Many, if not most, of the elderly people, male or female, are suffering from some form of hormonal imbalance. The organs or glands that secrete hormones, chemical substances produced in the body that control and regulate the activity of certain cells, are less able to accomplish its purpose for which they were created. In other words, they function less efficiently than when they were 30 or 40 years ago. Consequently, symptoms of aging worsened. In men, for instance, it is not uncommon for their testosterone levels to go down as they get older in age. They can lose muscle mass and muscle strength in a short time; loss of balance and difficulty of walking and become irritable, fatigue, more forgetful, decreased libido over the long-time. Most male patients when they suspect that they are suffering from deficient testosterone hormone see their regular Family Practice or Internist doctors. More often than not their doctors will order Total Testosterone blood test. Why? Because that is what they had learned from their basic medical textbook in school, order Total testosterone. Some don't read new information that is out there for more than five years. Total Testosterone, however, does not give the full picture of how much free testosterone is bio-available for your body to use. Most serum testosterone is either bound to protein Albumin (weak bond) or strongly attached to SHBG (sex hormone-binding globulin). This means that even though your Total Testosterone is “normal”, most of them are bound to SHBG and is not bio-available to the target cells. In other words, you can really be testosterone deficient even though Total Testosterone reads “normal”. Human sex hormone-binding globulin (SHBG) is the major transport protein in serum that can bind androgens and estrogens and thus change a chemical’s availability to enter the target cells. I believe that it is important for you to see an experienced and knowledgeable bio-identical hormone MD if you suspect that your symptoms are caused by deficient testosterone or from a deficiency of other hormones in your body. See your PCP and get a referral to see a specialist doctor. Regardless of whether you are a male or a female, your goal should always be to strive for "optimal" health, and not merely "normal" health. Why? Because optimal health is much better and is preferred over "normal health," and that optimal health is not the same as "normal" health. Don't let anybody fools you and makes you believe that optimal health is the same as "normal" health. It is not! Your doctor might order Free Testosterone test in addition to Total Testosterone, PSA, and other chemistry or hormone panels if you are a male. BEWARE, however, that the test is NOT FDA approved. The test materials, etc. that are used in your lab may come from China, India, Pakistan, Mexico, and third world countries. They are often very inaccurate, and cheap to buy. Labs in the U.S. like to buy cheap stuff from overseas so they can make lots of profit. And if your doctor says otherwise, that it is reliable, don't you believe him. He is lying to you. And, if you are in your bragging mood and you want to show off to your friends that you know how to calculate your own Free Testosterone, ask your doctor to order Albumin, Total Testosterone, and SHBG and you can plug the numbers in this old web Testosterone Calculator. But demand that the doctor also orders Free (Direct) Testosterone, in addition to Total Testosterone, for comparison. I want to repeat again, however, that the test is not FDA approved. You take that, and other blood tests, at your own risk. Make sure that when you see an endocrinologist he/she knows how to read and interpret the numbers (results) correctly and not compare "oranges" with "apples" since different laboratories may use different units of measurements and reference ranges. First and foremost, however, you want to know the standard reference range for your blood test, and where you stand in relation to the laboratory standard using the same units of measurement. Some old fashioned and unsophisticated doctor may say that your lab result is "normal" when it is not. Don't you believe him if you don't feel physically normal. Most doctors make their clinical decision, to treat or not to treat, based on lab values. Lastly, if you suspect that your doctor is a "textbook doctor," please look for the nearest exit door and leave in a hurry. And you should walk out even faster if your doctor repeatedly yawns to your face when you ask him questions about your treatment plan. My doctor yawns to my face at least two or three times during the short visit that I have with him in his office. My best wishes to you, as always.