HJAR Jan/Feb 2024

46 JAN / FEB 2024 I  HEALTHCARE JOURNAL OF ARKANSAS DIALOGUE COLUMN UROLOGY TESTOSTERONE, the naturally occurring hormone produced by Leydig cells in the testicles, controls men’s mood, muscle mass, body fat distribution, bone mass, red blood cell production, and sex drive. It’s estimated that 1 out of 4men over the age of 30 suffer from low testosterone (low T), with roughly 13 millionAmerican men experiencing its effects. Yet, the symptoms of low T are of- ten similar to those commonly shown by aging men, potentially leading to misdiagnosis and patient complications. Low T is defined as having less than 300 nanograms (ng) of the hormone per deciliter (dl) 1 of blood in the body. There’s cur- rently scientific discourse between urologists and researchers debating whether 300 ng of testosterone per dl or 250 ng per dl is indicative of low T in a patient. Testosterone levels are usually at their highest in the morning and decline throughout the day. If left untreated, chronic low T can lead to decreased bone density, loss of muscle mass, increased weight gain, loss of body hair, lessened beard growth, fatigue, obesity, depression, reduced sex drive, erectile dysfunction, and can predispose men to Type 2 diabetes — causing discomfort and reducing the quality of life for men across the country. Misdiagnosing low testosterone Low T is commonly associated with a primary and secondary cause. A primary hypogonadism (testicular disorder) suggests that the pituitary gland is producing a higher frequency of lutein- izing hormone (LH) and follicle-stimulating hormone (FSH) in response to lower testosterone levels in the body. The hormones are adept at signaling testosterone and sperm production, but when damaged, they’re unable to respond to increased levels of gonadotropins (FSH). Congenital primary hypogonadismmay result from several dif- ferent factors, including an absence of testicles at birth (anorchia), undescended testicles (cryptorchidism), Leydig cell hypoplasia, Klinefelter’s syndrome, Noonan syndrome, or myotonic dystrophy. The Unseen Effects of Low Testosterone