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In the last few years, “Low T” has literally become a catch phrase that we are hearing more and more. And centers are literally opening up on every corner to address this apparent epidemic. But while more attention is being devoted to this issue, very few men (or women) really understand how important this issue is, why it happens, and how it can be corrected. And, there is also very little understanding about the other hormones involved. For many men, simply correcting low testosterone may not be the answer.
To begin, let’s talk about a few hormones that are critical to a man’s health. These include:
- DHEA
- Androstenedione
- DHT (dihydrotestosterone)
- Testosterone
DHEA is often called the “Fountain of Youth” and is often a hormone touted to have almost magical benefits. But what does it really do? First, DHEA is a pro-hormone; which means that it is not only active in and of itself but it also goes on to produce other hormones. When DHEA is present in normal amounts, it supports the immune system, lowers serum triglyceride, and may potentially block the formation of deadly plaques within our blood vessels. In addition, it improves insulin sensitivity and so may also play a pivotal role in preventing obesity. It supports bone density and tissue strength and also plays a role in repair of damaged tissue. It enhances memory and protects our brain as well as providing an overall sense of well being. These qualities alone make it an extremely important hormone when attempting to achieve optimal health.
Androstenedione is also a pro-hormone and is ultimately converted to both Testosterone as well as DHT within the body. While it’s production occurs predominantly in the male gonads and adrenals, it is also the principal steroid made by the post-menopausal ovary. But too much Androstenedione in men can lead to a relative increase in estrone (one of the estrogens); and in women, an excess can drive up levels of testosterone.
DHT (dihydrotestosterone) is another critical hormone. About 25% of its circulating volume is secreted by the male testes which the remaining 75% if directly converted from testosterone by the enzyme 5-alpha reductase within the liver, kidneys, muscle prostate, and skin. While it only accounts for about 10% concentration in the blood as compared as circulating levels of testosterone, it is as least twice as potent because of its increased affinity for the androgen receptor. DHT is responsible for the development of male sex characteristics but too high of levels can lead to balding in men and overgrowth of hair in women. This hormone is effectively an end product in the steroid chain and so (unlike testosterone) it cannot be converted to estrogen.
Finally, let’s talk about Testosterone itself. Testosterone is primarily secreted by Leydig cells in the male testes under the influence of LH (Luteinizing Hormone) and secondarily in the adrenal glands. This critical hormone plays a number of very important roles including the following:
- Protects against osteoporosis
- Helps maintain lean muscle mass
- Inhibits estrogen-induced proliferation of breast tissue
- Maintenance of libido and sexual performance
Unfortunately, a variety of factors can lead to its decline including various disease states, medications, and various environmental toxins. Disease states that can affect Testosterone levels include:
- Diabetes
- Liver Disease
- Hemochromatosis (excess iron levels in the liver)
- Obesity
In addition, it can be lowered by smoking as well as excessive consumption of alcohol as well as a slew of various commonly used medications.
When testosterone levels decline, a man effectively enters what is called Andropause. Symptoms include:
- Loss of drive and competitive edge
- A decreased level of overall fitness and inability to achieve effectiveness with workouts
- Joint pain and muscle stiffness
- Increased brain aging/decreased memory
- Increased aging of the heart and circulation system with an increased risk for both heart attacks as well as strokes
- Loss of lean muscle mass
- Loss of bone mass
- Anemia
- Fatigue
- Depression and/or mood changes
- Reduced libido
- Reduced morning erections
- Longer recovery time between orgasms
- Reduced erectile tension
In addition, men with sub-optimal levels are also at an increased risk for the following diseases:
- Diabetes
- Metabolic syndrome/obesity
- Elevated levels of inflammation
One author pointed to this decline and suggested that it may be heading in a growing and very negative direction: “…recent years have seen a substantial, and yet unrecognized, age-independent population level decrease in testosterone in American Men.” (Travison TG et al. A population‐level decline in serum testosterone levels in American men. J Clin Endocrinol Metab 2006, Oct 24
Under normal conditions, testosterone levels generally decline in men beginning in the early 30’s and by age 40 go down by as much as 1% every year. This natural decline is generally due to various age-related changes including an increasing level of sex hormone binding globulin, decreasing LH, and an overall decrease in Leydig cell activity. But other factors can contribute to this and accelerate its decline including a poor diet, insulin resistance, stress, various medications, infections, alcohol, rising prolactin levels, trauma, and exposure to environmental toxins. This decline can lead to a 30% decrease in total levels of testosterone and a 50% decrease in bio-available testosterone.
Since we all seem to be under a lot of stress these days, let’s talk about the effects that this has on lowering our testosterone levels. First, as our levels of stress and inflammation rise so also does production of the stress hormone, Cortisol. When cortisol increases, it can block the conversion of the thyroid pro-hormone T4 to the more active hormone, T3. This decline not only lowers our overall energy levels but it also signals the thyroid to produce more TRH (Thyroid Releasing Hormone). When this goes up, so also do our levels of the hormone, Prolactin. Prolactin then ultimately signals LH/FSH to down-regulate the production of testosterone. And when this happens, not only do our Testosterone levels go down but so also do our levels of Growth Hormone. And the result? Not a pretty picture!
So the next time you reach for Cialis, think about what may be actually causing your concerns and the fact that this may be causing much more than the Bedroom Blues. Adequate correction of testosterone deficiency requires testing to determine not only why your levels are low but also the most optimal means for replenishing these levels. Many physicians, such as myself, will commonly prescribe not only testosterone replacement but also supplementation with DHEA as well as an estrogen blocker to make sure that these higher levels of T don’t simply get converted to estrogen (which is NOT a good thing for a guy).
I will be posting more informative articles in the coming weeks and look forward to hearing your feedback. To learn more about how we can help you achieve Optimal Wellness and get more life out of your years, I encourage you to contact us at BEAUTY by BUFORD to schedule your consultation (office: 303.747.6719 or email: [email protected]). If you truly care about the quality of your life, you will be glad you did!
And yes, that before/after picture is actually me. And I am also a client!
We look forward to working with you!