Got Low Testosterone?
Testosterone injections and anything that increases testosterone is the craze right now. This, along with other things like allergies, infertility and autism are definitely on the rise. But why? We all know that as we age, there will be a slight decrease in male hormones specifically testosterone and everything else associated with male hormones like libido and muscle strength, but in healthy individuals these changes should not normally occur until age 40 or 50.
Unfortunately, it is becoming more and more common to see decreased testosterone occur in younger males. Men in their early 20s or younger are appearing with low test and there is a large percentage of people in their 30s that suffer with moderate to severe symptoms. Although we jokingly refer to the decrease in a man’s testosterone levels as “man-o-pause”, men don’t or at least shouldn’t experience the same dramatic and abrupt changes that women experience.
You may not have heard about male hormone problems as frequently in daily conversations, but male disorders are becoming more and more prevalent whether we talk about it or not. In general female hormone imbalances are well known because women tend to feel more comfortable talking about their symptoms, while men usually choose to keep their symptoms to themselves to maintain their bravado. Men don’t want to talk about lack of desire but if women talk about decreased libido it as accepted as normal. (another mistaken concept) Given the stigma that exists around erectile dysfunction, low libido and even male infertility, I am always impressed when a male is willing to admit they have any of these symptoms.
Male hormone problems (which can be many and varied) can as a group be called androgen disorders. While there are many other male hormone disorders today I want to cover the most dreaded concept, that of “low testosterone”.
Low testosterone appears to be an easy fix for traditional medicine as they simply inject you with more testosterone any time you feel down. They do not usually inform you will need more and more testosterone as you keep getting injections and unfortunately this doesn’t resolve the problem and as we will discuss later, it can even lead to more symptoms.
Symptoms of Male Hormone Problems
- Erectile Dysfunction
- Lack of Beard or Body Hair
- Gynecomastia (often referred to as “man boobs” or “moobs”)
- Decreased muscle mass and strength
- Decreased assertiveness
- Low Sperm Count/Infertility
So You Think You Have Low Testosterone
Many men do in fact have low levels of testosterone, although the range for “normal” testosterone levels can vary dramatically from person to person. If you in fact do have low testosterone it doesn’t mean that need to run and get a testosterone injection. Instead it means you need to figure out why you have low testosterone.
HINT #1: It’s not because you are getting old.
By getting testosterone replacement therapy you will decrease your own body’s ability to create testosterone, sperm and many times make your imbalance worse.
5 Common Patterns Found in Men with Low Testosterone
- Adrenals and Inflammation – Adrenal fatigue and inflammation can suppress the brains signal to stimulate testosterone production. Thus finding out why you have adrenal fatigue and inflammation is the most important part. Common stressors of the adrenals are SUGAR, food sensitivities, environmental toxins, stealth/hidden infections, dysbiosis/SIBO and heavy metals.
- Use of Steroids or Hormone Replacement Therapy – By using exogenous hormones whether bio-identical or synthetic, it places a heavy load on the liver that it may not be able to handle. An overburdened liver that cannot properly detoxify the excess hormones will decrease testosterone production in order to spare the liver. Properly detoxifying the liver is critical to restoring normal levels. Hint #2: Milk Thistle doesn’t help. Milk Thistle is one of the best herbs to protect the liver cells from damage, but although it is in almost every liver product on the market, in my office I have found that it doesn’t seem to regulate or detoxify hormones very well. To overcome this, the correct liver pathway that supports detoxification of the hormones needs to be used. Which nutrient support you need depends on the exact hormone you are trying to detox and your liver’s overall health status.
- Excess Steroids or Hormone Replacement Therapy – Whether you went to the local supplement store or you went to a medical doctor, once higher than normal levels of testosterone are in your body, your brain stops sending the signal to your testes (Sertoli cells) to produce testosterone. After you stop the supplement or therapy, it takes time for the brain to readjust and start sending the signal back to the testes to create testosterone. This can take from one month to many years depending on your health. Often times people need to support their brain with supplements that help the hypothalamus and pituitary in the brain so that it starts sending the proper signals to the testes again.
- High 5-Alpha Reductase – 5-alpha reductase is an enzyme that converts testosterone to DHT. DHT is a testosterone-like substance is 10x stronger than testosterone and has similar effects. As an elevated level of DHT is in the body, the body has less need for testosterone and thus you end up with low testosterone. DHT works similar to testosterone, but not the same, so you will suffer many symptoms. In addition excess DHT downregulates the testosterone receptors. Discovering why the body wants or is converting more DHT and stopping that process will increase testosterone. An often used supplement for this is Saw Palmetto. It can be used, but if you don’t discover why this imbalance occurred in the first place, it will be a never ending cycle. The most common culprit here is sugar once again.
- Excess Estrogen – Testosterone can be converted into estrogen. Estrogen then sends its own signals to the brain that say that you have excess estrogen and so essentially the brain decides to slow down testosterone production because it knows that all the testosterone keeps turning into estrogen. For this we have to look into why you have high levels of aromatase.
What is aromatase?
Aromatase is the enzyme that changes a man into woman….literally. Aromatase converts Testosterone into Estrogen.
This has been demonstrated extensively in fish where if you expose a male fish to enough estrogen it begins to produce female proteins and then the male fish actually begin to produce female eggs!
In today’s society we are seeing this more and more in adult males as well as children. You can be underweight or obese and still suffer from too much aromatase. Male breast reduction surgery is one of the fastest growing cosmetic surgeries in the world. But once again, surgery doesn’t address the underlying imbalance. Catching the signs of excess aromatase early is very important as treating it isn’t impossible, but reversing its body changing effects is very difficult.
What stimulates aromatase?
Three major stimulators of aromatase are insulin, obesity and alcohol. High aromatase leads to gynecomastia. (see pics)
- Alcohol – Simply stop drinking it. Alcohol has never been a health promoting drink. There are definitely some medicinal uses, but it wreaks havoc on the liver and digestive tract.
- Obesity – Obesity promotes the conversion of testosterone to estrogen. It makes it a difficult cycle to beat because if you are already in the obese category (using BMI) then you already make more estrogen than you need. Decreasing abdominal fat is critical. But, this is not the only piece to the puzzle. Even “skinny” males can have too much estrogen. (see pics)
- Insulin – Insulin surges increase aromatase which leads to a low testosterone to estrogen ratio. In the body ratios are very important and in males, keeping estrogen in check is really important. If you are unfamiliar with what creates insulin surges….SUGAR! Allergies also create large insulin surges.
Dysbiosis and Excess Flatulence
Just like in women, dysbiosis in men can lead to a recycling of estrogen. As the liver tries to detoxify estrogen and allow it to escape in the feces, the pathogenic or “bad gut bugs” actually undo the work that the liver accomplished and free the estrogen back into circulation. I mention flatulence because a man that frequently “passes gas” almost always has dysbiosis. Treating dysbiosis first before treating low testosterone is critical.
TAKE HOME: Testosterone turns into estrogen due to high aromatase. So, having high estrogen is a sign that you have low testosterone. If get a testosterone shot (hormone replacement) and you have high aromatase, then all of your testosterone will turn into estrogen. The opposite of what you were hoping for!
The first step in fixing low test is to treat some of these underlying imbalances. Eating a healthy diet is going to be critical for addressing aromatase, adrenal health, excess inflammation and excess estrogen. Some cases are more complex and require in depth treatments. By addressing these common causes of low testosterone, you can reverse most if not all of the symptoms that have developed over time.
Often times lab testing can be very beneficial for difficult cases. Like always, I use saliva only to test these because it gives me the amount of free and unbound hormone that can actually do work in the body. For more information about male hormone testing see here.