Low testosterone is becoming more and more common. Our preferred laboratory actually dropped the normal level in the blood by over 25% in the last year. The average man tested today against blood samples drawn from the same aged man in 1950 show half the testosterone levels. Low levels of testosterone in the blood are very important as well as all the symptoms to go along with low testosterone including: lower muscle tone, sexual function, energy, motivation and sleep.
So, once the existence of low testosterone is verified, what is the best way to provide optimal levels of testosterone? After providing hormonal therapy for 30 years I believe the only proper form of testosterone replacement is natural bio-identical compounds. These compounds can be given in several different ways though all require regular laboratory monitoring and careful attention to the blood count and estrogen levels to prevent competitions and side effects. I will list them in my order preference:
- Extended release subcutaneous hormone pellet therapy (after a little numbing medicine is injected a small instrument that looks like a big syringe it slipped under the skin and a customized amount of hormone is placed and a Band-Aid and waterproof dressing is applied.) This generally last 3 months.
- Twice weekly intramuscular injection (many clinics provide injection weekly or twice monthly I believe this is inadequate to get stable levels. This can generally be done at home by a well-trained patient.)
- Transdermal testosterone gel at 200 mg/cc can be applied to the skin once or twice daily.
- Oral bio-identical liposomal testosterone can be given safely though variations in blood level make this a less desirable approach. Other forms of oral testosterone are dangerous and should not be used.
Testosterone replacement with bio-identical compounds has been part of my practice for almost 3 decades and is exceedingly safe when done properly.