Testosterone-what is it?
Disclosure: I am not an Endocrinologist. For a full detailed explanation of testosterone, you should see an Endocrinologist or Urologist.
Testosterone, or T, is the male body’s hormone fountain of youth. T is also a very important hormone in women, but we’re not talking about women, are we? The first 10-12 years of a boy’s life is overall pretty similar to a girl’s body; not much body hair, small reproductive organs, minimal, if any, sexual thoughts/dreams. However, one night a boy goes to bed and the next morning he wakes up with sagging balls, deep voice, and hair beginning to grow in the armpits and genitals.
Moreover, young lads begin to think/obsess over girls. And why not? Girls begin to develop as well. Friday after school, little Mary doesn’t have boobs. Monday morning, little Mary comes to school with obvious bumps under her shirt, the crux of most boy’s obsession.
But what is Testosterone? T is the hormone that is produced by the testicles in males, ovaries in females. It is abundant in boys that cause; muscle development, strong bones, hair in all the right or wrong places, deep voices, aggression/competitiveness, big ball sacks, enlarging penises, erections that can hammer nails into concrete blocks. It’s the hormone that gives males energy, vitality, acne, body weight control, basically LIFE!
Unfortunately, T levels begin to rise about 12-15 years old, puberty, and peak in the 20’s. The levels steadily declines about 1-1.3% each decade from that point onward (Quora). But, it gets more complicated than this.
Testosterone testing:
There are things to consider when considering T levels. First, you have to understand the testing. On one hand we have total T which is the both active (free) and inactive (bound) T. The inactive T is bound to proteins such as Sex Hormone-Binding Globulin (SHBG) and albumin. When in the inactive form, it is not available to act in tissues, which is a good thing because there is regulation of T in the tissues, which if too high, may cause problems. And, when it is bound to proteins, it prevents destruction of the hormone in the liver and kidneys. Approximately 95% of T is in the inactive form. This form has a level range of 250-1100ng/dL; optimal levels 1000-1200ng/dL (Quora). When the tissues are ready for a blast of T, it is released into the tissue from the protein.
Free T is the active form, making up 2-5% of the available T in the blood stream. This form of T is not attached to proteins and in theory can become active in tissues readily. Free T levels are 35-155pg/mL; optimal levels 200-250pg/mL (Quora). Measuring free T is a complicated process that involves levels of SHBG and albumin, along with age, weight, BMI. The higher the SHBG, the lower the free T because there is more protein for the T to bind to. It is a calculation from total T. Neither form is more important than the other, but low levels in either can cause problems in the male body.
Bioavailable T is the amount of T bound to albumin, which is an easier bond to break making the T available for tissue use (Medichecks). Bioavailable T can switch from active to non-active forms quickly depending upon the needs of the tissues.
Testosterone levels are at its peak between 7am-10am and slowly drop throughout the day. T levels are on the sleep cycle, circadian rhythm-think morning wood, or wet dreams. So if you’re going to get your T levels checked, first thing in the morning is the best time to get the most accurate levels.
Affects on Total and Free Testosterone.
Many body conditions can affect T levels. Conversely, low T levels can have impact on the body, the two phenomenon can have direct and indirect affects.
Firstly, low T levels can, and will cause, fatigue, low energy levels, disinterest (anhedonia) in previously interested hobbies (sports) or sex. This can be from low T levels from poor production of T from the testes. Or, can be from low T levels from medical conditions (obesity, Diabetes, sedentary life style-think choices). Or from certain medications causing low T levels. Aside from the obvious-female hormone replacement-think transgender. Certain medications such as SHBG raising estrogens, anti-seizure medications, and metformin-used for treatment for diabetes type 2. Medical conditions such as liver disease, hyperthyroidism, and HIV can elevate SHBG levels which has an inverse relationship with testosterone; the higher SHBG levels, the lower the T levels.
How to raise your T levels naturally:
Let’s start by saying in the United States, there is a pill created for every condition, and a condition created for every pill. We like to have the fastest way to improved health than actually putting in some work. Which, in this case can and will increase T levels naturally-exercise.
Cardio will certainly increase T levels. If the muscles and heart are used, T will increase because of other metabolic conditions are also affected. Cardio, as we know it, will reduce body weight, which decreases the risk for cardiovascular disease and diabetes. Obesity is a direct medical condition link to sooooo many other medical conditions.
We are in the state of allowing everyone to look the way they want, but as so many conspiracy theorist claim, healthcare and big pharma don’t want to help people; just make them sicker to charge them more money. If this is truly the case, let me be the first to say, making people obese is not a money maker, but the treatment(s) that derive from obesity is a money maker. Healthcare professionals and big pharma are on the reactive side of obesity, not the proactive side of obesity. Meaning, none of the two entities are stopping people at the grocery store, restaurants, drive-thrus, or ice cream shops
We are all born of the same relative size (length) and weight. Some people do develop medical issues early on in life, from heredity, causing obesity and the sequela cascade of medical conditions. However, in the majority of us, obesity is a condition of sedentary life style-think choices, and overeating-think more calories in than needed.
Two things to consider: genetics and environmental. Genetics, such as cardiovascular disease may run in the family, or diabetes may run in the family, but this does not mean you’re going to get any of them. Risk factors on top of genetics may increase your chances of getting whatever problems your dad or grandma had, but with reduced risk factors; sedentary life style, obesity, smoking, excessive alcohol intake on a regular basis, and other poor choices will increase the risk of getting the diseases that you’re pre-disposed to.
On the other hand is environmental. These are bad choices we make for 50+ years then wonder why we develop a medical condition. Type 1 diabetes is a genetic disorder, but can also be an acquired disease. I’ve met patients who became type 1 diabetics due to a virus that affected their pancreas which caused failure, hence type 1 diabetes. This is a very abnormal thing to happen, but it happens. Environmental medical problems that is/are a sequela of poor life choices-again sedentary life style, smoking, obesity secondary to excessive caloric intake, alcohol, drugs (cocaine, weed, heroine, pills, etc.). Most of these medical problems can be reversed, however, the longer we’ve had them, the more difficult and longer it is to reverse.
Cardio related exercises will keep body weight to a reasonable level, which will also keep you strong. Facts; the more I do intense cardio, the more hungry I am, but there is also a sense of self-control, eating healthy/non-fattening foods. A person can not outrun their diet, for sure, but doing plenty of cardio will keep the weight down.
What type of cardio am I talking about? Glad you asked. Any activity that gets your heart rate in the 80-90% of your max heart rate for 20-30 minutes/day. How do you know your max heart rate? Easiest way is to use this formula: 220-your current age. For me 220-58=162. 80-90% of my max HR is 130-146/min. This is a highly contested formula, but we’re not competing in the Olympics, it’s fine to use for us mere mortals. Again, this level of exercise won’t get you a ripped body, so self-control in the kitchen is still required. This level of cardio will keep some of the extra weight off. If you see this level isn’t as effective and you’re gaining weight, either increase the duration, intensity, or eat one less spoonful per meal.
I, on the other hand, am a competitive cyclist. I train at max HR on a regular basis. I max in the 180 range for varying durations on any given day. As an endurance athlete, previously runner, now cyclist, maintaining muscle mass is always a fight. Endurance folks must take in a higher than usual amount of natural protein and lift weights to keep the bit of muscle mass we had/have. Then the big kick in the ass is natural muscle mass loss (sarcopenia) not related to lower levels of testosterone.
Weight lifting is another way to increase T levels naturally; probably the best way. The more the muscles are subjected to force, the more T is produced and used in the tissues. The conundrum in the U.S. is that high protein supplements are used to gain muscle mass. Unfortunately, the mass gained turns to fat/extra weight when the person stops lifting weights. Easy, just don’t stop lifting. Reality, everyone gets hurt and takes time off, or, life-responsibilities take hold and prevents the gym-rat life. Yes, you can get back to it later, or maintain, etc., but the better idea would be to eat high protein foods in their natural forms; meat, beans, legumes, certain veggies, etc., as opposed to muscle/weight gainers-protein powders, bars, etc. When you need to take a weight lifting break for whatever reason for however long, the weight gained by natural proteins don’t turn into body fat which then sets up the person for low T levels.
Finally, T replacement therapy. If after you’ve tried to raise your low T levels with exercise, weight loss, improved eating pattern, improved sleep, reduction of stress, etc. speak honestly and openly with your health care practitioner. Explain your symptoms-low libido, energy, lack of interest in anything, weight gain (not from excessive caloric intake), hair loss, etc. Some practitioners are very happy to help. They will order all of the testing that needs done, including PSA testing, which, may indicate prostate cancer. When those results come back, the levels may not be low enough to start a testosterone hormone replacement therapy (t-HRT). If the practitioner wants to wait until the levels are lower, you can either try to reason with him/her, or raise the levels naturally, or seek another practitioner.
Some practitioners are afraid to start t-HRT if the levels are low-normal. Their reasoning may be; it’ll tell your testes to not produce anymore and you’ll get it through supplementation. Or increase the risk of prostate Cancer. These are legit concerns, but with more discussion, there can be a happy medium. Such as low dose t-HRT with frequent level testing. If your practitioner is absolutely against it, seek out another practitioner who is willing to at least consider your symptoms with your current levels. And yes, a woman can go into a GYN office and claim to have heat flashes, mood swings, etc., and they are put on HRT right away, but men have to wait until their T levels are nearly 0 before supplementation will be prescribed. Don’t fall into this, just seek out another practitioner, don’t guilt them into anything.
Naturopathic practitioners are helpful when all others fail: urololgist, family practitioners, endocrinologist, etc. The concern for naturopathic practitioners is/are they may try to sell you supplements in bottles on their shelves in their waiting rooms before prescribing a pharmaceutical HRT medication. Others are too aggressive and start out with estrogen blockers along with T replacement. Others want to put T pellets under your skin for long duration excretion of the testosterone.
Sometimes, just a small amount of T cream smeared onto your skin under your arm, or inside of the thigh is enough to give you a boost to increase libido, energy, etc. But, if a naturopathic practitioner is all you can find who will listen and be helpful, then go with it but start conservative (no supplements in bottles) with real testosterone medications.
Unnatural ways to raise Testosterone.
Look, I’m not a mad scientist living my life in a lab, but I know that some things are too good to be true. Testosterone boosters are a gimmick. If you don’t believe me, do an experiment; get your T levels checked-Total, free, SHBG, albumin, and PSA (prostate antigen) levels. Then take the desired T booster for 30 days, then get the same levels checked to validate or not validate, the supplement company’s claim.
If you decide to do this, and while you’re getting blood drawn, get your liver function tests (LFTs) checked, too. In most areas, there are labs that you can order your own blood tests, without a physician order. Most times you will have to pay out of pocket for the tests, but it’s also nice that you have control of what and when tests are completed.
I’ve never taken any supplemental T booster. I have seen many problems related to supplements claiming improved health, weight loss, concentration, memory, eye sight, prostate issues, sex health, you name it. Medical conditions such as liver failure, splenic rupture, cardiac problems, metabolic disorders, and others directly related to supplementation. In most cases, the supplement may be an overall low risk. However, many times the person takes more, because that’s what we do, or, the person is on prescribed medications that interfere with supplements.
Supplement companies are not required to follow the FDA (food and drug agency) regulations. The companies do not have to include all of the ingredients, or other important information such as interfering with certain prescribed medications. Also, the companies are not held liable for conditions as a result of taking the supplement. When a medication has a certain percentage of adverse reactions on a patient, or has a big adverse reaction to a few patients, the drug is pulled from the shelves until more research is completed by the pharmaceutical company.
Supplement companies open and close without regard to backlash of adverse reactions to their supplements. Or, they change the label and active ingredients on the label and sell it as new & improved-whatever. These supplements are metabolized in the liver and excreted either in feces, or urine, or both. If you’ve ever taken a supplement only to see the full pill in your poop, you just ate and shit out money!
If you do your experiment of T levels-take a booster-then recheck the levels, without doing anything else; exercise, eating healthy, stopping alcohol intake, etc., and your levels of T actually rise, you should have it checked again immediately to make sure it wasn’t a lab error. If it still is elevated after the second test (or third) then you have the one booster that actually worked. I seriously doubt it will, but sometimes science can’t explain everything. The reason I recommended to have your LFTs checked before and after taking any supplement for a month is to monitor liver effects of the supplement. I saw a young lady (early 40’s) get a liver transplant for taking a fat burner supplement that put her in full liver failure. We did MARS on her which is dialysis for a failed liver, for quite sometime until a donor liver was found.
One final note, if you can’t afford ordering your own blood work, or there aren’t any independent labs in your area who do ala ‘carte lab work, a true test of low testosterone is easy to do. If you wake up most mornings with a raging hard on, or, you’re engaging in sex on a regular basis (masturbation included), and you have plenty of stamina/energy all day on a decent night’s sleep, you probably have mid-range normal to high levels of testosterone. Testing and T supplementation may not be needed at this time.
Good luck. Reach out if you have questions!