Male Hormones: Adjustment or Replacement
Improve Hormonal Health and Body Comp:Dr Berardi’s Precision Nutrition SystemDr Walsh’s Fat Is Not Your Fault ProgramAs popular as hormones are in today’s baby boomer anti-aging movement, it’s surprising how many health care professionals completely screw up hormones. The physiology of males’ hormones is not terribly complex, as you’ll see, but for some reason many doctors completely miss the big picture.
Too much testosterone
Before I continue – and before I share with you my
ideas on hormonal adjustment and replacement – I’d like to go on the record as saying that hormone replacement therapy is way over-prescribed for men.
Yes it is popular, mainstream, and promoted by some high-profile doctors and celebrities. And yes, testosterone replacement is necessary for some individuals.
But, in general, it’s a quick-fix, no-thought-required, formulaic approach that’s actually making many people worse.
Call me old fashioned, but when you start artificially messing with physiology, it finds a way of messing back.
“But my friend went on hormones and felt great.”
Really? People can take cocaine and feel pretty good on it, too. Just because something makes you feel better doesn’t mean it’s good for you.
For these and other reasons I’m a big fan of optimizing hormonal levels naturally. There is a natural ebb and flow to life, to aging, and to nature that has been going on long before any of us were here. And to start toying with the system is asking for trouble. But enough of the soapbox — on to the good stuff.
Male hormones 101
Guys, we’re lucky. The hormonal system in male bodies is pretty basic. There are some subtle deviations to watch out for, but it’s nothing like a woman’s hormonal profile. Here is a quick video to help give you an overview of basic male hormone physiology.
The many roads to low mojo
There are a number of things that can misfire in a man’s body, all of which can create low testosterone symptoms, but none of which require hormone replacement. In fact in some cases, hormone replacement will make the situation much worse.
Rather than describe the defects, here is another short video explaining five of the more common defects in male hormone physiology. When you understand these, you’ll have a better working knowledge of male hormone physiology than many doctors.
So let me ask you this. Are symptoms of low testosterone always due to low testosterone production? Obviously not! Low testosterone symptoms could be due to:
- Decreased liver detoxification
- Poor gastrointestinal health
- Altered adrenal function
- Blood sugar and insulin issues
- Altered enzyme activity – 17,20 lyase, aromatase, beta-glucuroniase, 5-alpha reductase
- Compromised pituitary function
The good mechanic
Let’s say you were a car mechanic and three people came to you reporting low gas mileage. Would you:
1. Give them all the same gas additive and call it a day, or
2. Assess things that can affect gas mileage such as tire pressure, spark plugs, fuel injector, oxygen sensors and the air filter, and then make your recommendations accordingly.
Good mechanics obviously do the latter. Now let’s pretend you are a doctor.
Three men come to you all complaining of low testosterone symptoms. Do you automatically give all of them Androgel? No.
One person might have liver and pituitary issues, another person might have upregulated 5’delta-desaturase activity, and the third could have blood sugar issues causing increases in androstenedione and estrogen.
What to do
Honestly, this is the section I like least because it’s not as simple as simply saying “Everyone needs zinc, tribulus, and horny goat weed.” Unfortunately it doesn’t work that way. Now, if one of those supplements has worked for you, this is great evidence. In fact, it could be somewhat diagnostic.
For example, if the herb tribulus terrestis helped increase your testosterone levels, you likely had low lutenizing hormone caused by pituitary suppression. But why was it suppressed?
If zinc helped you increase your testosterone levels, you were probably zinc deficient. But why was your zinc low? Was it hypochlorhidria, fluoride toxicity, and/or blood sugar issues?
If you have symptoms of low testosterone, get tested. A good male hormone panel will include total and free testosterone, the estrogens (estrione, estradiol, estriol), androstenedione, sex hormone binding globulin, DHEA, DHT and lutenizing hormone. Also consider an adrenal salivary panel to assess cortisol levels.
It can be difficult to find a doctor that will run all of these for you, so you may have to look around for a more proactive doc.
One option is to see a naturopath. In our office, we most often use salivary testing for male hormones.
In summary
Today, men are experiencing what could otherwise be described as Functional Andropause at alarming rates, and it is not limited to sedentary, overweight men. Many exercise enthusiasts are affected, too.
The conventional medical establishment is doing virtually nothing to help any of these men and in many cases is making them worse using the replacement model.
Male hormones physiology is not terribly complex when you know what to look for and many times you can correct imbalances without resorting to drugs or hormones.
The best thing you can do is first educate yourself. Then, with that education, get tested. Have an intelligent conversation with your doctor rather than merely listening to what s/he says. If they won’t listen, find another doctor.
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