The Times Magazine 29uring lockdown I acquired several
new things. There was a guitar
I purchased impulsively, never to
be strummed again. There was
the excess weight around my
midriff, the result of too many
late nights gorging in front of the
television. And there were the
patches of grey that had appeared
in my beard.
My barber swore he couldn’t see them.
Truth be told, I was relaxed. I’m 38. I expect
to see a few silver streaks. And besides, my
barber said it might suit me (although he also
threw in the term “silver fox”, which did make
me question his judgment).
I was undergoing some other changes too- changes I’d hoped my body would forestall
for a few more years. I’d been feeling tired
and lethargic. I was moody and my libido
had atrophied. The patches of grey seemed to
represent an outward manifestation of some
irreversible internal decline.
I blamed lockdown. I told myself I’d be
back to my best when things reopened. Yet,
when things did reopen, I didn’t feel better.
I wasn’t back to normal. Feeling rotten had
become my “new normal”.
I began searching the internet for clues as to
what might be wrong with me. Within half
an hour I’d diagnosed myself with three rare
conditions, two of which were terminal. The
symptoms I typed into Google – fatigue, low
mood, a lack of libido – encouraged the
algorithm to bombard me with advertisements
for virility aids. Did I want to chemically
enhance my masculinity and “go all night”?
I mainly just wanted to sleep. That was part of
the problem. I was staying with my 92-year-
old grandmother during lockdown. A product
called Steel-Libido dropping through the
letterbox would probably finish her off.I suspected I might have low testosterone.
The more I read online – and the more I
listened to the internet’s ubiquitous armchair
experts – the more I convinced myself that
low T was killing my vibe.
Testosterone is the principal androgen
controlling the development of the male body.
It deepens the voice. It helps the hair and
muscles to grow. It boosts sex drive. It affects
how the body distributes fat. The male sex
hormone comes mainly from the testicles, but
also from the adrenal glands. Healthy testicles
produce lots of testosterone during puberty,
which is part of the reason why adolescent
boys can seem obsessed with sex. Women also
produce testosterone, albeit in much smaller
quantities (about one tenth to one twentieth
of the amount of testosterone as men’s bodies).
Testosterone levels peak at the age of 20,
hold steady for a while and then start todecline by about 1 per cent a year from about
the age of 40. Low testosterone is believed to
affect about 10 per cent of men aged between
40 and 60. For those aged 60 to 80, the figure
is one in five. Other symptoms of low
testosterone include reduced muscle mass,
brain fog and anaemia.
At 38, wasn’t I too young for this?
Apparently not. Younger men can also be
affected by low testosterone. A condition
called hypogonadism can prevent the testicles
from producing enough testosterone. The
condition may be genetic, it can occur after an
injury or it can happen because of lifestyle-
related factors. Secondary hypogonadism, also
known as hypogonadotropic hypogonadism
(yes, those are two different words), is usually
caused by a problem with the pituitary gland,
the thyroid or the hypothalamus.
Joe Kennett, 35, is from Manchester. He is
an incident manager for a bank. When it has
a major problem – people can’t use their credit
cards, do online banking or payments go
missing – he manages the bank’s response.
He works days, but is also on call at night. It
is considered a high-stress job, but he says he
enjoys it. However, he went to his GP five
years ago with symptoms that included a lack
of energy, brain fog and trouble sleeping.
“I’m not your typical man you would think
suffered [from low testosterone],” he says. “I’ve
been going to the gym and lifting weights for
seven or eight years.”
It is difficult to get a diagnosis for low
testosterone through the NHS. The symptomscan be vague. They can also resemble the
symptoms of depression. Within the NHS,
knowledge about testosterone deficiency is
very often poor.
“My GP was utterly clueless,” says Kennett.
“I had a chat and I got given antidepressant
medication. I was on that for a few years.”
“Everything just crashed,” says Nigel, a
48-year-old university lecturer, when I ask
what first prompted him to seek help for
symptoms he eventually discovered were
caused by low testosterone.
“Initially, it was the loss of sexual function.
Then all of a sudden I was stressed, I couldn’t
do my job. I was suffering in my relationship
with my wife and children. I had no energy.
I had mood swings and I just felt depressed.”
Like Kennett, Nigel made an appointment
with his GP. Also like Kennett, he was offered
antidepressants and counselling.
“I said that’s not what I need. Then I
started to read about my symptoms. I’m an
academic – I’m not a doctor – but I’m capable
of reading up on things. And I started looking
into testosterone and TRT [testosterone
replacement therapy].”I was browsing Reddit looking for my own
answers. I had written, “Do I have low
testosterone?” at the top of a sheet of
A4 paper. The document was divided into
two columns: “For” and “Against”. I was
18 months away from my 40th birthday- that surely went under the “For” column.
Against: I was still 38. For: I was tired all
the time. For: I tended to put weight on
around my midsection.
It was time I got myself tested. It was
impossible to get a face-to-face appointment
with my GP, so I thought there was little point
in going down the NHS route. I found a
UK-based medical company that specialised
in testosterone deficiency. I parted with £75
and requested a home blood-testing kit.
Months later, I heard the company I initially
went through described as the “comedic bad
guys of the TRT world”. Its marketing was
savvy, though, and it successfully reeled me in.
The kit arrived a few days later in the post.
Inside it were several small needles, each
encased in a plastic hood. It took several
attempts to draw enough blood from a finger.
A healthy range of testosterone for a young
male is between 300ng/dL (nanograms per
decilitre) and 950ng/dL. The number that
really matters, however, is “free” testosterone.
You can have adequate levels of testosterone
and suboptimal levels of free testosterone.
This can occur due to an imbalance in sex-
hormone binding globulin (SHBG) or albumin.
Most of the testosterone the body produces
(about 98 per cent) is bound to either SHBG
or albumin (a protein produced in the liver).
Free testosterone is the roughly 2 per cent
D
‘Symptoms of low T
include brain fog and
reduced muscle mass.
At 38 , wasn’t I too
young for this?’
James Bloodworth, 38TOM JACKSON