Sunday, October 27, 2019

Testosterone - the sequel

This post will be short and sweet as I am packing to go to the ILADS conference in Boston. Woohoo!

This graphic is from Spectracell labs and covers almost everything I'm discussing today - how nutrients affect hormone production, specifically testosterone.

Some of these nutrients you would expect to get in your regular diet but the 'Standard American Diet' or SAD is dramatically void of the required nutrients because of over processing and soil depletion from over-farming.

In my Functional Medicine practice I test for vitamin and mineral levels and frequently see many deficiencies. Most common is vitamin D deficiency. The reference range is usually around 30-100 ng/ml (very wide) but optimal levels are above 50, which I rarely see in people who do not supplement. Vitamin D regulates the production of testosterone (acting like a hormone) so low vitamin D means low production of testosterone.

Vitamin K2 (there are two main forms of K - K1 and K2) is necessary for the enzyme which drives testosterone production to work so a deficiency in K2 will result in lower testosterone. There are now some high quality supplement manufacturers that are offering vitamin D3 and K2 in a combination form since both are also needed for maintenance of strong bones by helping move calcium into your bones. Talk to your integrative or functional medicine doctor about what dose might be right for you.

Most people do not need to supplement vitamin E as it is found in olives, olive oil, avocados, almonds, shrimp, squash, sunflower seeds, spinach and broccoli. Doses above the minimum recommended amounts for a long period of time may lower testosterone.

Folate and B6 are important B vitamins that support healthy testosterone levels. Here is a report on an association between low folic acid levels and erectile dysfunction. Leafy green vegetables like spinach, oranges and other citrus fruits and whole grains are good sources of folate.

B6, or pyridoxine, is found in pork, poultry, fish, grains, eggs, soy beans, peanuts and vegetables so you likely get enough in your regular diet. Don't take more than 10mg daily unless instructed to do so by a doctor.

Zinc and Magnesium are two important minerals that affect testosterone. Both are commonly deficient in my patients. I usually check RBC levels of both, as well as serum levels. Zinc should be around 90-110 mcg/dL optimally and is found in meat, shellfish(oysters!crab!yum!), legumes (like chickpeas and lentils), nuts, seeds, dairy, eggs and whole grains.

Magnesium levels should be about 2 mg/dL You can get it by eating spinach, almonds, tofu, dark chocolate, bananas, avocados and quinoa. A deficiency in either of these important minerals may cause low testosterone. If you supplement with magnesium you should get either glycinate or citrate chelates for better absorption, Magnesium threonate crosses the blood brain barrier and can support brain health. Magnesium sulfate (Epsom salt) is nice for sore muscles, twitchy muscles and detox.

Carnitine is found in red meat, poultry and dairy. beans and avocado. It may prevent the loss of testosterone after strenuous activity and may increase dopamine levels which usually correlate with testosterone levels. If you are vegan you may need to supplement with acetyl-l-carnitine.

Last but not least, vitamin C may be protective of the prostate in the presence of testosterone related tumors. A good maintenance dose of vitamin C is 1000mg daily. I recommend 2000mg daily in flu season for the immune boosting benefits. Vitamin C is found in broccoli, cauliflower, kale, oranges, kiwi, strawberries, cantaloupe, papaya, red, green and yellow peppers, sweet potatoes and tomatoes.

Lifestyle also matters - exercise, especially weight lifting, and eating a diet without sugar or alcohol and keeping blood sugar in the normal range helps to improve testosterone levels. If you or a loved one has noticed low energy, loss of sex drive, loss of muscle mass, 'man boobs', depression or moodiness, have your/his testosterone levels checked and help him get his mojo back with lifestyle and dietary modifications and supplement support.


Sunday, October 6, 2019

Testosterone - the nitty gritty

Whole books are written just about the male hormones so I'm going to try to cover the basics of testosterone for men and women.

<--------ORGANIC FOOD - helps keep hormones in balance!

Testosterone is the determining hormone of male external sexual characteristics. If an XY embryo has a defect that doesn't allow the production of testosterone then the external genitalia will be female by default.

Testosterone is secreted by the ovaries in women, testes in men and by the adrenal gland in both sexes. It will provide a healthy libido, help maintain bone density, prevent loss of muscle mass (common in aging), increase muscle strength, contribute to motivation, allow you to remember by maintaining the neural pathways that affect memory, increase fat burning and improve skin tone.

In men testosterone influences sperm production, health of the prostate gland and is an important contributor to mood and motivation.

So how can we balance this important hormone? First let's look at symptoms of imbalance:

Women might notice the following issues if they have too much testosterone -

  • Hirsutism (unwanted hair, especially on the face and chest)
  • Increased abdominal fat
  • Acne
  • Scalp hair loss
  • Irritability
  • Rage or increased anger
  • Sagging breasts or decreased breast size

If they have LOW testosterone, women might notice -

  • Loss of muscle mass
  • Fatigue
  • Low or absent libido
  • Low bone density
  • Increased body fat
  • Decreased motivation
  • Depression
  • Hair loss
  • Dry skin or poor elasticity
  • Loss of vitality
Men usually suffer from low testosterone as they age for various reasons and may experience

  • Increased abdominal fat
  • Loss of muscle mass
  • Erectile dysfunction
  • Low libido
  • Impotence
  • Fatigue
  • Bone density loss
  • Prostate problems
  • Sleep disruption
  • Loss of vitality
  • Increased risk of heart disease and death
  • Depression
  • Hair loss
  • Dry skin and/or poor elasticity
Occasionally men taking exogenous testosterone will have too much testosterone and have

  • Increased agressiveness
  • Acne
  • Increased temporal or scalp hair loss
  • Prostate enlargement
  • Increased hemoglobin and red blood cell numbers
  • potential for increased chance of cancer

So how can we keep it in balance? Most importantly both men and women should remove xenoestrogens (hormone disrupting chemicals) from their lives as much as possible. Most of the exposure comes from increased use of pesticides (another reason to eat organic) and other agricultural chemicals. Phthalates (see here for more info) found in cosmetics, soaps, some plastics (including sex toys) can cause suppression of testosterone production.

Since the adrenal gland is involved, stress management (discussed here) is key to balancing testosterone production. I also recommend doing an adrenal stress test to see if you need adrenal support supplements. Some of these supplements increase cortisol production (which could be bad if you already overproduce) and some decrease or balance cortisol production (which you don't want if you are already too low) so testing is critical to getting the right adrenal support.

The third 'pillar' of testosterone balancing is eating a LOW glycemic diet. Keeping your A1c below 5.7 will improve your hormone balance by lowering insulin. Regular exercise will also lower insulin and improve hormone balance.

For men, exercise can actually raise testosterone levels back to normal if insulin is in the normal range. For men worried about heart disease, exercise is important to improving cholesterol and the lowering the risk of heart disease. Men should try natural methods of cholesterol management before statins as they have been found to lower testosterone production.

To sum up - the following will help improve testosterone balance:

  • Clean up you diet and environment to avoid EDC (endocrine disrupting chemicals)
  • Practice stress management (including getting enough sleep)
  • Have your adrenal gland function tested by a Functional Medicine or Integrative health practitioner
  • Eat colorful organic foods in a Low Glycemic way
  • Exercise at least 150 minutes weekly
  • Have sex regularly
  • Eat enough healthy fats and complex carbohydrates and protein
  • Get exposure to morning sunlight
These are just the basics of keeping a healthy testosterone level. See a Functional Medicine or Integrative practitioner for help if you are doing these things and still experiencing symptoms.

Hope you are having a break from the heat today - get outside and enjoy it!

Dr. M