| Posted December 8, 2015 | By Joel Locke, M.D. | Categorized under *Uncategorized* |

Fatigue in men is a very real issue and because of the prevalence of advertising about treatments for low testosterone, or "Low T," I have men asking for testosterone replacement therapy by name multiple times a day in my office. 


Mr. T

Testosterone is the hormone that makes a man a man. It controls his outlook, energy, competitiveness and it increases muscle mass and bone density. A lot of the energy return men get when they add testosterone is the return of that outlook and competitiveness and those positive feelings. 

Men with low testosterone can get symptoms of depression, but often times you can reverse that. Many men in their 70s supplement their testosterone and it makes them feel better without seeming to cause any problems. 

Although testosterone replacement therapy can be a very good option for men who need it, it may not always be the perfect solution to your particular problem. It's not always the quick fix that advertisements tell you it is. 



There are so many causes of fatigue and low energy levels, ranging from poor sleep, to medications a person might be taking, lack of exercise, poor diet, obesity and even certain diseases such as diabetes. Taking testosterone wouldn't necessarily help if one of these issues is the root cause of your fatigue. 

Too many men today that are dealing with fatigue are quick to assume low energy equals low testosterone, but it's important to make sure there isn't something else causing the problem. It's becoming too easy for a man to go and get testosterone replacement and maybe overlook a more important medical problem. 


Undiagnosed Issues

For example, many men can have undiagnosed hypertension. Or undiagnosed cardiovascular disease. Maybe their exercise routine has lapsed. Or they are obese. 

In men who have loss of libido, fatigue, low energy and have demonstrable low testosterone levels, then replacement therapy can be beneficial in some but not all of those men. It depends on the age of the man. 


Age Matters

If you are younger and at an age where fertility is important, you have to be careful with testosterone therapy. In an older man, you have the possibility of associated prostate cancer. The therapy doesn't increase the risk of prostate cancer, but you can have it and not know it and testosterone will advance the disease. 

However, well-monitored testosterone therapy is safe. We check blood counts every four to six months, for example. 

If you are interested to find out if this therapy is right for you, I always recommend you go see your internist. I prefer to manage testosterone supplementation in coordination with an internal medicine physician so we can work together to watch medications, weight and diet. 


Natural Process

A drop in testosterone in men is natural. The testicles, over time, just stop producing it. It's not unlike female menopause; only it tends to diminish over time and is a much slower progression in men. It's hard to equate this with a certain age in men, because testosterone levels begin to drop in men at different ages and at different rates. 


Muscle Mass

With the drop in testosterone, you begin to lose muscle mass and strength and endurance. If you are a biker that is used to riding 50 miles at a time and now that same 50 miles is killing you, it could be the testosterone level naturally dropping and you want it back. This is an example where replacement therapy could be a great solution. 

I tell men, though, that they have to work at it. Whatever their age, they need to be exercising, which naturally boosts energy. They need to be eating right and we also need to rule out any other possible medical issues that could be contributing to their lack of energy. 

Although in many cases supplementing your testosterone levels can help boost your energy, unfortunately it isn't the magic bullet that will make a man in his 60s feel 30 again. But it can help make you the best at 60 that you can
possibly be. 

By Joel Locke, M.D.

Joel Locke, M.D., is a board-certified urologist with Urology Associates in Franklin, Tennessee, and is credentialed with Williamson Medical Center