Low testosterone affects almost every major system in the male body and has potentially serious long-term health consequences. Testosterone significantly affects the brain, libido, muscles, blood, and many other aspects of male health.
A 1996 study reported in the New England Journal of Medicine followed three groups of men. The first group was given testosterone and prescribed a strength training program; the second group was given testosterone and told not to exercise; the third group was just given a training program without testosterone. It was no surprise that the group which exercised on testosterone gained the most muscle and lost the most fat, but the group which took testosterone without exercise actually had greater improvement in muscle and fat composition than the group which trained without it. You can't build muscle without it!
Some causes of low testosterone levels include congenital problems (such as deficiencies of male hormones and rare malformation syndromes) and acquired problems that include aging, chronic illness, drugs, starvation, stress, head trauma, infections, cancers, surgeries, alcoholism, removal of or trauma to the testicles, and infection or twisting of the testicles in their sac. In addition, certain drugs compete with testosterone in the body.
Married males have significantly lower testosterone levels on average. One study found that unmarried males had up to 20% higher average testosterone levels than married males.
The symptoms of low testosterone usually develop gradually, with the result that many men simply ignore them and get used to feeling lousy and functioning poorly. Symptoms include:
Men with low testosterone often develop an attitude of not caring about anything, instead just 'existing' day-to-day. Pleasure and desire can be greatly decreased, which in turn affects most aspects of life including career and relationships.
One study of men suffering from low testosterone (average level: 268ng/dL) found the following:
- 89% reported a lack of energy
- 79% reported erectile dysfunction
- 70% reported a loss of pubic hair
- 66% percent reported a decrease in sexual endurance.
Verifying testosterone levels is very simple: a blood test will produce results within a few days. The official criterion for testosterone being 'low' is 260ng/dL. This figure is in fact very low; long-term health issues generally start becoming apparent at levels below 350.
One study in 2008 found that almost half of the male subjects with testosterone levels below 300ng/dL in fact had no obvious or significant symptoms. For this reason, all middle-aged men should consider having their testosterone levels tested, whether they are showing symptoms of deficiency or not.
Those with slightly low testosterone levels (in the 400-500ng/dL range) can often treat this condition naturally through sex (both sex and sexual anticipation boost testosterone levels); diet (increased monounsaturated fats, fish oil capsules, processed carbohydrate and sugars avoidance, lower carbohydrates in general); increased quality sleep (testosterone production increases during sleep); 'winning' and having a 'winning attitude' (in other words, a positive change of attitude.)
Sports of all kinds (including chess!) are excellent and natural testosterone boosters.
Low testosterone is associated with increased risk of many conditions, including heart disease, depression, metabolic syndrome, diabetes, cognitive impairment, osteoporosis, cancer. A 2007 study found that low testosterone is associated with increased risk of death in general.
Once large study in 2008 found that men with testosterone levels below 250ng/dL were fatter and had lower HDL, higher triglycerides, higher blood pressure, and higher blood glucose – all serious markers of poor health and high risk. These men were tracked over 18 years and were found to have a 40% higher death rate from all causes.
Baltimore Longitudinal Study showed a strong correlation between low testosterone levels and dementia, as well as increased risk of Alzheimer's disease.
Researchers at Columbia University Medical School studied 55 men undergoing X-ray exams of their arteries and found that those with a lower testosterone level had higher degrees of heart disease (blockage of the coronary arteries). This study also found that the protective HDL cholesterol levels were higher in men with higher testosterone levels.
Low testosterone is linked to hypertension, obesity, atherosclerosis and increased waist-to-hip ratio – all of these being heart attack risk factors. Administration of testosterone to men has been reported to decrease the risk factors for heart attack.
Researchers at Columbia University Medical School found that serum testosterone levels were about 90ng/dl lower in patients who had suffered myocardial infarctions (MI) than in those who had not. These results suggest that low testosterone levels predispose men to MI and are lower in men with severe coronary artery atherosclerotic disease than in controls.
Testosterone is converted into estrogen naturally. When this conversion is overactive the result is too little testosterone and too much estrogen. High levels of estrogen also trick the brain into thinking that enough testosterone is being produced, thereby reducing the natural production of testosterone.
An estimated 45% of men with untreated AIDS and 25% of asymptomatic, untreated HIV-infected men experience low testosterone levels. Both men and women may be negatively affected by testosterone deficiency.
Depression can be caused by low levels of certain hormones, including testosterone.
Several studies have found that sufferers of cluster and migraine headaches tend to have subnormal levels of total testosterone, DHEA sulfate, and pregnenolone.
Some 30% of men with spinal osteoporosis have long-standing testosterone deficiency, and one-third of men with testosterone deficiency have subnormal bone density that puts them at risk of fractures.
Many studies over the years have shown that testosterone is critical to sexual desire. One of the most common symptoms of low male testosterone level is a loss of libido.
(This relationship of testosterone levels to zinc status does not apply to women.)
Studies support the use of zinc supplementation in the treatment of low sperm count especially in the presence of low testosterone levels. Both sperm count and testosterone levels rose in men with initially low testosterone levels. Zinc status should be evaluated in men with decreased serum testosterone levels. [Nutrition Report, September-October, 1996;14(7): p.52]
Without sufficient testosterone the penile muscles atrophy, with the result that insufficient blood is trapped for developing or maintaining an erection, which in turn leads to poor performance and the anxiety that follows. One study found that low testosterone is a factor in 20% of men under 30 with erectile problems.
In patients with below-normal serum testosterone levels, physiological levels were reached after treatment with Tribulus. Amongst patients with normal initial levels, the testosterone level was not significantly changed after treatment.
The original and primary use of testosterone is for the treatment of males who have too little or no natural endogenous testosterone production: males with hypogonadism. This hormone replacement therapy helps to maintain serum testosterone levels in the normal range.
DIM helps to balance the sex hormones estrogen and testosterone. The usual dose range of DIM for men is 200-400mg per day taken with food. For men involved in a plan of muscular development or fat loss, the dose of bioavailable DIM should be increased to 400-500mg per day.
Clinical studies using testosterone injections, creams, or patches have often failed to provide a long-lasting, libido-enhancing effect in aging men. This is because testosterone can be converted to estrogen, which is then taken up by testosterone receptor sites in cells throughout the body. When an estrogen molecule occupies a testosterone receptor site on a cell membrane, it blocks the ability of serum testosterone to induce a healthy hormonal signal. It does not matter how much serum free testosterone is available if excess estrogen is competing for the same cellular receptor sites.
Aromatization is the process of converting testosterone to estrogens, and this process increases with age. Aromatase blockers such as DIM and Chrysin can reduce estrogen levels and enhance testosterone levels. If these fail to increase free testosterone and lower excess estradiol, then consider asking your doctor to prescribe the potent aromatase inhibiting drug Arimidex (anastrozole) in the very low dose of 0.5mg, twice per week. Arimidex reduced estradiol by approximately 70% within 24 hours and by approximately 80% after 14 days of daily use.
Unfortunately, there is no general agreement on the threshold of testosterone value below which a man would be considered hypogonadal. In the United States, levels below 200 to 300 pmol/l from a morning sample are generally considered low.
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