We’re going to focus on the guys today.

Getting testosterone levels at least normal, if not optimal, in men who start with low levels is commonplace these days, but it wasn’t always so. As it turns out, testosterone optimization has been around for a while – it has an intriguing history, so we might hit on that in a future column. Anyway, testosterone optimization for health in men has really seemed to “come of age” within the last few years. Follow me as I take you through how we got here.

Testosterone historically had a bad rap because of its abuse potential. Honestly, from as far back as I can remember, the first picture that ever popped in my head when the word testosterone was used was that of a bodybuilder as I associated testosterone directly with its abuse. And let’s be honest – it’s still abused.

I have patients who come in to see me who admit to past or current steroid abuse. When it’s abused (in other words: when it’s used at inappropriately high levels), we do see risks associated with it. The biggest concerns are heart disease risk and altered mood (aggression, emotional instability, etc). When it’s abused at such high levels, I’ve also seen guys who have then “burned out” their testicles’ ability to make its own testosterone. Just suffice it to say abusing it at inappropriately high levels is not a good thing…Don’t be that guy.

Well, what about normal or even optimal testosterone levels? Is this range good for you, bad for you, or somewhere in between? Honestly, they’re good for you, and that’s generally agreed upon in the medical community now, but let’s see how we got here – it wasn’t long ago that there was real concern over testosterone optimization.

Four or five years ago, there was a series of four articles that came out stating that testosterone optimization possibly increased the risk of heart disease. It wasn’t long after that the FDA changed the labeling to state this and the lawyer commercials started: “Have you ever been on testosterone? Call this number.”

Well, as experts in the field began to scour through the data, they couldn’t find a single study that could directly link testosterone optimization and an increased risk of heart disease. They actually found the opposite – that testosterone optimization had either a neutral or beneficial impact on heart disease risk. This then led several key players, including the AUA (American Urological Association), the Mayo Clinic’s Male Consensus Committee, the American Society for Men’s Health, the Sexual Medicine Society of North America, the Society for the Study of Male Reproduction, and several others to publish what in the medical community we call “position statements” in defense of the health benefits of testosterone. To sum them up, they said essentially the following: Testosterone deficiency is a well-established, significant medical condition that negatively affects male sexuality, reproduction, general health and quality of life. A patient with the signs and symptoms of low testosterone may benefit from treatment regardless of whether there is an identified underlying cause. Low testosterone is a global health concern, and therapy for it is effective, rational and evidence-based. There is no scientific basis for any age-specific recommendations against the use of T-therapy in men. And, the evidence does not support an increased risk of heart disease or cardiovascular events with testosterone therapy.

I would definitely say there was a pothole we had to drive through in these last few years when it comes to testosterone optimization in men but I think, with the help of several major medical organizations, we recovered quickly and are back on track with a consensus that normal testosterone levels are healthy and beneficial. That said, you still need to have a healthcare provider who knows this stuff monitor you if you think you have low testosterone or are already on supplementation for it because there are other things that still need monitoring like your red blood cell count and PSA (your “prostate number”) to name a few. For testosterone, there seems to be a Goldilocks effect – across the board, you have more health risk when it’s either too low or too high. You want it to be just right.

As healthcare providers, we are always trying to do what’s best to serve our patients. We’ll drive down that road of health with you and guide you along the way.

• Dr. Thomas is a board-certified physician who operates Complete Health Integrative Wellness Clinic and Thomas Urology Clinic in Starkville, Mississippi. Is this column helpful or are you looking for more information? We’d love to hear from you. Go to www.CompleteHealthIWC.com or call 662-498-1400.

This newspaper column is for informational purposes only and is, under no circumstances, intended to constitute medical advice or to create or continue a physician-patient relationship.  If you have a medical emergency, you should immediately seek care from your nearest emergency room, and if you have specific health questions, you should consult your own physician.