Testosterone Replacement Therapy: What You Need to Know

If you are diagnosed with low testosterone levels, your doctor may suggest testosterone replacement therapy as a treatment option.

Michael Heile MD, a family medicine doctor at The Family Medical Group, explains a few things to consider if you end up taking that treatment route.

#1: Close Monitoring is Critical

In cases where you are checked and your testosterone level is under 300, then you will likely be asked to repeat the lab to verify it is correct prior to considering treatment.

If the second test confirms testosterone deficiency and especially if you present with symptoms of low testosterone levels (including low libido, erectile dysfunction, infertility and fatigue), your doctor will determine the best treatment option, which may include testosterone replacement therapy.

From there, if testosterone replacement is started, your doctor will monitor you closely to make sure your prostate-specific antigen (PSA) levels don’t increase, because, in rare cases, replacement therapy could fuel prostate cancer or make it worse. “We like to watch PSA levels very closely in anybody that we initially put on replacement or increase their dose, just to be sure we’re not missing something,” Dr. Heile points out.

#2: Ask Your Doctor About a Complete Blood Count (CBC)

Occasionally, testosterone replacement therapy can change your blood counts, causing different types of blood count abnormalities, like polycythemia vera. Polycythemia vera is a bone marrow disease that leads to an abnormal increase in the number of blood cells (primarily red blood cells).

“We do a CBC after we start testosterone replacement, to make sure we’re not missing polycythemia,” Dr. Heile points out.

Another Cause of Low Testosterone

Dr. Heile says it's important to note that not all low testosterone levels are due to testosterone underproduction by the testicles. Sometimes the testicles are on a normal physiological level, but instead "low T is caused by low levels of brain chemicals that fail to signal the testicles to make testosterone," he explains. "In these cases, patients need to see specialists, such as endocrinologists, to appropriately work up and treat the condition."

Tags: Miscellaneous

Last Updated: March 1, 2014