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.
What Causes Excess Estrogen Estrogen in Men?
There are many different causes of male hormone imbalance and here is a list of the most common ones.
Symptoms of Male Hormone Imbalances
Depressed, Melancholy or feeling Bla
Loss of muscle tone
Brain Fog (Concentration, Focus)
Blood sugar issues Insulin Resistance
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.
Here is how it all goes downhill for many men. The pathway which forms the male hormones is actually very similar to the female pathway. It all begins with Cholesterol, which is then converted into pregnenolone, and from this point it divides into two separate pathways. One potential pathway is for the pregnenolone to be converted into progesterone, which in turn will convert into the adrenal hormones, aldosterone and cortisol.
Pregnenolone can also get converted into DHEA, which in turn gets converted into the male steroid hormone, androstenedione, which in turn gets converted into testosterone. Testosterone under certain circumstances will then convert into either DHT or Estradiol.
With a man different enzymes are involved in the conversion process of testosterone. 5-alpha reductase is involved in the conversion of testosterone to DHT, while aromatase is involved in the conversion of testosterone to estradiol, as well as androstenedione into estrone.
#1 you will notice that all the hormones come from Cholesterol. Cholesterol gets a bad rap and over the years has been unjustly vilified. If you are taking cholesterol altering or cholesterol lowering medications this can be a problem for your hormones. (antidepressants, statins, Acid reflux and many other medications can interfere with this process.)
#2 Many men will suffer with loss of libido, loss of strength, fatigue, belly fat, man boobs, hair loss, insomnia when they start converting their male hormones into female hormones. We call this andropause.
Instead of rushing out to take androgel, testosterone pills, DHEA or some other over the counter supplement you heard could help, you should find a doctor who has experience in working with men who suffer with hormonal imbalances and get TESTED. You can very easily make your self worse.
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.
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 hormones such as the ones you see in the above diagram.
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.