by Gabriel Ariciu, DC
You probably have heard the radio ads, “Are you lacking energy? Are you tired all the time? It could be low T, you should get checked out.” That is usually how they go, but how do you go about finding out whether it is low T or something else entirely? In this article I am going to break it down for you and give you some options for raising your testosterone naturally. You are not alone either. It is becoming increasingly more common for a variety of reasons which I will talk about as well.
First let’s lay out some of the common signs and symptoms of low testosterone. You do not need all of these to have low T neither is this an exhaustive list. One of the most important signs is a lack of morning erection. But here is the list:
- Low libido
- No morning erection
- Increased body fat
- Loss of muscle tone
- Emotional issues
- Enlarged prostate
- Heart disease
As you can see the signs and symptoms are numerous and can represent other issues too. That is why it is important to get a good, comprehensive analysis done. I will explain what that means by breaking down what testosterone is and its role in the body as well as accurate testing, so you can find the proper practitioner to provide it.
What is Testosterone?
Testosterone is the dominant male sex hormone or androgen. It is found in females too but in a much smaller amount. Therefore, I will be focusing on males in this article. I will write about estrogen in another article later. Like all sex hormones, testosterone is a steroid hormone, which means it is derived from cholesterol. About 95% of it is produced in the testes and the remaining 5% is produced in the adrenal glands by converting DHEA into testosterone.
I think for most of us we associate testosterone with the big bodybuilders. Many of which do use anabolic steroids to build more muscle. That gives you some clue to its function and no I am not advocating for anyone to take steroids. I do not believe the so-called benefits outweigh the risks. But that is beside the point. In addition to muscle building, testosterone has several functions. It is responsible for male secondary sex characteristics such as growth of the penis and scrotum, body hair, and vocal sound depth. As an anabolic hormone, meaning “to build”, it also stimulates muscle growth, bone maturation and increased density. It is responsible for the creation of sperm. It also has been shown to improve mood (1,2), reduce fat and increase basal metabolic rate (3), improved circulation by increasing nitric oxide production (4), and apparently women are more attracted to men with higher testosterone levels (5).
Testosterone production begins with the hypothalamus release of GnRH (gonadotropin releasing hormone). The hypothalamus is a structure within the forebrain below the thalamus that regulates most of our hormones. GnRH’s job is to signal the pituitary gland, in a sense the master endocrine gland, to produce LH (luteinizing hormone) and FSH (follicle stimulating hormone). LH travels to the testes via the bloodstream. It acts upon specific cells called Leydig cells, triggering the production of testosterone from cholesterol. As testosterone levels increase it signals the slowdown of GnRH and LH through a negative feedback loop. Pretty cool how the body works. The brain keeps an eye on many different levels so that everything is functioning within its proper place.
Another aspect of testosterone regulation is SHBG (sex hormone binding globulin). The liver releases this to bind to testosterone making it inactive. It binds about 98% of testosterone in the blood. So the more you have, the less you have of free or active testosterone. Approximately 2% of testosterone is free and able to attach to androgen receptors on cells and signal them to increase protein production among other things. I hope you begin to see the complexity of the testosterone production and regulation. Also, I hope you begin to see that testosterone deficiency can come from multiple areas.
Lastly, I feel it is necessary to explain dihydrotestosterone (DHT) and steroid hormone metabolism. DHT is created from testosterone via an enzyme called 5α-reductase. DHT has a higher affinity or attraction to androgen receptors than testosterone and it can last longer too. It is more androgenic promoting hair growth and masculine characteristics, better mood, more confidence and energy, and increasing libido. However, it is less anabolic than testosterone. Testosterone is much better at inducing muscle growth. It is important to think about this in regards to proper testing which I will explain later on.
Steroid hormone metabolism takes place in phase 2 of liver detoxification or conjugation pathways. Specifically this happens through the glucuronidation and sulfation pathways. Glucuronic acid and sulfite binds with the hormones for metabolism. The conjugated metabolites are then excreted into urine or bile. Speaking of steroid metabolism it is important to point out that testosterone can be converted to estrogen via aromatase enzyme. Men do need small amounts of estrogen but too much can be one of the causes of low T and further issues which I will explain later on. But testing should be the first step in evaluating your testosterone levels.
Testing and Optimal Levels
It may be necessary to run several different labs to get an accurate portrayal of your levels. Some common blood labs are free and total testosterone, DHT, and SHBG. Free and total testosterone should be done by liquid chromatography and mass spectrometry for more accuracy. DHT can be useful to see if you are converting adequate amount of testosterone into DHT or too much. SHBG is also good to see in case you are binding too much testosterone, but this is can also be seen indirectly via free testosterone. If you do not have enough free testosterone you are likely binding too much of it.
Another test and one that I recently took is the Dried Urine Test for Comprehensive Hormones or DUTCH for short. It is done by Precision Analytical. The test includes cortisol, estrogen, and androgen metabolites, enzyme activity, neurotransmitters, and a lot of other things over a 24 hour period of time. It is a very good comprehensive test to get a detailed picture of what is going on. It has helped me put together the big picture of what is happening with my testosterone levels among other things. So I highly recommend this test.
I also think free and total testosterone LC/MS are valuable too. Just to get a picture of what is going on inside the blood. You may have already had these run but I want to talk a little more about total testosterone since it is done most often. The typical reference range is 250-1200 ng/dl. That is a broad range. But what many call “normal” falls within that range. But what is deemed normal often is not optimal. Further, a common misconception is the idea that your testosterone levels should decline with age. They should not and many do not.
While researching more into testosterone I came across a podcast interview talking about testosterone. Chris Walker, the person being interviewed, has devoted his life to researching testosterone because of a medical condition he developed as a young man. He had a pituitary tumor that suppressed his testosterone. After several mishaps and getting frustrated with the medical system, he felt compelled to find a way to increase his testosterone levels naturally. After many long days of researching and trial and error, he was able to raise his testosterone from 11 to over 1000 ng/dl! A dramatic change. It is a fascinating story. Check it out if you have time. In his book, Chris talks about what the levels should be. His book is worth a read too, I will post a link to it at the bottom of the page. Chris breaks down the levels like this:
0-400 ng/dl: low testosterone with many of the classic signs and symptoms
500-700 ng/dl: “normal” levels, typically no signs or symptoms present
700-1000 ng/dl: missing a morning erection is rare
1000+ ng/dl: He believes this is the optimal level for all men. Most men are nowhere near this level.
A radical difference compared to the typical advice men receive with their testosterone levels. But we are not looking for what is typical but improving and optimizing health. And interesting tidbit is that there is some evidence that our ancestors had much more testosterone than us. (6) If they had more than we do now, why the decline?
Our testosterone levels are impacted by several culprits. High cortisol levels, high estrogen, nutrient deficiency, insulin resistance, lack of sleep, chronic inflammation, and environmental toxins take up the vast majority of the culprits.
Having high cortisol levels is kind of a catch-all. Cortisol is often called the stress hormone, you may have heard about it in the news. When we are under stress, cortisol increases to help us deal with the stress. For example, if you are walking in the woods and come across a mother bear with her cubs you are suddenly thrown into to fight or flight mode. This is called the sympathetic response. Your visual acuity is heightened, your digestive processes are slowed, immune system is suppressed, and your heart rate increases. You are ready to fight or run! Cortisol is released from the adrenal glands to come to the rescue. Cortisol plays a major role in glycogenolysis, the processes of breaking down glycogen in the liver and muscle for energy, and and gluconeogenesis, the process of creating new glucose from non-carbohydrate sources such as protein. Very valuable if you need more energy to run away from mama bear. However, long term high cortisol levels is very destructive. It suppresses breakdown of fat, calcium absorption for bone formation, increases insulin resistance, inhibits protein formation, and suppresses the immune system. It leads to brain atrophy, increases susceptibility to neuroinflammation via blood-brain-barrier breakdown, and hippocampal degeneration. Your hippocampus is also very sensitive to cortisol. The hippocampus is the part of your brain deals with memory. High cortisol can damage the hippocampus leading to poor declarative memory, impaired circadian rhythm, and poor visual spatial processing. Cortisol is a very useful hormone but in today’s society it is chronically high and destructive.
However, cortisol almost always secondary to something else. Something raised your cortisol levels. The metaphorical mama bear in your life causing increased stress levels. Usually we can handle most things thrown at us, but over time, as the burden grows heavier, it can become impossible to bear. I will mention several examples of this.
Our diet is first and foremost on the biggest stressors we come up against. We live in a world of sweet treats and processed convenience foods. But that convenience comes with a price. First, we become nutrient deficient. We eat an abundance of nutrient poor food. The typical hamburger and fries has a lot of caloric energy but often lacking in vital nutrients that are needed. Some of us try to combat this with taking a multivitamin but those are poorly absorbed and filled with synthetic, damaging chemicals. But we need the micronutrients. Each of our biochemical pathways need certain nutrients. Take for example the making of testosterone from cholesterol. A host of vitamins and minerals are needed for that pathway. Without them we cannot adequately run the system. It is like a factory without enough workers and supplies. At some point you will come up short and be found wanting.
In addition to the lack of vitamins and minerals we are eating too many processed carbohydrates. This leads to spikes in our insulin throughout the day developing insulin resistance overtime. Insulin resistance leads to lower testosterone levels with a host of other symptoms. Overtime, untreated insulin resistance will lead to type 2 diabetes. Our food, especially the prevalent use of vegetable oils, is often filled with omega 6 fatty acids and trans fats leading to more inflammation. Our meat is filled with hormones and other disrupting chemicals. Fruits, vegetables, and grains are covered with pesticides and herbicides. These wreak havoc on our gut causing dysbiosis and leaky gut further fueling inflammation and causing malabsorption. This further lowers testosterone levels.
Weight gain and insulin resistance upregulate the activity of the aromatase enzyme. Aromatase is responsible for the conversion of testosterone into estrogen. In such a case you can be making adequate amounts of testosterone only to have low testosterone because you are converting it all into estrogen. It is further compounded by xenoestrogens and phytoestrogens. Xenoestrogens are things like pesticides, herbicides, and BPA from plastic. These act as estrogen within our body leading to a more estrogen dominant state. Phytoestrogens are substances from plants most commonly soy that act as estrogen. Our diet and lifestyle are filled with both.
Next our lifestyle compounds the effects of our diet. We often do not get adequate sleep leading to higher cortisol levels. We drink a lot of caffeinated products leading to higher stress levels and less sleep. We do not get enough sunlight and thereby, we do not make enough vitamin D. We consume a lot of alcohol which leads to significantly lower testosterone levels. (7,8,9,10) Tobacco use, specifically smoking, reduces testosterone as well. One study found that declining testosterone levels had nothing to do with aging and everything to do with lifestyle factors including smoking. (11)
As you can see our modern lifestyle hits testosterone levels at several different angles. All of it compounds into why many have low T. It also explains the reason a lot of people have adrenal fatigue. We are under so much stress that the adrenal glands have a hard time keeping up with cortisol production to help us fight off all the metaphorical mama bears. Diet, lifestyle, and behavior change is greatly needed.
Natural Approach to Boosting Your T
I am going to lay out the natural approach we recommend to our patients. Of course, this varies from person to person. This is meant to give you an idea of what is going on. For more specifics, seek out your holistic practitioner. First, diet. I recommend to all my patients a complete switch to a nutrient dense diet. This is done step by step with us guiding you so it is not difficult but it will require work. It is essential however to get the vital nutrition you need. This includes but is not limited to pasture-raised meat and eggs, healthy fats such grass-fed butter and coconut oil, a variety of local, organic vegetables and fruits, and cutting out all processed foods and sugars. That is the first thing I will explain with my patients. It is a necessity.
Secondly, I evaluate them for leaky gut and dysbiosis. That must be fixed before testosterone levels will normalize and optimize. They are often caused by a poor diet and food sensitivities. There are several supplements that help with this including neem and noni herbs that can help clear up the “bad” bacteria in the gut and normalize digestion. A healthy gut flora is essential for the production of certain nutrients such as B vitamins and vitamin K. If food sensitivities arise, they must be avoided at least for a period of a month or more with gradual reintroduction to see if symptoms return.
Alright, enough with the generalities. What will specifically help with testosterone? In order for us to create testosterone we need a certain amount of macronutrients: carbs, fats, and protein. Low carb diets can be detrimental to our testosterone levels and I know they are all the craze right now. Unless you are living in an area like the Arctic and have adapted to that specific climate there is not reason for you to go low carb at least for an extended period of time. Let’s talk about the research. One study compared 2 groups. One group was high carb, low protein. The other was high protein and low carb. At the end of the study, the results showed consistently higher levels of free testosterone, lower SHBG, and lower cortisol levels. (12) Remember, GnRH? I talked about it earlier. When more blood glucose is available, the more GnRH signals the pituitary for more testosterone synthesis. (13) Now, don’t think you can eat any carbs. I recommend starchy vegetables and fruits to be the majority of your carb intake. Grains are notorious for causing inflammation and they can also lower testosterone levels. This does not mean you need to cut them out completely, unless you are sensitive to them, you just need to limit them. Gluten, a protein within wheat, barley, and rye, increases prolactin levels which causes a reduction in testosterone levels. (14,15) Systemic inflammation raises cortisol which leads to lower testosterone, which I talked about earlier.
Onto fats. Fats can be broken down into monounsaturated fats, polyunsaturated fats, and saturated fats. There are some myths surrounding saturated fats that need to end. They have been perpetuated by shoddy science. If you haven’t read my article on cholesterol do yourself a favor and read it. I explain the myth surrounding saturated fat and cholesterol. The real problem we have is polyunsaturated fats or PUFAs. Don’t get me wrong, we do need some PUFA. That is where we get our omega 3 fats, an essential fat. However, we consume a lot of PUFA in the form of vegetable oil, canola oil, sunflower oil, etc. These oils are high in omega 6 fats which lead to inflammatory conditions. Further because of the biochemical structure of the fat it is easily oxidized. This is leads to inflammation and is one of the big underlying factors of heart disease. Again for more info on this check out my cholesterol article. We do need fat in our diet and most of us are starving for it. One study showed a diet high in saturated and monounsaturated fat significantly increased testosterone levels as compared to a diet high in protein and PUFAs, which lowered testosterone. (16)
Protein. The one thing so many athletes desire, but what is the proper amount? It might be lower than you think. Which you can easily deduce from the studies mentioned above. Higher amounts of carbs and fats in comparison to protein raises testosterone levels more than a high protein diet. In another study, researchers found that consuming protein before strength exercise significantly lowered testosterone compared to a placebo. (17) Further, source does matter. Animal proteins are much more bioavailable than plant proteins, meaning you are able to digest and utilize them. (18,19)
According to the research it looks like staying near 20% of your calories from protein optimizes testosterone production. This is a guideline and it can be altered. You may need more or less protein. But not by much. This is about 1g to 1.5g of protein per pound of body weight.
Ok, micronutrients, your vitamins and minerals. Due to soil erosion and modern agricultural techniques, soil has been depleted of micronutrients. The soil bacteria diversity is being destroyed due to pesticides especially roundup which is also a potent antibiotic. We are getting less exposure to probiotics and less micronutrients. This is also the reason for the rapid decline in bee populations. Certain vitamins and minerals are essential to testosterone production. I will name a few important ones.
First, magnesium. Mg is used all over the body. It is used in glutathione production, an important antioxidant. It It has an important role in the citric acid cycle for energy production, and is needed for the synthesis of neurotransmitters such as dopamine. It also increases free testosterone levels by inhibiting SHBG. (20) It is an important mineral. I often find many of my patients needing this and I usually give them magnesium glycinate, one of the best for absorption. That combined with a nutrient dense diet will ensure adequate amounts of magnesium. Cacao, beef, and dark green leafy vegetables are high in magnesium.
Second, zinc. Zn is very important in steroid hormone metabolism. You need it on several levels to turn cholesterol into testosterone. One study compared athletes taking 3mg/kg of zinc compared to a placebo. Those taking zinc had significant increases in testosterone and thyroid hormone levels compared to the placebo which declined in those hormones. (21) In addition to supplementation, make sure you are getting enough zinc from grass-fed steak, shellfish, and egg yolks. Like all supplementation, make sure you are getting it from a good source. I use zinc picolinate. Furthermore, and I think this goes without saying, make sure you get checked out my your practitioner. This is not intended to be medical advice.
Last, boron. B is a trace mineral that can often be overlooked. But it has been shown to increase testosterone levels. In a study from the Journal of Trace in Medicine and Biology, the researchers gave the subjects 10mg of B daily. After one week, the subject’s free testosterone increased by 28%, DHT increased, and estrogen and inflammatory markers decreased. (22) Amazing results. Boron is high in raisins, avocados, and brazil nuts.
This was not meant to be exhaustive list by any means neither is it meant to be medical advice. But I hope it may help you get an idea of what is needed to determine if you are low in testosterone and what you can do about it nutritionally. Some other important nutrients that may be needed are vitamin A, B vitamins, vitamin D, selenium, and choline.
Last part of treating low T naturally is lifestyle. We are sedentary, lack quality sleep, and exposed to environmental toxins. One of the best things we can do is get moving. We just need to get out and walk. Enjoy nature. Go on a hike. In fact, hiking in a forest can decrease inflammation and boost your immune system. But in regards to raising your T levels, you need to strength train. Researchers found that strength training increased resting testosterone levels by 40% in a group of males who never strength trained before. (23) Other studies show a similar result. (24) So a good lifting program is very helpful in increasing T levels. Next, make sure you are getting enough sleep. Lay off the caffeine. Darken your room, turn down the temperature and snuggle in for at least 8 hours. You need quality rest for approximately 8 hours to optimize T levels. (24,25) Lastly, remove all environmental toxins by getting rid of plastic food and water containers. Go organic. Get a proper water filtration system to remove fluoride, chlorine, pharmaceuticals, and heavy metals. Use natural skin care and hygiene products.
That’s it. For more information or to get assessed, get ahold of a holistic practitioner. Everyone is different, so their needs are different. Hopefully this has given you enough information that you can take action now. Many men are dealing with low T and you don’t need to live with it. It is not normal for your T levels to decline with age. If you are tired and dragging like I have been then do something about it! As always we are here to serve and there is always hope!
Master Your T, by Chris Walker