Feeling tapped out? Foggy? Just not all that into sex? Gotta be your testosterone, some people would have you believe. And we’re believing it, too, with interest and investment in T-boosters and T-supplements rising steadily in the past decade.
Don’t get us wrong: testosterone is one critical hormone. Babies first encounter it in utero, when it triggers the differentiation of boys from girls. In puberty, it contributes to your bone growth and muscle mass, and continues to affect functions including your red-blood-cell production and mood stability.
But the message certain vested interests are sending plays right into the economic and social anxieties men are facing. It’s like when anti anxiety meds such as Valium first came onto the scene, says urologist Elizabeth Kavaler. “All these middle-aged women were addicted to Valium, because that was the solution to everything. Testosterone has become the new answer for a life of quiet desperation.” More and more of us are feeling the exhaustion of uneasiness. We are being asked to do more with less. We’re just trying to get through the day alive. “Men think, ‘Well, if I just get a little testosterone, I’m going to feel great!’” Kavaler says. “And that’s not the case.”
There’s so much information out there about T – much of it speculation and lore – that leads us to jump to conclusions about it. Men put all kinds of psychological weight on their testosterone number – a low one makes you think you’re somehow less manly; a high one means you’re basically LeBron James – and that’s where we get things wrong. There’s little evidence for those stereotypes. Low doesn’t automatically imply you’re weak or retiring; high doesn’t guarantee you muscles or MVP athletic performance.
A low number might not even be a low number for very long. It might just indicate that you haven’t been treating yourself very well. A high number doesn’t mean you’re programmed to be aggressive. As long as your T is in the normal range, there’s nothing about a high number that’s better than a low one, or vice versa. In the name of science and good journalism, I got my testosterone tested twice while writing this story.
It put my assumptions up against a pretty big test, too. What do you really know about this famous hormone? Here, we break down the best and latest information to give you the clearest picture yet of what T means for you.
What testosterone can – and can't – do
IT CAN . . .
- Build muscle mass
- Help maintain bone density
- Boost red-blood-cell production, increasing oxygen-carrying capacity
- Improve libido
- Promote erections
- Help keep mood stable
BUT TOO MUCH ALSO CAN . . .
- Thicken the blood, creating a clot/ embolism risk
- Cause acne
- Cause man boobs
- Shrink your testicles
IT CAN’T . . .
- Grow connective tissues and ligaments (meaning if you’re using T to get jacked, all the extra muscle could end up being unsupported, leading to injury)
- Make your penis bigger
- Make your erections last longer
- Make her love you again
BUT IT ALSO CAN’T . . .
- Give you ’roid rage (at least not on its own – aggression stems from a variety of factors)
- Increase odds of prostate cancer
- Create heart problems (it may even reduce them)
What you need to know about testosterone
1. Get tested
You should have at least two blood tests, since T is constantly in flux. It peaks in the morning, so if you’re young and on a typical sleeping schedule, aim to be tested by 10am. If you’re over 50, it doesn’t matter as much. Also note: vitamins with biotin can lower your score, so skip them for three days before testing.
2. Don't read too much into it
A T level of 8.64 to 29 nanomoles per litre of blood is considered normal. If you are close to 8.64 and you feel fine, then you’re no less healthy than a guy whose level is 35 and also feels fine. There’s an exception to that, though. (See “What the Numbers Mean”.)
3. Not reading into it is harder than it sounds
I got my first test at the tail end of a busy week. I’d slept less than five hours the night before, then scrambled to the phlebotomist in a daze. My number: 9.9. That’s in the normal range, but just barely. I have no symptoms of low T, but it was hard to shake the feeling that there was something wrong with me, even though I know that normal is normal, no matter where it is in that range. Eleven days later, I was tested again. My number was 14.8. Why such a dramatic change? It might be because I’d slept better and cut out my multivitamins. Irrational or not, I felt like more of a man. The whole experience was a microcosm of our relationship with T. We act like it’s destiny, but it’s just biology – easily misunderstood and more varied than we think.
Symptoms of low testosterone
Common symptoms of below-normal t, which could affect as many as 500,000 men in Australia (generally older men):
1. Lack of energy
You’re lethargic – not like you didn’t get enough sleep last night but like no matter what you do, you never feel rested.
2. A paunch
Having a dad bod doesn’t mean you have low T – but it could be one indicator.
3. Lack of libido
Sort of. It’s the lack of your base level sex drive – that sudden feeling of being turned on by the sexy person you spot on the street – that indicates low T, according to Dr Tobias Kohler, of the Mayo Clinic. It’s not considered low libido when you don’t want to have sex on a Thursday night after you’ve been crushed by work all week.
4. Erectile problems
Only precipitously low T will keep you limp. But if you have problems getting it up, you may have other issues to solve, which may require a visit to a doctor. Or a little blue pill. Or couples therapy
What can you do if your testosterone is low?
If your t is truly low you’ve got three courses of action, says mills, in order of increasing aggressiveness. choose wisely.
1. Lifestyle Adjustment
The single best thing you can do to improve your level is be healthier. Avoid stress, get more sleep and lose weight – an enzyme in fat tissue converts testosterone to estrogen. That’s one reason flab can lower your T. It’s also why overweight guys can develop man boobs, and why bodybuilders who juice can also develop man boobs – they don’t have much fat, but they’ve jacked their T levels so high that there’s a lot of it available to be turned into estrogen. Thinking of T strictly as “the male sex hormone” oversimplifies the complex hormonal interactions that make our bodies work. Which is also why, if you can avoid it, you don’t want to go with the needle-in-the-butt routine to raise your T.
2. A Testicle Stimulant (plus lifestyle adjustment)
If your level is low enough to warrant more aggressive treatment, your doctor can prescribe a drug that causes your pituitary to tell your gonads to make more testosterone. The typical choice is clomiphene citrate (Clomid), a common fertility drug for women. Using it doesn’t exempt you from needing to get healthy, though, as it doesn’t diminish the risk of losing T to bad sleep and a beer belly.
3. Testosterone Replacement Therapy (and yes, you’ll still need to adjust your lifestyle)
This should be your last resort. When you give your body T, it stops making its own, and there’s no guarantee it can start again. Before you replace it, find a doctor who can help you choose from the following delivery systems (see right), and be glad that we’ve moved past the early days of replacement therapies, like one in the 1920s that involved transplanting goat testicles into men.