Testosterone 101
What is Testosterone?
Testosterone is a type of androgen (male sex-hormone) that plays a crucial role in male development. Testosterone gives men their masculine features. However, it's important to note that testosterone is present and important in females as well, albeit in smaller amounts.
How is Testosterone Made?
Testosterone is produced through a complex process originating from deep structures in the brain (hypothalamus and pituitary gland) involving various glands and hormones within the human body. The production of testosterone primarily occurs in the testicicles aka the “balls” of men. In women, it is produced, to a lesser extent, in the ovaries and adrenal glands.
Testosterone contributes to muscle mass and strength by promoting protein synthesis, which is vital for muscle growth and repair. It aids in the development of lean muscle mass and is critical for athletes and individuals engaging in physical fitness activities.
Testosterone is crucial for bone density and strength, helping to maintain healthy bones and prevent conditions like osteoporosis. It supports bone growth and mineralization throughout life.
Testosterone contributes to muscle mass and strength by promoting protein synthesis, which is vital for muscle growth and repair. It aids in the development of lean muscle mass and is critical for athletes and individuals engaging in physical fitness activities.
Testosterone is responsible for the development of male sexual characteristics during puberty, such as deepening of the voice, growth of facial and body hair, and development of the male reproductive organs. It also enhances libido and is essential for sexual function in both men and women.
Testosterone influences fat distribution in the body, helping to maintain a healthy ratio of lean muscle to fat. Lower levels of testosterone can lead to increased fat accumulation, particularly in the abdominal area.
Testosterone affects metabolism by influencing the body's ability to burn calories and manage fat. Testosterone is also involved in the regulation of insulin sensitivity and glucose metabolism. Low testosterone levels have been linked to an increased risk of metabolic disorders such as diabetes.
Testosterone levels tend to be highest during the morning, and some research suggests that testosterone may play a role in regulating circadian rhythms.
Important Lab Values to Understand:
Total & Free Testosterone
Total testosterone refers to the overall amount of testosterone circulating in the bloodstream, encompassing both bound and unbound forms of the hormone. Free testosterone is the active portion of circulating testosterone and directly influences functions such as muscle development, libido, and hormonal balance.
Follicle stimulating hormone (FSH)
FSH is a hormone released by the pituitary gland in the brain that is responsible for spermatogenesis (sperm production) in men. Its main function in females is to help regulate the menstrual cycle.
Luteinizing hormone (LH)
LH is a hormone released by the pituitary gland in the brain that is responsible for stimulating the Leydig cells in the testicles to produce testosterone. In females, LH stimulates steroid release from the ovaries, ovulation, and the release of progesterone after ovulation by the corpus luteum.
Sex hormone binding globulin (SHBG)
SHBG is a protein that binds to Testosterone and makes it biologically inactive. High levels of SHBG can cause low free (active) testosterone despite having high total testosterone levels.
Dehydroepiandrosterone (DHEA) / Pregnenolone
Pregnenolone is converted from cholesterol to DHEA. DHEA is produced in the adrenal glands, testes, brain and is a precursor for testosterone. It also plays an important role in total to free testosterone conversion. Low levels of DHEA can result in less total to free testosterone conversion leading to less bioactive testosterone within the body.
Albumin
Albumin binds to and transports hormones, such as testosterone. When testosterone is bound to albumin, it is not as available for the body to use as when it is free, meaning albumin inhibits the function of testosterone.
What are “Normal” levels?
This is not as basic of a question as you may think. Let’s break it down. “Normal” total testosterone can range from 270 to 1,070 ng/dl for men. As you can tell, this is quite a wide range.
Let’s put this into perspective: A 45 year old man with a total T of 300 ng/dL may feel much different than a 35 year old man with a T level of 800 ng/dL, yet both of these individuals would be classified as “normal” on paper. Crazy? We know.
Many different factors should be considered when you are evaluating your levels - what were levels 5-10 years prior? Are you having low T symptoms? What time of day did you check your labs? Assessing your symptoms is most important when considering treating your testosterone levels.
The Impact of Hypogonadism (Low Testosterone)
Both men and women can experience imbalances in testosterone levels. Low testosterone levels can have a significant impact on physical and mental health. Symptoms may include decreased energy, reduced muscle mass, weight gain, low libido, erectile dysfunction, mood swings, difficulty concentrating, and reduced bone mineral density. Low testosterone has also been linked to increased risk of cardiovascular disease if left untreated.
Hormone imbalances, unfortunately, are often overlooked in western medicine and have been deemed as “part of the aging process”. These imbalances have been masked with use of antidepressants for anxiety and depression, statins for high cholesterol, insulin or metformin for type II diabetes; without treating the root cause of the symptoms - HORMONE IMBALANCES.
Let’s give an example - John, a 45 year old male, has noticed significant weight gain since turning 40 years old. He adheres to a healthy diet, but has noticed he is now in the pre-diabetic range and overweight. He has been placed on a statin and metformin. When comparing his testosterone levels over the past 10 years - his levels have dropped from 750 to 271.
Let's look at the science - optimal testosterone levels have been linked to preventing weight gain, increasing muscle mass, and improving overall metabolic health [6]. As your testosterone levels begin to decline, your risk for obesity, diabetes, and other metabolic diseases increases. In the case of John, his testosterone levels declined tremendously which has led to a significant increase in visceral body fat (obesity) which in turn has been associated with insulin resistance (type II diabetes). As you can see, this is all interconnected. Treating the root cause, will help prevent future metabolic disease which have been seen during the aging process.
Can my diet affect my testosterone levels?
Yes! Diet has a critical role in a person’s testosterone production.
Foods that can increase T levels include red meat, lean meats, healthy fats (avocados, nuts, olive oil), zinc, vitamin D, magnesium, and eggs. Foods that can decrease T levels include flaxseed, soy, alcohol, high sugar diets, high fat diets, and processed foods.
Boosting Testosterone Levels:
There are many different methods to increase your testosterone levels and which method is best for you is dependent on your goals. Diet and exercise alone can increase your testosterone levels by 100-200 ng/dL. Now, is this enough of an increase for you? If you’re suffering from significant low T symptoms - this 100-200 point increase is typically not enough to notice a significant difference in your day-to-day lifestyle.
How can Nuform Help?
Blood Work Analysis - Our team can order a full, extensive hormone panel that will tell our physicians exactly what they need to know in regards to your hormone health.
Physician Consultation - Once results are back, you will have a face to face zoom consultation with a Nuform Physician who will break down each value, what it means, and whether or not your deficient, normal, or optimal.
Diet & Lifestyle Adjustments - During your consultation, our physician will recommend a diet and lifestyle plan for you based on your goals and lab results.
Treatment Plans - You will be given a few different treatment options to choose from based on your goals, lab results, and budget. These plans will be customized and tailored to YOU. No “cookie-cutter”, subscription based, one size fits all type of plans.
Nuform’s Testosterone Optimization Options:
Nuform’s Formula T Protocol - Enclomiphene Citrate
Enclomiphene Citrate is an oral capsule used to increase testosterone levels naturally. Enclomiphene works by blocking the negative feedback loop between the testes and hypothalamus, leading to an increase in luteinizing hormone (LH) and follicle-stimulating hormone (FSH) - two hormones responsible for sperm production and testicular production of testosterone. Simply put - enclomiphene works by telling your body to increase its NATURAL production of testosterone.
Enclomiphene therapy is fertility friendly and does not “shut down” your body’s natural hormone production. It is a great alternative to testosterone replacement therapy due to its ability to naturally increase testosterone while avoiding some of the unpleasant side effects of TRT which can include infertility, testicular shrinkage, acne, hair loss, and long term reliance.
Bio-Identical Testosterone Replacement Therapy (TRT):
TRT is exactly what it sounds like - it replaces your body’s natural production of testosterone with synthetic testosterone. TRT is a great option for men who are suffering from low testosterone that cannot naturally produce testosterone (primary hypogonadism) or for men that do not respond to natural remedies. The benefits of TRT are noticeable more quickly than enclomiphene.
There are things to consider…
Because TRT replaces your body’s natural production of testosterone, your body will begin to stop making its own and therefore leading to testicular shrinkage and potential harm to fertility. If fertility is of concern, there is an alternative option - Enclomiphene Citrate Therapy.
Conclusion
Testosterone is a vital hormone for men’s overall health. Without adequate testosterone levels, the body is at a disadvantage to achieve optimal health. Understanding what testosterone is, why it could decline, and how to increase it if symptomatic is crucial to achieving your body’s full potential.
