The Relationship Between Low Testosterone Levels and Asthenia in Adult Patients: An Original Study
Main Article Content
Abstract
Objectives: This study assesses the correlation between testosterone levels and fatigue severity, as measured by the NRS.
Methodology: This cross-sectional study was conducted from January to July 2024 at Hayatabad Medical Complex, Peshawar. A total of 150 adult patients presenting with asthenia were included. Serum testosterone levels were measured using standardized immunoassays. Fatigue severity was quantified using the Numeric rating scale (NRS), where patients rated their Fatigue on a scale from 0 (no fatigue) to 10 (extremely fatigued). Demographic data was summarized using descriptive statistics, while the Pearson correlation coefficient (r) was employed to evaluate the relationship between testosterone levels and fatigue severity.
Results: The frequency of low testosterone levels (<300 ng/dL) in the study was 40% (n=60). The average testosterone level for the low testosterone group was 250 ± 20 ng/dL, compared to 450 ± 30 ng/dL for those with normal testosterone levels. Patients with low testosterone had significantly higher Fatigue NRS scores (7.5 ± 1.5) than those with normal testosterone levels (3.2 ± 1.1) (p < 0.001). A significant negative correlation was observed between testosterone levels and fatigue NRS scores (r = -0.65, p < 0.001).
Conclusion: Low testosterone levels are prevalent in adult patients with asthenia and are significantly associated with increased fatigue severity, as measured by the NRS. These findings suggest that assessing testosterone levels in patients presenting with unexplained asthenia may be valuable, and testosterone replacement therapy could offer potential therapeutic benefits.
Article Details
Work published in JPMI is licensed under a
Creative Commons Attribution-NonCommercial 2.0 Generic License.
Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
References
Bhasin S, Brito JP, Cunningham GR, Hayes FJ, Hodis HN, Matsumoto AM, et al. Testosterone therapy in men with hypogonadism: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2018;103(5):1715-44.
Imerb N, Thonusin C, Chattipakorn N, Chattipakorn SC. Aging, obese-insulin resistance, and bone remodeling. Mech Ageing Dev 2020;191:111335.
Wittert G, Grossmann M. Obesity, type 2 diabetes, and testosterone in aging men. Rev Endocr Metab Disord 2022;23(6):1233-42.
Wang C, Swerdloff RS. Testosterone replacement therapy in hypogonadal men. Endocrinol Metab Clin North Am 2022;51(1):77-98.
Tsujimura A. The relationship between testosterone deficiency and men's health. World J Mens Health 2013;31(2):126-35.
Storer TW, Woodhouse L, Magliano L, Singh AB, Dzekov C, Dzekov J, et al. Changes in muscle mass, muscle strength, and power but not physical function are related to testosterone dose in healthy older men. J Am Geriatr Soc 2008;56(11):1991-9.
Basaria S, Coviello AD, Travison TG, Basaria S, Coviello AD, Travison TG, et al. Adverse events associated with testosterone administration. N Engl J Med 2010;363(2):109-22.
Surampudi P, Swerdloff RS, Wang C. An update on male hypogonadism therapy. Expert Opin Pharmacother 2014;15(9):1247-64.
Harman SM, Metter EJ, Tobin JD, Pearson J, Blackman MR. Longitudinal effects of aging on serum total and free testosterone levels in healthy men: Baltimore Longitudinal Study of Aging. J Clin Endocrinol Metab 2001;86(2):724-31.
Bhasin S, Cunningham GR, Hayes FJ, Matsumoto AM, Snyder PJ, Swerdloff RS, et al. Testosterone therapy in men with androgen deficiency syndromes: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2010;95(6):2536-59.
Snyder PJ, Ellenberg SS, Cunningham GR, Matsumoto AM, Bhasin S, Barrett-Connor E, et al. The testosterone trials: Seven coordinated trials of testosterone treatment in older men. Clin Trials 2014;11(3):362-75.
Araujo AB, Esche GR, Kupelian V, O'Donnell AB, Travison TG, Williams RE, et al. Prevalence of symptomatic androgen deficiency in men. J Clin Endocrinol Metab 2007;92(11):4241-7.
Rhoden EL, Morgentaler A. Risks of testosterone-replacement therapy and recommendations for monitoring. N Engl J Med 2004;350(5):482-92.
Zitzmann M, Faber S, Nieschlag E. Association of specific symptoms and metabolic risks with serum testosterone in older men. J Clin Endocrinol Metab 2006;91(11):4335-43.
Shores MM, Smith NL, Forsberg CW, Anawalt BD, Matsumoto AM. Testosterone treatment and mortality in men with low testosterone levels. J Clin Endocrinol Metab 2012;97(6):2050-8.
Mulligan T, Frick MF, Zuraw QC, Stemhagen A, McWhirter C. Prevalence of hypogonadism in males aged at least 45 years: The HIM study. Int J Clin Pract 2006;60(7):762-9.
Kaufman JM, Vermeulen A. The decline of androgen levels in elderly men and its clinical and therapeutic implications. Endocr Rev 2005;26(6):833-76.
Traish AM, Saad F, Guay A. The dark side of testosterone deficiency: II. Type 2 diabetes and insulin resistance. J Androl 2009;30(1):23-32.
Zitzmann M, Nieschlag E. Testosterone levels in healthy men and the relation to behavioral and physical characteristics: facts and constructs. Eur J Endocrinol 2001;144(6):497-507.
Morley JE, Perry HM. Androgen deficiency in aging men: role of testosterone replacement therapy. J Lab Clin Med 2000;135(5):370-8.