“How’s it hanging?” It’s a question that some guys generally ask each other, adding a touch of crude male humor to the real question as to how things are going. Unfortunately, if you’re a man who suffers from low testosterone, the initial answer in your head may lean toward the literal ask.
“Oh, you know…things are okay” – or something along these lines – is your usual response. However, you know that’s not entirely true. Sure, things in general may be okay. You specifically, though? Nope.
Those six-pack abs you coveted in your twenties are starting to resemble mini bread rolls. Your bones and muscles now ache to the point that you start making excuses to avoid your regular workouts. The energy levels that gave you a reputation among friends as being “tireless,” “constantly moving” or “a machine”? Well, the machine’s currently out of service and in dire need of repair. So’s the plumbing. You almost feel like you need to file a missing person’s report for your sex drive. And if it does “pop in” for a quick visit, it can’t stay long. Really, it’s a. Quick. Visit.
Then there’s the emotional aspect. You constantly feel horrible, overwhelmed, depressed. You can’t think straight, and your focus is such that it takes an hour and a half to watch 60 Minutes. Sleep? *Pfft* You tried getting 10 hours, but you feel like you got only 10 minutes. Essentially, you’re so run down that you feel beaten by the world before you even get out of bed in the morning.
The fact is, men generally don’t know or appreciate the importance of their testosterone until it starts fading away. And it does fade away, make no mistake. Regardless of a well-balanced diet and solid exercise regimen, at some point, your body changes as you age, and your hormone levels naturally decline (approximately 1.6 percent every year).
For weeks, months, maybe even years, you’ve quietly suffered. You think that you’ve done something wrong and believe you can no longer be the capable, virile person you once were. Most men don’t talk about it and, more often than not, they may not even be aware they have a problem. They just think that, on some level, they’ve failed as men.
The truth is, men, it’s not “you.” It has never been “you.” The decline of your testosterone has detrimentally impacted you physically, mentally, emotionally. And you are far, far from being the only one to experience this.
Advancements in testosterone replacement therapy (TRT) have provided men with a way to reclaim control of their bodies and, as such, their lives. However, don’t fool yourself into thinking TRT is some sort of miracle, overnight cure. Save the magic for David Blaine and understand going into the process that your road to self-improvement is not a sprint, but a marathon. It’s also one that doesn’t really have a set finish line, and that’s all right. As long as you follow the treatment prescribed by your doctor, you’ll not only stay ahead of the problem, you’ll leave it eating your dust.
Let’s discern which medical benefits exhibit quickly through TRT, and which ones take longer to manifest.
- I FEEL BETTER ALREADY...I THINK
- THINGS ARE LOOKING UP
- IT'S IN THE BLOOD
- GET ON THE STICK ABOUT PSA
- A SENSITIVE SUBJECT
- COMPOUND NUMBERS
- INFLAMMATORY COMMENTS
- MOURNING MASS? TIME TO REBUILD
- BONE UP ON TESTOSTERONE
- IT'S A GUT FEELING
I FEEL BETTER ALREADY...I THINK
It’s not an immediate effect; in fact, you may not even notice a change at first. But you will start feeling better within three to four weeks after your treatment begins. You might realize you’re not quite as lethargic as you felt a month earlier, or that you’re having some better nights sleeping and feeling more rested overall.
More important, the formidable cloud that has been hanging over your head is starting to dissipate. Your mental focus and memory show signs of improvement within the first two weeks of treatment, while feelings of depression and sudden mood swings start subsiding within three to six weeks. One month in, you’ll find yourself feeling motivated to get off the couch and do more, and we all know how important physical activity is to your wellbeing. Results can vary, but by 18 to 30 weeks, your change in demeanor will support a radically improved self-confidence and clearer mindset, plus an inner strength that’s more ready go toe-to-toe with whatever life throws your way.
Thankfully, TRT can quickly improve your love life with your spouse or partner. You’ll start to feel that amorous appetite return in as soon as three weeks of treatment. By six weeks, you and your loved one will discover that your sex drive is back to what it once was, if not better than before.
Do realize, however, that even though you may feel that way, the more obvious physical benefits will take a while longer to surface. Improved erections and ejaculations can take as long as up to six months, in fact. But really, it’s worth it, and you’ve at least regained the gumption to keep trying until everything else gets back on track.
Your body produces red blood cells through a process called erythropoiesis. When you suffer from hypogonadism (low T), red blood cell formation can slow to a crawl, which in not-so-medical terms is no bueno. Those cells made in your bone marrow contain hemoglobin, an essential protein that carries oxygen. As your count decreases, you’re left feeling progressively anemic, or fatigued and weakened. Your blood pressure may also test higher than normal. The rest of your body has to work that much harder to get oxygen to your cells and keep your organs operating as they should.
TRT, fortunately, gets your red blood cell count back into the flow of things. Results will vary based on your age and the dosage prescribed by your doctor, but the improved formation of your cells will produce a noticeable effect after three months. Those bouts of fatigue you’ve been fighting will lessen, and your blood pressure should stabilize closer to within normal range. Your maximal output should peak between nine and 12 months. By then, your body is producing enough hemoglobin on its own to keep you energized, and the measurement of your red blood cells (known as hematocrit) reaches what you and your doctor determine to be your normal levels (traditionally within the 41-50 percent range).
Your prostate is a walnut-sized wonder of a gland below your bladder. It navigates tissue like a fighter pilot to produce small but potent amounts of protein serum called prostate-specific antigen, aka PSA. That serum is a key component of your ejaculations. However, when low T leaves your once-maverick libido feeling less like a “top gun” and more like an empty pistol…well, your cockpit’s “ejection system” is bound to malfunction.
Thankfully, testosterone treatment helps refuel your sex drive, mood and energy levels. Even better, since you don’t want to produce too much PSA, those levels should only rise marginally and plateau at around the one-year mark. Bear in mind that any additional elevation of your PSA or volume is likelier connected to aging, or it may be an indicator of an unrelated health issue. Either way, it’s best to review with your doctor before your levels fly into any danger zone.
When you’re hypogonadal, your sensitivity to insulin can be compromised, your blood sugar levels can spike, and you run a risk of contracting Type 2 Diabetes. TRT increases your insulin sensitivity, meaning it enables your body to effectively absorb glucose, or blood sugar, and give you energy when you need it. You’ll experience small bursts of “get-up-and-go” within days of starting treatment, with the full effect taking anywhere from three months to a year. Also remember, one little spark is all you need to motivate you into becoming more physically active, which also increases your insulin sensitivity.
Love to the lipids. These organic, water-insoluble compounds are your cellular membrane’s key building blocks (or LEGOs, if you prefer). Lipids also serve as your energy’s personal storage warehouse and promote the signaling of electrical impulses throughout your brain. When you suffer from significantly clinical hormone deficiency, so can your lipids – your mental acuity, particularly your memory, becomes muddled, and your body stops producing the fuel needed to function at peak capacity.
It takes about a month of treatment before your lipids correct themselves and get back to storing that energy you’ve been missing, and resharpen your biochemically dulled brain. Within six to 12 months, the effect on your lipids should reach their utmost, which in effect will take you one step closer to becoming your utmost.
Inflammation is the ultimate defense mechanism (physically speaking, not emotionally). It’s a body’s best friend in that it aids your autoimmune system in combating physical injuries, infections, toxins or anything else that causes cell damage. If your testosterone tumbles, however, the physical impact it puts on your body causes more widespread inflammation, and for extended periods. Simply put, your body’s friend is overstaying its welcome, and it’s hurting you.
TRT helps regulate your body’s need to produce inflammation and how it communicates with your autoimmune system. Your body isn’t working overtime trying to combat cell damage that may not exist. It takes between three weeks to three months of treatment for your body to fully re-establish a healthy, positive relationship with acceptable levels of inflammation.
MOURNING MASS? TIME TO REBUILD
Who doesn’t want a killer bod, or at least the strength and stamina to do things that were so easy to do when you were five years younger? Diet, rest and exercise are key to your success, of course. However, when your testosterone levels dip below your normal range, your strength strains, your body mass gets mushy and your once-unbeatable endurance…well, it ends.
Testosterone makes for a good spotter and helps with the heavy lifting to improve those areas. Over the first three months, your body mass becomes leaner, your muscles grow meaner and you develop a stamina that won’t easily quit. These effects are likely to start leveling off after six to 12 months of treatment. However, it’s not unusual for your body to continue experiencing marginal progress over the next several years.
If a snap-crackle-pop in your morning comes from your back and not your bowl of Rice Krispies, you may be feeling the effects of reduced bone mineral density (BMD). The daily process in which your body adds new bone while breaking down old bone naturally slows down as you age. However, low T can accelerate natural bone breakdown over bone formation which, left unchecked, can develop into osteopenia or, in more severe cases, osteoporosis.
Before the problem literally reaches the breaking point, consider giving TRT a crack. Six months of treatment starts to decelerate bone breakdown, or resorption, giving new bone time to fortify. The stiffness you’ve been feeling in your tendons and ligaments also lessens dramatically. With continued treatment, the effects of maintaining if not improving your BMD can last as long as three years, potentially longer, before they plateau. Until then, enjoy your cereal. (Though, really, consider some wholegrain oatmeal or eggs.)
When your body’s testosterone thins out, it’s common for your waistband to expand. Low T slows your metabolism to the point where it can no longer effectively burn off fat mass. The only thing it builds up are fat deposits around your midsection, which leaves you to carry a growing problem wherever you go.
Hormone replacement therapy works twofold. After three months, you not only start burning off fat mass, you also begin increasing lean body mass. The belly flattens while muscle builds, giving your testosterone even more of a boost. Before long, you can trade in that vicious cycle of low T-increasing-fat-increasing-low T for one with two wheels, 10 speeds and a kickstand. If you’re following your prescribed treatment, studies show your body can continue seeing the dual effects for up to two years. Plus, you can look down and see your toes again.
As we’ve stated, testosterone replacement treatment is not an overnight solution. It’s especially important to follow the prescribed plan outlined by your doctor and to be patient. Prescribed dosages are likely to be adjusted along your journey, and that’s fine. You want to lock into a prescribed “sweet spot” so that your body can produce maximum results over long periods of time, and you regain the ability to focus and enjoy what matters most: Being you.
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References:
Saad F, Aversa A, Isidori AM, Zafalon L, Zitmann M, Gooren L. Onset of effects of testosterone treatment and time span until maximum effects are achieved. Eur J Endocrinol. 2011; 165(5): 675-685. doi: 10.1530/EJE-11-0221