Testosterone Replacement, Natural & Unnatural Part 1
In 2017, Forbes magazine published an article provocatively entitled “You’re Not The Man Your Father Was”. The articles cited a 2007 study from the Journal of Endocrinology and Metabolism (JEM) which found that testosterone levels have dropped approximately 1% per year beginning in the 1980’s. This would mean that the average 60-year-old male today in 2020 has testosterone levels 35% lower than a 60-year-old man in 1985. A study of Danish men showed similar results. Other studies have made clear that obesity and physical inactivity are also on the rise in young men and women. Beyond the inference that we are less manly (whatever that means) these days, do these findings matter? If you watch TV or listen to the radio, then you will no doubt have heard that having “low T” is something the medical community appears concerned about and you should have it addressed. Are there compelling health reasons to look into this, or is this an example of the dangers of direct-to-consumer pharmaceutical advertising?*
To answer these questions, we need to first understand what testosterone is and the functions it enables.
Testosterone is a hormone manufactured in the testes in men, and to a much smaller extent, the ovaries in women, and in men is responsible for the development of male sexual characteristics in fetal development and puberty. In adulthood, it is essential for the production of sperm, the manufacturing of red blood cells, bone density, muscle strength and mass, fat distribution, libido, and the presence of facial and body hair. In short, what makes a male male, genetically speaking. Testosterone levels do begin to naturally diminish, as with most other hormones, as we age. Low testosterone, also known as hypogonadism, has been associated with diminishing sexual desire, infertility and erectile dysfunction. It has also been associated with increased body fat, increased fatigue, decreased bone density, muscle mass and strength, as well as diminishing body hair. Emotional consequences of low T are decreased motivation or self-confidence, sadness or depression and cognition is sometimes affected in the form of memory issues and concentration.
As bad as that sounds, it gets worse.
A 2018 study from the journal Scientific Reports showed low testosterone is linked to having 2 or more of the following chronic diseases, even after adjusting for obesity: high blood pressure, arthritis, cardiovascular disease, type-2 diabetes, stroke, pulmonary disease, clinical depression, high cholesterol and high triglycerides. As you will see if you read on, it is difficult to determine if low T causes these diseases or the diseases cause low T, but one thing is certain- having these diseases makes it much more likely that you will die sooner. Because low T causes diminished strength, the results from a 2015 study published in the medical journal Lancet is also very troubling. This study demonstrated that diminished grip strength is a stronger predictor of death than systolic blood pressure and was linked to substantial increases (7% for every 5-kg decrease in strength) in the risk of heart attack, and stroke (9%), with findings fairly consistent between different countries and socioeconomic levels. This is concerning because studies have shown that the average 20-34 year-old man’s grip strength is now 98 pounds, compared to 117 pounds on average for a similarly aged man in 1985.
So yes, low testosterone is linked to early death, most notably cardiovascular causes, and needs to be addressed for those reasons alone, not to mention the damage from diminished sexual performance, depression, lost motivation and memory problems. Now that COVID-19 is part of our reality, the importance of being as healthy as possible in all ways (mentally, physically, emotionally and spiritually) is more apparent than ever.
The authors of the 2007 JEM study on which the Forbes article was based, concluded that the causes of the testosterone drop were likely many, but probably due in very large part to the drastic increase in environmental toxins, including pesticides, parabens and BPA. The increasing prevalence of cancers of the endocrine system, including testicular cancer, as well as increasing rates of diabetes and obesity, mirror the increasingly toxic nature of our environment.
* Known as DTCPA. The US, New Zealand, and Canada to a limited extent, are the only countries in the world that allow this type of advertising. The pharmaceutical industry spent approximately $207 billion in 2018 on such ads, with an estimated return on investment of 5:1.
Unnatural Considerations
We all now live in a much more toxic environment- mentally and physically. The pace of modern life has now, with COVID, been revealed to be something not only incredibly stressful, but something we may not have been aware we didn’t want. The stress of a pandemic and the myriad concerns it has introduced are not helping.
Physically, the chemical burden has increased dramatically. In 1962 the book Silent Spring brought the dangers of DDT to mass consciousness and it was banned in the US in 1972. It was first used in 1943. The chemical persists in our bodies for 20 years if we stop ingesting it, however, it is still manufactured in India and used for malaria and dengue fever control in many third world countries from whom we buy food and clothing. DDT has been shown to still rain down in this country after being brought by weather from those countries, and, along with its metabolite DDE, has been found everywhere in the world, including the breast milk of Inuit women living near the Arctic Circle. A potent neuroendocrine disruptor, it is now associated with many cancers, including pancreatic, breast, liver and lung.
The Chemical Abstract Service now lists 160 million registered chemicals in its database, up from 92 million in 2014. The EPA cannot test all of these and instead relies on computer modelling and prior data to determine safety, therefore risks only become apparent after years and possibly decades of damage. This is how asbestos, PCB’s, CFC’s, dioxin and others were finally restricted. Unfortunately, we are bathed in these chemicals (often literally as you will see) and they slowly accumulate in our tissues, especially our fat. One hundred years ago, this was not the case and it is part of the price paid for our technological advancement.
The Center for Disease Control’s Fourth National Report on Human Exposure to Environmental Chemicals showed 100% of those tested had the rocket fuel ingredient perchlorate in their blood, and nearly all had fire retardant chemicals. Both are linked to tumors of the thyroid, and fire retardants are also linked to tumors of the kidney, infertility, hyperactivity and interfere w/brain signaling. Ninety percent had BPA in their urine. These chemicals all damage endocrine and immune systems, causing neuroendocrine disease by blocking hormone receptors, imitating different hormones like testosterone, interfere with signaling and compete with the binding of the body’s own naturally occurring hormones. The rise in thyroid disease, diabetes, obesity and cancers mirrors the growing prevalence of these chemicals in our environment.
The top 12 endocrine disruptors according to the Environmental Working Group’s website:
BPA (bisphenol A): imitates sex hormones in the body. Found in plastics, thermal paper receipts and food can linings.
Dioxin: disrupts sex hormone signaling, impacts immune and reproductive system. Byproduct of industrial processes. Found in many animal products as it pollutes the food chain.
Atrazine: herbicide for corn crops and now a water contaminant. Linked to breast tumors, delayed puberty and prostate inflammation.
Phthalates: causes testicular cell death and is linked to low sperm counts and birth defects in the male reproductive system. Found in plastic food containers, plastic wrap made from PVC, and in personal care products as “fragrance”.
Perchlorate: rocket fuel ingredient which contaminates produce and milk. Adversely affects thyroid due to competition with iodine.
Fire Retardants: aka polybrominated diphenyl ethers (PBDE). Disrupt normal thyroid functioning, can have 3 to 10 times higher concentration in US than in Europe. Very persistent and accumulate over time.
Lead: old paint and ground contamination. Disrupts normal hypothalamus action and toxic to the brain.
Arsenic: water contaminant that interferes with blood sugar regulation as well as adrenal gland function.
Mercury: naturally occurring as well as through coal-burning. Compromises sex hormone signaling, interferes in fetal brain development, and damages pancreas leading to diabetes. Primarily found in seafood and dental amalgams.
Perfluorinated chemicals (PFC’s): linked to decreased sperm quality, low birth weight, thyroid and kidney disease. Found in non-stick cookware and stain-resistant coating on carpet, furniture and clothing.
Organophosphate pesticides: alters thyroid hormone levels, alters testosterone signaling, among others.
Glycol ethers: associated with lower sperm counts, asthma, blood abnormalities. Found in cosmetics, paint solvents and cleaning products.
As you can see, testosterone and sperm production are affected by several of these chemicals. Given the increasing rate of neurodegenerative disorders, cancers, obesity and diabetes, it is apparent these chemicals are impacting more than testosterone levels. Our bodies recognize these chemicals as unsafe and sequester them in our tissues- primarily our fat. EPA biopsy studies of human fat show 100% contained PCB’s, dioxin, xylene and dichlorobenzene.
The body needs the fat to store these chemicals, and often preferentially stores calories as fat to maintain the safe storage of these chemicals. Unfortunately, higher rates of obesity are linked to suppression of testosterone which is why detoxification is a necessary step in successful weight loss and testosterone recovery. More about that later.