Testosterone Supplementation in Men: Fad or Well-founded?
The term used to describe declining testosterone levels in men as they age—andropause—is not really the same thing as menopause in women. That’s because the decline in male hormones happens over a longer period of time.
According to the Mayo Clinic “testosterone levels gradually decline throughout adulthood — about 1 percent a year after age 30 on average.” It’s estimated that as many as 5 million men per year suffer from low testosterone levels.
The Role of Testosterone
Among other functions, testosterone is a stress-handling hormone in men. It makes men feel more vital and plays a number of other critical roles including sperm production, achieving and maintain erections, supporting liver function, bone formation, and blood cell production.
Symptoms of low testosterone include:
- Decreased muscle mass
- Reduced endurance
- Decreased libido
- Nervousness & depression
- Hair loss
Excess levels of testosterone can lead to an overgrowth of the prostate gland and can lead to aggressive behavior.
Getting an Action Plan
If you think you have low testosterone, it’s important to verify this with an accurate diagnosis. Because many conditions can mimic symptoms of testosterone deficiency, you’ll want to rule out other causes of your symptoms.
Male hormone levels can be measured easily via blood or saliva tests, but saliva tests are superior in their ability to measure active hormone levels in the body. Hormones in the blood are largely inactive because they are bound to proteins. Blood hormone levels must then be extrapolated to calculate active levels or a given hormone.
In my office, I often order a male hormone panel from DiagnosTechs to get a more detailed picture. In addition to assessing levels of testosterone, this test also assesses levels of hormones like DHEA, progesterone, and androstenodione.
Testosterone Delivery Methods
Though many forms of testosterone supplementation exist, transdermal gels seem to be the most efficient delivery method. That said, the cost of this method is more expensive than others. If you think you have low testosterone, consult with you urologist or primary care physician for more information and recommendations.
A Role for Acupuncture & Herbs
Acupuncture can be used to support mood and energy and can also promote blood flow to the low back and reproductive areas. In addition, Chinese pulse diagnosis is an excellent tool for identifying any ‘kidney deficiency’ that may be contributing to the problem. Kidney yang deficiency in particular, is a condition that correlates with low libido and declining levels of testosterone.
The Chinese are famous around the world for their herbal ‘ yang tonics’ like deer antler, tiger bone, and sea cucumber (pictured here). Fortunately, many of these banned substances have very good sustainable substitutes.
Tribulus: A Western Herbal Alternative
In my practice I use an herb called Tribulus terrestris. As far as I know, the only legitimate species comes from Bulgaria and the active ingredients come only from the aerial parts of the plant (leaves and stems).This limited availability has led to a multitude of fakes on the market which are often made of different species or from the root.
How Tribulus works:
Tribulus is thought to work by stimulating androgen receptors in the brain, which in turn tell the pituitary gland to make more lutenizing hormone (LH) in men. LH stimulates cells in the testes to produce testosterone. Just as with medications, herbs like tribulus should be taken under the care of an herbalist or qualified physician. Tribulus should also be used with caution by men with prostate issues including benign prostatic hypertrophy (BPH) and prostate cancer.
The Risks of Supplementation?
Hormone production in the body is a highly sophisticated process and supplementing can have unintended results. In some cases, supplementing with testosterone can lead to elevated levels of estrogen. This occurs when aromatase—an enzyme found in fat cells—converts testosterone to estrogen. It stands to reason that overweight men are at greater risk for this to occur. In addition, testosterone may be converted to another male hormone: DHT (Dihydrotestosterone). Elevated levels of DHT are associated with excess prostate growth.
Balance Is the Key
Active hormones in the body are so potent that they are measured in parts per million (ppm) and sometimes parts per billion. So supplementing with an active hormone—that which can be used immediately by the body—can be risky business. Any hormone supplementation program should be accompanied by active monitoring of hormone levels in the saliva (ideal) or blood. I suggest a 3-month interval between testing along with monthly evaluation of symptoms. An even better scenario would be to have a baseline measure of hormone levels before any symptoms occur. It may also be prudent for the prostate to be assessed in advance of any hormone supplementation.