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Testosterone

Low Testosterone in Men or Hypogonadism

Hypogonadism is a treatable medical condition which means simply that a man’s Testosterone Level is below ideal for his body.  A normal Testosterone level is around 450 but will vary from person to person. The normal level  is adjusted based on symptoms and each person’s optimal level is dependent upon their own body chemistry and age.   We do know that levels under 450 are a very strong indication of the condition and will require treatment.

How men produce Testosterone

The chart shows the HTPA System (Hypothalamus, Anterior Pituitary, and Testes).  Each gland produces a compound which all combine to become Testosterone.

Before an individual is treated for low Testosterone or Hypogonadism, it is important to know the type of Hypogonadism that is causing the low T levels.

There are three types of Hypogonadism

Primary Hypogonadism 

The Testicles have an issue and are not producing enough Testosterone to keep your bodies Testosterone levels normal.This could be caused by

  • Klinefelter’s syndrome
  • Leydig cell tumors
  • Chronic disease
  • Testicular atrophy
  • Testicular radiation
  • Chemotherapy
  • Testicular Trauma

In general, the best treatment for Primary Hypogonadism is Testosterone injections and other compounds may be required based on the test results.

Secondary Hypogonadism

This is the result of the pituitary gland not making sufficient amounts of LH or LH and FSH to allow the testicles to produce Testosterone.   Can be caused by:

  • Pituitary adenoma or tumors
  • Cerebral trauma (concussions)
  • PTSD
  • some medications

The treatment, in this case, is usually to supplement with a hormone called HCG which mimics LH and stimulates the Leydig cells in the testicles to produce Testosterone.  It is important to note that HCG doesn’t raise testosterone levels, it stimulates the cells that produce it.  If stimulation of the Leydig cells does not raise the Testosterone level to an appropriate level, the patient will be prescribed Testosterone injections.

Tertiary Hypogonadism

It is Rare that patients are diagnosed with Tertiary Hypogonadism because to properly diagnose is extremely expensive and time-consuming.  A clue that Tertiary Hypogonadism can be obtained by measuring GnRH levels. The treatment for Tertiary and Secondary Hypogonadism is the same, so most times they are diagnosed and treated together.

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