Understanding and Treating Relative Androgen Deficiency in Men: Addressing Low Testosterone Levels for Optimal Health

June 24, 2024

Relative Androgen Deficiency in Men and How to Treat Low Testosterone.

Relative androgen deficiency refers to a condition where there is a lower level of androgens (male sex hormones, such as testosterone) than what is considered optimal for an individual's age and physiological needs, but not necessarily a complete deficiency. This condition can occur in both men and women, although it is more commonly discussed in the context of aging men. Often, we have patients who come to us because their primary care physician will not consider TRT for reasons like, “Your testosterone levels are within normal ranges.” or “Declining testosterone levels are normal for your age.”  

Some physicians will only treat patients if their levels fall well below traditionally low hormone ranges, but this doesn’t take into consideration the variations between individual patients as well as their potential for symptom resolution when starting hormone replacement therapy. A 30-year-old male with testosterone levels in 300’s may not fall below the reference range that labs use however they are certainly low and would benefit tremendously with treatment that optimized their hormone levels. Why is it so hard to find doctors who know this and can help men in their 30’s with Low T?

What is Relative Androgen Deficiency?

Relative androgen deficiency is a condition that describes a large portion of males who have testosterone levels that are low enough to begin experiencing some of the signs and symptoms associated with Low T but may not be below the threshold that traditional medicine deems as "below normal." This is a controversial area, as this can include both a male in their 30's and a male in their 70's and lump them together despite there being a large gap in what their hormone levels SHOULD be at for their given ages.

Age-Related Decline: As men age, testosterone levels will naturally decline. This decline can start as early as in their 20’s or 30s and continue progressively by around 1% per year. By the time a man reaches his 60s or older, their testosterone levels will usually be significantly lower compared to his levels in youth. This decline in hormones can contribute to multiple health issues, although not everyone will experience symptoms the same or even severely enough to require treatment. Often the decline is gradual, and men will just accept it as part of their “new normal” however there are steps that can be taken to reverse this process to improve overall health and wellness.

Testosterone Levels: In subclinical hypogonadism, testosterone levels are lower than what is considered normal but not significantly enough to cause clear clinical symptoms. These levels might be just below the lower limit of the normal range or fluctuate around it. Often levels are measured between 250-1000 ng/dl on most hormone panels.

Symptoms of Androgen Deficiency: Some of the symptoms associated with relative androgen deficiency (often called Low T), may include:

  • Decreased Sex Drive (Low libido)
  • Erectile dysfunction (ED)
  • Fatigue and decreased energy levels
  • Loss of lean muscle mass and overall strength
  • Increased body fat, particularly around the abdomen
  • Decreased bone mineral density (osteoporosis)
  • Decline in cognition/brain fog
  • Mood changes, like depression and/or irritability

Diagnosis: Diagnosing relative androgen deficiency, or Low T, typically involves several steps to get a diagnosis and prescription for testosterone from a doctor:

Clinical assessment of symptoms via physician consultation.

Blood tests that measure serum testosterone levels. It is important to measure both total testosterone and free testosterone levels (the bioavailable portion). Estradiol, a PSA, CBC, CMP, LH, FSH and SHBG may also be helpful.

Consideration of other factors that could influence testosterone levels, such as overall health, medications, lifestyle choices and comorbid conditions.

Treatment of Low Testosterone: The management of relative androgen deficiency may include:

Lifestyle changes, such as improving diet, avoiding drugs and alcohol, increasing physical activity and exercise specifically weight training, reducing stress, and increasing sleep.

Addressing any underlying health or medical conditions that may help contribute to low testosterone levels.

Testosterone replacement therapy (TRT) might be considered for those men who have consistently low testosterone levels along with significant symptoms that impacts their quality of life. TRT should be carefully monitored by an experienced healthcare provider due to potential risks and side effects.

Considerations for Treatment of Relative Androgen Deficiency: There is ongoing debate within the medical community about the benefits and risks of testosterone replacement therapy, especially in older men. It is essential to balance the potential improvements in quality of life and symptom relief with the risks of therapy, which may include side effects. Not all physicians are experienced in the nuances of HRT and having a doctor that knows how to monitor and create a personalized protocol with proper dosing of testosterone for patients is vital for their success. There is growing mountain of scientific literature and clinical trials which show the benefits of optimal testosterone levels in men with Low T, so the interest in TRT is gaining popularity due to the potential benefits and improvements in health and wellness.

Relative androgen deficiency is a condition characterized by lower-than-optimal levels of androgens, particularly testosterone, in relation to age and individual needs. It can lead to various physical, emotional, and cognitive symptoms. Diagnosis and treatment require a comprehensive approach, including lifestyle modifications and, in some cases, hormone replacement therapy under medical supervision. To learn more about whether you may qualify for treatment, call or text NovaGenix Health and Wellness at 561-277-8260 or email us at info@novagenix.org to see how we can help treat you for relative androgen deficiency.


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Blood Work Request Form

This subsequent lab panel is necessary for males undergoing Testosterone Replacement Therapy (TRT) through NovaGenix Health and Wellness. It allows physicians to assess the patient's response to prescribed medications, covering sex hormone levels, thyroid function, adrenal health, hematocrit, and liver and kidney function. The panel includes tests such as:

  • Complete Blood Count
  • Comprehensive Metabolic Panel
  • Testosterone (Free and Total)
  • Estradiol Sensitive
  • Thyroid Stimulating Hormone
  • Prostate Specific Antigen

Each test serves a specific purpose in monitoring overall health and treatment effectiveness. When required, Dr Mackey may require LH and FSH (Luteinizing hormone, follicle stimulating hormone) SHBG (Sex hormone binding globulin) or any other tests which may be important for your health and optimizing your hormones.

The Comprehensive Hormone and Wellness Panel for Women offers a foundational assessment of sex hormones, thyroid function, adrenal health, metabolic activity, and overall well-being. This panel serves as a diagnostic tool for identifying testosterone and estrogen deficiencies, assessing health risks, and detecting potential thyroid issues before considering hormone replacement therapy. Additionally, it includes insights into hematocrit (red blood cell volume), as well as liver and kidney function. The panel encompasses various tests such as:

  • Complete Blood Count (CBC)
  • Complete Metabolic Panel
  • Testosterone (free and total)
  • Estradiol
  • Thyroid Stimulating Hormone (TSH)
  • Progesterone

When indicated, Dr. Mackey may require additional tests such as Follicle Stimulating Hormone (FSH), and IGF-1 and Cortisol.

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