While testosterone replacement therapy (TRT) is often mentioned in discussions about men suffering from Low T, and often involves major doses of testosterone to offset the deficits experienced in those subjects, there are instances in which TRT is only needed in small doses. These include everything from men who are just on the low side of the normal testosterone scale, to trans men undergoing transition.
Understanding how testosterone works, as well as the ins and outs of low dose testosterone therapy, can go a long way toward determining whether it is the right strategy for you.
WHAT IS TESTOSTERONE?
Testosterone is the primary male sex hormone, responsible for determining most physical and sexual characteristics associated with biological maleness. An anabolic steroid, it controls functions relating to the prostate and testes, as well as muscle mass, bone density, and body hair growth. Overall, testosterone plays a significant role in preventing osteoporosis and contributing to overall well-being and physical health.
Testosterone works by binding to the androgen receptor, which then allows it to bind to specific nucleotide sequences that produce the typical effects of testosterone – regulating libido, building muscle mass, strengthening bone mass, and more.
WHAT IS TESTOSTERONE REPLACEMENT THERAPY?
Testosterone replacement therapy, or TRT, is a regimen in which testosterone supplements are administered to a patient in the form of injections, gels, creams or patches. This externally introduced testosterone then acts within the body as free testosterone, which binds to the androgen receptor to perform the normal duties of testosterone.
TRT is especially useful for individuals with Low T, or lower than normal levels of testosterone in the body. Low T can occur for any number of reasons, whether through a genetic disorder or the normal aging process; TRT is a common remedy for the symptoms of Low T.
However, there are some patients for whom a full-bore TRT regimen is not necessary – they may only want to adjust their testosterone levels in comparatively marginal ways. This is where low dose testosterone therapy comes in.
WHAT IS LOW DOSE TESTOSTERONE THERAPY?
Low dose testosterone therapy works roughly the same way as normal TRT, but patients instead receive a fraction of the normal dose typically administered to someone participating in a standard regimen. Some patients take ¼ of the testosterone levels found in a “normal” injection – instead of 1cc of 200mg/mL, low dose T treatments will contain ¼ cc of the same concentration. Often, these regimens will last longer than the typical TRT treatment plan, typically to administer the same levels of testosterone with
There are several different reasons why people might want to undergo low dose testosterone therapy:
- Trans patients who want a slow, gradual transition. Trans people who wish to undergo hormone replacement therapy (HRT) might consider low dose therapy a way to test the waters of their transition – to give them time to think about processing their body dysmorphia, the extent to which they wish to transition, and more. Having a more gradual process allows trans men to have a greater degree of control over their transition and evaluate the goals of their journey.
- Hypogonadal children who require anabolic or androgenic therapy. This includes children with Turner syndrome, growth hormone deficiency and more. Since the patients in question are younger, they do not need as large a dose as a fully-grown adult undergoing TRT. As such, low dose testosterone therapy is the most prudent option for children with hypogonadal conditions.
- Cisgendered men with slightly-below-average testosterone levels. While most TRT is performed on men who have Low T (i.e. men who have testosterone levels below the standard range of 300 mg/dL), there are also men who may have T levels on the lower side of that spectrum. With low dose testosterone therapy, they have the chance to improve their testosterone levels only slightly, just enough to get to the higher side of the normal range. This way, they can optimize their existing health, virility, cognition and more, while not having to take as comprehensive a treatment plan as men with Low T.
WHAT ARE THE EFFECTS OF LOW DOSE TESTOSTERONE?
Many of the effects of low dose testosterone therapy are the same as full-strength TRT, simply reduced in intensity.
- Higher sexual function. Patients who undergo low-dose testosterone therapy have found slight improvements in sexual activity and sperm count, though erectile dysfunction rates were roughly unchanged. However, that may have more to do with external psychological factors than a direct correlation to Low T.
- Greater expression of male characteristics and body composition. Both for men with lower than average T and for trans men in transition, low dose testosterone therapy allows for slow, gradual reintroduction of male characteristics, such as body hair growth, lower fat mass and small changes in overall body composition.
- Improved bone density, muscle mass. As testosterone has the effect of improving bone mass density and preventing osteoporosis, patients taking low dose testosterone treatments experience slight recovery in bone density. Furthermore, as fat mass decreases with TRT, lean muscle mass subsequently increases.
- Improved mood and cognition. Low dose T also has a measured effect on cognition and mood, improving on factors like memory and reduced irritability.
- Reduced risk of cancer. Normal TRT carries with it an increased risk of prostate cancer; low dose testosterone therapy lowers that risk, while also eventually administering similar cumulative levels of testosterone.
Low dose testosterone therapy has proven to be a useful variant of testosterone replacement therapy that permits people who simply need small adjustments to their testosterone levels to get the treatment they need. This can be done as part of a gradual transition from female to male for trans people, or for men who simply wish to increase their slightly below average T levels.
While there are some side effects that merit consideration before embarking on a low dose testosterone therapy regimen, these effects can be strongly mediated by supervision from seasoned wellness professionals and hormone specialists. If low dose testosterone therapy is something you might be interested in, please consult a wellness professional near you.