Patient: My boyfriend just turned 30 years old. He is 6’6″ and weighs 300 lbs. He lifts weights daily and does cardio regularly, he eats very healthy and does not drink or smoke. He does not take any illegal substances of any kind. For a few years he has been struggling with some things that stress our relationship: low motivation, low libido, and not feeling like himself. This week he finally agreed to go to the doctor and get tests to find out what may be going on. He had perfect blood pressure and cholesterol but his testosterone was around 400 (the test was done during the peak time 7am). I know this is supposedly in the “normal” range but for a 30 year old who is having many symptoms of low testosterone which are distressing I think this may be the issue. Would he be a candidate for different hormone replacement therapies or what could help other than the things he is already doing (multi vit, vit d, exercise and eat healthy)? This is hard on our relationship and I would like to find a positive solution! Thanks!!
Symptoms: Low motivation, low libido, lack of drive
Doctor: Hello,Thanks for the query to ATD for an opinion,Considering the fact that your boyfriend is otherwise healthy b ut recently since last few years you have been noticing that he seems tired, less motivated and low libido. The testosterone levels oaf 400g/dl are not less but not good as well. In general, the normal range in males is about 270 to 1070 ng/dL with an average level of 679 ng/dL. A normal male testosterone level peaks at about age 20, and then it slowly declines.It is suggested that apart from daily exercises and healthy diet and lifestyle he can be placed on testosterone replacement therapy provided Fsh and Lh values are normal for at least 3 months. Testosterone replacement therapy is available in several forms. All can improve testosterone levels:1. Skin patch (transdermal): Androderm is a skin patch worn on the arm or upper body. It’s applied once a day.2. Gels: AndroGel and Testim come in packets of clear testosterone gel. Testosterone is absorbed directly through the skin when you apply the gel once a day. AndroGel, Axiron, and Fortesta also come in a pump that delivers the amount of testosterone prescribed by your doctor. Natesto is a gel applied inside the nose.3. Mouth patch: Striant is a tablet that sticks to the upper gums above the incisor, the tooth just to the right or left of the two front teeth. Applied twice a day, it continuously releases testosterone into the blood through the oral tissues.4. Injections and implants: Testosterone can also be injected directly into the muscles, or implanted as pellets in the soft tissues. The body slowly absorbs the testosterone into the bloodstream.As the symptoms have been there since last few years and this has been affecting your relationship, he can be placed on testosterone replacement therapy under supervision of an endocrinologist.I hope I have answered your query in detail,Wishing him good health,Regards