Men who suffer from low testosterone (also known as testosterone deficiency or “low T”) may suffer from depression on top of that, research finds.
A study of 200 men with low testosterone showed that 56% have symptoms of depression, have been diagnosed with depression, or are taking antidepressants. Dr. Michael Irwig, an associate professor of medicine and director of the Center for Andrology at George Washington University, ran the study.
Irwig told members of the The Endocrine Society at an annual meeting that “over half the men referred for borderline testosterone levels have depression.” He also reported that many of the participants have poor physical health, especially in terms of their weight. Fifty-one percent of respondents admitted to not exercising at all. Twenty-seven percent claim they exercise one to three times a week. Only 22% claim to exercise more than three times a week.
Thirty-nine percent of the patients are overweight and 43% are obese. Only 16% maintained a normal weight and 2% are underweight.
Sexually, the men are more similar. Nearly 89% of suffer from erectile dysfunction; 69% suffer from low libido; 52% suffer from chronic fatigue; 42% suffer from sleeping problems such as insomnia; and 27% suffer from an acute lack of focus.
“A lot of these patients have all these co-morbidities and maybe depression or undiagnosed depression,” Irwig said. “For the patients who had undiagnosed depressive symptoms, I often recommend that they seek a formal evaluation from a mental health professional. For those who have been diagnosed and are overweight or obese, I do encourage weight loss and an exercise program using a pedometer. Loss of weight is associated with the body’s ability to produce its own testosterone.”
“Although weight gain is the number one symptom that drives men to our clinics, it is the moodiness and depression that the wives notice most,” says Kevin Meuret, Founder, Low T Institute. “Testosterone has a systemic effect on men. It impacts muscle mass, metabolism, libido, and energy. Many men overlook the symptoms of moodiness or even depression that set in because it happens slowly over time.”
Irwig also administered a mental health test to his patients. Those who received a certain score were referred to a mental health professional. Additionally, he recommends healthy eating and consistent exercise as effective and natural ways to combat obesity.
The doctor cautioned patients on the effectiveness of any one treatment. According to him, there is little consensus in the medical community about how to treat low testosterone. He also warned that the 200 men in his study may not necessarily reflect the characteristics of low testosterone patients as a whole. The men who participated in the study were referred to Irwig, an endocrinologist, because of fatigue, low libido, and other symptoms. Men who exhibit these systems but do not seek treatment may not suffer from the same problems as the patients in the study.
Dr. Cynthia Stuenkel, a fellow endocrinologist and expert in the field, echoed Irwig’s siding with caution.
“When a patient presents with some symptoms and is found to have a low testosterone level, as The Endocrine Society’s guidelines recommend, we ask why this is,” Stuenkel said. “We know that there are some very clear endocrine reasons that involve the hypothalamus, the pituitary, and the testicles that can be related to diseases that can cause low testosterone.”
“I always feel that the first step in treating these patients is to clarify what the diagnosis is because we might be able to fix it, we could remedy it,” she continued. “If there is not a clear diagnosis, then the next step we need to do is to repeat that testosterone test — usually several times.”
If no diagnosis can be given at the point, she said, the patient’s life should be examined in greater detail, taking into account such factors as age and medical history in order to establish if “there is a role for a trial of testosterone therapy, again being mindful that there could be placebo effects.”
Stuenkel also notes that despite the variables that could effect proper treatment of Irwig’s study (such as, for example, the fact that the patients were referred to him rather than volunteering), she finds the study’s findings “plausible.”
“He might be on to something,” she said. “If we can get this depression fixed, maybe these patients will feel more like exercising and losing weight.” She hopes more studies will be done on the link between low testosterone and depression. “We need more studies to look into this.”
“Being the best for our families means being healthy, balanced, and bringing the beast we can be to the table. Low testosterone can throw a guy off his game enough that he may feel he is just not himself. The most logical step is to get the testosterone levels checked by a specialist trained in treatment of low t. Restoring normal testosterone levels can be the easiest way to impact the overall quality of life not only for the patient, but for those in his life.”