Testosterone is a sex steroid hormone. It is the primary male sex hormone. Although almost everyone thinks of men, sex drive and muscle when testosterone is mentioned, it has other important roles in humans, both male and female which include:
– bone strength and the prevention of osteoporosis
– brain function: cognition, attention, memory and spatial ability; neurosteroid activity on GABA-A receptors (calming)
– immune function
– metabolism
Testosterone production declines with age. This is evidenced by older men having smaller muscles, and getting hunched over from spinal bone changes and shrinking. (Osteoporosis). ‘Grumpy old man syndrome’ also describes the changes associated with declining testosterone levels: irritable mood, fatigue and sleepiness, increasing waist size/ belly fat.
Today, we are seeing younger and younger men with declining testosterone levels.
Causes of lower testosterone:
1. Exposure to xenobiotics
(substances foreign to the body)
Environmental pollutants have been shown to reduce testosterone. Chemicals like Bisphenol A (in plastics and receipts), PCB’s (polychlorinated biphenyls – 209 chemicals with similar structure, they do not deteriorate easily in the environment, found in industrial uses, coolants, electrical equipment), triclosan (antibacterial agent in soaps and hand sanitizers) have all been shown to affect hormone balance in humans. They are called endocrine disrupting chemicals (EDC).
2. Nutritional deficiencies.
We live in a society where we are overfed and under-nourished. Food is nutritionally depleted. Whether it is from depleted soil or processed artificial foods that are man made, nutrient density is lacking in most people’s diets.
Important nutrients are:
– protein which gives amino acids that are the building blocks of hormones.
– Vitamin A, Vit D3, Zinc, Magnesium
3. Estrogen and estrogenic compounds
Obesity is a rising epidemic. Adipose tissue (fat) produces an enzyme called aromatase which increases the production of estrogen. When estrogen levels rise, testosterone is proportionately lower in the body.
Some of this is modulated by sex hormone binding globulin (SHBG), a protein which binds hormones and carries it in your blood. Estrogen causes a rise in SHBG and this binds testosterone which makes it less valuable to the cells for use.
Xeno-estrogens are a group of chemicals that mimic estrogen in the body.
They are found in a wide variety of places.
- Skin care: many chemicals in lotions, creams and sunscreens are xeon-estrogens. Eg. Parabens.
- Industrial: plastics (BPA, phthalates, PCB’s, PBDE’s – flame retardants in clothing and furniture and beds)
- Insecticides and herbicides: DDT, lindane, atrazine, and others.
- Building: wood preservatives, paints and thinners, adhesives, etc.
Symptoms of low testosterone
- Changing sexual function
- decreased libido (sex drive). This includes desire and frequency of thoughts.
- decreased erectile function. A reduction of strength of erections, ability to achieve erection and also the frequency of morning spontaneous erections.
- Loss of muscle mass and muscle strength
- Increased abdominal obesity and overall body fat
- Low energy.
- Brain/ mood changes: low mood and depressive symptoms, decreased focus, irritability, low confidence and decreased motivation.
- Metabolic derangements: increased weight and slow metabolism, increased blood sugar levels and risk for diabetes.
- Anemia (low hemoglobin)
Laboratory testing for testosterone
Free/ bioavailable testosterone
Total Testosterone
SHBG
It is most important to discuss the difference between low and optimal levels of testosterone.
Low means BELOW the normal range.
The range for bioavailable testosterone is 4.0 to 16.0 nmol/L, a man must have a level below 4 to be diagnosed with low testosterone. If he is 4.8 or 5.9 or even 6 nmol/L he will not be considered LOW.
Might he not FEEL low if his usual levels when he was at his prime were 11 nmol/L?
The 50th percentile in this range is 10 nmol/L.
In my practice, I work with a patient to achieve a level of free testosterone of at least 10 nmol/L to achieve OPTIMAL levels of bioavailable testosterone.
Free testosterone is more helpful to assess testosterone status in men.
Total testosterone looks at all testosterone that is free and bound to carrier proteins like SHBG.
Bioavailable/ free testosterone is available to the cell receptors and allow the clinical effects of testosterone.
This is why xenobiotics and xeon-estrogens, as well as other toxins that block hormone receptors on cells are important to address prior to starting any hormone replacement protocol.
To find out more about our hormone balancing protocol and how to achieve optimal hormone levels, click here.
