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The number of men turning to treatment for low testosterone has jumped dramatically over the past decade. But there is sharp disagreement on whether testosterone therapy does any good.
Medical professionals quoted in a recent USA Today article are deeply divided on low T therapy. One person says it’s helpful, while another says it’s just a marketing tool from pharmaceutical companies.
Johnnie Cook, M.D., with the American Academy of Family Physicians, says he believes low testosterone is a real problem for some men and there is a proper place for this kind of therapy. However, he also believes low T has been widely over diagnosed.
Cook says, “All men should not be treated with testosterone, only those who have documented symptoms.”
Cook says he has had patients with symptoms like low libido and low energy, asking for a specific testosterone treatment, even though they didn’t need it.
“I have had several men come in who had symptoms of hypogonadism low testosterone, they thought, but, they had normal blood levels. In that situation it’s not appropriate to supplement them with testosterone,” Cook says.
There also is some debate on what a low level of testosterone is. Recent reports show there isn’t one set definition that has been widely accepted. But Cook says studies have been done where researchers have looked at free testosterone and total testosterone levels among large populations of men, and they can see if a man’s chemistry is out of that range.
He says, “The recommendation of many experts is that you should be tested three separate times, have three separate low blood testosterone levels on blood levels that are done first thing in the morning, when it’s most accurate, to assure that you actually have low testosterone before you treat it.”
Plus, there are possible dangers of inappropriately supplementing testosterone in men who don’t need it. Cook says it should never be given to a man with prostate cancer, and it might negatively affect an enlarged prostate. He says older men and former athletes misuse this kind of treatment frequently.
“They get more muscle mass, but they have much [higher] chance of side effects and risks and it’s not appropriate,” he says.
For many men, it may not be necessary to take medication to boost their testosterone levels. Cook says if men exercise more often and eat a more nutritious diet, their levels may go up on their own.
