David Castrilli, M.D.
This week marks the 23rd annual observance of Men’s Health Week. First designated in 1994 and observed the week leading up to and including Father’s Day, the focus of Men’s Health Week is to encourage men to get regular check-ups and seek medical advice to prevent health problems and promote early detection of diseases in men of all ages.
Low testosterone, or low T, is a common worry for men as they grow older. Testosterone levels fluctuate during a man’s lifetime. Peaking during adolescence and early adulthood when males develop facial and body hair, their voices change and they develop muscle mass and strength, testosterone levels begin to decrease around age 40. “Low T is the top health concern I talk about with men,” said David Castrilli, M.D., with CHI Memorial Internal Medicine – East Brainerd. “They want to know if it is causing the symptoms they’re experiencing and if the medication or supplements they’ve seen advertised can ‘fix’ their symptoms.”
The answer may not be so obvious. The symptoms of low T are also common symptoms men experience as they age: fatigue, low libido, lack of motivation and general muscle weakness. Dr. Castrilli says the focus should be on what is causing the low T. “We have to look at whether the low level is the result of normal aging or if the body is having trouble producing the right amount of hormone or if it’s the result of another health problem.” Health concerns such as thyroid problems, diabetes, depression and medication side effects can all affect testosterone levels. Proper treatment of these conditions could cause the hormone level to rise.
A blood test is only way to diagnose hypogonadism, a disease in which the body doesn’t produce normal amounts of testosterone because of a problem with the testicles or the pituitary gland that controls the testicles. Dr. Castrilli says the blood test should be given at a certain time of day to get accurate results. “Testosterone levels fluctuate throughout the day, reaching a maximum level usually around 8 a.m. Taking a blood sample between 8 – 10 a.m. will provide the most reliable results. But because there can be a slight fluctuation of level during the peak morning hours, it’s best to confirm the test results with a second blood test on a different day of the week to avoid false positive results,” explains Dr. Castrilli. The results of the blood test are usually available within a couple days.
Testosterone replacement therapy (TRT) can be used to treat hypogonadism. Because of possible health risks associated with TRT (sleep apnea, acne, enlarged breasts, growth of prostate and blood clots), Dr. Castrilli says a man diagnosed with hypogonadism should consult an endocrinologist to discuss the risks and benefits and determine if TRT is the right treatment. Patients who are misdiagnosed and begin TRT have an increased risk of developing heart disease, blood clots and prostate cancer.
For men whose low testosterone level is due to normal aging, your doctor may recommend natural ways to boost hormone levels including losing weight and resistance exercises to increase muscle mass.
Dr. Castrilli encourages all men to schedule regular visits with their doctor to discuss any health concerns.
CHI Memorial Internal Medicine Associates – East Brainerd is at 720 Gunbarrel Road, Suite 206, Chattanooga, TN 37421. For more information, or to schedule an appointment, call (423) 648-8110.