A doctor who battled crushing fatigue and relentless brain fog for years has told of how he missed his own low testosterone diagnosis.
Dr Maxim Draper went from being active and driven to feeling like a shadow of himself after he was diagnosed with testicular cancer and later, viral meningitis.
The 39-year-old GP from Newcastle, who now specialises in men’s hormones, suffered with a “persisting fatigue” that gradually developed into “very bad anxiety and brain fog” that left him feeling “defeated”.
But as a father-of-three, he put his constant fatigue down to “burnout” due to the stress of illness and young children, but he never considered it could be a hormonal issue.
“I never really recovered until I went on testosterone treatment,” he told The Independent.
Dr Draper first noticed a lump in 2016, when he was 29. “The dog ran across the bed as the postman came. I remember it very vividly, and he stepped on my crotch area, and I noticed a lump down there,” he recalled.
He went to the GP and an ultrasound scan revealed it was testicular cancer. He didn’t need chemotherapy, but his left testicle was removed.
About a year and a half later, he had a stiff neck, headache and temperature, and ended up in A&E where he was diagnosed with vital meningitis – a serious infection of the protective membranes that surround the brain and spinal cord.
But once the flu-like symptoms and headaches subsided, he was still left with fatigue, which developed into anxiety and depression. He suffered with his mental health for more than two years and was even prescribed antidepressants.
Yet it wasn’t until a nurse suggested they test his testosterone levels because he was feeling tired, that he realised his issue was hormonal. He saw a private endocrinologist who put him on testosterone replacement therapy (TRT) in 2021.
Testosterone, the male sex hormone, not only affects libido but also affects mental health, bone and muscle mass, and fat storage, as well as red blood cell production.
Although testosterone deficiency can affect men of all ages, the hormone does start to naturally fall in men after the age of 40.
It can significantly impact quality of life and overall health, but the symptoms are often vague and misdiagnosed as depression or dismissed as natural ageing.
Symptoms can include weight gain, breast enlargement, sweating, mood changes, feeling low, lack of motivation and energy, lack of early morning erections and erectile dysfunction, according to Orchid Cancer, a charity that raises awareness of testicular, penile and prostate cancer.
Dr Draper, who has since written the book Testosterone Decoded, said: “The transformation that came from testosterone replacement therapy was nothing short of lifesaving. My energy returned, my mind cleared, and I started to feel like myself again.
“What shocked me most was this: I was and am a doctor, a qualified GP for several years by then, and yet I had almost no real understanding of how critical testosterone was to a man’s health.”
However, it is not uncommon for men to struggle with symptoms before seeking a diagnosis. A survey of 2,000 men with the condition by Imperial College London and Manual – a private provider of testosterone – revealed 24 per cent of men with low testosterone levels said they waited five years before seeking medical help, while 85 per cent waited a year.
Dr Draper doesn’t know exactly what caused his deficiency, but suggests it may have been triggered by losing a testicle to cancer.
While research shows about 5 per cent of testicular cancer patients do have low testosterone before cancer treatment, surgery and chemotherapy can reduce the production of the hormone.
Robert Cornes, a nurse at Orchid Cancer, told The Independent: “Normally, if the remaining testicle following surgery is healthy, testosterone shouldn’t be affected, but subsequent chemotherapy can reduce production, and this can take some time to recover.”
A study by researchers in Norway also suggests that testosterone levels can fall as men age following cancer treatment, affecting 40 per cent of men aged over 60.
The NHS urges men who are experiencing these symptoms to see a GP who may order a blood test to measure testosterone levels.
