Male hormone imbalances is a growing problem. More and more men are becoming aware that their symptoms (Fatigue, Depression, Weight gain, Anxiety, Hot flashes, irritability) may be tied into less than optimal hormone levels.
Over the last 5-10 years more and more men are undergoing hormone testing and what we are finding is an increase number of men in their 30′ s and 40’s are experiecing less than optimal testosterone results. While there are many simple diet and lifestyle changes to be made, the first thing I recommend doing is testing your hormones. I say Hormones plural- because their is so much more to male hormones than just testosterone. One particular hormone we are interested in when it comes to male hormone optimization is Estrogen. Yes, you hear that correct. Very often the very symptoms you might think are related to low testosterone could be caused by elevated Estrogen. Men CAN and often do have problems with estrogen.
Signs and Symptoms of Excess Estrogen
You do not need to have all of these symptoms if you have excess estrogen, these are the most common symptoms that men experience with male hormone imbalance.
- Low testosterone and excess estrogen can cause similar symptoms in men
- Excess estrogen can cause excess weight, especially around the breasts, hips and abdomen and is the most common male hormone imbalance in overweight men.
- Excess estrogen can lead to low libido, infertility and erectile dysfunction
- Increased risk of stroke and heart attack because of an increased risk of clotting
- Increased risk of prostate cancer
Signs and Symptoms of Low Testosterone
Low testosterone has many similar symptoms to excess estrogen, with more muscle weakness and fatigue being the main difference, whenever you think of male hormone imbalance you usually think low testosterone is the cause.
- Similar to excess estrogen, low testosterone can cause low libido and erectile dysfunction.
- Muscle weakness and poor recovery from exercise.
- Fatigue and lack of energy, this can be caused by many things and low testosterone is one of them.
- Mood changes and depression.
- It can lead to weak bones and osteoporosis as you age.
What Causes Excess Estrogen Estrogen in Men?
There are many different causes of male hormone imbalance and here is a short list of the most common ones.
- Melancholy or feeling Bla
- Belly Fat
- Loss of muscle tone
- Excessive sweating
- Brain Fog (Concentration, Focus)
- Blood sugar issues Insulin Resistance
- High Cholesterol
- Weight gain
- Sleeping Problems
- Prostate problems
- Maintaining Erection or Ejaculation.
How To Test Your Hormones
Hormones can be tested in blood, urine or saliva. Each one of these testing methods provides unique insight into production utilization and finally metabolism of hormones. Sometimes I run all three on my male patients and some times we only used blood. No one method is better than the other. It depends on what kind of information we are looking for.
Saliva Hormone Testing
Saliva testing is a non-invasive collection method where patients collect their saliva in plastic tubes in order to measure hormones like cortisol, estrogens, progesterone, and androgens. This non-invasive saliva collection is ideal for patients because it allows them to collect their sample in the privacy of their home or office. Hormone imbalances can be caught early through saliva testing because the hormones being tested are “active hormones”. Because hormone blood tests only measure protein-bound hormones, understanding the true effect of hormone imbalances is difficult. This is why testing hormones in saliva is performed.
Why Do We Test Hormones in Saliva?
Steroid hormones in the bloodstream are 95-99% bound to carrier proteins, and in this form are unavailable to target tissues. Saliva testing measures the amount of hormone available to target tissues – the bioavailable amount. For this reason, saliva testing better relates to specific symptoms of excess or deficiency.
DUTCH Hormone Testing- Urine
Urine Testing like the DUTCH tests provides some additional insight for men looking to optimize their health and wellbeing. While many focus only on increasing testosterone, it’s important to know the key roles other hormones play in symptoms such as fatigue, abdominal weight gain, gynecomastia, male pattern baldness, depression, insomnia, and more.
In addition, the three main estrogens (estrone, estradiol and estriol) plus estrogen metabolism show if a male patient is estrogen dominant, estrogen deficient and how his estrogen detoxification (methylation pathways) is working. While estrogen metabolism is often associated with women’s health, men need healthy clearance as well. Moreover, hormones such as cortisol and melatonin also play a role in testosterone production and spermatogenesis.
Is taking Bio-identical Testosterone for “Low T” Bad for You?
Yes, No, Maybe? there is no easy answer to this. Each case is different. What I will say is that taking testosterone for Low T rarely if ever fixes the root cause of the problem. Most doctors don’t properly manage their male patients and so in the long run the testosterone replacement causes problems. In my office, the majority of men come to me who have not been properly managed. Remember, taking testosterone because you have low T (in most cases) does not address the underlying root cause of the problem. All you are doing is replacing low levels, this does not explain why levels are low in the first place!
Hopefully that explanation will give you a better understanding of some of the pitfalls we often encounter and to be aware of them.
How To Detect A Male Hormone Imbalance:
In addition to the symptoms that I listed in the beginning of this article, here are some of the tests which can help determine whether someone has a hormone imbalance:
1. Male Hormone Panel- This test would evaluate the male hormones in Saliva
2. DUTCH hormone panel- This test would evaluate male hormones in Urine
2. Comprehensive Metabolic Blood Panel. This test will evaluate things such as Vitamin D levels, blood sugar levels, infection, Iron Levels, Thyroid Hormones, Liver enzymes, and Markers for inflammation. You always want to have Homocysteine, C-reactive protein, Hemoglobin A1C, TSH, T3 and T4. (make sure you get both)
3. Cholesterol levels. Since cholesterol is a precursor to all of the hormones, it of course is important that people have a sufficient amount of it. Most people are concerned about their cholesterol levels being too high, but it also can cause problems if these levels are too low.
4. Additional Testing depending on other symptoms. This would be individualized to the male and depends on other concerns or health problems that may be playing a role.