Testosterone Replacement Therapy: Here's Everything You Need to Know

The truth about the treatment behind the ubiquitous ads.

By Ari Notis, Best Life

All those “low-T” ads you’ve seen on TV the last few years? Well, it turns out they work. In fact, they’re so effective that, according to Reuters, more than 1 million men (out of a study of 17 million) had their T-levels tested between 2009 and 2013, the period in which those ads really started to take off. 300,000 of those guys went on to receive testosterone replacement therapy (TRT), the process by which men receive supplemental testosterone.

Of course, you don’t need a degree in rocket science to understand why TRT is an easy sell. After all, what guy wouldn’t fork over a few bucks to instantly have more energy, better sex, bigger muscles, greater focus, and a healthier all-around temperament?

But the big question remains: unless you’re part of the tiny percentage of men who actually suffers from hypogonadism—or “T deficiency”—do you really need a shot of testosterone in your rear? And is TRT ultimately safe course of action? Herewith, we address all of your concerns about today’s supplemental “fountain of youth.” And while you’re exploring T therapy, don’t forget the tests you need to demand from your doctor.



1

It’s Way Too Easy to Get

The first thing you need to know about TRT is that it requires a prescription. However, that prescription is very, very easy to get. According to The New York Times, primary care physicians—by no means dedicated experts on testosterone levels—are dishing out more than 60 percent of all TRT prescriptions. “A lot of people are walking into doctors’ offices and asking for prescriptions, and doctors are complying, in part because they don’t want to lose patients,” John Hoberman, the author of Testosterone Dreams, told Men’s Fitness. “A lot of sloppiness and fraud comes when you just slosh this stuff out there and let every Tom, Dick, and Harry try it.”

Remember: just because you can get it doesn’t mean you need it. Make it a point to consult an endocrinologist who specializes in hormones.



2

You Need a Blood Test

According to the same Men’s Fitness report, “one in four men undergoing TRT never seeks a blood test.” That means that a quarter of all testosterone-taking men out there are basing their treatments on instinct—or worse, WebMD. For starters, get some blood-work done, and you’ll know your T levels. When you know your T levels, you’ll know whether or not you could actually use some more testosterone.



3

Even Old Guys Can Have “Normal” T-Levels

Your testosterone level peaks around the age 20 and starts falling after 30 at a rate of roughly one percent per year. Blood-testosterone levels are measured by nanograms per deciliter. (Don’t worry: doctors won’t actually remove a deciliter of blood from your system.) A range of roughly 270 to 1,070 is considered average. And even geriatric 80-year-olds can test near 400. Hope that doesn’t make you feel too bad about your eventual results.



4

Your Sperm Count Will Deplete

In a dramatic twist, TRT causes sperm counts to crash faster than drunk truck driver on an icy road. If you’d like fatherhood to be in your future, we suggest holding off on treatment for the time being.



5

It’s Not Always a Shot

The most popular form of T treatment by far is AndroGel. It’s a topical salve, clear and odorless, that you rub onto your upper body daily. (Of note: according to AndroGel’s web site, women should avoid contact with unwashed parts of the body where the gel has been applied. So keep that in mind.)



6

Your T-Levels Change Throughout the Day

Your testosterone levels aren’t fixed; they, like the amount of caffeine in your system, or the amount of food in your gut, fluctuate between when you wake up and when you turn in. Levels are at their highest around 8:00 a.m. For those that never arise that early, life will never see you at your highest T-count.



7

TRT May Increase Red Blood Cell Counts

There haven’t been any critical, wide-ranging studies on this matter, but there may be a link between TRT and an increase of red blood cells. An increase like that, of course, can lead to not-so-fun side effects, like a heart attack or a stroke. Again, no significant data about this point has come out, but it’s certainly worth bearing in mind if you’re considering treatment.



8

TRT Won’t Turn You Into Hugh Jackman

A series of studies at the Charles R. Drew University of Medicine and the McMaster University have shown that if a man’s T-levels are higher than average, yet still in that 270 to 1,070 range, he won’t put on muscle at any increased rate. In other words, TRT isn’t steroids.



9

There Are Alternatives

To borrow parlance from every medicine television ad ever, TRT isn’t for everyone. There are natural ways to augment your T-levels—a diet rich in protein and vitamin B and D; getting a good night’s sleep—but for a safer, yet still artificial, solution, there’s always Clomid. Also known as clomiphene citrate, Clomid was designed to stimulate ovulation in women, but has been effective at raising T-levels in men, too. The writer of the Men’s Fitness report, in fact, tried it out—and saw his T-levels increase from 133 nanograms to an astonishing 722.



10

Some Guys Need It. You Probably Don’t.

If you’re a healthy guy in your 30s and 40s, your testosterone will be declining—but that doesn’t mean you actually need treatment. “If you go in and say, ‘Well, you know, in the past 10 years I’ve gotten more tired, I’m having trouble keeping weight off…’ that’s simply not enough—it’s a natural phenomenon!” Jacques Baillargeon, Ph.D., an epidemiologist at the University of Texas Medical Branch at Galveston, told Men’s Fitness. However, if you’re a man north of 50, and you’re having difficulty getting it up, you’re feeling depressed, and you’re generally unhappy, you should seek out TRT.

See more at: Best Life