TESTOSTERONE DEFICIENCY

WHAT IS TESTOSTERONE?

Testosterone is a hormone and an anabolic steroid that plays a variety of several important functions in the body (1). It is produced by both men and women by the gonads (testes in men and ovaries in women); however, testosterone is present in greater levels in men (2).

WHY IS TESTOSTERONE SO IMPORTANT?

Testosterone is an androgen, meaning it stimulates the development of male characteristics (3).  It is considered a vital male sex hormone that initiates the development of the male internal and external reproductive organs during fetal development and male sexual development during puberty.  As a man transitions from childhood to adulthood, testosterone spurs the growth of hair on the face, in the armpits, and around the genitals. Hair also may grow on the arms, legs, and chest (2).  It is also essential for the production of sperm (4).

In women, testosterone is important during the menstrual cycle and is required for ovulation.  It is also required to support the early stages of pregnancy (5).

POTENTIAL CAUSES OF LOW TESTOSTERONE IN MEN

• Smoking
• Obesity
• Lack of regular sexual activity
• Cardiovascular disease
• Lack of physical activity
• Eating high saturated fat low nutrient diet
• Use of anabolic steroids
• Damage to cells in the testes that produce testosterone
• Trauma
• Inflammation
• Testicular cancer
• Cancer treatment, including radiation and chemotherapy
• Diseases that affect parts of the brain, such as the hypothalamus and the pituitary gland
• Disorders that affect the hormones, such as pituitary tumors or high prolactin levels
• Chronic diseases, including type 2 diabetes, kidney and liver disease, obesity, and HIV/AIDS
• Genetic diseases, such as Klinefelter syndrome, Prader-Willi syndrome, hemochromatosis, Kallman syndrome, and myotonic dystrophy (3,5,6,7,8,10)

ALL SYMPTOMS OF A LOW TESTOSTERONE DEFICIENCY

Testosterone travels around the body in the bloodstream. The only way to know your testosterone level for sure is to have it measured. This usually requires a blood test (10).

Having low testosterone levels can lead to several complications:

• Reduced libido
• Low sperm count
• Erectile dysfunction (ED) (10)
• Enlarged male breasts, called gynecomastia
• Loss of confidence and lack of motivation
• Lower ability to concentrate or cause feelings of sadness
• Sleep disturbances and lack of energy
• Loss of some body hair
• Increase in body fat
• Mood disturbances
• Loss of muscle tone (11)

TESTOSTERONE DEFICIENCY FACTS AND STATISTICS

According to the Boston University School of Medicine, 4 to 5 million men in the United States have low testosterone.

After the age of 40, the concentration of circulating testosterone falls by about 1.6 percent every year for most men (12).  About 4 in 10 men have hypogonadism (reduced secretion of hormones by testes) by the time they reach 45 years old. The number of cases in which older men have been diagnosed as having low testosterone increased 170 percent since 2012 (5,12).

MEDICAL TREATMENT OF TESTOSTERONE DEFICIENCY

Testosterone levels in men tend to decline with age. That’s why many older men try testosterone replacement therapy. Low testosterone is becoming more and more common. The number of prescriptions for testosterone supplements has increased fivefold since 2012 (12).

Low testosterone can be treated in a variety of forms:

• Skin gels
• Patches
• Injections

The safety of testosterone treatment is still being researched.  It has several possible side effects and some possible long-term effects, as well (2,9).

Side-Effects:

• Increased risk of heart attack and stroke
• Sleep apnea
• Promotion of prostate and breast growth
• Increased risk of prostate cancer
• Lowered sperm count (9,10,13)

NATURAL WAYS TO SUPPORT HEALTHY TESTOSTERONE LEVELS

Practices to Support Healthy Testosterone Levels:

• Lose weight
• Cardiovascular exercise
• Strength training
• Intermittent fasting
• Eating a balanced diet of vitamins and nutrients
• Reduce stress
• Limit or eliminate sugar
• Eat healthy fats
• Boost healthy proteins (9)

Natural Supplements That Support Healthy Testosterone Levels:

• Zinc (14)
• Saw palmetto (15)
• Horny goat weed extract (Epimedium sagittatum) (16)
• Tribulus fruit extract (Tribulus terrestris) (17)
• Fenugreek seed extract (Trigonella foenum-graecum) (18)
• Maca root extract (Lepedium meyenii) (19)
• Longjax root extract (Eurycoma longifolia jack) (20)
• Muira puama root (Ptchopetalum olacoides) (21)
• Korean ginseng root (Panax ginseng) (22)
• Catuaba bark extract (Trichilia catigua) (23)

REFERENCES

1. The Effects of Testosterone on the Body. https://www.healthline.com/health/low-testosterone/effects-on-body. Accessed July 20, 2018.
2. The influence of testosterone in men. https://www.mayoclinic.org/healthy-lifestyle/mens-health/multimedia/the-influence-of-testosterone/img-20007271. Accessed July 20, 2018.
3. Shi Z, Araujo A, Martin S, O’Loughlin P, Wittert G. Longitudinal changes in testosterone over five years in community-dwelling men. Journal of Clinical Endocrinology and Metabolism. 2013; 98(8):3289-3297. DOI:10.1210/jc.2012-3842
4. Wein H. Understanding How Testosterone Affects Men. https://www.nih.gov/news-events/nih-research-matters/understanding-how-testosterone-affects-men. Accessed July 20, 2018.
5. Mulligan T, Frick MF, Zuraw QC, Stemhagen A, Mcwhirter C. Prevalence of hypogonadism in males aged at least 45 years: the HIM study. Int J Clin Pract. 2006 Jul 1; 60(7): 762–769. doi:10.1111/j.1742-1241.2006.00992.x.
6. Wittert G. The relationship between sleep disorders and testosterone. Current Opinion in Endocrinology, Diabetes and Obesity, 2014; 21(3):239-243. DOI:10.1097/MED.0000000000000069
7. Yeap B, Araujo A, Wittert G. Do low testosterone levels contribute to ill-health during male aging? Critical Reviews in Clinical Laboratory Sciences. 2012;49(5):168-182. DOI:10.3109/10408363.2012.725461
8. Atlantis E, Lange K, et Al. Testosterone and modifiable risk factors associated with diabetes in men. Maturitas. 2011;68(3):279-285. DOI:10.1016/j.maturitas.2010.12.007
9. Is testosterone therapy safe? Take a breath before you take the plunge. https://www.health.harvard.edu/mens-health/is-testosterone-therapy-safe-take-a-breath-before-you-take-the-plunge. Accessed July 20, 2018.
10. Erectile Dysfunction Worsened, Testosterone Levels Decreased by Some Drugs for Treatment of Prostate Enlargement. https://www.bu.edu/news/2015/06/12/erectile-dysfunction-worsened-testosterone-levels-decreased-by-some-drugs-for-treatment-of-prostate-enlargement/. Accessed July 20, 2018.
11. Testosterone. http://www.yourhormones.info/hormones/testosterone.aspx. Accessed July 20, 2018.
12. Murrell D. Why do we need testosterone? https://www.medicalnewstoday.com/articles/276013.php. Accessed July 20, 2018.
13. Bassil N, Alkaade S, Morley J E. The benefits and risks of testosterone replacement therapy: a review. Ther Clin Risk Manag. 2009; 5: 427–448.
14. Prasad AS, Mantzoros CS, Beck FW, Hess JW, Brewer GJ. Zinc status and serum testosterone levels of healthy adults. Nutrition. 1996 May;12(5):344-8.
15. Mclelland J. Does Saw Palmetto Increase Testosterone? https://www.livestrong.com/article/522054-does-saw-palmetto-increase-testosterone/. Accessed July 20, 2018.
16. Horny Goat Weed. https://examine.com/supplements/horny-goat-weed/. Accessed July 20, 2018.
17. Tribulus terrestris. https://examine.com/supplements/tribulus-terrestris/. Accessed July 20, 2018.
18. Bagchi D, Swaroop A, et Al. A novel protodioscin-enriched fenugreek seed extract (Trigonella foenum-graecum, family Fabaceae) improves free testosterone level and sperm profile in healthy volunteers. Functional Foods in Health & Disease. 2017; 7(4).
19. Maca Root Health Benefits for Men. https://prostate.net/articles/maca-root-benefits-for-sexual-and-prostate-health. Accessed July 20, 2018.
20. Talbott SM, Talbott JA, George A, Pugh M. Effect of Tongkat Ali on stress hormones and psychological mood state in moderately stressed. J Int Soc Sports Nutr. 2013 May 26;10(1):28. doi:10.1186/1550-2783-10-28.
21. MUIRA PUAMA. https://www.webmd.com/vitamins-supplements/ingredientmono-574-muira%20puama.aspx?activeingredientid=574&activeingredientname=muira%20puama. Accessed July 20, 2018.
22. Leung,K W Wong A ST. Ginseng and male reproductive function. Spermatogenesis. 2013; 3(3): e26391. doi:10.4161/spmg.26391
23. Campos MM, Fernandes ES, Ferreira J, Santos AR, Calixto JB. Antidepressant-like effects of Trichilia catigua (Catuaba) extract: evidence for dopaminergic-mediated mechanisms. Psychopharmacology (Berl). 2005 Oct;182(1):45-53. DOI:10.1007/s00213-005-0052-1