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“Are you tired? Have you lost your edge, you sense of vitality, your ‘mojo’? Does sex feel like work, or maybe it does not work out any more? Is your mood blah? Have you put on a gut even though you don’t seem to be eating any more than your ever did? May be it is your age. Or maybe just maybe, you have a medical condition called low testosterone, or, as I prefer to call it low T.”

So starts the book Testosterone for Life, by Abraham Morgentaler, M.D., Associate Clinical Professor at Harvard Medical School.

Testosterone for Life

In my previous blogs, I mentioned how early last year, for the first time in my life, I did a comprehensive blood tests. I got these tests done through Life Extension Foundation. These test included all basic hormones.

Only two items showed up not within the “Reference Ranges”: A1c and Free Testosterone. With respect to the LabCorp’s reference rages, my Hemoglobin A1c value of 5.8 was too high (reference range 4.8 to 5.6), even though my fasting Glucose was 91, well within the reference range.

On the other hand, my Free Testosterone value of 5.5 was too low (Reference Range 7.2 to 24.0), while Total Testosterone, DHEA-Sulfate and Estradiol where all within the reference rage.

Now I was quite familiar with A1c, even though I expected it to be normal since my fasting glucose has always been stable around 90 during all my wellness tests.

But Testosterone I did not know anything about. So, I hit the books. The above referenced book by Dr. Morgentaler was one of the first authoritative books I read on the subject. Male Hormone Restoration is another good source. There are also many papers on this subject on NIH Pubmed, for example: The benefits and risks of testosterone replacement therapy: a review.

One of the guidance that Dr. Morgentaler and others practitioners offer is that not all low Testosterone (or Low-T) cases need to be treated. Physicians must examine low-T blood test measurements and correlate with the clinical symptoms. List of symptoms looks the same as at the top of this post for this condition called Hypogonadism:

  • Are you tired?
  • Have you lost your edge, you sense of vitality, your ‘mojo’?
  • Do you have no or low libido (desire for sex)?
  • Do you have erectile dysfunction?
  • Is your mood blah?
  • Have you put on a gut even though you don’t seem to be eating any more than your ever did?
  • Do you have difficulty building muscle mass, bone mass or gaining strength even with workouts and right nutrition?

So per recommendation of practitioners, if some combination of above symptoms exists along with low-T, boosting testosterone may be in order.

I could answer yes to several of the questions above. I had also noticed that fat loss and muscle gain had also plateaued in spite of my continued regime of workouts and nutrition. In fact, in the book, The Life Plan, Jeffry S. Life, M.D., describes how at one point in life low-T became an impediment to maintaining his body composition.

The life plan

I immediately researched and added some supplements to my regime: Miraforte from Life Extension and Male Rejuvenator from Xtend-life. Over the following six months I noticed my Free Testosterone improve as much as 70%. However, my A1c even to increase.

Concerned with trend of my A1c, about six months ago, I started working with Benjamin Gonzalez, M.D. who specializes in functional medicine and hormone replacement therapy (HRT).

After reviewing my tests, conditions and efforts, Dr. Gonzalez started prescribing Testosterone Replacement Therapy (TRT).  In fact, he like many researchers, believes that optimal testosterone levels should be on the high end of the range, close to what men in their 20s will have. This can be a source of slowing down or reversing many age related issues.

The only known downside of TRT is that it is that the supplementation is not recommended if you have enlarged prostates – although that risk is still not proven in the research. 

The treatment involved once a day regime of DHEA supplements as pills and bio-identical testosterone applied as topical cream on wrists. It took about six weeks, before the impact of TRT became apparent. I started noticing that:

  • My daily energy level and “mojo” is up
  • Sexual performance is much better
  • Libido is much improved
  • My fat loss and muscle gain has resumed.

Just last week, I did a set of follow up tests and review with Dr. G. – about six months since starting TRT and coincidental with my 61st birthday. Free Testosterone, DHEA-Sulfate and Estradiol levels are now actually higher than the high end of respective reference ranges.   As a result, Dr. G. has advised, backing down somewhat the daily amount of testosterone.

Fortunately, my wife has also chosen to undergo HRT at the same time I did to balance and optimize her own hormones.  She is also experiencing very positive results.  So, we are well matched in energy and libido.  How lucky for me!

Having gone further up, my hemoglobin A1c is back down to 5.8, but I don’t have enough data points to see if the improvement in A1c is correlated to testosterone levels. So, getting my A1c down is still an active chase for me.

In the past couple of months, I have been talking to my friends and family, especially those over 50 to get their Testosterone levels checked and pursue treatments the levels are low and they have symptoms of hypogonadism.

To bring this issue to light, many researcher have been popularizing the term Andropause, which is like menopause for women.  However, for most men, the decline of testosterone is very gradual starting in their 30s and is not a sudden event as for most women.

So, how about you? Have you had any experience with hormone replacement?

What was your experience?

I would love to hear, so I can and others learn from your knowledge and experience.

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