All about Testosterone: How to spot if you have High or Low T

Testosterone is a word many have heard of, but may not know a lot about. To some, the word may be an unknown entity that sweaty rugby players charging around a field probably have plenty of, but nobody knows why or what specifically it is. To some, testosterone is purely linked to the display of aggressive behaviour, but it is more complex than that.

Testosterone is actually the principal male sex hormone derived from the androgen group and is an essential factor in sexual and reproductive development, produced primarily in the testes.  It helps a number of important functions such as muscle mass/strength, sex drive, sperm production, fat distribution, bone density and red blood cell production.

The development of secondary sex characteristics at puberty is also aided by testosterone, such as voice deepening and growth of facial and body hair.

Testosterone is also present in women too, but at substantially lower amounts than those found in men. In women, testosterone is generated within the ovaries and adrenal glands, with their levels at an estimated tenth to a twentieth of man’s levels. As it is a steroid hormone, testosterone is derived from cholesterol.

Low testosterone

Levels of testosterone are known to decrease over time with age, but many health experts are in disagreement about what brings on ‘Low T’, known as hypogonadism, and the topic is often a controversial one. Men typically receive treatment for hypogonadism if their testosterone levels are below 300 nanograms per decilitre and they are showing symptoms of low testosterone.

Many men are terrified that dwindling levels of testosterone will lead to a huge drop in sexual desire and performance will be impacted. As men advance in their years, sexual function could be affected by lowered levels of the hormone, including:

. Infertility.
. Less desire for sex.
. Erectile dysfunction (ED), or less erections that may occur randomly, such as during sleep. The link between ED and testosterone is not fully understood, however low testosterone levels are with the same health conditions that have been linked to ED, such as type 2 diabetes, obesity and heart disease.

Other low T symptoms may include:

. Losing muscle mass.
. Decreased energy.
. Increased body fat.
. Depression/bad mood.

Low T treatment depends mainly on what you and your doctor deem to be the most suitable for you.

Gels and Solutions
Testosterone gels and solutions are applied each day, with the testosterone in the gel being absorbed directly through the skin when you apply the gel or solution.

Patches
Patches mean testosterone can be absorbed by the skin and are normally worn on the arm or upper body. They are applied once each day.

Injections and implants
Testosterone injections are typically administered into the upper buttock, every 1-2 weeks by your doctor. Testosterone may also be implanted as pellets within soft tissues. The testosterone is slowly absorbed by your body into the bloodstream.

High testosterone

If a woman’s body produces too much testosterone, she may experience irregular or absent menstrual periods and excessive body hair (hirsutism). In addition, frontal balding – similar to male pattern baldness -  is another sign that a woman has high testosterone levels as well as suffering with acne, increased perspiration, an enlarged clitoris, increased muscle mass and their voice deepening.

However, the good news is that a combined anti-testosterone (androgen) and oestrogen medicine named Dianette (Cyproterone Acetate / Ethinylestradiol) can be prescribed for women with these problems. Not only does it work as an oral contraceptive pill, Dianette can be prescribed to regulate periods, combat excessive hair growth on the face and body (hirsutism) in women, help to reduce acne which hasn’t improved after the long-term use of oral antibiotics in women and can help women who suffer with female hair loss.

Spironolactone could reduce the pain for millions with arthritis

The potassium-sparing diuretic Spironolactone may have another use in the near future after scientists found that it could help the millions of people around the world suffering with debilitating arthritis.

Now commonly referred to as a ‘water pill’, due to the fact it can treat fluid retention (edema) caused by various conditions such as kidney or liver disease, Spironolactone was initially developed more than 40 years ago as a treatment for high blood pressure and heart failure.

However since then, the capabilities of Spironolactone have been revealed and the medication can now be prescribed as an acne treatment (for women only). For over 20 years, Spironolactone has been a popular anti androgen in the treatment of acne and hirsutism, becoming the most widely prescribed medication for these problems in the USA.

If all that wasn’t enough, new research has shown a breakthrough that could benefit the estimated 6 million Brits who are struggling with osteoarthritis – the most common type of arthritis in the UK – forcing 1 million people in the UK to see their GP about it each year.

The first study, led by Professor Marion McMurdo, head of ageing and health at Dundee University, was conducted earlier this year and assessed the effects of whether taking 25mg of Spironolactone daily for a duration of 5 months would provide any relief for osteoarthritis sufferers.

The results have been published in the American Journal of Medicine, and report that many patients said they had a decrease in pain levels.

Those behind the study believe that Spironolactone reduced pain by suppressing a hormone called aldosterone, previously linked to inflammation in the joints, or could increase levels of cortisol, a hormone lessens the body’s sensitivity to pain.

The next stage for Professor McMurdo and her team will be the monitoring of 86 patients aged 70 or over, all of whom suffer with severe knee pain. Participants will either be given Spironolactone or a ­placebo, daily for 12 weeks. Pain will be analysed and their joint inflammation will be measured before and after the trial.

Professor McMurdo said: “Osteoarthritis affects over half of the older population and there is no cure, so the goal is to reduce pain and stiffness. Older people are particularly prone to drug side effects. Most commonly used painkillers cause side effects – like confusion and constipation – and can cause bleeding from the stomach. Such bleeds are much more serious in an older person. So fresh drug approaches to managing osteoarthritis in older people are urgently required. If effective, Spironolactone would provide a safer, more economical prospect than many modern anti-inflammatory drugs. It only costs £1 a week and we know from its use as a heart treatment that it is relatively safe.”

Professor Alan Silman, medical director of Arthritis Research UK, has put his faith into Spironolactone being a successful and viable treatment option for arthritis in the future, even pledging £135,000 to help cover the research cost.

Professor Silman commented: “Spironolactone has been around for decades so we know it is safe.”