As a doctor with male patients over age 40, I hear many complaints about fatigue, little or no sexual energy, weight gain, irritability and/or depression. When they remark that their symptoms are just part of growing older and that there’s nothing they can do about it, I like to tell them about my 89-year-old neighbor George.
George is a testament to healthy male aging. He is a brilliant conversationalist, full of vitality, with never more than the occasional mild cold. He pursues his passion of traveling the world like a much younger man always accompanied by his lovely lady friend. One day I joked that he must have found the fountain of youth on one of his travels. In response, George told me that he had always eaten a good diet, exercised, and taken vitamins, but had also been on testosterone supplements for many years! I wasn’t surprised, as I knew that good testosterone levels were very important to a man’s physical and emotional well-being at any age, especially as he grows older.
In this first of two-part series, I’d like to talk to you about deficiencies in the male hormone testosterone, the causes and the symptoms. Part II will deal with methods of testosterone supplementation and some things you can do to ensure that your testosterone levels stay optimal.
First let’s look at a few things that can contribute to low testosterone.
Modern World Full of Estrogen
There have always been reasons why a man’s testosterone level might be too low including genes you were born with, diet/nutritional deficiencies, and just plain aging in general. We’ll go into more detail about these in Part II. But there is one specific factor I’d like to address here; a side effect of modern technology, that has become a critically important health issue: environmental.
In today’s modern world, we use fertilizers to keep our lawns green, pesticides and hormones to grow our food, and have landfills full of plastic from our microwave dinners, water bottles, and food containers. All of these factors have one thing in common: they contain xenoestrogens, an environmental version of the female sex hormone estrogen. These estrogens get into our food and water supply and can imbalance a man’s testosterone levels. In fact, a 20 year study of testosterone levels in men showed that testosterone levels had dropped 17% overall in the population between the years 1987 and 2004.
Too much estrogen in a man’s system can result in undesirable feminizing effects such as:
- Enlarged breasts
- Obesity – particularly belly fat.
- Inability to get or sustain an erection
- Low sperm count
- Decreased/lighter facial/body hair
Because they are so widespread in our environment and in our food packaging, it’s near impossible to avoid coming in contact with environmental estrogens. However, here are some simple things you can do every day to avoid ingesting an overabundance of them:
- Avoid all pesticides, herbicides, and fungicides. Wash your fruit and vegetables well with a special wash you can buy in most produce departments.
- Use a good water filter on your tap water.
- Buy hormone free meats and dairy products if possible.
- Do not microwave food in plastic containers or use plastic wrap to cover food for microwaving. Heating allows the chemicals in the plastic to leach into your food. Instead buy brands that use only cardboard warming trays. Use wax paper to cover your food.
- Use glass or ceramics whenever possible to store food.
- Do not allow plastic containers to stay in the sun, especially those containing soda or drinking water. Exposure to heat releases chemicals into your beverage. Discard them if they are heated and do not drink the contents of the bottle.
Symptoms and Health Concerns of Low Testosterone
Testosterone can start to decline in men as early as age 30 but usually it starts in middle age, roughly the late 40’s through mid-60. Current research estimates that 2-4 million American men have low testosterone levels and only about 5% of them are being treated for it. Having low testosterone levels not only make you feel miserable, they can also contribute to some serious diseases like:
- Heart disease
- Prostate problems
- Adult onset diabetes
Many of my male patients come in with the following symptoms and I suggest that we do a simple blood test to take a look at their testosterone levels. Symptoms include:
- Unusual fatigue (though this can accompany many health issues)
- Erectile dysfunction (may be testosterone or heart related)
- Sleep disturbance (too much, not enough)
- Decreased/lighter body hair
- Decreased stamina, muscle mass, physical recovery after activity
- Weak bones, fractures
- Weight gain/fat distribution (breasts and belly)
- Memory loss
- Psychological symptoms can include decreased motivation, impaired judgment, foggy thinking, lack of aggressiveness, apathy.
Should You Take Testosterone?
If you suffer with any of the symptoms mentioned above, a simple blood test can determine your testosterone levels. Although younger men with low testosterone levels frequently receive testosterone injections, there is some controversy amongst doctors whether to give it to older men, even though their symptoms and blood tests may warrant it. Most of the concerns arise from previous beliefs that higher testosterone levels put men at higher risk for prostate cancer. However, the Journal of the National Institute of Cancer recently reported that there is no real cause and effect between higher testosterone levels and prostate cancer.
In the past, the widespread use of a form of testosterone in anabolic steroids amongst athletes and bodybuilders, and its negative effect on heart health was also a concern. However, like my neighbor George, many men have taken testosterone supplementation for years without adverse effect. In fact, it has allowed them to stay active and healthy into advanced years. More about methods of natural and synthetic testosterone supplementation will be discussed in Part II.
Although decreasing testosterone levels are a natural part of getting older, you don’t have to live with the quality-of-life affecting symptoms it can cause. Just as many women take estrogen replacement therapy in menopause and regain many health benefits, men too can benefit from supplemental testosterone. As I tell my patients, it is absolutely possible to regain, or maintain, healthy testosterone levels so you can have energy, a satisfying sex life, optimal weight, and a bright mood that puts you back in the game!
Mark Rosenberg, M.D.