There is truly a difference between normal and optimal when it comes to lab values, especially as it relates to hormones. Low testosterone (low T) is a reality for men at some point in their lives as it is part of the normal aging process. While many men who have suboptimal testosterone don’t seem to be bothered by symptoms, there are some men who experience depression, emotionality, fatigue, low sex drive and metabolism changes very acutely. For those men, we have options from herbal treatments to bioidentical testosterone replacement. Before and during testosterone replacement therapy, hormones are measured in a detailed way so that all the information needed to balance testosterone and other hormones in the pathway is obtained.
DR. BERKSON : This was back in the 70s. My wife had several miscarriages, and I still did not want to be a medical doctor. She had had 5 miscarriages, and at that point, I thought that, if a person was the head of a department at the University of Chicago or Harvard or Stanford, they really knew more than anybody else. We went to doctors like this and she’d have these miscarriages in the 4th to the 6th month, in the 2nd trimester. Their answer was always, “These babies are normal; just get her pregnant again. Maybe next time she’ll be able to carry the baby.”
Part of the problem is that as is the case with estrogen levels in women, testosterone levels in men begin decreasing after the age of 30. The topic was reviewed well in the New England Journal of Medicine nine years ago, so this is not new information. Contrary to the abrupt and rapid decrease in sex hormone levels that occurs in women when they enter menopause, in men testosterone levels decrease more slowly, with the serum total testosterone concentration decreasing from a mean of about 600 ng/dL ( nmol/L) at 30 years of age to a mean of about 400 ng/dL ( nmol/L) at 80 years, although, the review noted, the range is wide at all ages. However, the “normal” range for serum testosterone levels varies with age, decreasing as a man ages. In younger men, the low end of the normal range is generally considered to be around 300 ng/dL, and that is often the level recommended as the cut-off by the “low T” websites.