Search

When lifelong trekker and adventurer Dorismae Weber learned her aortic valve was shutting down, she was afraid she was losing something she loved most: her daily walks. But following a trans catheter aortic valve implantation, Weber reclaimed her walking shoes — and her life. This is her story. An avid walker and traveler, Dorismae Weber’s life changed dramatically when she was exploring Mongolia and began having trouble breathing. Weber, 84, learned her aortic valve was shutting down. “It’s scary when you lose what you’ve always done,” Weber says. “I’ve walked all my life, and it’s always been the place I’ve gone to for comfort, for solving problems, for just enjoying. But all of a sudden, I couldn’t do this anymore.” Weber was not a candidate for traditional open heart surgery because she had heart surgery in the past. Then Weber learned about about trans catheter aortic valve implantation, also known as TAVR. She went to see Renown cardiologist Jake Ichino, MD, who put her through a battery of tests before performing the procedure. “Unlike the standard traditional open heart surgery, TAVR is a less invasive approach,” Dr. Ichino says. “We traditionally go up the artery of the leg with a catheter tube device and then we implant a valve without opening the chest.” After the TAVR procedure, Weber was once again able to complete her daily five-mile hikes. “When I woke up, all I can tell you is that I looked around and I thought, ‘I have a whole new life ahead of me — when I was told there was very little left,'” Weber says. She has also planned a trek just below the arctic circle with the environmental group Earthwatch. “I’m here because I had that procedure,” Weber says. “I’m here because they offered that procedure. And I’m very grateful for it, because I wouldn’t be here without it.” To learn more about TAVR, visit Renown’s Institute for Heart and Vascular Health.

Read More About How Dorismae Reclaimed Her Life and Walking Shoes with TAVR

Fishing can be great for relaxation, and it’s a great family activity. Here are five suggestions for great local fishing spots, plus a recipe for trout if you wind up catching one! There are many ways to unwind in the great outdoors in our beautiful region, and fishing can be easily added to that list. The benefits of casting a line are many. According to a study by Harvard Medical School, fishing was compared to yoga for its links to stress relief. The study notes that fishing brings out the relaxation response that slows down breathing, reduces blood pressure and relaxes the muscles. So, get out there and find some fish. There are many lakes of many styles to practice this ancient art, but here are the five that keep coming up in local conversation, virtual or otherwise. If you want to explore more options, the Nevada Department of Wildlife’s fishing guide can fill you in (and then some!). One thing to note about two of the areas we’ve chosen, Pyramid Lake and the Truckee River. Winter flooding has led regional officials to make necessary repairs to both areas, and there may be restrictions to access, including roads that lead to some of the fishing areas in both of these large bodies of water. Be sure to check first at the sites below before heading out, and you can also go to the flood advisory page for our region on water.weather.gov to check on flooding advisories throughout the summer as snowmelt continues. Five Great Regional Fishing Spots Boca Reservoir Location: Stampede Dam Road, 2 miles north of the Boca exit on Interstate 80 Two types of fish: rainbow trout, kokanee salmon More details: One of the more reliable year-round spots, Boca Reservoir even hosts ice fishing once (or if) the body of water freezes over. It’s located in the beautiful Tahoe National Forest. Donner Lake Location: Take the Donner Pass Road exit from Interstate 80, turn onto South Shore Drive Two types of fish: brown trout, mackinaw trout More details: A great scenic lake at the edge of Donner Memorial State Park, this fishing spot includes a public pier, while its China Cove on its southeast end is also a good place for mackinaw in the fall. Paradise Park Ponds Location: Take US Highway 395 to the Oddie Boulevard exit, follow it about a mile to the corner of Oddie and Silverada boulevards Two types of fish: rainbow trout, channel catfish More details: The Reno-Tahoe area has several urban lakes ripe for fishing, including this longtime spot for anglers. There are two large and two small ponds for a fun experience no matter your skill level. It’s also open year-round. Pyramid Lake Location: Interstate 80 to the Fernley exit, then take the Wadsworth/Pyramid Lake ramp to State Highway 447 Two types of fish: cutthroat trout, Sacramento perch More details: This is one place everyone talks about for fall fishing, as the season, which opens on Oct. 1, is very popular. The lake is run by the government of the Paiute Tribes and has distinctive rules for those who choose to fish here. Truckee River Location: Along Highway 89 and Interstate 80, between Tahoe City limits and Reno city limits Two types of fish: rainbow trout, mountain whitefish More details: This portion of the Truckee is where most of the fishing takes place, although the Reno-Sparks Recreation and Visitors Bureau notes that “this is not a river to fish to death in one spot. There is plenty of room and one should keep moving until one finds some agreeable fish.”

Read More About Get Reel: Top 5 Fishing Spots in the Truckee Meadows

Ready to start your garden? Get started with these easy-to-follow tips from local expert, Liza Detomasi, Workman Farms. Gardening is in my family. We started Workman Farms in Fallon in 1964 and I started working here when I was 14. I have always had a love for food and enjoy gardening and cooking. Gardening can be great for your health. It has been known to reduce stress, lower blood pressure, put you in a good mood and you benefit from the flavorful fresh produce. If you are interested in starting a garden here is a short intro into gardening in northern Nevada. Step One: Location, Location, Location For the beginners be sure to choose a location in your yard that receives 10 hours of sunlight, it doesn't have to be continuous but a total of at least 10 hours is best. Prepare the ground before you plant with nutrient soil and compost from your local nursery. Step Two: Choose the right plants Northern Nevada can be a bit tricky to grow a successful garden. With our low yearly rain totals and summer heat there are some plants that just don't like it here. But there are many that thrive. Those that do are grouped into two categories – cool weather and warm weather. Cool Weather Veggies Plant in early spring Carrots Beets Celery Broccoli Cauliflower Lettuce Radishes Onions Potatoes Snow peas Strawberries Kale Cilantro Warm Weather Veggies Plant in early May to late spring Tomatoes Peppers Squash Green beans Cucumbers Pumpkin Tarragon Basil Parsley Rosemary Thyme Oregano   Step Three: Enjoy! Always have fun and get creative! Start with a hamburger garden (lettuce, tomato, onion, pickling cucumbers), Salsa garden (tomatoes, peppers, onion, cilantro, tomatillos) or a stir fry garden (snow peas, carrots, broccoli, scallions). Never be afraid to ask your local nursery questions. Easy Plants for Desert Yards The Spruce provides a comprehensive list of nurseries in the Reno area to get you started. Happy planting!

Read More About How Does Your Garden Grow (In Northern Nevada)?

Meet a couple that's all heart. After each had a heart attack one year apart, they committed to Renown's new Healthy Heart Program and support each other along the road to heart health. Almost a year to the day that Janis VanHorn had a heart attack, her partner, Carl Edson, had one too.  "That kind of doubled the dose of making sure that we were doing everything that we could to continue with our life," VanHorn says. "It's a very life-altering thing.” And after Edson's quadruple bypass open heart surgery, he was grateful for the simple act of getting into the car with the woman he loves. "I was so relieved," he says. "I didn't realize how precious life was until that moment." The couple see the same cardiologist, Richard Seher, M.D., FACC, FSCAI, who recommended they participate in Renown's new Healthy Heart Program, a 12-week, 36-visit intensive cardiac rehabilitation curriculum that includes monitored exercising and cooking classes. Now they're both familiar faces at the program, which is located at the Renown South Meadows Medical Center. After several weeks, Edson says he has lost 10 pounds and VanHorton has lost inches and feels more toned. Tackling the program together has brought the couple closer and given them the opportunity to fuel one another's health goals and longevity. "I would be lost without this man," VanHorn says," and anything I can do to help him live longer, I'm going to do that." Edson adds, "She is to me my whole life, and I mean that sincerely. There's no one else I can turn to that has helped me in my life as she has, and I'm just trying to return the favor in a big-time way. She is my everything."

Read More About Carl and Janis Team Approach to Renowns Healthy Heart Program

Not all memory loss is inevitable — there are several things you can do to keep your brain nimble at any age. Find out how brain exercises, a healthy diet and daily movement can improve your brain’s focus. A modest decline in memory is to be expected as we get older. We forget someone’s name but recall it later. We find the need to make lists to remember things more pressing. Manageable? Yes. But frustrating nonetheless. The good news is we don’t have to sit back and succumb to age-related memory loss. There are concrete things we can do at any age to keep our brains sharp, nimble and engaged. Five Simple Brain Exercises 1. Volunteer or participate in meaningful activities outside of work. This engages your brain and emotions in a healthy, positive way. 2. Engage in moderate, regular exercise to tone body and mind. Overall good health is critical to brain health. Even casual daily walking can boost your mental abilities. 3. Eat the rainbow. Choose to include plenty of colorful fruits and veggies and ease up on processed foods in your daily diet. The proper nutrients can improve circulation to your brain, which will amp up your cognitive abilities. Consult your doctor for the best diet and supplement choices for your specific health needs 4. Get a blood test to determine your body’s hormonal and nutrient levels. Specific hormones and nutrients can affect cognition. Be mindful of your cholesterol levels, and if you take cholesterol medications, such as statin drugs, be aware they can also affect your mental faculties. 5. Engage in brain activities like reading, crossword puzzles, Sudoku and Trivial Pursuit. These types of activities can improve your brain’s focus and concentration and — most important — test your memory and general knowledge. You derive more benefit by engaging in these activities consistently for short amounts of time, so make a weekly appointment with yourself to build brainpower.

Read More About 5 Tips to Keep Your Brain Nimble

Renown’s team of nurses and respiratory therapists discuss what you need to know before undergoing surgery, including fasting guidelines and how to improve recovery. There are several things to know before you undergo surgery, including steps to prepare at home in advance of your procedure.   Fasting Guidelines: No solid foods eight hours prior to surgery You may have clear liquids three hours before your surgery. Clear liquids include water, apple juice and lemon or lime-flavored soda water (not cola). In addition, do not chew or smoke tobacco (regular or e-cigarettes) after midnight the night before your surgery, unless instructed by your doctor or anesthesiologist.

Read More About How Do I Prepare for Surgery?

At 85, James Domingos is still enjoying life as a cowboy, thanks to a transcatheter aortic valve replacement. Always rolling with the punches when it comes to life, 85-year-old James Domingos faced his health issues with the same grit. For many years, he roped cattle for friends and rounded up horses for the Bureau of Land Management. In recent years, a pacemaker controlled the rhythm of his heart, but didn’t slow him down. “We used to be able to take walks for 15 minutes in one direction and take the dog,” says Domingos’ wife, Joy. “Then it got to be less and less.” Tests at Renown Health revealed a heart valve was nearly closed. His heart doctor, Jake Ichino, MD, FACC, FSCAI, suggested a transcatheter aortic valve replacement, known as TAVR, which repairs a heart valve without removing the damaged valve. The procedure is recommended for patients who are at high risk for open heart surgery.

Read More About True Grit Healing a Cowboys Heart

If you’re having surgery on your shoulder, why does it matter what’s in your stomach? We asked Dr. Matthew Hoberg to explain more about pre-surgery directives, including fasting. If you have an upcoming surgery, your care team likely gave you instructions to fast before your procedure. But why? We asked Matthew Hoberg, M.D., medical director of Renown Surgical Services, to explain why it’s important to forgo food and drinks before surgery. Why are patients instructed to fast before surgery? Regardless of surgery type or site, we want the stomach to be empty before having anesthesia, because anesthesia can reduce your body’s ability to protect and prevent food or acids from the stomach from entering the lungs. Normally, your body is able to prevent this, but anesthesia medicines make it harder for your body to do so. When food or liquids from the stomach get into the lungs, doctors call it “aspiration.” This is rare, but can be dangerous if it does happen. Solid foods and liquids leave the stomach at different rates too. Solid food takes longer to empty from the stomach than liquids, so the time to stop eating solids (eight hours) is longer than that for clear liquids (two hours). The body has energy reserves to produce needed nutrients and fuel during fasting. Recently, studies have shown it is important to stay hydrated and have some carbohydrates in clear liquids up to two hours before surgery, so clear liquids are allowed until two hours before surgery. There are also special rules for babies and young children who need surgery. For example, you may give breast milk up to four hours before surgery. If your baby drinks formula, you should stop six hours before surgery, and all solid foods you should stop eight hours before. Your child’s doctor or nurse will give you exact instructions. What if you show up for surgery and have broken the no-eating rule? Will surgery be re-scheduled? If patients have not followed the fasting guidelines, surgery will be postponed or rescheduled due to the possible increased risk associated with not having an empty stomach. The exception would be emergency surgery that cannot be delayed in which case special precautions are taken to help prevent anything from getting into the lungs. What other pre-operative rules should be followed to the letter? All instructions given to patients before their surgery or procedure should be followed. There are specific medical reasons behind all the instructions and they are designed for safety — to minimize risks, lower complications like infections and enhance the recovery process to help patients get back to normal as quickly as possible. Also, many patients ask if they should continue taking medications before surgery. The answer is: It depends. Your doctor or nurse will tell you which medicines you should take and when. Some medicines need to be stopped before surgery. But for others, it’s important you keep taking them as usual. You may also get new medicines to take before surgery. You may be asked to take some medications before surgery as part of advanced pain management protocols. If you need to take medicine right before your surgery, you can take it with a sip of water.

Read More About Why Can't I Eat Before Surgery?

To be on the move is a scary concept when you’re recovering from surgery. But did you know getting up and at ’em could be the key to a quicker recovery, post-surgery? Here’s some expert insight from Renown Surgical Services. The team at  has some news for you: Rest and movement are important to prevent serious complications. Here are some tips about how to get mobile after your procedure — and why it’s fundamentally important. Tip 1: Start Simple While you’re in bed, move your legs and feet up and down. Be sure to ask the nurses to help you get out of bed and into the chair for all your meals, or walk to the bathroom when needed. If you feel up to it, take a walk in the hallways with the nursing staff. Tip 2: The Sooner, the Better This may be surprising, but too much rest is not necessarily a good thing. The old saying “You use it, or you lose it” rings very true to maintaining the strength needed to get yourself out of bed. Beginning the mobility process early in your hospital stay will not only help you maintain strength and function, it may also help you get home sooner. Though it may seem counter intuitive, lying in bed all day can delay your healing time and cause serious complications to arise, including pneumonia, deep vein thrombosis or blood clots, pressure ulcers and sometimes constipation. Tip 3: Mobilize Your Support System Getting out of bed, sitting in a chair for meals and walking around your room or hospital unit can help reduce your risk of complications. The nursing staff will help you out of bed the same day of your surgery if it’s cleared by your doctor. Tip 4: Safety First The nursing staff is here to keep you safe, so make sure you call them for assistance getting out of bed. Even if you think you can do it yourself, use your call light to notify the nursing staff you are ready to get up and move. In addition, new medications can sometimes impair our judgment, balance and safety, so it’s always better to have help even though you may not need it. This is also why you may have a “bed alarm” on, to remind you to call for help and keep you safe while you are recovering. Tip 5: Move, But Manage Your Pain Many people find that getting up and moving actually helps their pain, rather than making it much worse. Taking the right amount of medication at the right times will minimize your pain and help you to get moving. Your care team will work with you on how much pain medication is right to manage any postoperative pain, with the goal for you to be comfortable enough to be able to move and gradually increase your activity each day. Tip 6: Maintain that Momentum at Home Mobility doesn’t end once you’re discharged from the hospital. It’s key to keep moving to maintain health and function. When you first arrive home, it’s crucial to take frequent movement breaks throughout the day. Increase activity as it becomes more comfortable, and be sure to ease back into an active daily routine. If you have concerns about your mobility once home, be sure to discuss this with your doctor at your follow-up appointment. Renown Surgical Services | 775-982-3993 Ask your doctor if you have any questions about your medical condition or the specific surgical procedure planned, or contact the team at Renown Surgical Services. Learn More

Read More About Want to Recover from Surgery Faster? Get Moving!

Need fresh hiking trails? These hiking trails offer new views, a different route or the motivation you need to get outside. Of course, whatever you’re looking for this summer, these trails were made for sunshine in Reno-Tahoe. Easy Hiking Trails Oxbow Nature Study Area Nature Trail Location: 3100 Dickerson Road, at the Truckee River. Parking: There is a parking lot onsite. Time Out and Back: 30 minutes Items to Bring: Water, sunscreen and a hat. Although this loop is just under one mile, it’s the perfect escape in the heart of Reno. And this riverside trail is accessible for all skill levels. Bird watcher? Certainly, keep an eye out for black-crowned night herons, red-shouldered hawks, mule deer, beavers and more wildlife in the area. Tahoe-Pyramid Bikeway – Sections 2 to 4 Location: West Reno to Sparks Parking: Woodland Drive, Crissie Caughlin Park, Idlewild Park, 1st Street, Rock Park and Spice Island Drive. Time Out and Back: 2-4 hours (each section, out and back) Items to Bring: Water, sunscreen and a hat. From west Reno to Sparks, this paved portion of the trail stretches more than 8 miles. And it is easy to find as it runs along the Truckee River. As one of the easiest hiking trails in the region, it includes numerous parking access points and you can walk as long or short as you desire. In particular, one great route is from Rock Park on S. Rock Boulevard to Cottonwood Park on Spice Island Drive in Sparks. It’s an easy walk for all hiking levels. Notably many evening hikers explore this area to view the bats living under the McCarran Bridge. Additionally, an array of birds and river views can also be found along this enjoyable path. For maps for sections of this path, visit Tahoe-Pyramid Bikeway’s website. Cave Rock Hiking Trail Location: South Lake Tahoe; turn right on Cave Rock Drive from Highway 50, just prior to the tunnel. Parking: Park on Cave Rock Drive. Time Out and Back: 30 minutes Items to Bring: Water and sunscreen. Not only does this short trail have breathtaking views of Lake Tahoe, but it is also meaningful. Chiefly the rock was created more than three million years ago. Equally important, it is still considered sacred to the Washoe Native Americans. Also, leashed dogs are welcome on the trail. Moderate Hiking Trails Steamboat Ditch Trail Location: To get to the trailhead, take Mayberry Drive in west Reno. Then turn south on Plateau Road and right onto Woodchuck Circle. Parking: There is a dirt area for limited parking. Time Out and Back: 3-5 hours Items to Bring: Water, layers, sunscreen and a hat. Of all the hiking trails listed, this one offers some of the best views of downtown Reno and the surrounding hillsides. Built by Chinese laborers in the late 1870s, the Steamboat Ditch is the longest ditch in the Truckee Meadows region. In fact, the water serves as a vital source for ranchers and farmers south of Reno. First, start behind the Patagonia in northwest Reno at the Tom Cooke Trail or park off of Woodchuck Circle. Next head west to find the “Hole in the Wall.” Surprisingly this is a tunnel engineered through the hill, so the ditch could supply water to the Truckee Meadows. This hike is a little over 8 miles with the halfway point just under 4½ miles. With this in mind, if you’re thinking of hiking with your four-legged friend, remember to bring your leash because rattlesnakes can be spotted. Usually there’s also little shade, so plan accordingly by bringing a hat and dressing in layers. Thomas Creek Trail Location: Head out on Mt. Rose Highway going west to Timberline Road. Then drive 1.3 miles past the end of the pavement, stay on Timberline and you will see the trail head on your left shortly after you cross the bridge. Parking: There is a paved parking area on Timberline Drive. Time Out to Back: 2-6 hours Items to Bring: Water, layers, food and a phone with GPS or map. Definitely put he Thomas Creek Trail on your hiking trails list. Located off of Mt. Rose Highway, it is a very scenic hike winding along Thomas Creek into a Jeffrey pine forest. You may choose to hike to what appears to be the end of the trail (where it meets the road) or continue further up for 1/8 of a mile into the Mt. Rose Wilderness. Hiking up the trail to the creek crossing, and then taking the dirt road back down is a great way to see the entire canyon. While this hiking trail is closer to 5 miles, it can be shortened by turning around at any point. Another option is to look for signs to turn off the Thomas Creek Trail at the junction for Dry Pond Loop. Dry Pond is a 4½-mile, out and back hiking trail from the Timberline parking lot. Ultimately you may see a pond or hilltop meadow, depending on the season and weather. Overall it is possible to go anywhere from 2 to 6 miles (or more), based on what you choose to hike. The gain along the creek is minimal, with an 800-foot gain at the top part of the trail. In particular, watch for mountain bikers, as this is also a very popular biking trail. Hunter Creek Trail Location: Go west on Mayberry Drive to Plateau Road. Then turn left and go up the hill to Woodchuck Drive. Lastly, turn right and follow Woodchuck to the hiking trail head. Parking: Paved parking on Woodchuck Drive with a bathroom and benches. Time Out and Back: 2-5 hours Items to Bring: Water, layers, a snack, sturdy shoes and sunscreen. The Hunter Creek trail is about a 7-mile day hike with a little over 1,000 feet of overall gain leading to a waterfall. Ultimately it’s totally worth the trip! This hiking trail winds up Hunter Canyon through sagebrush, Jeffrey pines and interesting rock formations. The waterfall is a great place to sit on shaded logs and enjoy lunch. This trek is very rocky and narrow at times, so good trail shoes are recommended. Furry friends should also be leashed, as rattlesnakes and wildlife are common along the trail. Difficult Hiking Trails Hidden Valley Loop Location: Hidden Valley Regional Park; drive east on Pembroke Drive and turn left on Parkway Drive. The park is at the end of the road. Parking: Park on the east side of the park, closest to the hills. Time Out and Back: 3-6 hours Items to Bring: Water, sunscreen, shoes with good traction and a lunch or snack. Overall this 6-mile loop has about 1,800 feet of gain and is located east of Hidden Valley. We recommend starting the hike from Hidden Valley Regional Park. First, head southeast on a dirt road and then turn east onto a very steep trail that winds over red dirt for about a half mile. In fact, this is the steepest part and it’s a leg burner. Once you get past the climb, the trail gradient decreases. Then you wind along the south side of a big bowl lined with pinyon pine and juniper trees. The hiking trail continues up to the ridge line where there are incredible views of the Truckee Meadows and Mt. Rose. You can hike back down from this point, but it is best to continue on the trail along the ridge line to where it isn’t as steep with incredible views. Frequently you may see wild horses while hiking in this area. Mount Tallac Location: Southwestern side of Lake Tahoe, between Emerald Bay and Camp Richardson. Turn south on Mt. Tallac Road from Highway 89. Parking: Follow Mt. Tallac Road to the parking lot. Time Out and Back: 6 hours Items to Bring: Water, layers, lunch or snacks, sunglasses, hat, sturdy shoes and sunscreen. Definitely a big hike with an even bigger reward — an incredible view of the Desolation Wilderness and Lake Tahoe. This hiking trail is 10.5 miles out and back with a 3,500-foot elevation gain. If you’d like to explore the area without the 6-hour commitment, hike 1.7 miles out to Floating Island Lake or 2.3 miles out to Cathedral Lake. Day use permits are required and you can fill one out for free at the trailhead.

Read More About 8 Local Hiking Trails You Need to Explore

Watch what happens when a family’s matriarch finds out she has to have heart valve replacement surgery. Thanks to supportive cardiac care, she is now back to health and enjoying her extended family with a healthy heart.  Marilyn O’Gorman has a full heart full of love: Just ask her six children, 15 grandchildren and six great grandchildren. However, in 2009, tests showed that same heart had medical issues. So her close family was by her side when she underwent heart valve replacement surgery. O’Gorman says her heart doctor, Athan Roumanas, MD, FACS, put her at ease about the surgery. “You’re very nervous — you’re scared,” says O’Gorman. “You don’t know: Are you going to come out of it? Is it going to work?”  Heart Valve Replacement Surgery Comes with an Unexpected Question O’Gorman was asked to choose whether she’d prefer a pig or a cow valve — ultimately inquiring of Dr. Roumanas which one he’d choose for his own mother.  “And he said, ‘Well, probably pig,'” she recalls. “And I said, ‘OK, I’ll oink for you.’ And that’s how I got that, and he did a wonderful job.”  O’Gorman continues her care at the Renown Institute for Heart and Vascular Health, so she can stay heart healthy and spend her free time with the many generations of family in her life.

Read More About Happy and Healthy Life After Heart Valve Replacement Surgery

You probably know testosterone (T) plays an important role in how boys physically develop into men. But is that all you know? What happens when a man's T levels are off? Are there symptoms men should look for? And what are the treatment options? Dr. Bobby Kahlon, MD, Renown Medical Group provides answers in a Testosterone Q&A.   What does testosterone do for men?  "Testosterone is known as the 'manly hormone' for a reason," says Dr. Kahlon. "Though women also naturally produce small amounts of it, men produce testosterone at much higher concentration levels. And it affects men in more physical and obvious ways. How much hair a man has on his chest, how deep his voice is, or how muscular he is are all attributable in some way to testosterone. It's also responsible in large part for sex drive and bone strength and affects how men think, learn and experience their surroundings."  Testosterone in men:   Powers virilization (male physical characteristics) and sexual function Builds muscle mass and strength  Supports bone density  Improves cognition  T Trivia: Discover Magazine reveals that “manly” testosterone and other sex hormones evolved long before we did — 500 million years ago — from the ultimate “female” hormone, estrogen. Can you have too much or too little testosterone?  Though high testosterone isn't a concern for most men, low testosterone or low T occurs more frequently and develops for two primary reasons.  Dr. Kuhadiya explains, "Subnormal testosterone concentrations occur either due to pituitary or testicular failure and the causes for each need to be discussed with your physician."  Pituitary failure: Approximately one-third of men with obesity, type 2 diabetes, or metabolic syndrome (which includes increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels) have low free — or "bioavailable" — testosterone. These health conditions can cause the pituitary gland to "fail" to release follicle stimulating hormone (FSH) and luteinizing hormone (LH) which are essential for triggering testosterone and sperm production. And that can cause low testosterone (hypogonadism). Testicular failure: Though less common than pituitary failure, testicular failure may also be responsible for low T. It's caused by diseases or illnesses affecting the testicles, injury or trauma to the testicles, or certain medicines and treatments such as chemotherapy or opioid pain medication. Providing your complete medical history to your doctor is always the first step toward a proper diagnosis.  What are the symptoms of low T?  The following indicators could be a sign that you have low T, say the doctors.  Lack of motivation and determination, including mild depression  Loss of physical endurance and muscle strength  Loss of or diminished early morning erections  Reduced libido (sex drive)   Erectile dysfunction (ED — difficulty achieving or maintaining an erection)   Gynecomastia (male breasts)  Small testes  T and Time: T levels in men naturally begin to decline by about 1% a year starting at age 30.  How do you test for low T?  "There are different methods for testing testosterone levels," says Dr. Kuhadiya. "Each approach uses a blood sample to evaluate total testosterone, which includes free and attached testosterone that combines with proteins albumin and sex hormone-binding globulin (SHBG). For the most accurate results, testing is based on samples collected in the morning after fasting, and from tests on two different days."  What treatment options are available?  "Well, your best natural option may be YOU," says Dr. Kahlon. "Men with pituitary failure are often able to treat their low T by losing weight to increase levels of the hormone. And even if you don't lose weight, exercise can help boost your testosterone. Unfortunately, if you have testicular failure, weight loss and exercise may not have the same effect."  So, are there other options? "You may want to consider Testosterone Replacement Therapy (TRT)," says Dr. Kuhadiya. "TRT is only available to men who are hypogonadal — with a clinical diagnosis of low T. Injection, gel, skin patch and nasal spray are available TRT options. The best option is the one that works best for the patient. Convenience, insurance coverage and cost are all factors to consider." Dr. Kahlon's TRT preference? Daily gel treatments, which are applied directly to the skin. On the other hand, Dr. Kuhadiya recommends intramuscular injections, which take place once a week or every two weeks.  But both doctors agree on this: physicians and their patients need to weigh the benefits and risks of TRT before proceeding with treatment — especially if your low T condition may require lifelong treatment. "In my clinical practice, I have seen some very good long-term results with an improved quality of life," says Dr. Kuhadiya. "However, in certain situations, TRT may increase the risk of heart disease and is not recommended for men with a history of prostate cancer." Dr. Kahlon adds, "Patients receiving any type of hormone therapy need to be closely monitored throughout the treatment process for any changes in their health."   How do you feel about steroids and T boosters?  "I don't recommend them, certainly not for hypogonadism," advises Dr. Kahlon. "There is no evidence to support anabolic-androgenic steroids or testosterone boosters as a safe or effective treatment for low T in men."  "In fact, there continues to be emerging evidence they may lead to side effects that could potentially harm the liver and the pituitary and endocrine functions of the body," warns Dr. Kuhadiya. "And that damage may be irreversible."

Read More About Testosterone, Men and Health: What You Need to Know