Testosterone is a naturally occurring hormone that flows through the veins of every healthy male or female, even making its presence known as early as the womb. In males it’s responsible for development of genitalia and secondary sexual characteristics that occur during puberty (like a deepening voice, facial hair, broader shoulders, etc.). It’s also responsible for muscle size and tone, erections and sexual function, mental health, bone health, cardiovascular health, and overall health in general.
While it doesn’t play quite so prominent a role in female development, it also plays a role in their lean muscle mass and strength, along with their libido, energy, bone strength, and health in general.
Having healthful levels is crucial to the health of both men and women throughout their lives, and it’s only illegal if it isn’t prescribed by a doctor.
Of course, certain sports organizations have rules regarding using testosterone and other drugs to enhance performance. Case in point, famed cyclist Lance Armstrong was stripped of many of his awards because he used amounts of testosterone that were above and beyond the amount normally found in healthy adult males.
Myth #2: Testosterone is a steroid and steroids are dangerous.
Testosterone is in fact a steroid, but the term steroid is just a chemical classification of certain fat-soluble organic compounds, many of which are found naturally in the human body.
They’re responsible for having a whole slew of physiological effects ranging from tissue growth, reproductive development, inflammation, immune response, and even salt and water balance. Examples include estrogen and, of course, testosterone.
As mentioned in Myth #1, testosterone is responsible for the development of secondary sex characteristics in the male like broader shoulders, a deeper voice, development of sexual organs, facial hair, and most of the physical characteristics that distinguish men from women. When men get older and their testosterone levels drop, testosterone replacement therapy is often prescribed to reverse many of the effects of aging and to restore confidence, libido, and a more youthful, energetic feeling.
Of course, when most non-medical people refer to steroids, they’re referring to anabolic steroids, which are typically used for cosmetic reasons or physical performance (like building muscle, burning fat, or enhancing athletic ability).
It’s true that all anabolic steroids are synthetic variations of naturally occurring testosterone, but as mentioned, they’re used for non-health reasons and aren’t suitable for testosterone replacement therapy. Many have unpredictable side effects and they’re almost always used in extremely large, potentially dangerous doses.
So yes, testosterone is a steroid, but it‘s a naturally occurring one that’s vital to a healthy, functioning body and when used in therapeutic doses and monitored by a physician, it’s quite safe.
Myth #3: Testosterone causes wild mood swings and violent behavior.
There’s no evidence of any kind that testosterone causes men to lose their temper and turn into less-green versions of the rampaging Hulk.
Testosterone replacement therapy doesn’t even cause increased aggression in the slightest, nor does it lead to unpredictable behavior. In fact, the opposite seems to be true. Men – or teenage boys – who have low testosterone or have experienced delayed puberty are often excessively irritable and thin-skinned in general.
While “roid rage” might exist in athletes who use huge amounts of anabolic steroids, it just doesn’t happen in men receiving therapeutic doses of testosterone.
Myth #4: Testosterone causes prostate cancer.
Back in the 1940’s, doctors didn’t know much about prostate cancer (or any cancer, for that matter). However, they noted that men with metastatic prostate cancer lived a bit longer when they were castrated. This led the doctors – and a couple of generations of doctors that succeeded them – to assume that it was testosterone itself that promoted prostate cancer.
They were wrong. All their observations proved was that the only men at risk for the growth of prostate cancer from higher testosterone levels were those that had already been castrated. Fortunately, the population of castrated men is almost non-existent.
The truth is, men with low testosterone don’t have anything to fear from TRT (testosterone replacement therapy). It won’t increase their risk of developing prostate cancer. Consider the analysis of more than a quarter of a million records of men in Sweden that was just released at the annual meeting of the American Urological Association in San Diego, California this past May (2016).
The researchers found that men who’d been prescribed testosterone for longer than a year not only had no overall increased risk of prostate cancer, but their risk of aggressive disease had been reduced by 50 percent.
And this is only the most recent of many studies that squelch the myth that TRT causes prostate cancer.
Myth #5: High testosterone leads to baldness.
It’s long been thought by the general public that men with male pattern baldness have higher levels of testosterone than their well-coiffed counterparts. They don’t. In fact, they have the same amount of testosterone as men with full heads of hair.
Baldness is genetically determined. Now it is true that some testosterone in the body is converted to a chemical DHT, or dihydrotestosterone, and that chemical can bind to follicles and weaken them, eventually causing the hairs to fall out. However, that’s only in men genetically pre-disposed to baldness. Even in men who are genetically pre-disposed to hair loss, most of that seems to stabilize in their 30’s, so it’s highly doubtful that TRT will make things any worse.
Besides, the baldness drug Propecia specifically prevents the formation of DHT, so those who are overly concerned about TRT and hair loss can use it to ameliorate their fears (and presumably, their feared hair loss).
Myth #6: Testosterone causes heart disease.
A couple of years ago the FDA became worried about testosterone. All their worries stemmed from one single study that appeared in the journal Plos One.
The authors of the study examined a large healthcare database for guys who’d been on testosterone replacement therapy (TRT) for 90 days. Younger men with a history of heart disease who started TRT had a two to three-fold increase in the risk of myocardial infarction. Guys over 65 who started TRT had a two-fold increase in the risk of myocardial infarction, regardless of their cardiovascular history.
The study had several problems, though:
- The study didn’t consider levels of testosterone before treatment or after treatment. Therefore, we have no idea if the men had low testosterone in the first place, or if in fact they were being grossly overdosed.
- The study didn’t monitor estrogen levels or red blood cell levels. If high estrogen levels aren’t addressed by medication and high red blood cell counts aren’t adjusted by changes in dosing, heart problems are possible.
- The study’s entire control group was on a drug that prevents heart attacks, making the comparison between them and the testosterone group ludicrous.
So let’s throw that study aside, preferably over a bridge and into a raging river. Consider that about a month before that study was published, the Journal of the American Heart Association published a meta-study that compiled the results of over 100 studies on testosterone and heart health. They found, unequivocally, that higher levels of testosterone were essential to heart health.
In fact, the journal reported that low testosterone was associated with a higher rate of mortality in general, along with higher rates of cardiovascular mortality, obesity, and diabetes!
The list of possible conditions associated with low testosterone was downright scary:
- Higher risk of cardiovascular disease
- Narrowing of carotid arteries
- Abnormal EKG
- More frequent congestive heart failure
- Increased incidence of angina
- Increased body mass index
- Type II diabetes
- Metabolic syndrome
- Insulin resistance
- More belly fat
- Higher death rate from all causes, including cardiac mortality
So what it comes down to is that you have one ill-conceived study portraying testosterone in a bad light, compared to at least 100 others proving that low levels of testosterone are bad, very bad for your health.
But let’s look at one more study, just to put your mind at ease. Three years ago, researchers at the Intermountain Medical Center Heart Institute in Salt Lake City recruited 755 heart patients between the ages of 58 and 78 who also tested low in testosterone.
The men were divided into three groups, two of which received testosterone replacement therapy in the form of gel or an injectable, and one group that served as the placebo group.
After one year:
- 64 patients who weren’t on testosterone replacement therapy suffered a major cardiovascular event (stroke, heart attack, or death).
- Only 12 patients on medium doses of testosterone experienced a major cardiovascular event.
- And only 9 patients on high doses of testosterone experienced a major cardiovascular event.
In other words, non-testosterone patients were 80% more likely to suffer an adverse event!
The same trends continued 3 years later. One hundred twenty-five of the untreated men experienced stroke, heart attack, or death, as compared to 38 of the medium-dose testosterone replacement patients and only 22 of the high-dose testosterone replacement patients.
Clearly, normal or even slightly higher than normal testosterone levels are good for the heart and cardiovascular health in general.
Myth #7: Men should only be treated with testosterone if their blood levels are low.
Most doctors don’t measure testosterone levels. Historically, it just hasn’t been part of the standard health panel of drug tests, but it damn well should be.
If they do measure testosterone levels, however, they’ll almost always measure something called “total testosterone,” which is, as the name implies, a measurement of the total amount of testosterone flowing through your veins.
The numbers might range anywhere from 300 to 1100 (nanograms per deciliter of blood). The trouble is, it tells you almost nothing about your hormonal status. For one thing, blood values of testosterone vary by the minute. The only way to get a reasonably accurate reading would be to collect urine over a 24-hour period and have the lab use it to measure testosterone and its metabolites. Alternately, you could donate at least three blood samples from different times of the day. The lab would then pool the samples together and test that sample.
But those ways are more expensive, more time consuming, and more inconvenient. And even if you did pool multiple blood samples, it still wouldn’t tell you much. For one thing, even though the results might indicate that you have a “normal” level of testosterone, it might not be normal for you.
Perhaps you had a reading of 1,000 in your twenties, but now you’re getting by on a comparatively low level of 400. While 400 is considered normal, it might not be normal for you. The only way you’d know what was normal for you is if you’d established a testosterone baseline reading before you turned 30, but hardly anybody does that.
Then there’s the issue of steroid hormone binding globulin, or SHBG. It’s what’s called a glycoprotein and it literally binds up the sex hormones, including, on average, about 60% of your testosterone, and that percentage keeps climbing as you grow older. The more SHBG you have, the more of your testosterone is bound up, leaving less of it free to do all the good stuff. So while your testosterone level may be as high as 600, a good portion of it’s locked up.
That’s why, at the very least, when trying to determine your testosterone levels, doctors should ask the lab for your total testosterone levels, your “free” testosterone levels, and your “bioavailable” testosterone levels so you can get a little bit better of an idea of what your testosterone situation really is.
Determining normal testosterone levels is tricky, so regardless of what your lab values are, and given the problematical nature of the lab tests, you have to instead rely on symptoms and the simple desire to be more than you are, hormonally speaking.
Myth #8: The main symptom of low testosterone is a low libido or erectile dysfunction.
While many men first seek out TRT because they’re having trouble with erections or experiencing a diminished sex drive, there are plenty of other symptoms of low testosterone.
Among them are:
- Low energy.
- Inexplicable increase in body fat.
- Loss of muscle tone.
- Premature aging.
- Difficulty concentrating.
- Memory loss.
- Increased sadness.
- Failure to take the initiative when called for.
While low testosterone has largely been a problem of middle age and beyond, a 2006 study reported that 39% of men over 45 suffer from it. Another study said that while 13 million men in the U.S. may be deficient in testosterone, fewer than 10% get treatment for it.
And consider that these statistics reflect only those men that were clinically deficient, i.e., their lab tests indicated they were low. It leaves out the millions – many who are young or relatively young — whose lab tests say they may be fine but based on their symptoms, are probably deficient.
The bottom line is, don’t wait for your equipment to fail before seeking help. Be pro-active and see how you fare with the above checklist of symptoms.