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Men with extremely low testosterone

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As you know (check out the photo) the world is rapidly changing pace, more and more information about testosterone is made available from unreliable sources and even anonymous people in the Internet. Many of the symptoms of having low testosterone can easily misguide someone who is trying to keep his health. For example, feeling tired, not having enough sexual drive, gaining weight rapidly or having problems with physical performance are symptoms that could be misinterpreted. The reason they appear might not be low testosterone, and even though hormone replacement may have an effect, it does not attack the underlying cause

 

 

For example, in the European Male Ageing Study, 27-39% of men had symptoms of low libido and other sexual symptoms, but only 2% of them were diagnosed to have hypogonadism (the syndrome of low testosterone levels). On that line of thought, this article deals with men with extremely low testosterone levels. These group of patients usually have deep endocrine disorders, and the appropriate treatment for them is hormone replacement therapy, and nothing else. What could drive a man’s body to produce extremely low levels of testosterone?

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  • Delayed puberty: During the age 12 onwards, there’s a constant anxiety on young men to undergo the expected changes in their bodies: hair growing, penis enlargement, voice pitch changes, and overall increase in muscle mass. Delayed puberty is diagnosed after reaching age 14 years old. A physical examination must be made, including measuring the size of testes and the levels of testosterone. When it so happens, it can be caused because either the testes are not secreting testosterone, or the pituitary (the central gland that commands everyone else) is not doing its job properly. In case the testes are to blame, the most common is Klinefelter syndrome, and it is a genetic alteration. Otherwise, there are other less known syndromes, infiltrative diseases, and tumors doctors would have to cross out to know what happens and how to solve it.

 

effeminate men low testosterone

  • Functional hypogonadism: After having a normal puberty, men can undergo certain medical conditions that affect their secretion of testosterone. This happens remarkably on diabetes, obesity, and the metabolic syndrome. Note that all three of them have to do with weight and fat gain, and there are many reasons why. For example, the stem cells in our body can either become muscle cells or fat cells, and testosterone gives a signal that favors their conversion into muscle cells and not fat. Testosterone also blocks the incorporation of more fat into the fatty tissue, and aids in the chemistry of fat burning. On the other hand, fatty tissue releases a series of chemicals to the blood that blocks the normal activity of the pituitary, thus affecting the signals that release testosterone to the blood. Also, there is an enzyme in abdominal fat called aromatase, and it converts circulating testosterone into estradiol, woman’s sex hormone. As noted, testosterone and fatty tissue does not get along. However, not every person having these conditions should necessarily run a test, but only after reporting symptoms of low testosterone levels.

 

  • Aging men with Andropause: It is common knowledge that testosterone levels decrease with age. After the fifth decade of life, it is expected that testicular function starts to fall and with it the blood testosterone levels as well. However, it is not a rule of thumb: recent studies say that unless they have a serious disease, the levels of testosterone in older men can be similar to those found in younger men. Obesity, insulin resistance, and having undergone tumors, radiation therapy or chemotherapy would increase the chance of developing andropause.

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References:

Laaksonen, D. E., Niskanen, L., Punnonen, K., Nyyssönen, K., Tuomainen, T. P., Valkonen, V. P., … & Salonen, J. T. (2004). Testosterone and sex hormone–binding globulin predict the metabolic syndrome and diabetes in middle-aged men. Diabetes care27(5), 1036-1041.

Singh, R., Artaza, J. N., Taylor, W. E., Gonzalez-Cadavid, N. F., & Bhasin, S. (2003). Androgens stimulate myogenic differentiation and inhibit adipogenesis in C3H 10T1/2 pluripotent cells through an androgen receptor-mediated pathway. Endocrinology144(11), 5081-5088.

Herbst, K. L., & Bhasin, S. (2004). Testosterone action on skeletal muscle. Current Opinion in Clinical Nutrition & Metabolic Care7(3), 271-277.

Russell, S. H., Small, C. J., Stanley, S. A., Franks, S., Ghatei, M. A., & Bloom, S. R. (2001). The In Vitro Role of Tumour Necrosis Factor‐Alpha and Interleukin‐6 in the Hypothalamic‐Pituitary Gonadal Axis. Journal of neuroendocrinology13(3), 296-301.

Watanobe, H., & Hayakawa, Y. (2003). Hypothalamic interleukin-1β and tumor necrosis factor-α, but not interleukin-6, mediate the endotoxin-induced suppression of the reproductive axis in rats. Endocrinology144(11), 4868-4875.

Frost, M., Wraae, K., Nielsen, T. L., Hougaard, D. M., Brixen, K., Hagen, C., & Andersen, M. (2013). Similar reference intervals for total testosterone in healthy young and elderly men: results from the Odense Androgen Study. Clinical endocrinology78(5), 743-751.

Ucak, S., Basat, O., & Karatemiz, G. (2013). Functional and nutritional state in elderly men with compensated hypogonadism. Journal of the American Medical Directors Association14(6), 433-436.

Szulc, P., Claustrat, B., Marchand, F., & Delmas, P. D. (2003). Increased risk of falls and increased bone resorption in elderly men with partial androgen deficiency: the MINOS study. The Journal of Clinical Endocrinology & Metabolism88(11), 5240-5247.

Ferrucci, L., Maggio, M., Bandinelli, S., Basaria, S., Lauretani, F., Ble, A., … & Longo, D. L. (2006). Low testosterone levels and the risk of anemia in older men and women. Archives of internal medicine166(13), 1380-1388.

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