LYING in a hospital bed for five months waiting for his broken back to heal, Brian Cunningham longed for the day when he’d walk out of the ward, get back to work and back to the gym.
He had slipped on a wet pavement and fallen awkwardly while on holiday in Krakow, smashing part of his vertebrae. His journey home, after he’d been injected to the maximum with anaesthetic by a Polish doctor, was one of the most painful he’d ever taken.
When the plane touched down at Edinburgh Airport, a stretcher was waiting to take him to the Royal Infirmary and months of medical treatment.
Yet, even when the school science technician was back on his feet after rehabilitation at the Astley Ainslie, he couldn’t quite shake the feeling that he still wasn’t well.
“It was just put down to the accident I’d had and my broken back,” he says. “I was just told recovery from a trauma like that would take a long time. I’d basically had to lie still for months on end to let it heal naturally, so it was thought my low energy levels and lack of physical strength were to do with that. But I just didn’t feel like myself at all. So I thought if I just worked harder I’d get through it and eventually feel better.”
He didn’t, and it took a trip to the gym at the Thistle Foundation in Craigmillar to send him back to his GP demanding answers. “They run a course for people who’ve been through a trauma to help them cope with normal life again, and part of that was to do physical exercise. So I went to the gym and was doing about ten to 15 minute workouts, then having to go home and sleep for hours. “One time I tried to lift a six-kilo Kettlebell and it was though it was stuck to the floor, I couldn’t shift it.
“I was about 48 then and the accident had been three years before that. I was totally fed up and exhausted. “I have a bio-medical background so I started to research my symptoms and then took them to the GP.” What he discovered on the internet was that how he was feeling fitted the description for testosterone deficiency syndrome (TDS), a condition which it’s estimated affects around 20 per cent of men over the age of 50 in the UK. TDS symptoms include fatigue, night sweats, change in body shape, reduced libido and depression.
“When I mentioned it to my GP it was pretty much dismissed because there’s such a range of symptoms,” says Brian, from Abbeyhill. “But I was in a bit of a state by then that I wanted it to at least be ruled out.
“I was in considerable pain physically and psychologically, was working full-time as well as trying to run my own business, a pub, and I was finding it harder to get out of bed each morning.
“Often I’d stand in front of the bus wondering whether to jump out in front of it or board it.”
A blood test was done and when it came back the results showed a low level of testosterone at just 1.5 millimoles per litre of blood (normal levels are classed as between 12 and 30). “I thought, here’s the answer. But I was sent to take another blood test just to make sure – at 8am as testosterone levels should be at their highest first thing in the morning. The result was just as bad, so then I had to wait to see an endocrinologist.”
Five months passed before that appointment, five months in which Brian felt worse. “I felt like I was dying, it was that bad,” he recalls. “By the time I saw the endocrinologist on December 22 I was a wreck.
“I’m normally a well-mannered person but I was pretty snappy with her. She seemed almost dismissive of the results of my tests and more interested in whether I had fathered any children. Then, to my disbelief, I was told to slim down a bit and go back in six months. I said it was probable I wouldn’t be around then.
“I told her I’d read research papers by her department head, Professor Richard Anderson, which advocated testosterone replacement in cases like mine and it was only then that she sought a second opinion. She conferred with the professor who, on seeing my notes, said I was to start testosterone replacement therapy immediately.”
But the wait wasn’t over. Brian faced another fortnight with no treatment as no pharmacy in Edinburgh stocked the testosterone gel – and Christmas further delayed the order. “It felt like everything was against me, but when it did arrive it was the best present ever as I felt better within a fortnight of taking it. I know it sounds a cliché but I didn’t really feel like a man when my testosterone was low. I felt like an empty hulk. The spark was missing.
“I was known for my sense of humour but nothing seemed to stimulate any of my senses.”
Now, every morning 50-year-old Brian applies the gel to his upper arms and chest. “It’s part of my routine now, like brushing my teeth and it only takes a couple of minutes to apply the gel after my shower. I regularly have my levels checked and they’re now back towards the higher end of normal levels.
“I’ll most likely have to keep doing it unless my body starts making its own testosterone again. But I’m back working, back at the gym, and feeling good again. And I’d say to any man that if they feel they’ve got a load of symptoms for which there doesn’t seem to be a reason – because it can happen naturally, you don’t have to go through a trauma like breaking your back – then you should push for a blood test at the GP.
“It can change your life.”
‘We can learn lessons from our grumpy old men’
THE Andropause Society, which aims to raise awareness of testosterone deficiency syndrome (TDS), says that fewer than nine per cent of Scottish adults are aware of the importance of testosterone to men’s health.
In middle-aged men, a deficiency can show itself through weight gain around the waist, lack of energy, irritability, lack of virility and depression.
“It is grumpy old man syndrome,” says Dr Doug Savage, a GP who works out of the private Centre for Men’s Health in Manor Place. “But it’s alarming how many people are unaware of the condition – and that’s including GPs and other health professionals. Yet treating TDS can affect men’s health so positively it’s shocking it’s not more well known.”
He adds: “TDS has been called the male menopause, which is wrong as it doesn’t affect every man, and Andropause syndrome suggests it’s only middle-aged men, while it can affect those younger, so TDS is the best name – and it is what it is.
“Most doctors used to think it was fairly rare but there’s been a lot of research to show otherwise. I feel for men who are being treated with anti-depressants for a depression they don’t have, or are taking Viagra for erectile dysfunction, when in fact it could be easily solved with testosterone gel.” Dr
Savage, who is a member of the British Society for Sexual Medicine as well as a fellow of the Andropause Society, believes that testosterone has a “bad image” in the UK with its links to sexual activity and anabolic steroid abuse.
However, he says that studies have shown that in men with a family history of diabetes or heart disease, a lack of testosterone can increase their chances of death from these diseases.
“Obese men are four times more likely to have TDS than skinny men, studies have shown that where heart disease exists alongside TDS men are twice as likely to die within seven years of diagnosis, and with diabetes they’re 2.3 times more likely to be dead within six years. But by treating their TDS, their conditions improve.”
The Andropause Society’s voluntary chief executive, testosterone deficiency sufferer Paul Pennington, adds: “Evidence from the past decade has shown that by treating testosterone deficiency we could cut deaths from diabetes and heart disease, improve lives and save billions for the cash-strapped NHS. It is astonishing that so few men have been diagnosed and are on treatment.”
n For more information visit www.andropausesociety.org.