Some low T levels are considered “functional” meaning that they are due to another cause
rather than the T hormonal pathway. For these patients, the specific cause should be addressed rather than just prescribing T. Examples include:
• Medications such as opioids, anabolic steroids, and cholesterol lowering statins
(Schooling et al, The effect of statins on testosterone in men and women, a systematic review and meta-analysis of randomized controlled trials. BMC Med. 2013;11:57.)
• Alcohol
• Marijuana
• Nutritional deficiency
• Excessive exercise/overtraining
• Obesity
• Obstructive sleep apnea
• Chronic illness
Do fire fighters have occupational risk factors that may contribute to low T? The following, all of which are common in fire fighters, have been shown to decrease T:
And definitely some parallels with what I found in the Jensen and 2014 studies:
'The number of men with low T varies by age and how the condition is defined. There is no one accepted definition, but most include one or more T level lower limits with associated symptoms.'
'In the Massachusetts Male Aging Study, 4.1% of participants from 40-49 years of age (the youngest group studied) were classified as androgen deficient (T level < 200 or 400 ng/dL depending on symptoms).3 However, after an average of 8.8 years of follow-up, 7.1% of participants (now in the 48-59 year old group) were found to be androgen deficient. In 1475 Boston men, approximately 22% from 30-39 years of age had T levels < 300 ng/dL; this increased to 25% in those between ages 40-49.4 However most of those men did not have any related symptoms (approximately 3 and 6%, respectively, had symptoms the researchers connected to low T) and so did not meet the study definition of androgen deficient.'
This was another interesting caution:
'Laboratories have difficulty measuring T. When the same low T sample was sent to 1,133 laboratories, the measured values ranged from 45 to 365 ng/dL.
But this was the least surprising thing in the paper for me:
Perhaps “it’s killing us” was a bit hyperbolic. I appreciate the education and the work that went into this sir.
There's been a bit of research on firefighters, and I've known many on testosterone treatment regimens. Here's one study. https://www.iaff.org/wp-content/uploads/Kuehl-edit-Testosterone-Information-Document-2020-2.pdf
John, thanks for the share. There's a lot in here that matches up with what Geoffrey Dardia wrote on the LinkedIn post: https://www.linkedin.com/posts/erik-davis-73041b82_z14-operator-syndrome-activity-7336858697266081792--cF1?utm_source=share&utm_medium=member_desktop&rcm=ACoAABGA71QBoxrRRCQ8dqjoF5tfghxIxmi9HhE
(Hat tip to Hutch for bringing him in.)
'What are other reasons for low T?
Some low T levels are considered “functional” meaning that they are due to another cause
rather than the T hormonal pathway. For these patients, the specific cause should be addressed rather than just prescribing T. Examples include:
• Medications such as opioids, anabolic steroids, and cholesterol lowering statins
(Schooling et al, The effect of statins on testosterone in men and women, a systematic review and meta-analysis of randomized controlled trials. BMC Med. 2013;11:57.)
• Alcohol
• Marijuana
• Nutritional deficiency
• Excessive exercise/overtraining
• Obesity
• Obstructive sleep apnea
• Chronic illness
Do fire fighters have occupational risk factors that may contribute to low T? The following, all of which are common in fire fighters, have been shown to decrease T:
• Sleep deprivation
• Excessive exercise/overtraining
• Obesity
• Work demands/stress
• Poor diet
• Alcohol use
And definitely some parallels with what I found in the Jensen and 2014 studies:
'The number of men with low T varies by age and how the condition is defined. There is no one accepted definition, but most include one or more T level lower limits with associated symptoms.'
'In the Massachusetts Male Aging Study, 4.1% of participants from 40-49 years of age (the youngest group studied) were classified as androgen deficient (T level < 200 or 400 ng/dL depending on symptoms).3 However, after an average of 8.8 years of follow-up, 7.1% of participants (now in the 48-59 year old group) were found to be androgen deficient. In 1475 Boston men, approximately 22% from 30-39 years of age had T levels < 300 ng/dL; this increased to 25% in those between ages 40-49.4 However most of those men did not have any related symptoms (approximately 3 and 6%, respectively, had symptoms the researchers connected to low T) and so did not meet the study definition of androgen deficient.'
This was another interesting caution:
'Laboratories have difficulty measuring T. When the same low T sample was sent to 1,133 laboratories, the measured values ranged from 45 to 365 ng/dL.
But this was the least surprising thing in the paper for me:
'TRT is now a multi-billion dollar business.'