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A recent episode of the hit Hulu comedy “Only Murders in the Building” highlights a hormone therapy that many men request as they get older.
Steve Martin’s character, Charles-Haden Savage — a washed-up actor who gets a second career solving murders in his apartment building — brags of his newfound strength after starting testosterone therapy.
“Yesterday, I opened a pickle jar like it was no thang,” he said.
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While talking to Oliver Putnam, another crime aficionado who also happens to live in his exclusive New York apartment building, he admits, “If I’m being honest, I am also really fighting the urge to pick you up right now.”
“It’s supposed to build bone strength and give you energy,” Martin’s character added of the testosterone therapy.
So, can testosterone really help you open hermetically sealed jars or make you feel like a professional wrestler at age 80?
Here’s what the experts say.
What is testosterone?
“Testosterone is mostly produced in the testicles, with a small portion coming from the adrenal gland,” Dr. Petar Bajic, chair of the American Urological Association’s public media committee and director of men’s health at Cleveland Clinic, told Fox News Digital.
As boys become teenagers, the pituitary gland in the brain triggers the production of testosterone.
“Testosterone deficiency is quite common, affecting nearly 10% of men over age 50.”
The hormone helps to keep bones and muscles strong, maintains sex drive, produces sperm, and controls hair growth and body fat in men, according to the National Institutes of Health.
The hormone starts to naturally decline as men get older. “Testosterone deficiency is quite common, affecting nearly 10% of men over age 50,” Bajic told Fox News Digital.
Some conditions that can cause low testosterone include the following.
- Problems with the glands in the brain that control testosterone production
- Testicle injury
- Cancer
- Chemotherapy side effects
- Thyroid dysfunction
- Obesity
- Side effects of certain medications
Symptoms and diagnosis
Many symptoms of low testosterone can mimic other health conditions, according to Dr. Tanya Munger, a nurse practitioner who specializes in endocrinology at the Duke University School of Medicine in North Carolina.
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Some warning signs of low testosterone are listed below.
- Decreased sex drive and/or erectile dysfunction
- Infertility (decreased sperm count)
- Depressed mood, decreased concentration and irritability
- Increased body fat
- Decrease in muscle mass/strength
- Fatigue and decreased endurance
- Loss of bone mass
- Decreased hair growth
- Breast enlargement/tenderness (gynecomastia)
- Sleep problems
Men can ask their primary care doctors to perform a blood test to check their testosterone levels, Munger advised. A diagnosis requires two separate blood tests taken early in the morning (or two hours after waking) that show total testosterone levels below the normal reference range.
A low testosterone level is typically considered below 300, but the normal range depends on the lab conducting the test, the doctor added.
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If testosterone levels are found to be normal, the patient should ask a doctor to evaluate for other causes of symptoms, added Dr. Susan Spratt, an endocrinologist and professor of medicine at Duke University School of Medicine.
When to seek treatment
For those who have low testosterone levels without a reversible cause, the first strategy should be to target lifestyle factors like diet and exercise, according to Bajic. If those are not effective, testosterone replacement therapy may be recommended.
“Options include gels, injections, testosterone pellets implanted every few months, and oral testosterone,” Bajic told Fox News Digital.
Therapy should be generally reserved for men who have symptoms of hypogonadism, a condition where the body does not produce enough testosterone, according to the Endocrine Society.
Diagnosing hypogonadism can be challenging, however, because the symptoms are sometimes non-specific and may overlap with other medical conditions.
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Routine screening of testosterone levels in the general population in the absence of symptoms is not recommended, experts say.
Testosterone testing and prescriptions have nearly tripled in recent years, with up to a third of men placed on therapy without meeting the criteria for deficiency of the hormone, according to the American Urological Association.
Potential risks of therapy
Testosterone can increase the number of red blood cells, Spratt noted. “That sounds like a good thing — and it is if you have anemia, but there’s such a thing as too much of a good thing.”
High levels of red blood cells can increase the risk of stroke and clotting, the doctor noted.
Testosterone can increase the chances of the prostate becoming enlarged, causing blockage of urine. It can also increase prostate cancer growth for those who already have the disease, Spratt warned.
Experts say testosterone therapy can also cause the following side effects.
- Acne or oily skin
- Decreased sperm count (increasing risk of infertility)
- Decreased size of testicles
- Worsening of sleep apnea
- Increased breast tissue (gynecomastia)
Testosterone can also trigger mood changes, particularly for those taking higher doses than the body needs, Spratt said.
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For those who have normal testosterone levels and start undergoing therapy, that can cause levels to get too high, which can carry significant risks, experts caution.
“Some research shows that testosterone therapy can increase the risk of heart disease, but the data is conflicting and inconclusive,” Munger added. “Risks can be minimized by keeping the total testosterone levels in a healthy range and not exceeding the upper normal limits.”
Many symptoms of low testosterone can mimic other health conditions.
Providers often perform testing to measure baseline prostate levels and blood counts to ensure they are not abnormal before starting therapy.
Testosterone replacement therapy is designed to restore normal hormone levels in men with deficiency, not to boost or optimize performance, Munger noted.
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“Prevention strategies [for low testosterone] include maintaining a healthy diet, limiting alcohol consumption, engaging in regular physical activity and maintaining a healthy body weight,” she added.
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