Testing times for testosterone levels

Testing times for testosterone levels Hemant P Thacker, TNN | Apr 28, 2012, 02.01AM IST Tweet In an era when the metaphoric 'male dominance' is fast waning, the biochemical revelation about premature dips in testosterone 'T' levels is an eye-opener. There is a variation in 'T' levels in men of different races who also have different body composition with varied bone and muscle mass. While this may have a contribution from dietary and cultural differences across geographic regions, it is the alarming association of low 'T' levels with co-morbities like cardiovascular mortality, diabetes, metabolic syndrome, hypertension and COPD (chronic obstructive pulmonary disease), that needs attention. But here's the googly.Not all men who visit the doctor have classic symptoms of hypogonadism ('T' is secreted by the testes-gonads). From mood swings and depression to accumulation of body fat, lethargy and fatigue in the early stages, it is only later when reduced libido or zest come to the fore, that hypo 'T' is suspected. This enigma in identifying deficiency and its association with subsequent dire co-morbidities mandates increased awareness on the part of the physician and patients to undergo blood testing for 'T' levels routinely around the age of 40. Unfortunately today 'T' is only associated with sex and libido or muscle and macho. Most wannabes and gym enthusiasts want to pump muscle among other things and are looking for a 'T' zing. Unlike the female menopause, which is a physically manifested punctuation, the slide in 'T' levels is silent, creepy but ominous and is often missed unless suspected early. Premature 'T' deficiency emanates in the modern humdrum of competition and stress and is precipitated by smoking, excessive alcohol, drug abuse, consumption of chemicals and pesticides in diet, obesity and even radiation from groin-held cellphones. Endocrine changes like loss of bone mineral density leading to osteopenia and porosis, mild loss of height, wasting of muscles, frailty, anemia, male breast enlargement and low sperm counts are seen to affect the male profile. 'T' deficiency is more common in men with low education levels, those who have large body size, are inactive and have a poor health status. TRT (testosterone replacement therapy) is the answer in deserving cases. From transdermal patches and gels to intramuscular injections and subcutaneous pellets, numerous compounds are available and could be used to restore 'T' levels to normal consonant with age. Like HRT in females, TRT has a contrarole with the prostate, so the "good servant-bad master" dictum has to be strictly followed under medical supervision. For the man of today, early suspicion (4th decade) and quick detection with timely and adequate restoration of 'T' levels addresses the sexual, metabolic and non specific symptoms across the board which thus helps him to sail into the twilight of the 'climacteric' (7th decade) smoothly. This will provide the "Tezz" in life and ensure a "Housefull" of happiness far away from the "Hate Story." (Dr Hemant P Thacker is a consultant physician and cardiometabolic specialist in south Mumbai hospitals)