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Diane Brzezinski, D.O. FACOI

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Dr. B's Blog

Understanding Low Testosterone


The proverb “clothes make the man” was believed to be coined by Dutch humorist and philosopher Desiderius Erasmus in the 15th Century. Erasmus undoubtedly suspected that other elements were responsible for making a man, but the primary maker of a man was not officially discovered until 1935. That year, several European scientists independently discovered and isolated testosterone, a hormone and anabolic steroid that genuinely “makes the man.”

While the decline of an adult male’s testosterone production due to aging, disease, or injury does not make a man any less a man, it can impact their health, energy levels, and sexual functioning. And this can be especially troublesome when prolonged declines in testosterone levels occur in middle-aged or younger men.

With extensive clinical expertise in testosterone replacement treatment for men, Florid-based internal medicine specialist Dr. Diane Brzezinski, D.O. knows how vital the hormone is in supporting a man’s vitality. If you’ve been feeling run down, irritable, and depressed and have experienced a noticeable drop in your sex drive, you may struggle with testosterone deficiency syndrome (TD). Read on to understand more about the effects of low testosterone and its causes, symptoms, diagnosis, and treatment options.


Testosterone is primarily responsible for turning a boy into a man, as it supports the development of the male reproductive system and masculine secondary sex characteristics like muscle mass, bone density, and deepening of the voice. With the onset of manhood, testosterone continues to play an instrumental man-making role by stimulating the sex drive and sperm production and helping support muscle and bone tissue mass and energy levels.

Testosterone levels naturally fluctuate throughout the day, ranging between 500 to 1,000 nanograms (ng) per deciliter (dl) considered normal. Amounts that consistently fall below 300 ng/dl support a TD diagnosis, according to the American Urological Association (AUA). However, Dr. B recommends that patients should be treated when symptoms of TD occur, not just when their levels drop below 300 ng/dl.


A man’s testosterone production can naturally decline with age, and the AUA believes that up to 50% of men over age 80 have TD. The association believes up to 1% of American men under age 80 may also have TD, though some research suggests this percentage may be higher. Diseases and medical conditions that have been linked to testosterone deficiency in younger men include:

  • Damage to or loss of testicles.
  • Pituitary disorders (caused by tumors, kidney failure, inflammation, or drugs).
  • Mental or physical stress induced by illness or injury.
  • Use of opioids or steroids.
  • Kallmann Syndrome.
  • Diabetes.
  • Mumps.
  • Obesity.


A prolonged decline in testosterone production tends to produce numerous symptoms that can affect the mind and body. The following symptoms may indicate possible TD, though other diseases and conditions could also be responsible:

  • Significant sex drive decline.
  • Noticeable fatigue and decrease in energy levels.
  • Inability or difficulty in achieving or maintaining an erection.
  • Muscle and bone mass loss.
  • Mood swings, irritability, and depression.
  • Noticeable increase in body fat.
  • Hair loss.
  • Difficulty sleeping.
  • Hot flashes.


Because other medical conditions could be causing TD-related symptoms, diagnostic blood testing represents the best option for assessing whether testosterone levels are consistently low. When testing for TD, doctors typically conduct a blood test at different times to account for natural daily variations in testosterone levels. In addition to scoring testosterone levels, blood tests may also be used to assess potential underlying TD causes.


Other than treating the underlying causes of TD, hormone replacement therapy offers the best means of restoring testosterone levels and alleviating associated symptoms. Dr. B relies on the ease and effectiveness of all-natural hormone pellet therapy to restore the testosterone levels of her patients. Inserted into fatty tissues underneath the skin, the rice-size pellets deliver consistent testosterone levels into the bloodstream throughout the day, and treatments can occur as needed every 4 to 5 months. This consistent delivery helps ensure that testosterone levels remain high and helps avoid potential side effects caused by the inconsistent delivery offered by injections, pills, or creams.


If you or anyone you know is experiencing symptoms that may indicate testosterone deficiency, Dr. B can conduct an examination and blood testing to determine whether TD is truly the cause. If so, Dr. B can easily begin hormone replacement therapy and may recommend lifestyle changes—such as diet and exercise—to enhance the effectiveness of the therapy. Not only can Dr. B’s treatment alleviate TD symptoms, but also provide a significant boost to overall health. To learn more, schedule an appointment at her Naples-based internal medicine practice by contacting Dr. B’s office at (239) 261-9990.