Tuesday 12 November 2019
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Get the “low down” on low testosterone by Dr. Greenberg

Testosterone is the hormone that makes the men in your life not just a male, but a man. And I don’t mean that it makes him forget to put the seat down or your anniversary. Testosterone plays a key role in sex drive (the “Grrrrrrrrrrr”, as one expert puts it), mood, energy level, cognitive function (how sharp their thinking is) fitness to some degree, and a general feeling of well-being and enjoyment of life. Like many things in this world, it may be easier to understand what it does by thinking about what’s missing when men don’t have enough of it.

Here are the 10 questions doctors commonly ask when they’re trying to determine whether a man has low testosterone (Low-T). It’s known as the ADAM questionnaire.

Do you have a decrease in libido (sex drive)?  

Do you lack energy?  

Is your strength or endurance decreased?

Have you lost height?  

Have you noticed decreased “enjoyment of life”?  

Are you sad or grumpy?    

Are your erections less strong?  

Have you noticed a recent deterioration in your ability to play sports?  

Do you fall asleep after dinner?  

Has there been a deterioration in your work performance?

The answers are all “yes” or “no”, and if the answer is “yes” to question 1 or 7, or 3 or more in total, it’s worth taking the next step to find out if Low-T is in fact the problem.

I think on some level doctors need to ask these questions because in the relatively short period of time we spend with our male patients (if they show up at all) we can’t observe many of these things. However, if you “live” with them – i.e. spend a lot of time with them, perhaps even a co-worker – if you take a minute to think about it, you probably know the answers, maybe better than they do.

I suggest taking a minute to think about it, because the drop in testosterone that we see in aging men starts around 40, and the changes can be so slow and subtle, that you may have to take a minute to think about how much different they are than they were, at say, 35.

And this may surprise many people, but one thing doctors don’t like to do is blame things on aging. It’s our job to help people live the happiest, healthiest, most fulfilling lives that they can, so if there’s been a meaningful change in someone, we need to figure out why, and ask if there anything we can do to help.

So if there’s a man in your life who you care about, who is grumpy, low energy, getting thicker in the middle, doesn’t seem to be quite as sharp as he once was, can’t keep his eyes open after dinner or is canceling evening or active social activities, doesn’t seem to comment on or even notice the kind of women (maybe even you) who he used to find attractive, the right thing to do is to try to get him to go to the doctor.

Remember, he doesn’t have to have all of these things, and it may not be Low-T, but that’s the best place to start. When he gets to the doctor, they will take a history – i.e. ask the right questions, do a physical exam, and order some simple lab tests – that that will help to confirm if Low-T is the likeliest thing that accounts for why things are the way they are.

If so, great news! There are a number of safe, highly effective and easy to use testosterone products that will normalize their levels, that is, return them to where they should be. In much the same way that the decline may not have been noticeable, it may take a few months before it completely kicks in, but you should notice that they should start to get less grumpy and start thinking more clearly within a few weeks. Once they do start on testosterone, the doctor will have to monitor them every few months for at least the first year, to check both their response and their lab work.

If you’d like more information please go to I hope this helps, yours in good health, Dr. Dave

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