Millions of young men worldwide suffer from low testosterone levels but the symptoms are often mistaken for depression.
One of the most high-profile celebrities to speak out publicly about having low testosterone is Robbie Williams, the singer formerly in Take That. Diagnosed with testosterone deficiency in his thirties, Williams initially sought treatment for depression, but was told by doctors that he had the testosterone levels of an 80-year-old.
So what does it look like to have low testosterone?
Perhaps YES. These symptoms all point towards low androgens (aka, testosterone
Testosterone is the principal androgen controlling the development of the male body. It deepens the voice. It helps the hair and muscles to grow. It boosts sex drive. It supports production of healthy sperm. It affects how the body distributes fat. The male sex hormone comes mainly from the testicles, but also from the adrenal glands (in the precursor form, DHEA).
Healthy testicles produce lots of testosterone during puberty, which is part of the reason why adolescent boys can seem obsessed with sex. Women also produce testosterone, albeit in much smaller quantities (about one tenth to one twentieth of the amount of testosterone as men’s bodies).
Testosterone levels peak at the age of 20, hold steady for a while and then start to decline by about 1 per cent a year from about the age of 40. Low testosterone is believed to affect about 10 per cent of men aged between 40 and 60. For those aged 60 to 80, the figure is one in five. Other symptoms of low testosterone include reduced muscle mass, brain fog and anaemia.
I am only 30 something??? Am I too young for this?
Apparently not. Younger men can also be affected by low testosterone. A condition called hypogonadism can prevent the testicles from producing enough testosterone. The condition may be genetic, it can occur after an injury, or it can happen because of lifestyle-related factors. Secondary hypogonadism, also known as hypogonadotropic hypogonadism (yes, those are two different words), is usually caused by a problem with the pituitary gland, the thyroid, or the hypothalamus.
“I’m not your typical man you would think suffered [from low testosterone],” “I’ve been going to the gym and lifting weights for seven or eight years.” With low testosterone and DHEA, you need to work twice as hard at the gym to build and maintain muscle
Is it difficult to get a diagnosis for low testosterone? How do I find out if this is a problem?
No, not at all….it’s as simple as a blood test.
A healthy range of testosterone for a young male is between 300ng/dL (nanograms per decilitre) and 950ng/dL. The number that really matters, however, is “free” testosterone. You can have adequate levels of testosterone and suboptimal levels of free testosterone. This can occur due to an imbalance in sex-hormone binding globulin (SHBG) or albumin. Most of the testosterone the body produces (about 98 per cent) is bound to either SHBG or albumin (a protein produced in the liver). Free testosterone is the roughly 2 per cent that’s left over. The body draws on this to perform its functions.
Medical option for treatment: Synthetic testosterone injections (aka, think “roids”)
Injecting synthetic testosterone (testosterone replacement therapy TRT) is a life-altering decision, especially if you plan to have children. Injecting TRT shuts off the natural production of testosterone in the testicles. It’s difficult – though not impossible – to restart this process. It certainly isn’t something you mess around with for a few years before packing it in. Typically, TRT is a lifelong commitment and frankly, not safe.
Using TRT does carry risks. When synthetic testosterone is injected, it shrinks the testicles and decreases sperm production. You are significantly reducing your chances of fertility because you’re suppressing the pituitary.
So, that's a NO!!!
Supplementing magnesium (Mg) can help normalize testosterone levels. A diet comprising magnesium-rich foods (such as fish, nuts, beans, and green leafy vegetables) renders supplementation unnecessary, at least for the purpose of testosterone normalization, although hard-charging athletes or heavy sweaters may need extra magnesium. The standard dose is 200 mg of elemental magnesium once a day, though I personally use up to 500mg per day, typically taken in the evening because magnesium can have a sedative effect. Avoid taking calcium, iron, magnesium, and zinc, since high amounts of these minerals will compete for absorption.
Vitamin D has long been researched in the context of male fertility. Vitamin-D receptors can be found on sperm cells, and vitamin D may also play a role in the production of steroid hormones. Vitamin D deficiency is common, especially in people whose exposure to sunlight (without clothes or sunscreen) is limited. The darker your skin, the longer you need to expose yourself to sunlight to synthesize enough vitamin D. Vitamin D can be synthesized by sunlit skin (7-dehydrocholesterol) or ingested (D2 and D3). It then travels to the liver, where the liver converts vitamin D to its more active form: 25-hydroxyvitamin D. The kidneys then convert 25-hydroxyvitamin D into the very potent form of vitamin D called calcitriol (1,25-dihydroxyvitamin D). Ideally, take 2,000–3,000 IU (50–75 mcg) of vitamin D3 with a meal containing fat, either year-round or only during the colder, darker months, when you are least likely to synthesize enough vitamin D from sun exposure. Doses higher than 3,000 IU may be warranted in cases of severe deficiency or non-response at lower doses, as ascertained by a blood test. Keep in mind that 10,000 IU/day for three months has been shown to be toxic, and also keep in mind that Vitamin D should ideally be consumed along with Vitamin K2.
Zinc (Zn) is an important mineral for general health and is often marketed as a testosterone booster. Similar to magnesium, however, zinc supplementation can only help when low testosterone levels are linked to a zinc deficiency. If your body has enough zinc, taking more will not benefit you. As a matter of fact, over time, high doses of zinc can irritate the gastrointestinal tract. They can also cause a copper deficiency, since zinc kick-starts the process of creating metallothionein, a protein that binds zinc but also other metals, notably copper; the bound metals then leave the body as waste products. Even higher doses of zinc can also damage the liver and kidneys. Zinc requirements vary according to diet and level of activity. Sedentary people who do not sweat much and eat enough meat might not need to supplement zinc at all, and should otherwise limit themselves to 10–20 mg/day (15–25 mg/ day for vegetarians and vegans). Athletes and other people who sweat a lot (which results in zinc loss) can take 25–30 mg/day. Zinc should be taken with meals, to prevent potential nausea. I personally avoid excess zinc and get smaller amounts each day by taking a comprehensive multivitamin by Thorne, which also gives me Vitamin D, Vitamin K2, boron and a few of the other basic nutrients you’re reading about.
The hormone dehydroepiandrosterone (DHEA) circulates throughout the body and can be called to make other hormones, notably testosterone and oestrogens. Supplemental DHEA can support normal testosterone levels; this effect is especially reliable in case of age-related low testosterone. It’s pretty simple: you just take 25–50 mg of DHEA once a day with a meal. Please note that if you compete in any sports , DHEA may be banned for use in competition, and you must not take it if you fall into any of those categories.
Creatine is a molecule naturally produced in the body. It stores high-energy phosphate groups in the form of phosphocreatine. Phosphocreatine releases energy to aid cellular function during stress. This effect causes strength increases after creatine supplementation, and can also benefit the brain, bones, muscles, and liver. Most of the benefits of creatine are a result of this mechanism. Creatine can be found in some foods, mostly meat, eggs, and fish. Creatine supplementation confers a variety of health benefits and has neuroprotective and cardioprotective properties. It is often used by athletes to increase both power output and lean mass.
Creatine has been shown to influence androgen levels. Three weeks of creatine supplementation has been shown to increase dihydrotestosterone (DHT) levels, as well as the DHT: testosterone ratio. Creatine supplementation has been shown to increase testosterone levels when taken alongside a 10-week resistance training program. A study in male amateur swimmers also noted that a creatine loading phase (20g daily for six days) was able to increase testosterone levels by around 15% relative to baseline. I personally do not load with creatine but rather – due to the host of benefits from creatine – simply take 5g year-round, with no cycling or loading phases.
Like magnesium and zinc, boron is a dietary mineral. Some studies have also noted an increase in testosterone in men, even in young men, including an increase in the testosterone levels of young men taking 10 mg of boron per day. It is not recommended to take more than 20 mg/day.
So those are the basics: magnesium, Vitamin D/K, zinc, DHEA, creatine and boron…
The bottom line is this: for optimal testosterone production you shouldn’t go too low in calories (neither too high), shouldn’t consume too much protein (under 2g/kg) or eat too little carbs and too little saturated and mono-unsaturated fats. For me personally, the optimal ratio for T production seems to be on a 2500 kcal/day slight deficit diet with 98 kg bodyweight looks like this:
Multiple studies show that maca, a root vegetable, enhances drive in both men and women, and this effect keeps improving for 8 weeks before plateauing. Maca can serve to treat sexual dysfunction caused by selective serotonin reuptake inhibitors (SSRIs). It can also mildly benefit men with erectile dysfunction from other causes. Moreover, preliminary animal evidence suggests that red maca might improve prostate health and reduce anxiety. Maca does not interact with any major hormones, such as testosterone, oestrogen, or DHEA. For ideal dosing, take 1.5–3 g of maca root powder once a day with breakfast (for the purpose of improving sexual performance, there is no difference between red, black, or yellow maca).
Low nitric oxide (NO) levels can cause blood vessels to narrow, leading to poor circulation, which can result in erections that are softer and more difficult to maintain. Like the flavonoids in grape seed and pine bark, (-)-epicatechin and other flavonoids in cocoa can help support NO levels, thus improving blood flow and alleviating this type of erectile dysfunction. Simply take 1 g of cocoa polyphenols by consuming about 30 g of cocoa powder or 40 g of dark chocolate with a 75% cocoa content (FYI, neither milk chocolate nor white chocolate is a good source of polyphenols).
Eurycoma longifolia is also known by several other names, such as longjack and tongkat ali. Preliminary evidence supports its traditional use as a sexual performance enhancer for both men and women, and evidence also supports the use of Eurycoma longifolia as a male fertility enhancer. This herb does not seem to increase testosterone, however, or only to a small extent in men suffering from infertility or severe erectile dysfunction, but may increase testosterone in infertile men, and significantly increases the desire to mate in rodent models.
In Ayurvedic medicine, fenugreek is called methi (its Hindi name) and is used notably to increase virility. While the leaves and seeds are both used, most supplements favour the latter. When supplemented by healthy men, high doses of fenugreek appear to significantly increase sexual drive and satisfaction.
Low nitric oxide (NO) levels can cause blood vessels to narrow, leading to poor circulation, which can result in erections that are softer and more difficult to maintain. Like the flavonoids in cocoa, procyanidins and other flavonoids in pine bark and grape seeds can help support NO levels, thus improving blood flow and alleviating this type of erectile dysfunction. Pycnogenol, a patented pine bark extract standardized to 65–75% procyanidin, is the best-studied source of procyanidins. Grape seed extracts are cheaper, but their benefits to blood flow are less reliable and could take longer to develop (up to one month). To improve blood flow, Pycnogenol is a better choice than a grape seed extract, but neither option is as potent as cocoa or can boast as much supporting evidence.
Tribulus terrestris is an evidenced based Bulgarian herb used to support and optimised testosterone production.
Summary, in a nutshell…. Low testosterone: what you should know
Lifestyle changes such as avoiding alcohol, refined carbohydrates and sugar and limiting dairy can help. There is some evidence that soy-based products may lower testosterone (some experts recommend limiting intake of tofu and soya milk).
You’ll need some natural support
Taking supplements such as vitamin D, zinc and omega-3 fatty acids can naturally boost T levels and consider some herbal therapy with Maca, Pycnogenol, Tongkat ali, Tribulus, Fenugreek and Cocao.
We’d love to help…book your consultation to arrange testing and discussion around personalised treatment options at Floralia.
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