Testosterone: most often generates thoughts that it is for Sex Drive and Sexual Performance.
It’s a hormone we all have, both men and women. It is essential for both genders to feel and function optimally.
Testosterone in men supports health and vitality in many ways.
During your teenage years, it surges, helping to build muscle, strength, bone density and regulates your mood and sexual health. But here’s the thing—the testosterone levels in your body naturally start to dip after age 30. Even earlier nowadays.
Many factors can drain your testosterone levels—things like stress, poor sleep, weight gain, and toxic molecules in the environment that are everywhere. If your testosterone drops too low, you might notice changes like lower energy, depression, trouble building muscle in the gym, weight gain, especially around the middle, lower sexual function and drive, and irritability. Low testosterone levels (even low end, not necessarily below normal) have also been associated with increased risk and incidence of diabetes, heart disease and bone loss (osteoporosis). This is why Testosterone Therapy, or TRT, is very important.
In this article we will explore why testosterone levels decline, and then delve into the details of TRT to help you feel confident in making decisions that can transform your well-being. If you’ve been feeling like something’s “off” and you’re wondering if low testosterone could be the reason, read on. I’m here to help guide you toward the solutions that will bring your energy, strength, and vitality back to where you want it to be.
Let’s explore this together!
Why Do Men Need TRT?
Androgen replacement therapy (ART), or TRT, is a treatment doctors give to male patients with testosterone deficiency, showing symptoms of hypogonadism. Prescription of TRT helps restore levels in the blood, which in turn reverses the symptoms of low testosterone.
ANDROPAUSE is a clinical syndrome that started to gain popularity as a term in the early 2000’s. Prior to this, most men suffered in silence from all the symptoms associated with low testosterone. This is not just because of the lack of information in the medical establishment, but also there was no drug available that easily treated it. Androgel was released in 2002 in Canada and this made it easier for doctors to become aware of testosterone replacement therapy. In Functional Medicine, testosterone was used for decades prior to this, as a compounded cream or gel.
Low testosterone levels are often why men complain of decreased sex drive or erectile dysfunction. However, we know that there are many other symptoms that affect a man’s quality of life and his lifespan when his testosterone levels drop. Low testosterone needs to be treated early, and safely.
Causes of low testosterone include:
- Aging: Testosterone average levels drop after 30 years of age, losing an average of 1 – 2% every year. We are currently seeing men in their 20’s with low end of range testosterone levels.
- Endocrine disrupting chemicals: These chemicals block the production of testosterone or interfere with how testosterone works in your body. They can also increase estrogen levels which affects testosterone.
- Medical Conditions: Testosterone levels are reduced in type 2 diabetes, obesity, metabolic syndrome, sleep apnea,
- Alcohol Use: Chronic alcohol use can cause low testosterone levels.
- Injury or Infection: Injury to the testes can cause low testosterone levels. Mumps is a viral infection that can cause infection/ inflammation in the testicles.
- Medications: Specifically, certain medications, such as opioids and corticosteroids, may cause low testosterone.
- Congenital conditions: Klinefelter’s syndrome, undescended testicles.
Low testosterone levels can lead to a variety of symptoms and disease, including:
- Fatigue and low energy levels
- Loss of muscle mass and strength.
- Failure to gain muscle despite exercise and proper diet.
- Erectile dysfunction and low libido.
- Irritability, depression, and mood swings.
- Brain fog & inability to concentrate.
- Increased body fat, particularly belly fat
- Poor blood sugar control, pre-diabetes and diabetes
- Heart disease
- Reduced bone density (osteoporosis)
Men suffering from these symptoms and feeling worse overall can be helped by testosterone replacement therapy (TRT).
Advantages of TRT
There are many benefits of TRT therapy. These include:
- Improved energy levels as you feel less fatigued and more energetic.
- TRT helps improve overall sexual satisfaction, libido, and erectile function.
- Restoring testosterone levels builds muscle and reduces fat.
- Improved bone density.
- Relieve anxiety, depression, and cognitive issues including brain fog and memory challenges.
TRT improves quality of life. Those with better physical and mental health have more confidence and capability.
Correcting Low Testosterone
Before we start testosterone replacement therapy, we review extensive lab testing. We need to determine if your body is producing testosterone but your cells cannot detect what you have or able to use it.
Then we need to determine if stress (high cortisol) is upsetting the communication between the hormones from your brain that talk to your testicles and tell them to make testosterone.(The HPG axis: Hypothalamo-Pituitary-Gonadal axis)
A 3rd area of high importance before embarking on testosterone replacement is to assess the amount of estrogen your body makes and whether you have a tendency to shift testosterone into estrogen byproducts in a higher ratio compared to dihydrotestosterone (DHT). This state of estrogen dominance is vital, because this particular metabolic pathway needs to be carefully assessed, monitored and managed.
The world today is filled with toxins. These man-made molecules interfere with testosterone production.
At Live Younger, the first step we take is an in depth analysis of your biochemistry and levels of all hormones that intertwine with testosterone function and production.
It is important to note that simply taking testosterone is not the safest or best solution.
While it is now disproven in the medical literature that testosterone replacement itself causes prostate cancer, it is very accurate that there are metabolites of testosterone that can increase prostate cancer.
Toxic molecules like BPA and phthalates are known as endocrine disrupting chemicals.
EDC’s mimic or interfere with your body’s hormone production. Some can block the cellular receptor sites.
Food is a big source of EDC’s. They contain chemicals, additives, pesticides, herbicides and other substances that interfere with testosterone production. The storage of food in plastic containers or wrapping it in plastic wrap leads to increased exposure to the more harmful EDC’s. Heating food in plastic is especially bad for EDC contamination of food.
Personal care products that are not made from purely natural ingredients and free of the most toxic chemicals and EDC’s is another source of toxin exposure that affects testosterone levels in your body. (Eg. Soaps, shampoos, deodorant, perfumes, aftershaves)
Managing healthy testosterone levels starts with lowering your exposure to EDC’s/ toxic molecules combined with targeted therapies to remove the bioaccumulation of these toxins in your body that occurs over your lifetime.
During this phase of pretreatment for testosterone replacement therapy, we simultaneously address digestive health. Testosterone metabolites are excreted through your gut (bile and faeces). Without ensuring the metabolites have a clear path to leave your body, you will end up needing higher levels of testosterone outside of the safe limit, and you have a higher risk for gynecomastia (man boobs), erythrocytosis (increased red blood) and prostate cell simulation/ cancer of the prostate.
Without this step, simply taking testosterone can lead to unwanted, and even severe health threatening side effects.
The second step is managing stress. It has been clearly shown that stress affects hormone production.
Sympathetic dominance is far too common now, where people are living in a constant ‘stressed out’ state.
We use tools like hypnotherapy, HeartMath, Sound Wellness, Acupuncture, meditation and mindfulness to help our patients prepare for optimal and safe testosterone replacement therapy.
Salivary cortisol testing is the gold standard to measure your level of stress and the pattern of cortisol reveals important clues about your overall health, disease risk and how well your body will receive testosterone.
Testosterone Replacement Therapy (TRT)
At Live Younger, your TRT treatment uses compounded testosterone cream or injectable solution to increase testosterone levels. TRT is used to alleviate low testosterone symptoms and overall improve your quality of life.
At Live Younger, we use bio-identical testosterone. This means it is identical in structure to what your body makes. Synthetic testosterone is artificial, and can cause more side effects.
TRT can be administered through various methods, including:
- Injections: The most commonly used treatment is intramuscular injection (into the muscle) or subcutaneous injection beneath the skin. We prefer this method at Live Younger because it’s easy to monitor through easily accessible blood testing.
- Topical Gels and Creams: When such medicine is applied directly to the skin, it is absorbed into the bloodstream through the skin. For men who are afraid of injections or unable to administer it themselves, this is our next preferred method of administering TRT. Unfortunately, blood testing is not accurate. The gold standard to monitor topically administered testosterone is through saliva testing.
- Patches: These are convenient to apply but may sometimes pose skin reactions. Sweating and high activity levels may lead to loss of contact with the patch and poor levels of hormones result.
- Pellets: Testosterone-release pellets are implanted under the skin to release testosterone over months. We do not recommend pellets at Live Younger. Once a pellet is implanted, you cannot change the dose. In the event of an overdose or side effects, you cannot adjust the dose of this hormone. For hormone safety, more is not better. And it is certainly not safe.
Oral Medications: Oral options are less common and most often used in the underground world of bodybuilding. Studies clearly link liver problems and liver cancer to oral testosterone. We do not recommend this, ever, to any patient.
Possible Risks & Side Effects of TRT
Men also have potential side effects as well to consider before TRT, and they should talk to their healthcare provider about the risks. When bio-identical testosterone is used in the correct dose to bring your levels into the normal range, you should experience no side effects. We do not recommend increasing testosterone levels outside the normal range.
We monitor levels but more importantly, how our patients feel. Some men feel better with minor elevations in free testosterone levels. Others only feel better when their levels reach the upper limit of normal. There is no one size fits all treatment doses or levels. Remember that estrogen production from testosterone is normal and estrogen is important for men. It protects bone health and brain health/ cognitive function. We do use estrogen blockers in certain men if their estrogen levels are too high.
Side effects occur when the biochemistry, liver and gut function are not optimised, and metabolic pathways are not supported. The highest incidence of side effects is in those who overdose themselves on testosterone.
Your genes play a role in how your body metabolises testosterone. This does not mean you are stuck with it. There are certain nutrients and lifestyle measures that can turn off or on, certain genes that regulate hormone metabolism.
- Acne and Skin Irritation: Men who use topical creams can experienceacne and skin irritation. Taking too much testosterone to reach above normal range levels is the most common cause of acne. The next reason for acne is poor gut and liver enzyme function.
- Polycythemia (high red blood cells): High testosterone enhances the chance for increased red blood cell count and the probability that the blood will clot. This again, only occurs with poor monitoring and inappropriate dosing.
- Hair Loss: Some men drive testosterone preferentially down the pathway into DHT (dihydrotestosterone). This can result in hair loss. Again, if TRT causes this it is likely you are on an inappropriate dose. If you already experience hair thinning and male pattern baldness t a young age, your body is already predisposed to this. TRT will not make it worse than the natural progression you have started to have.
Who is a Candidate for TRT?
Men with symptoms of low testosterone and have blood levels in the low end or below the normal range are candidates for testosterone replacement. While the use in prostate cancer is contentious, there are some urologists that support TRT in low grade prostate cancer with certain provisors.
- Blood Tests: At Live Younger, we measure your testosterone levels and your estrogen conversion. We also assess your level of insulin resistance and metabolic syndrome, and the hormones of metabolism that affect testosterone at a cellular level. We evaluate the pituitary drive, and diagnose whether this is primary or secondary hypogonadism. Your liver enzyme function, body burden of toxins, and your digestive system (in particular your bile and excretion functions) are assessed to ensure you can safely eliminate the estrogen metabolites of testosterone. It is careless to simply prescribe testosterone without all of this.
- Functional Fitness: Your body fat percentage, muscle mass and strength are important measures for baseline and improvement.
- Symptom Assessment: Assessing the depth and consequence of the symptoms using the Q-ADAM.
- Medical History Review: This is used to identify underlying conditions that contribute to low testosterone. Sleep apnea is grossly underdiagnosed and can impact the success of TRT. We screen patients for sleep apnea, when indicated, before prescribing TRT.
- Prostate Screening: To look for prostate cancer and monitor risk.
- Estrogen metabolites and methylation: This highly specialized test is done annually to monitor the safety of TRT and your risk for DNA damage and increased prostate cancer risk.
It is vitally important for your brain, heart, bone and prostate health to have your metabolites of estrogen and testosterone measured and kept in the safe and optimal ranges.
How to Start TRT
If you are a man with symptoms of low testosterone, Testosterone Replacement Therapy can change your life.
TRT can help you regain vitality, boost energy, and restore confidence.
It is not better to have high levels of testosterone. Replacement must be done carefully and safely. This ensures that you age with vitality and your longevity plan is complete.
Take charge of your well-being with tailored hormone therapy at Live Younger. Call us or visit to book your consultation today and start feeling your best!
