There’s a commercial that plays in my town from a local men’s health clinic. The doctor in it states that all men over the age of 40 suffer from low testosterone. All men? This can’t possibly be true, or am I wrong? Most of the national commercials selling testosterone treatments feature fit, handsome men with beautiful mates seeking treatment. Do all men really need testosterone treatments? I decided to find out.
What is testosterone and what does it do?
Testosterone in males is the major sex hormone. Testosterone is produced in the pituitary gland located at the base of the brain. The brain signals the pituitary gland to produce testosterone. If there's too much testosterone in the blood, the brain yells to the pituitary “Take a rest!” If more is needed, the pituitary gland gets busy after receiving a command from the brain. It’s amazing how our bodies attempt to keep everything in balance. It’s when this balance is disrupted that problems arise.
We normally think of macho, muscular or sexy men when we think of testosterone, but testosterone plays several important roles in males such as:
· The development of the penis and testes (OK, I’m all for this)
· The deepening of the voice during puberty
· Fat metabolism
· The appearance of facial and pubic hair starting at puberty; it may play a role in balding
· Muscle size and strength
· Bone growth and strength
· Sex drive (libido)
· Sperm production/reproductive health
Fun fact for men:
A 2007 study on rats found that frequent masturbation lowered androgen receptors in their brains. Androgen receptors help your body use testosterone. BUT, listen up men! It has been found that ejaculating from masturbation doesn't have any noticeable, direct effects on serum T levels, however. This means that T levels don't get lower the more you masturbate.
My question is, “Whose job was it to watch the rats masturbate?”
Women need testosterone just like men do. In women, testosterone is produced in the ovaries and adrenal gland (small glands located on the top of each kidney). Testosterone in women affects:
· Ovarian function
· Bone strength
· Sexual behavior
In order for the ovaries to function properly, the balance between testosterone, estrogen and other male hormones (androgens) must be properly maintained.
Although Low-T is mainly associated with men, women can suffer from Low-T or even too much testosterone. Low-T in women can result in low libido, reduced bone strength, poor concentration or depression. However, most of the research on Low-T seems to target men.
How much testosterone is too little?
How little is too little testosterone? Here’s where things get murky. You see, no one knows what an optimal level of testosterone looks like. Plus, testosterone levels can vary thoroughout the day, much like your blood pressure and your heart rate. A blood test must be done to check testosterone levels. Free testosterone levels lower than 220-345 pmol/l are considered abnormal.
Equilibrium dialysis is the gold standard, but is expensive, complex, and commonly unavailable at most laboratories. Usually a simple blood test is done. Remember, free testosterone levels can vary thorough out the day!
Testosterone levels are said to drop gradually as you age. I’ve read anywhere from .4% to 3% a year after age 30 in men. Do all men over age 40 suffer from Low-T, like in the local commercial that I mentioned earlier? In a word, NO. However, it’s estimated that more than a third of men over age 45 may have low T.
In women, testosterone levels don’t drop as drastically as estrogen levels do during menopause. For this reason, big Pharma concentrates its dollars on men and Low-T.
In an abstract entitled, Testosterone deficiency in the aging male by J. Abram McBride, Culley C. Carson, III, and Robert M. Coward they reported:
Testosterone has become one of the most widely prescribed medications in the USA, increasing five-fold according to 2011 data. This increase has resulted in the dramatic growth of the testosterone replacement therapy (TRT) sector of the pharmaceutical industry from US$18 million in the 1980s to US$1.6 billion in 2011 [Handelsman, 2013].
What are the effects of Low-T in men?
In adult men they include:
· Reduced body and facial hair
· Loss of muscle mass
· Low libido, impotence, small testicles, reduced sperm count, and infertility
· Increased breast size
· Hot flashes
· Irritability, poor concentration and depression
· Brittle bones and an increased risk of fractures
Causes of Low-T in men and women
There are several conditions and diseases affecting the testes and pituitary and hypothalamus glands that can cause Low-T in men. For example:
Testes – direct injury, castration, infection, radiation treatment, chemotherapy, tumors
Pituitary and hypothalamus glands – tumors, medications (especially steroids, morphine or related drugs and major tranquilizers, such as haloperidol), HIV/AIDS, certain infections and autoimmune conditions.
Genetic diseases like Klinefelter syndrome (extra x-chromosome) can lower testosterone in men. In women, diseases of the pituitary, hypothalamus or adrenal glands can result in a testosterone deficiency. Removing the ovaries can as well. Estrogen therapy can also reduce testosterone levels. Low T in women can effect ovarian function, bone strength and sexual behavior. (Harvard Medical School, August 29, 2019)
Conditions like obesity, metabolic syndrome and cardiovascular disease can affect testosterone levels by restricting blood flow. Getting older, as well as the lack of exercise and muscle building exercises, can lower T levels as well.
Most medical literature does not discuss the relationship between eating meat and Low-T. Cortisol is a stress hormone that predicts cardiovascular death in men and women, even those without heart disease. In his book How Not To Diet, Dr. Joel Furhman writes, "A single meal high in animal protein can nearly double the level of the stress hormone cortisol in the blood within a half hour of consumption, more than twice that of meal closer to the recommended level of protein."
He goes on to say, "If you feed men a high-protein diet packed with fish, poultry, other meat, and egg whites, and then switch them to a lower-protein diet centered around bread, fruits, and vegetables, their cortisol levels drop about a quarter within ten days. Interestingly, at the same time, their testosterone levels shoot up by about the same amount. Contrary to the "flagrant misuse of scientific information" in Men's Health magazine, high-protein diets suppress testosterone. That's why if men eating meat every day, their testosterone levels go down, which, over time, might itself contribute to the accumulation of belly fat."
Milk has long been promoted as a health drink. Non-milk drinkers know this is a lie. As it pertains to testosterone, "Cow milk and especially milk from pregnant cows can elevate estrogen and lower testosterone levels in men. Most milk today comes from pregnant cows. Soy milk doesn't have the same effect on estrogen and testosterone." (Dairy and Sexual Precocity, Michael Greger, MD, FALCM, November 2010). This video explains the connection between milk and hormones.
Medical treatments for Low-T
Treating Low-T medically isn’t cheap. Costs can vary month to month and week to week depending on treatments. Gels, creams, and patches can cost between $200 and $500 per month. Pellets that can be inserted under the skin can cost $500 a month depending on the dose. Combining the cost of medications, labs, as well as medical services and supplements, it's not uncommon for treatment to average anywhere between $1,650 to $3,200 for the first year and from $600 to $1500 every year thereafter. I’ve seen costs quoted up to $6,000 a year for testosterone treatments.
Testosterone Replacement Therapy (TRT) is generally considered a safe and effective treatment for Low-T in younger and middle-aged men, but the same may not be true for men older than 75. Aging men experience exaggerated treatment side effects due to reduced capacity to metabolize testosterone and because many older men that go into treatment are already suffering from age-related diseases like heart disease and obesity.
For women, TRT might be recommended if they are diagnosed with Low-T and show symptoms of the deficiency. Treatment risks might outweigh the benefits however.
Treating Low-T through diet and lifestyle changes
Men (even young ones) seeking treatments for Low-T is becoming more and more common. The number of prescriptions for testosterone supplements has increased five-fold since 2012. Could this be due to the disturbing increase in obesity, metabolic syndrome and cardiovascular disease in this country, or is it the result of the steady stream of advertising promoting testosterone therapy?
Three things that you can do to help combat Low-T are to quit smoking, lose weight and stay hydrated. To keep blood vessels open, pack your diet with:
· Cayenne pepper - contains capsaicin that lowers blood pressure
· Pomegranate – high in polyphenol antioxidants and nitrates that are powerful vasodilators.
· Onions – high in flavonoids
· Cinnamon - Decreases inflammation
· Garlic – increases circulation through sulfur compounds.
· Beets – high in nitrites which are converted to nitric oxide that opens blood vessels
· Tumeric – contains curcumin that increases nitric oxide production and decreases inflammation and oxidative stress.
· Leafy greens – spinach, collards and cabbage are rich in nitrates
· Citrus fruits – oranges, lemons, and grapefruit contain high levels of flavonoids and antioxidants.
· Walnuts – stimulate nitric oxide production, loaded with l-arginine, alpha-lipoic acid (ALA) and vitamin E.
· Tomatoes – helps control blood pressure
· Ginger – lowers blood pressure and helps blood flow
· Ashwagandha – an herb that in some studies has shown to decrease cortisol and increase testosterone levels and sperm count.
Here are some other things you can do to help increase testosterone:
1. Exercise and lift weights – high intensity interval training and weight training are especially effective.
2. Minimize stress and cortisol levels. Increased cortisol levels can store dangerous fat around your organs.
3. Get sun or take vitamin D3 supplements. 50% or more of Americans are vitamin D deficient.
4. Take vitamin and mineral supplements. Zinc and vitamin B in some studies increased sperm quantity by 74%. Zinc is sometimes given to athletes who are testosterone deficient.
5. Get 7-8 hours of sleep every night.
6. Take natural testosterone boosters like Ashwagandha.
7. Avoid excessive alcohol consumption.
8. Minimize your exposure to BPA, parabens and other chemicals found in some plastics and personal care items.
9. Laugher and happiness makes everything better!!
Maintaining a healthy testosterone level is important for health in both men and women. It’s perfectly natural for testosterone levels to decrease with age, but despite what a commercial might say, not all men over 40 have levels of testosterone low enough to need medical treatment. And even though hormone replacement therapy for Low-T in younger and middle aged men does not pose as great a health risk as it does for older men, is it necessary?
In the gym, I’ve heard guys in their 20s talk about wanting to take testosterone. For them it’s about lifting more weight and better sexual performance. Commercials bombard men constantly with the message that even virile, rugged men suffer from Low-T. Maybe this is one reason why prescriptions are exploding. Treating Low-T is BIG business! None of these commercials mention replacing animal protein with plant protein, which is proven to elevate testosterone. No money to be made here by big Pharma!
As with all health concerns, there are many things that can be done through a whole food, plant-based diet and lifestyle changes that improve health and increase lifespan. Low-T is no different. A plant-based, whole food diet has been proven to elevate testosterone. There are no negative side effects that come from an improved diet and lifestyle. So go ahead eat your veggies, get plenty of quality sleep, snub out that cigarette, laugh more and hit the gym. These changes just might provide you with the testosterone boost you need. No matter what your age!
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