I believe I may have symptoms of low testosterone — low libido, increased breast tissue, belly fat and almost no energy. The level I had in my blood was 11.1, which is close to the average, however it’s still lower than what would be considered healthy. Are there any other recommendations you can make? I am 55.
Andy Gurry Lincolnshire
While your symptoms might indicate low testosterone, they could also be a sign of something more.
Healthy testosterone levels range from 10 to 30 nanomol/l. Hypogonadism occurs when the level drops below 10.
The levels you have aren’t necessarily cause to be concerned. I’d suggest a repeat test in three to six months to see if there is a declining trend.
Low testosterone can cause a variety of symptoms that you don’t mention, including erectile dysfunction and a decrease in body hair and beard growth, as well as loss of muscle mass and a reduction of bone density.
As an alternative, I suggest you check your thyroid function.
The healthy level of testosterone is between 10 and 30 nmol/l. Hypogonadism is a condition where the testosterone level remains below 10 consistently.
The hormones produced in the gland include thyroxine. This plays a crucial role in several functions within your body like metabolism and hair growth.
Hypothyroidism — where the thyroid gland works at a slower rate than normal — can cause low energy and weight gain, including larger breasts. These are the symptoms that you have mentioned.
You may also notice a decreased pulse rate and feeling dry and cold skin.
First, have a blood test done to determine the level of thyroid-stimulatinghormone (TSH), which is a hormone that the pituitary gland secretes in the brain. The TSH level will rise if the thyroid gland doesn’t function correctly.
If additional tests confirm that you are hypothyroid, levothyroxine will be prescribed to you. This is to replace the thyroxine. This medication is generally taken once daily and will resolve any symptoms. Ask your doctor for the blood test.
Prior to the lockdown, I was healthy at 74 years old and exercised each week. My GP sent me a text to inform me that statins were being prescribed for me (atorvastatin). However, I felt my legs ache and developed brain fog.
My surgery advised me that I should continue taking the statins because I was at risk for heart attack or stroke of 23%. However, they changed my mind and gave me pravastatin instead. My legs still ache, but when I stop taking the statins, they don’t. Is it worth being on these pills if it means I’m unable to stay fit?
Jenny Marsh, via email.
Because of a new scoring system called QRisk3, all GPs use to determine your likelihood of suffering a stroke or heart attack, you have been prescribed statins.
This data is for those over the age of 84 and includes information such as cholesterol levels, blood pressure, BMI, smoking history, and more.
Your GP practice concluded that you’re at high risk (i.e. more than 20 per cent — meaning you have a two in ten chance of developing cardiovascular disease in the next ten years), which is why you have been told to take statins.
One consequence of this pandemic is the fact that doctors are not visiting patients face-to-face to discuss treatment options or give advice about lifestyle modifications, such as diet and exercise.
Because of a new scoring system called QRisk3 that all GPs use, statins have been prescribed to you. This determines the risk of complications such as a stroke or heart attack.
If you are considering quitting a drug in order to determine if your symptoms have been caused by it, talk to your doctor first. It seems you belong to the tiny percentage who have statin intolerance, based on your description.
This drug partially blocks the absorption of cholesterol in small intestines and can be given to these patients. Statins slow down cholesterol production in the liver. Ezetimibe is less potent, but can still be effective — the only way to know is to try it for two to three months.
One of the PCSK9 inhibitors is another alternative. They work by blocking a liver protein that regulates cholesterol (called PCSK9). People with high levels of PCSK9 also tend to have high cholesterol.
As a monthly injection, the specialist may prescribe this treatment. This treatment can be requested by your GP, despite the fact that they insist on lowering your cholesterol.
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Replies should be taken in a general context and always consult your own GP with any health worries.
In my view: We must find the truth about Lyme disease
One example is the long-term effects of an infection can be called Long Covid. Another common cause is Borrelia burgdorferi, the bacterium carried by ticks which causes Lyme disease — and, in turn, symptoms that can last for weeks, months or even years.
But there is some good news — work is under way on a vaccine that cuts the risk of Lyme disease developing in the first place.
The vaccine causes the skin to respond so that the bite of a tick can be caught early. This allows for the removal of the organism before infection occurs.
It’s a welcome development, as Lyme disease can cause an unpleasant, flu-like illness and other problems in the immediate aftermath of the infection.
However, while this post- infection syndrome is well recognised, this isn’t the case for chronic Lyme disease, where patients experience symptoms years later, yet blood tests can find no evidence of Borrelia infections. As a result, mainstream medicine doesn’t acknowledge the diagnosis of chronic Lyme disease.
It’s happened before. There was an era when patients complaining of fatigue, joint pains or brain fog were common.
Since then, our greater understanding of the microbiome — our gut bacteria — has made such a condition seem unlikely.
These patients presented with medically unexplained symptoms. These patients have been around for a long time. It is crucial not to allow irrational speculation to override science and objectivity.