Hey guys, my name is Dr. Sam. Now, I’ve been asked by some of you lately to make a video on testosterone. What is the difference between free and total testosterone and how does testosterone affect erections especially with age? Well, if you keep watching, I’ll give you the lowdown! Welcome to my channel SwiftMedNZ. If you have a question that you’d like me to do a video on, please post it in the comment section below. And if you enjoy my videos, please remember to subscribe – and you can also hit the little notification bell, next to the subscribe button, so that you don’t miss out on any of our latest videos. What is the difference between total testosterone and free testosterone? When it comes to testosterone, there are two main types, “Free” and “Bound”. 98% of the body’s testosterone is either bound to sex hormone binding globulin (SHBG) or another protein called albumin. The other 2% is known as “free testosterone”. The free testosterone is what does all of the stuff in your body, like cell replication to make new bones and muscles, deepening the voice in puberty and creating facial hair. Total testosterone is the grand total of all the hormone in the bloodstream, bound and free. Usually, when you get a blood test done it is measuring the total testosterone level. Is there a backup testosterone supply? If your free testosterone level is running low the body can make some of the bound testosterone available for use. This is so your body always has an even supply of testosterone ready to go. How do you increase free testosterone levels? There are two ways to improve testosterone levels 1. Is to increase your Total Testosterone level. This is usually done through exercise or supplementation. The second way is to reduce the amount of bound testosterone. Vitamin D and Boron are thought to lower this. As men age the body naturally increases the amount of bound Testosterone, which means there is less free testosterone available. Also the total testosterone level declines with age. Is my testosterone level too low? This is when it becomes tricky! The total testosterone level is below the normal range in about a quarter of men over the age of 70 and in half of men over the age of 80. So if a doctor took a blood test from a man, who was 85, and the level came back low, that actually may be normal for him. In order to establish if the testosterone level is low for you, a number of factors have to be taken into consideration. Such as – what is your age? Do you have any current symptoms? Do you suffer from any chronic medical conditions? Or are you taking any regular medications? There are lots of causes of low testosterone. Including problems of the pituitary gland in the brain, opiate medications, problems with the testes or chronic medical problems such as Obesity, Type 2 Diabetes, Sleep Apnea, liver or kidney disease. In older men with chronic medical conditions the potential risks of long term testosterone therapy is unknown. This is particularly in regards to the risks of prostate cancer or vascular disease. So how does testosterone affect erections? Erections depend on testosterone, but we don’t fully understand the relationship. For some men they have normal erections, despite having testosterone levels that are well below the normal range. What we do know is the same causes of low testosterone are linked to the same conditions that play a role in Erectile Dysfunction. Such as Type 2 Diabetes, Obesity and heart disease. So if I take testosterone, will that cure my ED? If your total testosterone level is normal taking testosterone replacement probably won’t help your ED symptoms. Instead, try to find other causes of your ED and treat them. For men who have low testosterone levels, testosterone therapy usually improves a man’s sex drive or libido, but not the erections. If the erections seem to have improved with testosterone replacement, often extra help is still needed with erectile dysfunction medications such as Viagra or Cialis. This is because these medications improve the circulation to the penis. Some research suggests that erection improvements that result from Testosterone Replacement may not last over the long term. So what is the bottom line? If you have low testosterone and erectile dysfunction, your doctor may choose to prescribe a course of testosterone replacement therapy, to see if boosting your testosterone levels, also improves the quality of your erections and other symptoms as well. It’s completely individual though and my best advice is to have a chat with your doctor about the pros and cons. So that you feel well-informed enough to make a decision. Thank you for watching! I hope that you found this video useful. If you’d like to learn more about erectile dysfunction treatments, please check out some of my other videos on men’s health.