Low Testosterone – A New Epidemic?

Low Testosterone – A New Epidemic?

A recent editorial in the New York Times was titled “Overselling Testosterone, Dangerously.” It referred to a recently published study done by researchers at UCLA and NIH.

It says “testosterone doubled the risk of cardiovascular disease in a cohort of more than 7,000 men who were 65 or older, essentially confirming findings in previous studies…..Testosterone almost tripled the risk of heart attacks in a group of more than 48,000 middle-aged men with a previous history of heart disease.” The Times goes on to say that “many American men have embarked on a perilous course of over treatment…..testosterone is now being prescribed to men who are simply reluctant to accept the fact that they are getting older…..doctors are prescribing testosterone without even ascertaining whether a patient’s testosterone levels are actually low…..The reason seems clear. Drug companies have shamelessly propagated the notion…..that their testosterone-boosting product can overcome a supposed disease called ‘low T,’ which is characterized by feelings of fatigue, loss of sexual drive, depressed moods, an increase in body fat, and a decrease on muscle strength, among other symptoms……The overselling is reminiscent of the reckless overprescribing of hormone replacement therapy to millions of American women as an anti-aging elixir…..Men need to recognize the dangers of seeking a quick-fix for aging.”


To me this is puzzling on many levels. The Times recognizes that hormone replacement therapy for men (and women) is dangerous, but rather than stopping there and recommending alternative approaches for the people who need help, they go on to mock everything and everyone related to the “supposed disease called ‘low T.’ They belittle the patients who seek help for problems that, according to the Times, they should accept as merely normal aging. After all, their reasoning seems to go, if low T really is a problem, then wouldn’t hormone replacement help? Since it doesn’t help, but harms, the doctors and patients must be deluding each other, everybody manipulated by the drug companies. Now, I don’t fault them for demonizing the drug companies. They often deserve it. However, in this case the Times somehow made the leap from criticizing a dangerous treatment to mocking the need for such treatment. But what if the condition is real but the treatment is what’s wrong?


It’s true, hormone issues affect men. Many doctors call the syndrome related to male hormone imbalance “Andropause.” One doctor described Andropause thusly: “the typical story is of a middle aged man who gradually loses his sex drive, strength, energy, and enthusiasm for life and love…..An all-enveloping mental and physical tiredness descends on him, often for no apparent reason. He [becomes] a negative, pessimistic, depressed bear with a sore head, and is increasingly difficult to work with….. no amount of encouragement or urging will improve his performance……family relations tend to become increasingly strained, and social life and activities dwindle and wilt. His sexual life is usually a disaster area…..This creates a downward spiral of failing function both in the bedroom and the boardroom.”
Maybe you know someone like that. I don’t think this is an imaginary problem.


The answer is to balance hormone function without giving actual hormones. How is this possible? The approach we use is called Functional Medicine. It uses nutritional treatment rather than drugs. And this situation clearly illustrates an important difference between the traditional medical approach and the Functional Medicine approach.


The Functional Medicine approach to the symptoms attributed to “low T” would first measure the levels of testosterone to see if they really are low, or better, compare the levels of testosterone, estrogen (which men have as well as women), stress hormones, thyroid hormones, and other possibly relevant data. If there are any imbalances, a Functional Medicine doctor will supply treatment to help your body rebalance its own hormones, if possible, and would only consider hormone replacement as a last resort. Often there are nutritional programs which can help.  One trouble with hormone replacement is that since your body makes hormones as a function of how much is already floating around, when you take hormones to replace what seems to be missing, your body will reduce the amount of hormones it manufactures, making catching up and rebalancing harder. And, hormones work by acting on structures called receptors. Sometimes, when you take too much replacement hormone the receptors dial down their sensitivity, and you end up with less hormone action even if you have more hormone. For these reasons, I believe that hormone replacement should be used only when necessary, to support a gland that has failed. I think the Functional Medicine approach makes more sense and should be tried first.


Testosterone doesn’t act alone. Men, just like women, have estrogen as well as testosterone, and it’s the balance between testosterone and estrogen, not just the level of testosterone, that determines your health. In men, extra estrogen can come from environmental exposures of various kinds, and, more commonly, from the conversion of testosterone into estrogen by a substance secreted by fat. The more fat you carry, the more of your testosterone, dwindling though it might be, is converted into estrogen. This means that all the factors that cause you to be overweight can also lead to Andropause. And the higher your stress, the more you convert your testosterone to estrogen. So whatever increases your stress can contribute to Andropause.


Andropause and the factors that lead to it can contribute to diabetes, heart disease, and even Alzheimer’s disease. They are all connected. So low testosterone or Andropause have to be considered as one factor among many that determine your overall health and your predisposition to develop serious health problems. Interestingly, these are some of the same problems that develop in patients given hormone replacement therapy. Fortunately, Functional Medicine hasn’t led to the same problems.


 The necessary testing is inexpensive and non-invasive. The treatment is often not difficult, involving dietary modification, exercise, nutritional supplementation, and sometimes other things, based on your circumstances. The treatment of Andropause can open the door to transformation of your health and your life on many levels.
Call (303) 394-4204  or email:  allen.r.berger@gmail.com and start getting better.


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