Low Testosterone Not Linked to ED, Fatigue or Depression: Study

Nelson Vergel

Founder, ExcelMale.com
Traditional signs and symptoms commonly attributed to hypogonadism do not correlate with testosterone levels: the Cooper Center Longitudinal Study Experience

Laura F DeFina1, Nina B Radford2, David Leonard1, Rick K Wilson2, Tyler C Cooper2, S Michael Clark2, Gloria Lena Vega3, Carolyn E Barlow1, Benjamin L Willis1, Larry W Gibbons1, Ugis Gruntmanis3



Abstract

Evidence suggests that substantial testosterone therapy is occurring without checking levels of testosterone, presumably based on the presence of symptoms alone. We sought to explore the relationship between total testosterone level and non-specific symptoms, metabolic abnormalities, and sexual dysfunction associated with hypogonadism.

This cross-sectional study included 2994 generally healthy men aged 50–79 years examined at a preventive medicine clinic in Dallas, TX from January 2012 to March 2016.

Symptoms of hypogonadism were assessed. Screening morning total testosterone levels were measured and categorized into low (<250 ng/dL), low normal (250–399 ng/dL), and normal (≥400 ng/dL).

Multiple logistic regression models were used to test the associations between total testosterone and signs and symptoms of hypogonadism. When considering symptoms and signs of hypogonadism, only decreased libido (OR 1.31, 95% CI 1.00 to 1.70), fasting glucose ≥100 mg/dL (OR 1.47, CI 1.15 to 1.88), and hemoglobin A1c over 6% (OR 1.47, 95% CI 1.06 to 2.03) were associated with increased odds of low testosterone after adjustment for age, body mass index, and cardiorespiratory fitness.

Testosterone levels were not associated with fatigue, depression, or erectile dysfunction in our study (p>0.6). In this preventive medicine cohort, symptoms commonly attributed to testosterone deficiency were not associated with low total testosterone levels.
 
That seems like a totally counter intuitive conclusion. Those were three of the key symptoms that TRT relieved for me. Is this study saying that TRT did not help fatigue, depression and ED in the control group? Hard to believe.
 
Maybe I’m mis-reading the abstract, but I don’t think they administered TRT. They looked at people’s total T and their symptoms and tried to see if there was a correlation. But obviously many problems with this kind of study, almost too many to list.
 
Yes, I would view the study as suggesting that there are so many causes of depression, ED, etc. that low testosterone gets lost among them, i.e. didn't achieve statistical significance.
 
Yes, I would view the study as suggesting that there are so many causes of depression, ED, etc. that low testosterone gets lost among them, i.e. didn't achieve statistical significance.

Indeed - low T should definitely be there but it seems that things like fasting glucose and hemoglobin were more prevalent in this particular research.

Which once again proves that it's always best to check other relevant studies as well. Because different studies take different aspects into account and it'd be better to come to a conclusion based on the findings of more than a single scientific data.
 
In my opinion, I'm not sure this study really says very much at all. They consider anything above 250 ng/dL to fall into a normal range (even if it's categorized as low-normal). 30 years ago this reading would've definitely been considered as very much "not normal".

With the information in the abstract, a 60yo man could've walked into the clinic with fatigue, depression, and erectile dysfunction, with a 251 ng/dL total test level. This study would've said that it was not due to Low-T, since he was still in what is considered a normal range.
 

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⚠️ Medical Disclaimer

This tool provides predictions based on statistical models and should NOT replace professional medical advice. Always consult with your healthcare provider before making any changes to your TRT protocol.

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Understanding Your Hormones

Estradiol (E2)

A form of estrogen produced from testosterone. Important for bone health, mood, and libido. Too high can cause side effects; too low can affect well-being.

DHT

Dihydrotestosterone is a potent androgen derived from testosterone. Affects hair growth, prostate health, and masculinization effects.

Free Testosterone

The biologically active form of testosterone not bound to proteins. Directly available for cellular uptake and biological effects.

Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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