hol+ by Dr. Taz MD

Low Sex Drive, Depression, Weight Gain: The Hidden Signs of Low Testosterone
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[00:00:00] This is a global issue. 10 to 40% of men are suffering from low testosterone. You usually get alerted to your lower testosterone levels if you're having trouble building muscle or you've seen a change in your libido, but testosterone is way more potent than just those two particular areas of our wellbeing.

Testosterone plays into your mood. It plays into our cognitive health, how we think, how we remember things, how we function day to day. Welcome to this episode of Whole Plus, where today we are diving into men's health, specifically all things testosterone. I'm getting asked about this all the time. Let's get started.

Take a walk with me for just a second, all the way back to 2009. Now, I'm not gonna bore you with a ton of details, but in 2009, I first opened my clinic and I thought back then that the clinic was all about women and children. Well, it didn't take me long. To understand that men's health was an incredibly neglected area of [00:01:00] medicine, unfortunately, just as much as women's health and children's health.

Women would come in begging me to see their father, their brother, their husband, somebody in their family that was struggling and needed some support. Now, while we could talk about so many different aspects of men's health today, I wanna spend a few minutes talking to you about testosterone because one of the things I see.

Over and over again in practice is declining levels of testosterone in men of all ages. I'm talking about our young men, our boys, and of course people going into their forties, fifties, sixties and beyond. When we look at the statistics. This is what the numbers say somewhere globally. This is not just the United States.

This is a global issue. 10 to 40% of men are suffering from low testosterone. But let's break that down just a little bit more. What's more [00:02:00] concerning to me and exactly what I see in practice is that about 20% of men between the ages of 20 to 39 are also suffering from low testosterone, and let's wind it back just a little bit more, are kids and our teenagers are also showing these lower levels of testosterone.

What's going on here? We have to understand it. We have to start screening for it, and we need to break it down. But let me give you a little bit of context first. Why is this even important? Testosterone. Now, if you're a guy and you're listening to this, you're like, there's only one reason, maybe two, that you need testosterone, you usually get alerted to your lower testosterone levels.

If you're having trouble building muscle or you've seen a change in your libido. But testosterone is way more potent than just those two particular areas of our wellbeing. For example, testosterone plays into your mood. It plays into our cognitive health, how [00:03:00] we think, how we remember things, how we function day to day.

It plays into the ability to focus. It plays into the ability to feel happy and joyful and not kind of succumb to anxiety or depression. And in men, what we often see, anxiety and depression translates to anger and rage. We also know that testosterone's important for heart health, for bone health, for gut health, and so much more.

Testosterone plays a very important role in men's health. It does in women's health too, but we're gonna focus on men right now because again, I think this is such a neglected area and there's a lot of buzz and a lot of noise around it, but we're still not having the right discussions, and that's what I wanna make sure we do today.

Many come in complaining that they're chronically tired, or they can't focus, they can't get through a day at work, or suddenly they're getting a belly. Gaining weight and not sure what to do about it. Men just like [00:04:00] women, do that deep dive into, okay, I'm gonna start dieting, or I'm gonna start taking supplements, or I'm gonna go on testosterone replacement therapy.

And the answer should be right there. But oftentimes it's not because the issue is much deeper. When we think about testosterone as this bone building, muscle building, metabolically active hormone that all of us need, but our boys and our men need as well, then we start to understand that testosterone, just like all other aspects of health, does not function independently.

There are many different things that play into testosterone production. So simply showing up at your local doctor's office and getting a shot of testosterone is not going to be the answer. We need a holistic approach, and I'm gonna tell you why. Now, some of the things that are causing this global decrease in testosterone are not being talked about, not being [00:05:00] discussed in your exam room or even in the media, or even in all the ads that I know you're seeing every single day about getting testosterone replacement.

Let's start to break it down a little bit. Let's start with the basics before we get too deep, right? One of the fundamental things we see, and here's another statistic by the way, almost. 30% of men that are overweight have low testosterone. And as I go through all the different reasons for low testosterone, you'll start to understand why now, one of the first places or reasons that testosterone starts to fall is that gut health gets impacted, meaning the gut's not working well.

It's not breaking things down very well. You're not going to the bathroom every day. You maybe have reflux or bloating or some of these other symptoms, but all of those are actually impacting your testosterone levels as well. I know it's shocking, but the gut is the foundation of hormones and directly implicated and how our testosterone levels work [00:06:00] effectively.

What's happening here, and we see it when men start to engage in diets that are high in processed foods. High in alcohol, high in sugar, high in fast foods, their testosterone levels go down simply because their digestive system is not able to do the work it needs to do to metabolize testosterone effectively.

So maybe that concept is a little bit too broad or a little bit too hard to sink your teeth into. So let's dial it back to something that maybe you've heard of before. Nutritional deficiencies. Tied to poor gut health, tied to a poor diet, tied to other factors as well, will also cause a drop in testosterone.

Now I'm talking about nutrients that hopefully you've heard about and hopefully you're at least thinking about if you're a guy struggling with testosterone levels or just not feeling good, feeling tired, not sure why, and just having a completely different [00:07:00] personality almost is what many men tell me.

Vitamin D is important for testosterone production. Magnesium is important as well as is zinc, as is protein and essential amino acids. And when we start to lose some of these key nutrients, testosterone levels go down. There's one more critical area of nutrition that I feel like does not get talked about, and every time a patient is sitting in front of me, I feel like their jaw like drops to the ground when I say this because it seems so, you know, out of sync with what they're hearing.

Normally when it comes to medical information around hormones and around testosterone, specifically testosterone production needs. Fat. If we're not getting enough fat hormone levels globally, all your hormones start to go down. But testosterone in particular gets impacted. So I meet a lot of men who either because of their diet or because of alcohol or because of [00:08:00] fat fear, right?

There's that fat phobia out there that continues to exist today, even though, you know, we keep trying to turn that around for all these different reasons. Men are just as afraid of fat. As women are, but guess what the building block of testosterone is? It's actually cholesterol. So if you don't have cholesterol, which is made from fat at the end of the day, then you are going to over time, see lower and lower levels of testosterone.

So all of these nutrients, okay, so let's say you're listening to this. You're like, okay, I'm gonna go take D and I'm gonna eat more fat and eat more protein, and I'm gonna take magnesium, and I'm gonna take zinc, and I'm gonna boost up my testosterone levels that way. Well, this ties us right back to the gut because if that gut's not working well, then those nutrients don't absorb.

Don't do what they're supposed to do. So we have this whole issue with lifestyle, right? The diet, you're choosing alcohol that plays into dropping testosterone levels a gut that maybe [00:09:00] is not working the way it should be working, but there's more, and we've gotta dive into that as well. Another factor in declining levels of testosterone across the spectrum of ages has to do with the hormone cortisol.

Now, cortisol, you guys all know as stress, most men. Wear stress as a badge of honor. I don't know if you do as well, but the busier you are, the more productive you are. The more you're making, the more you accomplish, the more successful you are. Right? And many men fall into this line of thinking, one foot in front of the other until all of a sudden they have that same crash, the same one I talk about with women.

That crash, again, can look like burnout. It can look like anxiety, it can look like depression, but at the end of the day, cortisol starts to win and starts to help those testosterone levels decline further because the hormones are [00:10:00] all interconnected. In fact, picture this with me for just a second. Your brain is busy sensing and feeling the environment right?

Your brain houses. The hypothalamus, which is your sensor in your feeler. I've always called it kind of like the shark fin that we all have to understand if we're in danger what's going on, but sitting right next to that shark fin or that hypothalamus is the pituitary gland. And when cortisol goes up, because you're stressed, whether you're conscious of that stress or not, at the same time that pituitary gland responds and you have a crash in your pituitary hormones, which testosterone is one of those.

So cortisol and stress play into crashing levels of testosterone as well. Now, here's where it gets concerning and tricky, and I wanna advocate for everyone testing their levels at every age and understanding where they are. What we're [00:11:00] finding now is that the age of higher cortisol levels correlated with lower testosterone levels is shifting downward back to that first statistic I talked about, right?

Where 20% of young men, between 20 and 40, we are seeing with lower levels of testosterone. Again, we can blame food, we can blame gut. We can blame nutritional deficiencies. We can blame stress and cortisol, but it's happening. So this is a piece of the puzzle that we have to understand. Alright, let's connect that to sleep and sleep quality.

So many people are jumping on planes now, right? Or we're checking our email 24 7, or we're on social media, but we are up at night and being up at night and not having that consistent. Deep sleep and REM sleep, in turn is raising cortisol, raising blood sugar levels and crashing testosterone. So it takes a lot.

I mean, I'm looking at my own son, guys. I have a 16-year-old son and it is pulling [00:12:00] teeth to get him off of his phone and away from his electronics so his brain can actually rest, but that brain rest is going to influence. His testosterone levels, and I've actually done his labs to prove my case, and I hate to admit it's all playing out.

So when we're thinking about causes of low testosterone and why this is happening and why do we have this global epidemic, I. We've gotta think about cortisol and stress as well, and tied to it is sleep and the amount of light that we're getting. Because if we're not able to train the body to understand that we are now in a dark mode, it is time to sleep, we get that light right here through this pineal gland, then again, that hypothalamic pituitary connection is gonna crash and those hormone levels are gonna go down.

All right. I wanna talk about two more categories when it comes to causes of lower testosterone levels, because I think they're important as well. Some of this I've alluded to, [00:13:00] but it does deserve a category of its own, and that's environmental toxicity. We have study after study, right? Talking to us about, and showing us, honestly, demonstrating how BPA right, the derivative of plastics.

Phthalates, parabens, heavy metals. All of these different environmental chemicals and pollutants are crashing testosterone levels. We also know that glyphosate, which is the derivative in Roundup, used globally in our crops. Even when you're choosing organic, you still have cross-contamination with some level of glyphosate.

Is crashing testosterone levels. So the environmental component of this is real and very concerning because again, we're not screening for this early on. So people are showing up at different points in their health journey, shocked and surprised that their hormone levels are crashing when it was something they were never, ever warned about.

The environmental toxicity [00:14:00] component is so concerning, and I know that many people are working hard to get preservatives out of our food, to get dyes out of our food, to insist on higher quality food, but unfortunately, the toxic load of chemicals that we are all exposed to every single day is still taking its toll, and by the time we see cleanup environmentally, you, the patient is already impacted and affected.

All right. Let's do the last category. 'cause I think it's just as important. Medications, pharmaceutical drugs. Look, I've got a husband that we could make him a case study and talk about all of this, right? He's on a statin. Guess what statins do, guys? It lowers your testosterone. As do many other medications.

Alright, let's dive into the medication list. I don't have this memorized, I always have to refer back to it. I'm just being a hundred percent honest. But let's go back into this medication list of the medications that we know. Lower testosterone, [00:15:00] firsthand experience. I've seen statins, lower testosterone levels over and over again, but in addition to statins, there are others.

Antidepressants, lower testosterone antibiotics, especially some of your antifungals can lower testosterone levels too. Prostate cancer treatments, lower testosterone and we know things like chemotherapy will do it, but even some of our medications for, for blood sugar and for blood pressure, your metformin's and some of these can lower testosterone levels as well.

So think about sort of the conundrum. So many people are in, right? Testosterone levels are going down, blood sugar levels are going up, insulin's going up. So guess what? They end up on medications. They start to have cardiometabolic markers that then in turn demand more medications. What do those medications do?

They lower testosterone, then they're depressed, so they go on an antidepressant. Which also lowers testosterone. So again, like many other conditions in medicine today, patients, all of you are [00:16:00] dancing in this circle, not getting to the root, not being able to solve the problem at hand, and that's what we have to change.

The conventional treatment of testosterone is something we need to talk about as well. Now, let's say you identify that you're a low testosterone. Normal testosterone currently, by the way, is defined as levels between 300 and then going all the way up to about a thousand. Most patients, I feel like feel pretty good somewhere between 400 and 600.

Now, again, you have to correct for age. The younger you are, the higher the levels should be. If it's somebody over 50 or 60, then I kind of wanna keep them between that 400 to 600. A lot of you guys come into clinic and you want that thousand number mark as sort of the level that we're trying to get to, but that has risk and that has side effects that we need to talk about as well.

So you're coming in, you're checking your levels, which by the way, most people are not doing, and you find that you're low testosterone, so you and your doctor, or if you're one of our [00:17:00] patients, you guys decide to go on a path of testosterone replacement. In the conventional world of testosterone replacement, the options are testosterone shots, which are typically done weekly.

Usually it doses around a hundred to 200 milligrams and continued and maybe paired with something that prevents testosterone. From converting over to estrogen, right? Because that can happen. All these hormones are interconnected. And so you go on sort of this dual combo and off you go, and maybe you'll check your levels every six months or so, but so many of you are not, and that's dangerous the other way.

To really replace testosterone is to use testosterone gels. Now those are sometimes a slower rise in getting those testosterone numbers up to where they need to be. You still have to watch for conversion over into estrogen, but again, getting these numbers somewhere in that 400 to 600 range is typically what's safe over time.

And I was doing [00:18:00] some digging looking at the history of testosterone replacement, you know, to come on today and talk about this. Uh, people have been debating testosterone replacement since 1940, and originally it was actually forbidden because there was concern that testosterone was triggering prostate cancer or it was triggering cardiovascular disease.

Because what happens is at higher levels of testosterone, when we start to get into that 800 to a thousand or so, that's where we start to see more androgenic. Effects of testosterone. Another word, right? And I'll explain that in a minute. But those effects of testosterone do in turn have a risk of increasing your chances for prostate issues, prostate cancer, and also clotting disorders.

Like cardiometabolic or cardiovascular disease as we've progressed from 1940 forward, the research, honestly, is all over the place. I studied it, guys. You've got a study that says, [00:19:00] oh, it's safe. You've got another one that says, no, it's not. Sounds like the exact same debate. We're having in women's health.

So it leaves you again, confused and absolutely unsure of what to do while you're experiencing all these different symptoms. There's gotta be a better way to manage this, to think through this. And here's where thinking holistically. Makes a difference and really building that strategic plan to help you think all the way through about not just testosterone, but about your whole health.

So with all this confusion and all this research that seems all over the place, what can you do and what are your options? So let's dive into that for just a second as we start to understand the science around testosterone and testosterone replacement. What I'm about to introduce you to is what I've been calling the whole plus way.

This is what we've been doing in practice. This is how we think, and honestly, it's what works because we understand that a hormone is not just a hormone. It [00:20:00] actually impacts the entire body. And if you're not thinking about the body holistically, you're band-aiding over here, but then causing a problem somewhere else.

All right, so let's start. The first thing we wanna do is actually utilize. The rich wisdom that Chinese medicine, Ayurvedic medicine, and eastern systems of medicine gave to us, they would actually diagnose the root issue for every patient, including men, nine times outta 10. When men are coming in and we are trying to understand where to begin in a journey of rebuilding testosterone, we are able to identify the root cause using Chinese and Ayurvedic medicine, for example, using their way of thinking.

We can often identify that the gut. Is actually the starting point, or the liver might be the starting point, or it may be just about energy and stress. The meridian system in Chinese medicine would tease all that out, so I can have three different patients, for example, with low testosterone. But [00:21:00] one that might have triple energizer, pericardium Meridian issues is a cortisol issue, not just a testosterone issue.

So our starting point, which is what I want everybody to start to understand as they're tackling anything with their health, the starting point for this particular patient is going to be an anxiety management. Reduction of cortisol and then actually focusing on sleep and, and overall stress reduction before we do testosterone replacement therapy.

Because if we give this patient the one that's stressed, the one that's high cortisol, the one that in Chinese medicine has pericardium meridian or heart meridian, or triple energizer meridian imbalances, if we give that patient testosterone, it's gonna convert the wrong way. Let's take another example.

Somebody with spleen meridian issues or gut dysfunction, right? That's essentially the way that that translates is going to not handle testosterone well because the gut is not healthy in the same [00:22:00] way that somebody with a liver issue, liver meridian issue, which is not a disease by the way, it's a pattern of energy that we need to understand is also not going to handle straight testosterone very well.

So when we sort of engage this holistic approach to understanding how to help men of all ages with testosterone, our first goal is to identify the area of imbalance that is in the most critical need, the starting point. So for some of you it might be the gut, and how do you know that well do a quick scan or assessment of yourself?

Do you have digestive issues? Are you noticing that you don't use the bathroom every day? Are you having bloating or reflux? I. That's your starting point. You need a plan to repair the gut lining to help balance out the microbiome. Maybe take digestive enzymes to break things down and start to transition your diet to one that is anti-inflammatory, clean and low in alcohol.

In fact, the current [00:23:00] recommendations for men and alcohol are at about four drinks per week. We used to think that men would be okay with alcohol, but we're learning more and more that it has direct consequences on cortisol, blood sugar, cardiometabolic health, and of course testosterone as well. If the liver is the issue and your starting point, and let's talk about the liver for a second.

Many men have the genetics of poor hormone metabolism. So testosterone in essence, has to be broken down. It's usually broken down into androgens, which again, are responsible sometimes for some of the prostate issues and the cardiometabolic issues that we see with testosterone replacement. But it has to be broken down and then excreted eliminated.

Either through the gut or through the kidneys. But to do that, the liver has to work well. Now let's go back to alcohol, right? If the, if your liver has been burdened with a lot of environmental toxicity or alcohol, or any of these things that make it harder for the liver to do its [00:24:00] job, we come along and we give you a big dose of testosterone, it's gonna go the wrong way.

You're gonna produce a lot of estrogen with minimal benefit and minimal improvement. In your testosterone levels. So again, when we take the Chinese and Ayurvedic medicine or any eastern system of medicine and use their philosophy before we act medically, it's a win for everybody, especially for you. So understanding your starting point is key.

So a healthy gut, a healthy liver understanding where cortisol and stress and sleep play into your life are critical and kind of getting those lined out. First before you start to think about hormone replacement therapy is essential. A lot of times I'll sit with patients and we will literally draw something that looks like either a triangle or a house, and at the bottom is the foundation and at the top might be testosterone.

I'd love for you guys to do that. Now, if you're listening, you know, where do you wanna start? Is it the gut? Is it the liver? Where is your [00:25:00] starting point? And how do we get you on the right track to building hormones safely and effectively? Now, once you've tackled that, the next piece of the puzzle is getting those nutrients optimized, adding in things like vitamin D, a little bit of magnesium at night, which by the way also helps cortisol.

Zinc, which does help boost testosterone production and more protein and amino acids, which also play a role, will help you to build testosterone naturally. Now the fun part in practice is that we'll get through that much of the plan and we can see testosterone levels start to shift. Before we've even done hormone replacement therapy, I.

You do have to give it time. Of course, it needs at least probably three months or so of consistency, and we can see those levels rise somewhere between a hundred to 200 points. That's huge, especially if you're dealing with a young boy or a young man who might not need testosterone replacement quite yet.

So again, that becomes the [00:26:00] foundation of really getting back into building testosterone and getting it to work for you, not against you. Now moving on from that, sometimes we'll see patients who are doing that work, but nothing's changing, right? That's the environmental load. That's the light therapy that we need to be thinking about.

If, for example, somebody has heavy metals like mercury or cadmium and they're carrying them around, it directly impacts testosterone production. We've had so many cases of that, and one of the things that's been so interesting, so ED or erectile dysfunction, many men think. It's directly related to low testosterone, which it can be.

But that low testosterone we have found in some of our patients when they've had high levels of heavy metals has actually been the root cause of the low testosterone leading to the ed. And by removing those heavy metals. They were able to bring their testosterone levels up naturally. It's been amazing, and as we walk through this approach of [00:27:00] removing some of these chemicals from the body, right, and really being conscious of where they're coming in from.

You know, what are you using in your home? Are you using glass containers or plastic containers? What type of cleaning agents are you using? What type of body care agents are you, are you using? What is that cumulative toxic exposure that you've got when you move through your day? On any given day that you might be getting that could be impacting how your body metabolizes testosterone is something to start thinking about and you can do a quick scan of your environment and try to understand where those toxins may be coming from.

For you, there is testing available for that. It is a deeper dive. It's usually not done conventionally, but many of us in the functional, integrative, and holistic space do do that. Testing more just to provide a guide rather than really to create complicated protocols, right? Just to understand how that's playing into this overall picture of testosterone.

So that's where we need to begin, [00:28:00] and it is amazing to see results. Just with that much work. And here's the deal. When you do that work, that kind of foundation building, and you work your way up, sort of the whole plus way, when it comes time to giving you testosterone, the doses don't have to be mega doses with all the side effects and all the risk that you sometimes incur when we're doing those a hundred milligrams or 200 milligram shots of testosterone.

Instead, sometimes we're doing 25 milligrams or 50 milligrams, depending again on your age and circumstances and how much of the other work you've been able to do, and that gentle approach of hormone balancing. I call it the sweet spot because each of you are unique and individual, but finding your sweet spot without them needing.

More medications to just metabolize the testosterone or worrying about the side effects and the risk of testosterone replacement therapy is so worth it. You know, you're able to have [00:29:00] optimal testosterone levels for a long period of time, and constant monitoring and making sure the body's using it the right way is important, and that way we're not running into these mega doses of hormones that.

May or may not be connected to prostate cancer and cardiometabolic disease. So when we're thinking the whole plus way, we think foundation up. Hormone replacement as the tip of that iceberg or triangle or house, however you wanna think about it. Necessary, but maybe not necessary in these mega doses and what so many men are hearing, right?

And even our young boys coming in. And what they're hearing is that there's a quick fix, a one solution for low testosterone instead testosterone like many of our. Other hormones are superpowers and really influencing the biochemistry of the whole body. And at the end of the day, really getting this right is important, not just for you.[00:30:00]

It's actually important for every single person you interact with. When we look at families and we look at the dynamic within a family, when someone's not feeling well, whether it's due to low testosterone and unhealthy gut, too much alcohol, nutritional deficiencies, cardiometabolic disease, it reverberates and it kind of impacts every single member of the family.

If you don't have the energy and the vitality and the zest for life, it's going to impact your relationship. Right? You guys know what I'm talking about. If you are not feeling good, you may not make choices. I. Or take risk that you would otherwise take? My own husband said that, right? A 20-year-old Vic is different from a 40 something year old Vic in terms of his ability to take a risk or to gamble or to even believe in a positive outcome for something.

I don't know if any of you guys can relate. So testosterone is not just [00:31:00] about testosterone. It's about feeling good. It's about making sure that that vital sign is where it needs to be for you, wherever you are in your life. And if we flip it and start to look at it from the perspective of a mother of a son in the environment that we're in today, understanding your children, your teenagers, your 20-year-old levels of testosterone is imperative.

So that. Our children are not suddenly hitting this roadblock or this wall, not understanding why. Maybe there's an infertility issue, why there's an energy issue, a mental health issue. All of these things are interconnected. So testosterone at the end of the day, is your superpower. It's a connector. It makes men feel good, but it needs support from all the other areas of the body.

And that's the whole plus way. That's why a holistic approach matters. That's why for each and every one [00:32:00] of you listening today, I hope that you pursue this approach. It is more work. It is more time, but it guarantees longevity, fewer side effects, and more vitality. Thank you for watching or listening to this episode a whole.

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Don't forget to follow me on all social channels at Dr. Taz md. Until next time, stay healthy and stay whole.