The role of testosterone
Testosterone is a hormone produced by the body, and while it occurs in both males and females, it’s an especially important sex hormone for males. Produced by the testicles, testosterone affects appearance, sexual development, sperm production, and sex drive and helps build muscle tone and bone mass. For those who identify as male, maintaining healthy testosterone levels throughout life is key for good health in body and mind.
Gonads are the primary reproductive organs, and low testosterone production is often referred to as hypogonadism, a condition that affects an estimated four to five million men in the United States alone.
Hypogonadism can also be referred to as low T, testosterone deficiency syndrome, or testosterone insufficiency. Although it may occur at any age, testosterone production typically decreases with age, and low levels are especially common in older men.
How to recognize low testosterone
Studies suggest that hypogonadism in adult men is often underdiagnosed and undertreated as the symptoms are easily attributed to aging or other medical causes or ignored by patients and physicians.
Signs of low testosterone are often subtle and can be uncomfortable to talk about, so knowing these signs can play a significant role in determining who gets evaluated and treated. If you’re uncomfortable talking about your health, start by talking with someone you know and trust, like a Health Coach, who can support you in finding ways to communicate your health concerns.
Twelve signs of low testosterone in men:
1. Low sex drive (decreased libido)
Testosterone plays a key role in libido, or sex drive, in men. Some men may experience a decline in sex drive as they age. However, someone with low testosterone will likely experience a more drastic drop in their desire to have sex.
2. Erectile dysfunction (ED)
While testosterone stimulates a man’s sex drive and aids him in achieving and maintaining an erection, the hormone alone doesn’t cause an erection. Testosterone actually stimulates receptors in the brain to produce nitric oxide, a molecule that helps trigger chemical reactions necessary for an erection. Other recognized risk factors for ED include age, high cholesterol, low HDL, hypertension, diabetes, thyroid disorder, smoking, physical inactivity, coronary artery disease, myocardial infarction, and obesity.
Because both ED and loss of libido are hallmarks of hypogonadism, any patient who has symptoms of ED should have a basic hormone profile to determine if they have low testosterone.
3. Low semen volume
Men with low testosterone will often notice a decrease in the volume of their semen, the fluid that aids in the motility of sperm, during ejaculation.
4. Hair loss
Balding is a natural part of aging for many men. While there is a genetic component to balding, men with low testosterone may experience a loss of body and facial hair as well.
Men with low testosterone often report extreme fatigue and decreased energy levels. If you’re tired all the time despite getting plenty of sleep, or find it harder to get motivated to exercise, there is a high possibility of testosterone deficiency.
6. Loss of muscle mass
Since testosterone plays a role in building muscle, men with insufficient testosterone might notice a decrease in muscle mass (but not necessarily a decrease in muscle function or strength).
7. Increased body fat
Men with low testosterone may also experience increased body fat. They sometimes develop enlarged breast tissue or increased weight specifically in the abdominal area. This can be attributed to the hormonal imbalance between testosterone and estrogen.
8. Decreased bone mass
Osteoporosis, or lessening of bone mass, is often associated with female aging, but men with low testosterone are also at risk for bone loss. Since testosterone helps produce and strengthen bone, insufficient levels can make men more susceptible to fractures.
9. Mood changes
Testosterone influences mood and mental capacity in addition to physical health. Research has shown that men with low testosterone are more likely to suffer from depression, demonstrate irritability, or experience lack of focus.
10. Affected memory
Since aging is associated with a decline in memory and cognitive function, as well as a decline in testosterone, some doctors have theorized that lower testosterone levels could further contribute to affected memory. Some studies have linked testosterone supplementation with improved memory in men with low levels, but more research is needed.
11. Decreased testicle size
Low testosterone levels in the body can contribute to smaller-than-average testicles. This makes sense since the body requires testosterone to develop the penis and testicles.
12. Low blood count
Low testosterone levels are linked to an increased risk for anemia. When researchers administered testosterone gel to anemic men who also had low testosterone, they saw improvements in blood counts compared to those who used a placebo.
Further assessment for low testosterone
A simple blood test checking early-morning serum total testosterone is an inexpensive and reliable screening test for hypogonadism. The morning serum total testosterone level measures free testosterone plus protein-bound testosterone. A morning sample is recommended because testosterone levels demonstrate a diurnal pattern in which the highest level is reached in the early-morning hours (and lowest in the evening hours).
Diet and lifestyle modifications that address low testosterone
Once a testosterone deficiency is confirmed, talks of testosterone replacement therapy, more commonly known as TRT, can begin. Several treatment options exist for testosterone replacement, such as oral preparations of testosterone derivatives, intramuscular injections, a recently approved 1% testosterone gel, and transdermal patches applied to the scrotum, upper arms, legs, abdomen, or back.
Testosterone-boosting supplements have also gained a lot of attention recently. Although they are not FDA-approved, the men’s health supplement industry is a lucrative business as many men seek this alternative approach to treatment.
Whether it’s because some men are reluctant to broach the subject with their doctors or the stigma of TRT is scary for them, some men would rather try supplementation. The problem is that most of these supplements offer a proprietary blend of ingredients, so there’s really no way of knowing how much of each ingredient you’re getting and whether it’s enough to make a difference. For men looking to boost their testosterone levels without supplements or traditional medications, there are some foods that can boost testosterone levels.
Ten foods that can boost testosterone levels:
Ginger is a powerful antioxidant and contains anti-inflammatory properties.
Per serving, oysters contain more zinc than any other food, which is known to boost testosterone production as well as libido and sperm count.
This fruit is rich in antioxidants and drinking as little as one glass of pomegranate juice a day boosts testosterone production.
4. Foods rich in vitamin D
Fortified plant milks, egg yolks, tuna, and other foods rich in vitamin D have been linked to increased testosterone production.
5. Leafy green vegetables
Spinach, Swiss chard, and kale are all rich in magnesium, which has been shown to increase testosterone.
6. Fatty fish or fish oil rich in omega-3s
Salmon, mackerel, sardines, herring, and trout are all great examples of fish that are high in the healthy fats needed for testosterone production.
7. Extra-virgin olive oil
This oil has been shown to boost testosterone levels by at least 19% when used daily for a minimum of three weeks.
This delicious ingredient contains a powerful antioxidant compound called allicin, which has been shown to reduce cortisol levels. Since cortisol is a testosterone competitor, decreasing cortisol improves the actions of testosterone.
Though more research is needed, studies have shown a daily intake of fresh onion juice for four weeks significantly increased serum total testosterone levels in rats.
Honey is rich in the mineral boron, which has been associated with high testosterone levels. Honey also produces nitric oxide, which improves circulation by dilating blood vessels, thereby increasing blood flow to the penis.
Just as there are foods that help increase testosterone levels, there are foods that do the opposite as well. These include high amounts of processed foods containing trans fats, alcohol in excess of moderation, and foods packaged in containers that contain BPA (bisphenol A or bisphenol S).
Focus on preventive health and stay informed
It’s not always easy for patients to voice their concerns, particularly in cases where the physician identifies as female. Don’t let this get in the way of your health. More and more people are turning to “Dr. Google” rather that discussing sensitive subjects with their doctor face-to-face.
Consider writing down your questions and concerns and reviewing them with your doctor. If you are suffering from any of the signs of low testosterone, have your doctor screen you and discuss how to move forward with diet and lifestyle changes and medications where necessary.
As with anything in life, knowledge is power. Staying informed about your body provides the knowledge you need to tackle issues that arise. If someone you know is suffering from symptoms of low testosterone but doesn’t know how to address them, an Integrative Nutrition Health Coach may be just the resource they need to help navigate these stressful times.
Health Coaches create a safe space for clients to explore health concerns and help clients create a blueprint for addressing such concerns. Practicing how to communicate your concerns with a Health Coach could make your eventual doctor’s visits less stressful. And if you have experience dealing with a health issue, you may be empowered to share your journey with others by becoming a Health Coach!