There's a phrase that Dr. Haleem Mohammed said he hears often in his practice: "I don't feel like myself." He shared that this phrase it's very telling and may indicate that a patient has low testosterone levels. Whereas depression can make a mad feel sad, low testosterone can "make a man feel erased". It's a distinction, he said, that the American healthcare system has largely failed to make, and millions of men are living with the consequences.
Why so many men get the wrong diagnosis
The symptoms of low testosterone and clinical depression read like they were written by the same hand. There might be fatigue, low motivation, poor concentration, reduced libido, or sleep that doesn't feel restorative. When a man walks into a primary care office carrying those complaints, the path of least resistance is familiar: a PHQ-9 questionnaire, a diagnosis of depression, a prescription pad, and an SSRI.
Dr. Mohammed said he thinks that path gets taken far too often and far too quickly. "The standard insurance-based primary care visit is seven to twelve minutes and a PHQ-9 takes 90 seconds," he shared. "Prescribing an SSRI is fast and reimbursable. Ordering a proper hormonal workup, interpreting it, and having a real conversation about Testosterone Replacement Therapy (TRT) is none of those things. The system rewards speed, not accuracy."
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