Testosterone, touted as the “manly” hormone, is the most powerful androgen. Androgens are a group of steroid hormones whose name fittingly is derived from the Greek word for “man-maker.”
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The Role of Testosterone
Testosterone is well-known for its role in muscle growth, male pattern hair growth, and plays a role in erection and sexual performance. It is also necessary for maintaining optimal bone density, a healthy pain response, regular sleep patterns, optimal energy levels, and red blood cell production. While the effects testosterone has on male behavior are not completely understood, it plays a role in energy levels, aggressiveness, and is necessary for sex drive.
As men age, testosterone levels typically decline. Low T is the term used when testosterone levels are low. While some experts believe that testosterone levels naturally decrease at a rate of 1 percent a year after age 40, there is recent research indicating that the decline in testosterone may be the result (not the cause) of deteriorating general health.
Some signs of Low T include decreased libido, shrinking testicles, reduced facial hair, osteoporosis, weight gain, hot flashes/night sweats, sleep issues, infertility, fatigue/decreased energy, muscle loss, depression, poor memory/lack of focus, and anemia.
It is evident that testosterone benefits the body in a plethora of ways and is necessary for optimal functioning. (While we are focusing on men’s health, testosterone is an important hormone for women’s health as well!) Luckily, there exist a vast variety of ways to increase testosterone levels in the body. There are both natural means as well as pharmaceutical testosterone therapy. Learning about these different testosterone-boosting methods will help you make an informed choice for yourself or your loved ones.
The Testosterone Therapy Hype
Chances are you have seen commercials by the pharmaceutical industry promoting the use of testosterone replacement therapies, urging men to ask their doctors if they have “possible signs” of testosterone deficiency. FDA regulations allow for this pharmaceutical marketing (the US is one of only four nations that allows direct-to-consumer advertising).
According to Dr. Michael O’Leary, a urologist at Harvard, “Virtually everybody asks about this now because the direct-to-consumer marketing is so aggressive. Tons of men who would never have asked me about it before started to do so when they saw ads that say, ‘Do you feel tired?’” Dr. O’Leary states that being tired is low on his list when it comes to prescribing testosterone replacement therapy. If a client has significant low T symptoms, Dr. O’Leary always performs a lab test- even then, most of the men who come to him have normal testosterone levels.
When men do have testosterone levels below the normal range, they usually end up on long-term testosterone replacement therapy. Dr. Carl Pallais, an endocrinologist at Harvard, agrees with Dr. O’Leary in that the marketing of testosterone therapy has put men in the position of being informed of the benefits of testosterone therapy, without sufficient knowledge of its potential risks. He believes that men need to be more mindful of the long-term consequences. According to Dr. O’Leary, the body stops making testosterone while on treatment, making it hard to stop taking it. Along with other experts, he errs on the side of caution, weary that the risks of testosterone replacement therapy add up over time.
Testosterone Therapy May Have Immediate Effects, But Is It Safe?
According to Dr. O’Leary, “Men can often feel a big difference when they stop therapy because their body’s testosterone production has not yet recovered. This wouldn’t matter so much if we were sure that long-term hormone therapy is safe.” He refers to the treatment as a ‘testosterone trap’: men often feel better when they start treatment, but then there are side effects (dependency being a major one).
While most men feel better at the start of treatment, there are some who experience immediate side-effects, including acne, sleep apnea, breast swelling/tenderness, and swelling in the lower extremities. While on treatment, doctors monitor red blood cell counts, as increased counts could contribute to the risk of blood clots.
Unfortunately, the long-term effects of testosterone replacement are vague, as there has yet to be a large, definitive trail for testosterone therapy. The current research shows that men on testosterone treatment long-term have heightened risks of cardiovascular issues, including heart attacks, strokes, and death from heart disease. According to Dr. Pallais, the cardiac side effects are more immediate in older men.
While the evidence is mixed, and more research is needed for clarification, some experts worry that testosterone therapy could stimulate the growth of prostate cancer cells. Many experts believe that testosterone therapy should only be used by men with hypogonadism (except those with a history of breast or prostate cancer) or those enrolled in highly monitored clinical trials. Hypogonadism is a medical condition in which the testes stop producing and releasing adequate amounts of sex steroids (testosterone) and sperm. Hypogonadism can be congenital or acquired. It is most commonly acquired in late adulthood, presenting with co-morbidities including metabolic syndrome, obesity, and type 2 diabetes. Many physicians agree that low testosterone is often a sign of overall poor health—there are a handful of small studies displaying that lifestyle interventions can improve testosterone levels.
One expert in functional medicine, brings to light that other forms of hormone treatment have a history of dangerous side effects. For example, estrogen therapy has been linked to increased risk for breast cancer, and other synthetic hormone treatments have been shown to lower HDL cholesterol and increase the risk of stroke. With this in mind, this doctor recommends avoiding synthetic hormone treatment if possible.
The cost of testosterone replacement therapy will vary, depending upon your health insurance coverage. If you have insurance, there is typically a monthly co-pay ranging from $30-100 dollars. If paying out of pocket, you may pay upwards of 600 dollars per month, taking into account the blood tests and doctor visits needed to monitor your testosterone levels.
Natural Alternatives to Testosterone Replacement Therapy
One doctor recommends intermittent fasting as a top lifestyle change for increasing natural testosterone. Intermittent fasting is a practice in which one eats all of their food within a smaller timeframe- leaving at least 12 hours between your last and first meal of the day. This gives the body a chance to digest, rest and balance. In fact, it has been shown that this practice can increase testosterone by up to 200 and even 400 percent. A study at the University of Virginia Medical School revealed that human growth hormone also increased, which is a hormone associated with increased T levels.
Lifting weights and working out are great ways to naturally increase testosterone production. In particular, HIIT (High-Intensity Interval Training) has been proven helpful in weight loss.
De-stress. Chronic stress means excess cortisol (the stress hormone). The body’s response to cortisol is initially to increase testosterone production, yet the body cannot keep up. A 2010 study published in the journal, Hormones and Behavior, revealed that testosterone levels bottom out after the initial increase—in fact, testosterone levels become lower than they were prior to the cortisol spike.
Vitamin D3 is an important nutrient that boosts testosterone levels. Studies have shown that it can increase testosterone in men up to 30 percent. Spending 20-30 minutes in the sun is a great way to obtain vitamin D.
Decrease your sugar intake. Excess sugar intake puts you at risk for the co-morbidities associated with low T. When your sugar intake is increased, your body needs to produce more insulin to balance your blood sugar. Excess insulin overtime leads to insulin resistance, a condition in which your body’s cells no longer respond to insulin- this causes type II diabetes. People with type II diabetes are twice as likely to develop low T. Limiting your sugar levels can help your body to naturally balance your hormones.
Get your ZZZ’s. One doctor sites a study in which getting enough sleep (an average of 7 hours) and at the right time (sleeping between 10 pm to 2 am) is considered the most effective way to naturally raise testosterone levels. Our body’s circadian rhythms play a key role in overall hormonal balance. Getting enough sleep is also important for balanced weight maintenance.
Tongkat Ali is also referred to as “Malaysian Ginseng.” It is an ancient herb with traditional use as an anti-aging remedy. In modern times it is used as an adaptogen and is well-regarded for its ability to improve libido, energy, athletic performance and weight loss. In fact, it may be one of the most effective herbs for increasing free testosterone levels in the body!
Nettle Root Extract has long been appreciated as a nourishing tonic– it is touted as being high in minerals. The nettle root is particularly indicated for male hormone and prostate health. Studies show that nettle root can inhibit sex-binding globules from binding to testosterone, resulting in higher levels of free testosterone in the body. Nettle root has also been shown to support overall urinary tract and prostate health. It both nourishes and tones the male reproductive tract. Nettle root also has anti-inflammatory effects and has been shown to decrease swelling of the prostate—which can result in enhanced sexual satisfaction.
Pine Pollen is known for supporting male health and has been used in TCM for thousands of years. Pine Pollen is known for containing phyto-androgens (including testosterone), which is fitting as it is the male spore of the pine tree after all! Experts believe that the structure of these phyto-androgens allows them to work similarly to the body’s own hormones in an adaptogenic way. As a hormonal balancer, pine pollen can also support liver health and detoxification. It is also high in phytonutrients and antioxidants!
Ashwagandha is considered an adaptogen and has long been appreciated as a hormonal balancing herb in Ayurveda. It has been shown to reduce cortisol levels in the body and increases blood flow to the sexual organs. Taking this herb in a spagyric form also means that there are more minerals than a typical Ashwagandha tincture, due to the enhanced processing technique.
Black Maca has long been used as a remedy for sexual dysfunction and infertility. It is not a surprise that it is often used as an aphrodisiac. Maca is a tuber, which is filled with phytonutrients, including zinc and other important micronutrients. It can help build bone density, muscle, and is also touted for increasing energy. The powder is tasty too! It can easily be added to smoothies.
As you can see, when it comes to testosterone there are a plethora of lifestyle, dietary and herbal supports. Working with your body naturally can help increase your testosterone without being subject to a long list of side-effects. Your testosterone levels are important to your health and wellbeing. The way in which you choose to increase your testosterone levels has an impact on your overall health and wellbeing as well, so take the time to make the choice that is right for you.
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Hackett, Geoffrey. Advances in Pediatrics. Apr. 2016. Retrieved from: www.ncbi.nlm.nih.gov/pmc/articles/PMC4772354/
Is Testosterone Therapy Safe? Take a Breath before You Take the Plunge. Retrieved from: www.health.harvard.edu/mens-health/is-testosterone-therapy-safe-take-a-breath-before-you-take-the-plunge
Testosterone Replacement: A Cautionary Tale – Harvard Health. Retrieved from: www.health.harvard.edu/mens-health/testosterone-replacement-a-cautionary-tale
Older Age Does Not Cause Testosterone Levels to Decline in Healthy Men. ScienceDaily.2011 June 07. Retrieved from: www.sciencedaily.com/releases/2011/06/110607121129.htm
Talbott, Shawn M, et al. Advances in Pediatrics. 2013. Retrieved from: www.ncbi.nlm.nih.gov/pmc/articles/PMC3669033/