I always cringe when I see people turn to hormone therapy, as we just don’t have a full understanding of the complex ways in which hormones interact and their impacts on all the body’s systems.
It may be necessary for some people, but given that there are potential risks (and based on recent medical history, there are are almost certainly risks we don’t know), I’d want to start with more benign, modest approaches first.
First, like someone with borderline cholesterol concerns (setting aside, for the moment the debate about whether or not cholesterol is really the problem in cardiac health), I’d want to make sure that I had taken appropriate dietary and fitness steps, and then after giving these a fair chance, see how things are going. Do the symptoms you think indicate a problem persist or ease? Do your blood levels improve or not? Et cetera.
On diet, making sure I was eating clean, getting good fats, and cutting down on processed foods and foods that might contain hormone disrupting substances.
On the latter, I’m not thinking so much of individual foods, but on foods that may be coming with residual pesticides and accumulated environmental toxins, some of which can have important impacts on the body’s hormones and hormone regulating processes.
Eating a lot of animal fats that have been fed hormones, and God knows what other garbage, on top of the normal bio-accumulation of a number of fat-soluble, hormone disrupting toxins that comes from eating a lot of fat up the food chain, could be having an effect on your body’s hormones. Like a lot of other health matters, you may be more sensitive to some of these than others.
The point is to try to limit your exposures by reaching for organic foods, especially fatty foods and pre-processed foods where there may have been no attempt to really wash pesticide/herbacide/fungicide residues off crops before throwing them into the industrial-sized mixing bowl. This may or may not have an impact on you, but it seems a prudent step before you go messing with your hormonal balance.
Are you overfat or relatively lean? Low testosterone can contribute to difficulty gaining muscle and staying lean, but you also may find that with some hard dietary and exercise work that getting leaner has a positive impact on your testosterone levels.
I haven’t seen enough literature on this subject to make anything approaching a strong claim, but we know that body fat can influence hormonal levels and hormonal balances, and that lower body fat likely shifts some balances in a positive direction, e.g., estrogen to testosterone levels.
Again, this isn’t an area of done a lot of investigation into, but more based on my recollection of literature I’ve come across in looking into other issues, but at a minimum it might be worth a perusal through the medical literature, and Dr.PowerClean can probably add his more-informed two cents on the subject.
Obviously, there is a chicken and egg problem in that trying to get fit and healthy can be a problem if you have low energy from an underlying hormone/metabolic problem. You don’t say if you’ve been exercising regularly, what you are doing exercise and diet wise, and for how long you’ve been doing them. If you see no improvement from changing diet and struggling to get your exercise, then consider further intervention.
At that stage, I wouldn’t want to trust my general practitioner to give me a good treatment plan. I’d seek out a specialist whose practice is metabolic medicine, who is keeping up with the latest relevant literature, and who would be best suited to work with you to figure out just what is going on and how to treat it.
They are more likely to see the big picture and look for conflating or aggravating conditions, develop an effective treatment plan to address your particular situation, and understand the limits, side effects, and management issues in such a plan.
Regardless, if it were me, I’d want to sit down with whatever doctor you work with and ask about any long-term health risks a treatment may have, how you might be supplementing (not in the sense of taking more pills but in the adjuvant sense of the word) any treatment with diet and/or exercise, what contraindications there are to a therapy (as doctors don’t always know everything about you, so it is good to have them run through these to make sure that there isn’t something relevant that you overlooked telling them), and what side effects there might be.
I’ve just had too many experiences with doctors willing to prescribe lots of pills without fully disclosing what the potential risks are, or admitting levels of uncertainty about our understanding of a certain area of human physiology or a lack of understanding about how the particular mix of medications you would be taking affect us.
If nothing else, a doctor that isn’t willing to give you the time to talk about these issues or dismisses your request for the information that allows you to participate in the decisions about your health, might have you considering a second opinion or seeking out a different doctor for your care.