the brain. It is very small – only about the size of a pea. The pituitary gland has two parts. The front portion of the gland makes hormones that affect the breasts, adrenals, thyroid, ovaries and testes, as well as several other hormones. The main glands affected by the back portion of the gland are the kidneys. It plays a major role in regulating vital body functions and general wellbeing. It is referred to as the body’s ‘master gland’ because it controls the activity of most other hormone-secreting glands.

What could go wrong with my pituitary gland?
Conditions that affect the pituitary gland directly can be divided into three main categories:

• Conditions that cause the pituitary gland to produce too much of one or more hormone(s). Examples include acromegaly, Cushing’s disease and prolactinoma.

• Conditions that cause the pituitary gland to produce too little of one or more hormone(s). Examples include adult-onset growth hormone deficiency, diabetes insipidus and hypopituitarism.

• Conditions that alter the size and/or shape of the pituitary gland. Examples include empty sella syndrome.

What are the symptoms of pituitary conditions that produce too much of one or more hormones?

A prolactinoma is a tumor of the pituitary gland that produces too much of the hormone prolactin. High prolactin levels can cause women to have irregular or absent periods, infertility, or abnormal breast milk production. In men, high prolactin levels cause low testosterone which leads to fatigue, decreased muscle strength, low libido, erectile dysfunction, and infertility.

Cushing’s Disease is a hormonal disorder caused by a tumor of the pituitary gland. The tumor makes too much of a hormone called ACTH (adrenocorticotropic hormone). ACTH causes an increase in the stress hormone cortisol. Cortisol is a hormone that regulates blood pressure, blood sugar, and the immune system.

Acromegaly is caused by a tumor in the pituitary gland that makes too much growth hormone. Common symptoms of acromegaly are abnormal growth of the hands and feet, joint pain, face changes (enlarging forehead, nose, tongue, lips, widened space between teeth, and underbite), carpal tunnel syndrome, sleep apnea, diabetes, high blood pressure.

What are the symptoms of pituitary conditions that produce too little of one or more hormone(s)?

Hypopituitarism is a rare disorder in which your pituitary gland fails to produce one or more hormones, or doesn’t produce enough hormones. This can cause a variety of different symptoms depending on which hormone has been affected.

Growth hormone (GH) deficiency
In children, GH deficiency may cause growth problems and short stature. Most adults who have GH deficiency don’t have any symptoms, but for some adults it can cause fatigue, changes in body fat and muscle weakness.

Luteinizing hormone (LH) and follicle-stimulating hormone (FSH) deficiency
Deficiency of these hormones affect the body’s reproductive system. In women, the deficiency can cause irregular periods, hot flashes, low libido and the inability to produce milk for breast feeding. Men may also have symptoms such as erectile dysfunction, decreased facial or body hair, low libido and mood changes.

Thyroid-stimulating hormone (TSH) deficiency
This hormone controls the thyroid gland. A TSH deficiency leads to low levels of thyroid hormones (hypothyroidism). Symptoms include fatigue, weight gain, dry skin, constipation, hair loss and feeling unusually cold.

Adrenocorticotropic hormone (ACTH) deficiency
This hormone helps your adrenal glands work properly, and helps your body react to stress. Symptoms of ACTH deficiency include severe fatigue, nausea or abdominal pain, and low blood pressure, which may lead to fainting.

Anti-diuretic hormone (ADH) deficiency
This hormone helps your body balance its fluid levels. Symptoms of ADH deficiency can cause a disorder called diabetes insipidus, which can cause excessive urination and thirst.

Prolactin deficiency
Prolactin is the hormone that tells the body when to start making breast milk. Low levels of prolactin can cause women to have problems making milk for breast-feeding.

What are the symptoms of pituitary conditions that alter the size and/or shape of the pituitary gland?

Empty Sella
Most individuals with empty sella syndrome do not have any associated symptoms, but the finding raises concerns about hormone deficiencies.

What is the treatment?

The treatment for pituitary problems are vast. Sometimes only monitoring the patient is needed. Other times a simple medication can resolve problems; however, in some cases surgery is required.

Why you should contact TD&E?

Pituitary disorders are often complex, and successful diagnosis and treatment can be a challenge. The physicians at TD&E offer an integrated, comprehensive approach to all pituitary problems. To ensure the best chances for successful treatment, you should be cared for by experts who specialize in pituitary diseases.

Resources

1. http://pituitarysociety.org/patient-education/pituitary-disorders
2. http://www.yourhormones.info/glands/pituitary-gland/
3. https://www.hormone.org/diseases-and-conditions/pituitary-tumors
4. https://www.mayoclinic.org/diseases-conditions/hypopituitarism/symptoms-causes/syc-20351645

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