Testosterone is a vital hormone that is responsible for a number of functions in both men and women. Like other sex hormones, it can decline with age. However, there are lifestyle changes that you can make to keep your testosterone at an optimal level as you get older. We explore the role of testosterone within the body, how we can diagnose a deficiency, and how to increase testosterone naturally.

What Does Testosterone Do?

Testosterone has vital roles in the body for both men and women. Although men have 10 to 20 times higher testosterone levels than women, the lower levels in women are crucial to many tissue functions.

In men, it stimulates muscle growth and contributes to the maintenance of the skin, sex organs and bones. It is also responsible for the development of masculine physical features. High doses of testosterone are secreted in puberty, triggering increased lean muscle mass, sex organ growth, deepening voice and higher energy levels. Testosterone peaks from the early to mid twenties. 

Testosterone has other vital roles besides being a sex hormone. There are testosterone receptors all over the body, including the brain and the heart. This is very important in enhancing cognition, preventing cardiovascular disease and maintaining bone density, muscle tone, mood and general vitality. 

The hormonal actions of testosterone can be divided into: 

• Androgenic effects, which are masculinising or virilising, for example the growth of facial and body hair, sex hormone development and a deepening voice.
• Anabolic effects, which stimulate the growth of muscle, bones and red blood cells. 

What Can Cause Testosterone Deficiency?

Testosterone deficiency can be caused by a number of factors including:

• Andropause. Andropause refers to the male menopause. Not all men go through it, whereas all women go through menopause. It is a gradual process and can vary widely in individual men. During andropause, men experience a decline in the production of testosterone, but it doesn’t drop off as dramatically as sex hormones within the female body during menopause. 

• Body weight. Excess weight, especially abdominal obesity, can influence testosterone. In fat tissue, there is an enzyme called aromatase which stimulates the production of testosterone to estrogen. This means that men who have more body fat are actually converting some of their testosterone to estrogen. Excess weight can also trigger your cells to become more resistant to insulin, and insulin resistance can cause decreased testosterone. Decreased testosterone promotes weight gain and so a vicious circle forms.
• Illness or disease, stress levels, depression or mental illness, and endocrine disruptors. Endocrine disruptors are chemical compounds that interfere with regular functioning of the endocrine system (the system in the body that regulates hormones). A common endocrine disruptor in modern life is bisphenol A (BPA), which is an industrial chemical that has been used to make certain plastics and resins. BPA is found in plastics, water bottles, and reheated food in plastic containers such as ready meals. It disrupts the natural endocrine balance in the body and decreases testosterone levels. In one infertility clinic, when analysing men’s urine, traces of BPA were detected in 89% of samples. There are many silent disruptors in our environment found in plastics, flame retardant goods, the coating on non-stick pans and pesticides on food – all of these everyday things contain chemical substances to which the human body is very sensitive. It is vital for our health to be aware of this and minimise exposure, such as decreasing our use of plastics.

Symptoms Of Low Testosterone – How Do You Know If You Have A Testosterone Deficiency?

The physical symptoms of testosterone deficiency in men, in particular during andropause, are:

• Gynecomastia (man boobs)
• Reduced body hair
• Decreased libido
• Erectile dysfunction
• Weight gain, body fat increase and reduced lean body mass
• Reduced energy levels

Men are at increased risk of cardiovascular disease due to decreased testosterone levels. We know that testosterone helps build muscle, and the heart is a muscle, therefore low testosterone impacts heart disease by causing raised blood pressure, raised insulin levels, increased cholesterol and triglycerides, decreased coronary artery elasticity, weakening of the heart muscle and an increase of abdominal fat. 

Mental and emotional symptoms may include:

• Depression
• Irritability
• Mood swings
• Tiredness
• Decreased sleep quality
• Loss of concentration and memory
• Reduced cognitive function

Finally, sexual symptoms can also become apparent due to testosterone depletion. Men may experience decreased libido, poor sexual functioning and erectile dysfunction. This can really affect self esteem and contribute towards low mood and depression. 

Diagnosing A Testosterone Deficiency

The normal range of testosterone is quite broad, which means that an individual’s symptoms and general health must be taken into account when diagnosing a testosterone deficiency. We have found that male patients are less likely to volunteer information about their symptoms and medical history, so we have to be very targeted with our questioning during a consultation.

What we check for:

• Other sex hormones: DHEA, estradiol and progesterone levels.
• Full blood count: Testosterone replacement therapy can sometimes cause the blood to thicken; therefore a full checkup prior to administering the hormone and monitoring throughout treatment is important. 
• Diabetes screen (HBA1C) and cholesterol levels (lipid screen): Coexisting metabolic disease goes hand in hand with low testosterone. 
• Prostate specific antigen (PSA): This can increase if prostate cancer or other prostate disorders are present. 
• Lifestyle: Age-related decline is just one cause of low testosterone. It is also associated with stress, poor diet, low activity levels and obesity.

Dr Ghazala Aziz-Scott says, ‘It is very important to conduct thorough investigations before going ahead with any treatment. If a patient receives Testosterone Replacement Therapy (TRT), but they have excess aromatase in their system due to obesity, their body will convert some of that testosterone into estrogen, which is not the desired outcome. We assess and monitor our patients very closely with regular blood tests to ensure safe and effective treatment.’

What Impact Does Nutrition Have On Testosterone Levels?

TRT goes hand-in-hand with nutrition and lifestyle changes for optimal outcomes. 

Nutrition has a significant impact on testosterone levels. At the Marion Gluck Clinic, we advise taking steps to reduce refined sugars, white carbs and processed food in your diet. Processed food contains trans fats which can decrease testosterone levels. It is also important to maintain a low glycemic index (low GI) diet, as this will decrease insulin levels and hopefully aid weight loss. Weight loss increases testosterone levels naturally.

Focus on:

• Whole grains 
• Good quality fats like nuts, seeds and avocados 
• Lean, clean protein
• A rainbow plate of fruit and vegetables for a boost of phytonutrients

Specific foods to stimulate testosterone production include:

• Ginger 
• Oysters and other shellfish
• Red meats
• Poultry
• Beans, nuts and legumes
• Pomegranates
• Leafy green vegetables such as spinach and kale

Avoiding alcohol is essential, as the empty calories are a huge contributor to weight gain. The typical ‘beer belly’ increases the amount of aromatase and increases estrogen production in men.

Adaptogens are herbal supplements that help balance the body and moderate the stress response. Two adaptogens which have recently risen in popularity are ashwagandha and maca. Ashwagandha is an ancient medicinal herb used in Indian ayurveda.

Dr Ghazala Aziz-Scott says, ‘Men who supplement with ashwagandha could experience a 17% increase in testosterone and 167% increase in sperm count, so it’s quite a potent stimulator. It also lowers cortisol by 25% and improves insulin resistance, so it targets the causes of reduced testosterone through a number of different angles.’

Secondly, maca is a cruciferous vegetable from Peru, and maca powder is derived from the root of the vegetable. It can contribute to an increased sperm count in men. 

5 Tips For How To Increase Testosterone Naturally

1. Exercise and lifting weights. Even in the elderly, lifting weights and building muscle mass through physical exercise can raise testosterone levels. Resistance training and HIIT are ideal for this.
2. Stress reduction. Stress raises your cortisol as well as another stress hormone called prolactin. Increased stress hormones cause decreased testosterone. High cortisol also raises insulin levels and the fat around your abdomen, therefore it is important to look at how you can reduce stress in your life on a daily basis, perhaps with meditation, yoga, mindfulness and relaxation. Daily stress reduction is important, as opposed to maintaining a 24/7 adrenaline surge, which seems to plague our modern lifestyles. 
3. Increase vitamin D intake. Vitamin D affects all sex hormones, including testosterone, and deficiency is very common in cold climates. There are also genetic differences as to how different people absorb vitamin D. It is important for most people to supplement with vitamin D, as it is also a key vitamin in boosting immunity. 
4. Increase intake of zinc and B vitamins. These are very important for testosterone levels and sperm quality.
5. Improve sleep quality. Sleeping only five hours per night can cause a 15% reduction in testosterone levels. Everyone should aim for seven to eight hours of quality sleep per night.

Speak To A Hormone Doctor About Low Testosterone Levels

It is important to remember that whilst natural methods may help, optimal relief of the symptoms of low testosterone needs formal analysis and a comprehensive, personalised TRT treatment plan.

If you are experiencing symptoms of testosterone deficiency, or perhaps you have received a prior diagnosis, please do not hesitate to book a consultation with one of our hormone specialists at the Marion Gluck Clinic today.