In the last several years, there’s been a lot of interest in the possibility of men maybe deficient in testosterone. I know for years and years that it was something that wasn’t talked about. Men didn’t want to even think they were low in testosterone, sort of like that quote, “macho feeling.” However, as more and more data came out and more companies began to sell testosterone, more advertised and made the awareness even better. And now, we have men coming in who have had symptoms of low testosterone, that is things like fatigue, muscle weakness, decrease of libido, tired.
These things are symptoms that suggest they’re a definite low testosterone level. So as result, we’re now measuring the levels of testosterone. We’re measuring the total, the sex hormone binding globulin, as well as the free testosterone. This is something that a lot of clinics do not do. They only measure the free, if asked to do so. However, we measure all three different modalities. The reason for it is that the testosterone total can be normal but because it can be bounded in a protein, the free testosterone that is available for usage can be low.
These of course, issues of low free testosterone, as well as maybe a high sex hormone binding globulin will cause the symptoms of the decrease of libido, decrease of sex drive, muscle weakness, as well as fatigue.