Low T is more properly referred to as age related testosterone deficiency or late onset hypogonadism. While drug company advertising brought the condition to the public’s attention, the frequency of the disorder appears considerably less than imagined. The idea that a variety of age associated conditions including decreased cognition, memory impairment and loss of energy relates to Low T appears false.

Low T requires a combination of low levels of circulating testosterone together with lack of morning erections, loss of sexual desire or erectile dysfunction. The presence of symptoms is not sufficient; they must cause some associated distress. Of course these complaints may relate to a variety of other issues. For most men treatment with Viagra, Cialis or Levitra remains a better option than testosterone supplements.

Testosterone levels decline about 1.5% each year beginning around age 35. Testing for Low T requires blood sampling between 8-10 a.m. since levels fluctuate according to a circadian pattern. At least 2 tests on non-consecutive days are essential for establishing the diagnosis. A definitive cutoff level separating normal from low remains the subject of intense debate.

Testosterone levels depend on the concentration of a carrier substance in the bloodstream. Low levels of sex hormone binding globulin provide artificially subnormal testosterone readings without indicating a deficiency in free testosterone. Among conditions associated with low SHBG are elevated blood sugar, obesity, alcohol, steroids, kidney ailments and hypothyroidism.

For those in whom treatment may be appropriate, the American College of Physicians recommends injections with Depo-Testosterone rather than the much more expensive topical patches and gels.