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What are the warning signs of low testosterone?

Memory changes, dry skin, and heart attack could all be signs of low testosterone levels. Depression, fatigue, and low libido are some of the better-known symptoms of low testosterone, but did you know that low levels of this male hormone can also affect your bones, heart, brain, and body fat in less noticeable ways?

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Depression, fatigue, and low libido are some of the better-known symptoms of low testosterone, but did you know that low levels of this male hormone can also affect your bones, heart, brain, and body fat in less noticeable ways?

To get a diagnosis of low testosterone, you need a blood test to confirm low levels. Some symptoms are more obvious, but others may be gradual and silent. Here are some of the lesser-known warning signs of low testosterone.

1. Reduced Bone Mass

"You won’t realize your bones are getting thinner until they fracture, but lower testosterone can contribute to reduced bone-mineral density,” says Stephen Borst, PhD, associate director for research with the Geriatric Research, Education, and Clinical Center at the Malcom Randall Veterans Affairs Medical Center in Gainesville, Florida. Supplements can have the reverse effect. A research team gave supplemental testosterone for one year to men aged 60 and older who had low testosterone. By the end of the study, the men's bone mineral density had improved. The research, which was published in the February 2014 American Journal of Physiology-Endocrinology and Metabolism, “showed that testosterone treatment in older men caused a nice increase in bone-mineral density in two key areas: the lower spine and the hip,” Borst says. The mechanism by which lower testosterone leads to lower bone-mineral density isn’t fully understood, but probably involves a complex interplay among testosterone, estrogen, and bone health, says Borst.

2. Heart Attack or Stroke

“Currently there is a lot of debate about the safety of testosterone replacement, but we do know what happens when men do not have testosterone: They are more likely to fracture bones and have cardiac events, strokes and heart attacks,” says urologist Mike Butcher, DO, an andrology fellow at the Southern Illinois University School of Medicine in Springfield, Illinois. A review published in the November 2014 issue of Andrology looked at 53 testosterone studies published over 10 years. The researchers found a strong correlation between low testosterone, or hypogonadism, and an increased risk for early death or heart problems.

3. Nerve Pain or Numbness

“Testosterone and its derivatives, such as DHT, have recently been demonstrated to repair damage to nerves in the peripheral nervous system, which are not part of the brain or spinal cord," Dr. Butcher explains. "This damage could be from diabetes, chemotherapy, physical injury, and chronic nerve pain.” Research published in the March 2014 Journal of Endocrinology examined testosterone’s role in mitigating nerve damage. Researchers concluded that testosterone or its metabolites could play a role in treating neuropathy to prevent numbness and pain.

RELATED: 6 Ways You’re Ruining Your Testosterone

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If you have a condition such as diabetes and you find your nerve pain and numbness getting worse, talk with your doctor about the possibility that you may also have low testosterone.

4. Skin Problems

With low testosterone, "skin can become dry, and those with skin conditions such as psoriasis get worse,” Butcher says. Low testosterone could also play a role in worsening chronic skin conditions. When researchers compared men with psoriasis to those without psoriasis, they found higher levels of testosterone in those who did not have the condition. The research appeared in the May 2015 issue of The Journal of Dermatology.

5. Difficulty Losing Weight

“Men who are overweight tend to have lower testosterone levels,” says Ghandi Saadeh, MD, an endocrinologist at Sentara Medical Group in Kempsville, Virginia. If you’ve been dieting and exercising, and wondering why your excess weight sticks around, it might be because of your testosterone. When researchers tracked 181 obese men, they found that supplementing with testosterone reduced their weight by 47 pounds, on average. Supplemental testosterone also brought blood sugar levels under control, improved blood pressure levels, and led to healthier blood lipids, according to the study, published in the July-August 2014 issue of the journal Obesity Research & Clinical Practice.

6. Changes in Memory and Cognitive Ability

A man’s memory and cognitive ability may go down along with his testosterone levels, report researchers who tested, over a five-month period, a group of men aged 70 and older who were participating in the Concord Health and Ageing in Men Project. But the researchers caution that the finding, published in the April 2015 issue of The Journal of Clinical Endocrinology & Metabolism, doesn’t explain what underlies the correlation. Another change related to testosterone’s possible effect on cognition is its impact on the ability to carry out visual motor tasks. Researchers found that men who undergo androgen deprivation therapy for prostate cancer perform worse on tests of visual motor skills than do their peers, according to a study published in the August 2014 issue of Supportive Care in Cancer. Researchers are only now beginning to explore the many ways that low testosterone can affect your health. If you’re wondering whether there might be a connection between your symptoms and low testosterone, ask for a testosterone blood test. That’s the only way to get a definitive diagnosis.

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