Healthy ManTestosterone deficiency is commonplace, and closely related to age. Levels decline 1% yearly after the age of 40. We also see declines in men under stress, either emotional or physical, and in men taking psychoactive agents such as antidepressants, sedatives, as well as alcohol and other drugs, particularly narcotics.

Testosterone is easily measured with a simple blood test. Deficiency is variously defined, but levels under 300 ng/dl are considered low. Treatment with testosterone by transdermal gel, injection or subcutaneous pellet will raise blood levels, and restore energy, libido, muscle mass, bone density, and sense of well-being.

A recent study reveals a further benefit with weight reduction and lower waist circumference. These improvements were progressive over 5 years, not limited to a few months after starting therapy.

The study, reported at the annual Endocrine Society meeting, involved 255 men averaging 61 years of age. All were obese or overweight. Testosterone levels normalized with long-acting intramuscular injections. Mean body weight dropped 16 kg (35 lbs) over 5 years. Waist circumference dropped an average of 8.8 cm (3 ½ inches).

Thus, these were not temporary improvements, but long-lasting effects, far different from the roller-coaster effects seen in many weight-loss programs.

Other studies at the conference documented significant resolution of metabolic syndrome (prediabetes), and reductions of blood pressure, resting heart rate, glucose, LDL cholesterol and triglycerides. There was no increase in the incidence of prostate cancer.

We have found the incidence of testosterone deficiency to be surprisingly high in men we have tested, and almost universal in men over the age of 75. Men over the age of 40, and younger men with symptoms suggestive of testosterone deficiency, should be routinely evaluated.

Allan Sosin, M.D.

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