Early warning indicators of male hormone health risks

As long as any two of the three categories of "abnormal changes in physiological signs, deviation of hormone test values ​​from the baseline, and long-term abnormal mood and behavior" occur at the same time, and continue for more than 1 month without relief, you are a high-risk group. It is recommended to give priority to fasting serum testosterone testing to troubleshoot problems, and do not blame it on "too tired recently."

Not long ago, when I accompanied a friend to the men's department of a tertiary hospital for a follow-up consultation, I happened to meet a 32-year-old Internet product manager who came to check for hormones. He said that he stayed up late every day for the first half of the year to catch up on projects. He has shaved his beard, but it doesn't matter if he doesn't shave for two or three days. Recently, he keeps quarreling with his subordinates and his wife, and he can't control his temper. At first, he thought it was an anxiety disorder. After going to a psychiatrist for a checkup, he found no problem. The doctor asked him to check for testosterone. The result showed that the total testosterone was only 8.7nmol/L, which is almost 1/4 lower than the normal lower limit for adult men.

An andrologist who is familiar with me said that many people's current understanding of testosterone abnormalities is still "that aspect is not good". In fact, most of the early signals are hidden in daily details, but they are too easy to be confused with reactions to fatigue and stress. There has been debate in the academic circles before about whether abdominal obesity is the cause or the result of lowered testosterone. Now frontline clinical doctors have basically reached a tacit agreement: if you don't deliberately gain weight, your waist circumference will increase by more than 7 centimeters in half a year, and it will be difficult to lose weight by controlling your diet and exercising regularly. Take this as the first warning sign - after all, testosterone is responsible for helping the body metabolize fat. If the secretion is not enough, fat will be accumulated in the waist and abdomen first. It is not the same as the kind of fat accumulated by drinking beer or eating barbecue. This kind of abdominal fat caused by low testosterone is particularly difficult to lose.

By the way, there is another sign that many people ignore and avoid medical treatment: the frequency of morning erections suddenly decreases, or the need for intimacy decreases significantly. Don’t just buy kidney-tonifying supplements, and don’t blindly label yourself as “not good”. Many times it’s a testosterone wave. Many of the irritants, especially young men in their 20s and early 30s, are caused by staying up late, drinking high-sugar milk tea every day, and sitting for long periods of time. Most of them can be recovered by adjusting their work and rest. However, random supplements can easily disrupt their own hormone secretion rhythm.

Speaking of this, some people will definitely ask, I check my hormones every year during my physical examination, and the values ​​are within the reference values. Do I still need to worry? There are actually two different schools of thought here: The conservative view is that total serum testosterone must be lower than the lower limit of normal of 9.9nmol/L to be diagnosed as testosterone deficiency. However, more and more clinicians now tend to look at the individual baseline - for example, your testosterone test last year was 20nmol/L. This year, although it was still above the normal range of 10nmol/L, it dropped directly to 11nmol/L, and it is also accompanied by the symptoms mentioned above. Even if there is a risk, you can intervene in advance. Oh, by the way, when checking testosterone, you must do it on an empty stomach between 8 and 10 a.m. This thing fluctuates greatly between day and night. If you check it at three or four in the afternoon, the value will be about 30% lower than in the morning. If you look at the reference values ​​​​on the Internet, it is easy to scare yourself. If you want to check more accurately, you can also measure free testosterone. This is the active testosterone that can really be used by the body. Many people have normal total testosterone values, but have a low proportion of free testosterone, and will also experience related symptoms.

Another sign that is most easily ignored is abnormal mood and behavior. A 40-year-old university teacher came for consultation before and said that he used to take his family to hike mountains and play ball with friends on weekends. In the past six months, he had no interest in anything. When he got home from get off work, he would lie on the sofa and check his mobile phone. He also always got angry with his children over trivial things. He also felt that something was wrong. He went to the psychiatrist and said that he was slightly depressed. After taking medicine for two months, it was not cured. Finally, he found that his testosterone was low. After taking supplements for three months, his overall condition returned. To use an inappropriate metaphor, testosterone is equivalent to a man's "life battery". When the battery is enough, you are energetic in everything you do. When the battery is low, it's not that you don't want to move, but that the hardware can't carry it. There is really no need to force yourself to "carry on" and think it is a "mid-life crisis" or "bad mentality".

In fact, in the final analysis, these warning signs are just "little notes" handed to you by your body. Don't be overly anxious or take them seriously. I've seen too many people always think "I'm still young" and "I'm just tired recently", and they persist for a year or two. In the end, the indicators are ridiculously low, and it is troublesome to adjust. If something goes wrong for a month or two in a row, spending tens of dollars to draw blood is much more reliable than buying supplements worth thousands of dollars and doing random maintenance, right?