Low testosterone, androgen deficiency, hypogonadism or low T. Whatever you want to call it, it is one thing that most men never want to hear, but did you know that low testosterone is common in Australia, affecting 1 in 200 men under the age of 60?
Androgens are the group of sex hormones that give men their ‘male’ characteristics. They are essential for male sexual and reproductive function but they are also responsible for the development and growth of facial and body hair, as well as bone and muscle development.
The major sex hormone (androgen) in men is testosterone. It is produced primarily (90%) in the testes, and the adrenal glands and the brain. Female production comes from the ovaries and adrenal glands primarily, and from the brain. Testosterone production is controlled and regulated by a small gland in the brain (hypothalamus) called the pituitary gland.
The Major Functions Of Testosterone In The Male Body Include:
- starting and completing the process of puberty
- bone and muscle development
- fat distribution
- growth of body hair, including facial hair
- change of vocal cords to produce the deeper adult male voice
- sex drive (libido) and sexual function
- prostate gland growth and function
- sperm production
After 40 years of age, men’s testosterone production decreases about 1% per year, a process called ‘andropause’. However, up to half of men aged 50-70 years old have a testosterone level below the lowest level for a healthy 20-40-year-old, a condition known as hypogonadism.
Causes Of Low T
Androgen or testosterone, deficiency occurs when the body is not able to make enough testosterone for the body to function normally. Having low testosterone is not a life-threatening problem but it can affect your quality of life. Common causes of low testosterone are primarily testicular, but can also be caused by issues with the pituitary gland and hypothalamus.
Testicular causes may include medical problems that affect the testes such as Klinefelter’s syndrome or undescended testicle, testicular damage, surgery, infection such as mumps, chemotherapy or radiotherapy treatment and medication or toxin exposure.
Pituitary gland causes may include a benign tumour, congenital abnormalities and genetic conditions such as Kallmann’s syndrome, haemochromatosis – a genetic disorder causing excess iron stores in the body, thalassaemia – a genetic disorder that affects the production of haemoglobin resulting in severe anaemia. Other causes include certain drugs and medications such as opiates, anabolic steroids and corticosteroids used as an anti-inflammatory agent, ageing, obesity or excess alcohol consumption to name a few.
Signs & Symptoms Of Low Testosterone
The symptoms of androgen deficiency (low testosterone) often overlap with those of other illnesses and are often different for men of different ages. Some of the common signs and symptoms related to low testosterone include:
Physical Symptoms: decreased lean tissue, decreased muscle size, increased body fat, gynaecomastia (“man boobs”), weight gain, joint & back pain, decreased ﬁrmness of the skin, headaches and anaemia
Energy & Strength Symptoms: frequent tiredness and fatigue, feeling weaker and decreased endurance, poor recovery from exercise
Sleep Symptoms: insomnia, difﬁculty falling asleep, difficulty staying awake and night sweats
Cognitive Symptoms: decreased mental skills, decreased memory function, difficulty solving problems, confused, decreased memory, concentration and focus
Mood & Behavioural: depression, anxiety, social isolation, less motivated, increased irritability, mood changes and mood swings, anger, emotional volatility, lack of self-esteem, confidence, competitiveness and assertiveness
Sexual Symptoms: erectile dysfunction, decreased libido, decreased genital sensation, decreased orgasm experience, decreased ejaculate volume, testicular atrophy (decrease in size)
Low testosterone also causes increased blood fats and clotting, metabolic syndrome, diabetes, cardiovascular disease, osteoporosis, Alzheimer’s Disease, frailty, prostate cancer risk and decreased life expectancy. The number and severity of these signs and symptoms is not related to the degree of hypogonadism, however all can be reversed by testosterone supplementation therapy.
Women also need testosterone for similar reasons, including well-being, libido, sexual functions, mood, self-confidence, memory, muscle and bone strength, nipple and clitoral sensitivity and decreased body fat.
Optimal Levels Of Testosterone
The optimal male blood free testosterone range is 461-740 pmol/L
The borderline male range is 260 – 460 pmol/L
An unacceptable male level is < 260 pmol/L
Normal male saliva testosterone level 127-371 pmol/L
The optimal female blood free testosterone range is 18 – 34 pmol/L.
The borderline female range is 10 – 17 pmol/L
An unacceptable female level is < 10 pmol/L
Normal female saliva testosterone level 24-137 pmol/L
How To Boost/Optimise Your Testosterone
Testosterone production can be increased by nutrients, herbs and medications. Testosterone replacement therapy can be accomplished using a daily skin cream, or by weekly, monthly or three-monthly injections, or by subcutaneous pellets inserted each four to six months. This is decided by your medical practitioner, preferably one with and integrative background.
Testosterone supplementation/replacement can also help control blood pressure, blood sugar and anaemia, so medications for these illnesses may need to be reduced.
There are a number of natural ways to boost your testosterone.
Dietary fat is a key player when it comes to optimising natural testosterone production, however, keep in mind that you still have to be careful of the type of fat that you are eating.
Extra virgin olive oil, avocado, nuts and seeds, coconut oil, egg yolks, natural peanut butter are all great examples of the healthy fats that you could consider adding into your diet.
L-carnitine, selenium and zinc are important nutrients for male reproductive health with low levels associated with suboptimal sperm health. It has been shown that males with a low sperm count typically have lower seminal fluid carnitine levels. Studies have shown that supplementation with these nutrients has resulted in improved quality, motility and viability of normal healthy sperm.
Vitamin D is also paramount for the health of testosterone. Men with higher levels of vitamin D have significantly higher levels of free testosterone compared to those with insufficient levels of Vitamin D.
Bulgarian tribulus (Tribulus terrestris) is used in traditional Ayurvedic medicine as an aphrodisiac and male rejuvenation tonic for virility. Studies have shown that the steroidal saponin content in tribulus is the most important when it comes to its effects on libido and sexual function.
Other ways of boosting your testosterone is through high intensity interval training (HIIT) training, strength training, getting enough quality sleep, eliminating sugar from your diet, reducing stress and losing weight.
Also consider consulting your healthcare practitioner for strategies on how to get your testosterone strong again. Your practitioner should be able to direct you to the right testing, foods, supplements, sleep, stress and workout strategies which will help.
Robbie is a Sydney-based Accredited Practicing Dietitian and Sports Nutritionist who graduated with a Bachelor of Exercise Science and Nutrition and a Masters in Nutrition and Dietetics. He has over 15 years’ experience in the health and fitness industry and is the Director and Co-founder of Australia’s first online Nutrition clinic, TheHealthClinic.com.au.
Robbie has already had a diverse career in nutrition working in the areas of clinical and community dietetics and health, corporate health and private practice. He combines his clinical skills with a functional and integrative approach to treating his clients for best results. He is a men’s and women’s health expert and is regularly featured in the media. Robbie’s other expertise cover fat loss and muscle gain, cardiovascular disease, gastrointestinal disorders, food intolerance, diabetes, metabolic issues, hormone balance and fertility, and sports nutrition.
Robbie’s three key strengths are: achieving optimal health for his clients through an all-encompassing integrative approach to health, his diverse work in different areas of health, as well as interpreting and communicating nutritional science information.