Updated: Nov 2
As we head into November with the ongoing pandemic, I wanted to focus on how to help men maintain their hormone health as they age and show how hormones can be impacted by lifestyle choices.
Stress is a major factor contributing to men's (and women's) health issues for a variety of reasons, one being a resulting hormone imbalance. For men that means declining levels of testosterone. This is widely interpreted as a normal phenomenon of aging but it is actually not normal for a man to have low testosterone.
A man's body runs on testosterone.
Besides stress, low testosterone can result from obesity, abnormal blood sugars or diabetes, exposure to toxins - including heavy metals and endocrine disruptors like plastics , styrofoam and pesticides, among others - hypothyroidism and some would say aging, but the graph below from Clinical Endocrinology tells us that men have "normal" testosterone levels up to age 80.
And if you know a little bit about how these ranges are calculated, you can see that 'average' testosterone only changes from 584 +/- 2.5% at 40-49 y.o. to 488 +/- 2.5% at ages 70-79 yrs of age, assuming a bell curve distribution to determine the reference ranges.
And who wants to be just average? Most men I treat with testosterone feel better when their free testosterone is above 14 pg/mL or in the top quartile of the reference range (top 25% of the range).
So what are some of the signs of declining testosterone in men?
There may be a change in mood, a slight decline in energy and strength, a noticeable change in sexual function (lack of ability to achieve or maintain erection) and/or sex drive (lack of libido or desire), inability to build muscle mass, and/or lack of 'mojo' or motivation.
The first step to achieving your optimum testosterone level is to recognize that there is a problem and take steps to see if a few lifestyle changes result in improvements in symptoms.
Basic changes that can make a huge difference include:
1. Exercise - regular exercise, at least 150 minutes weekly, can dramatically improve testosterone levels. Start with weight training 30 minutes for 5 days a week and work up from there. A good online option is FitnessBlender.com if you can't get to the gym.
2. Nutrition - eat whole foods and avoid processed and fast foods. Eat organic whenever possible. Check out the Environmental Working Group's website for a list of the 'Dirty Dozen' foods that have the highest levels of pesticides and the 'Clean 15' with the lowest levels. Avoid alcohol. If you are pre-diabetic or diabetic then get your blood sugar under control and your Hemoglobin A1c under 5.7 by following a low glycemic or low-carb diet, see a Functional Medicine practitioner for personalized advice on diet and supplements to support a lower average blood sugar. See below for a great nutritious shake recipe.
3. Stress - stress management is a huge piece of the puzzle in restoring normal testosterone and function. It is important that the adrenal glands not be compromised as increased demand for cortisol can affect the ability to make testosterone. Plan to incorporate a daily mindfulness exercise to help balance stress and lessen impacts of stress on testosterone levels. For most men this means making time for daily meditation, breathing exercises or some type of mindful activity that they enjoy (listen to music or play music if you have that talent, read a book for fun, walk the dog, paint, do woodworking, etc) and getting adequate sleep - 7- 8 hours of quality sleep nightly. For more on hormones and stress management go here or here.
4. Supplements - nutrition is always key to maintaining health and the production of testosterone is optimized when the body has plenty of the following:
To ensure you are getting these and other vital nutrients essential to hormone health, it is important to have a good basic supplement regimen as we cannot get therapeutic doses of these nutrients through food alone.
A list of our recommended supplements are available here, at our Elevate Fullscript online supplement store. If you don’t already have an account, create a login ID and password to view the recommendations.
If your testosterone levels are still suboptimal after committing to lifestyle changes, consider scheduling with a functional medicine provider who specializes in male hormones to discuss hormone replacement therapy options.
Karen Miller, MD is an OB/GYN and Certified Functional Medicine provider who specializes in integrative women's health and complex medical illness. She is medical director and co-owner of Elevate Functional Medicine.