Commercials promoting testosterone therapy for men are becoming increasingly popular. These commercials target men who are experiencing symptoms of muscle loss, fatigue, weight gain, depression, difficulty concentrating, low libido, elevated lipid levels and the inability to respond during sexual activity. Without a doubt, strength, aggression, virility, passion, and a competitive attitude are highly desirable traits for men of all ages. Preserving these masculine traits is understandably very important for the majority of aging men. Besides the development of male characteristics and sexual health, testosterone assists with many important functions such as energy metabolism, body composition, blood pressure, heart health, and bone mineral density. Men experience a natural decline in testosterone as they age like women, although it's much slower and gradual progressive decrease starting around the age of 30. Consequently, the fear of having low testosterone levels ("low-T") sends many men running to their primary care physicians in an attempt to restore their youthful levels. Yet is testosterone therapy safe, and can diet and lifestyle choices influence levels?
Many Symptoms can be a Result of Poor Diet Choices, not Low-T
Although some loss in physical strength and endurance is a natural part of aging, many of the above symptoms (like weight gain, loss of libido and erectile dysfunction) can be a result from years of making poor food choices instead of a result from low testosterone levels. For instance, studies confirm that those who consume meat on a regular basis have more abdominal fat and higher BMI's. Similarly, erectile dysfunction is a clinical indicator of advancing heart disease - which again, is caused by years of consuming a diet high in processed/refined foods and animal products. Fatigue, depression and difficulty concentrating, can also be attributed to obesity, hypothyroidism, a nutrient-deficient diet, and/or side effects from prescription drugs. Statins, for example can produce memory loss, confusion, forgetfulness, fatigue and weakness. Consequently, the majority of men are taking testosterone for symptoms that can easily be remedied by changing to a whole-food, nutrient-rich, plant-based diet.
What Factors Lower Testosterone Levels?
Many lifestyle habits reduce testosterone levels. For example, increased body fat not only lowers testosterone levels, it raises estrogen levels in men. Furthermore, many prescription drugs lower testosterone levels, along with alcohol, sugar, and endocrine-disrupting chemicals found in industrial pollutants, pesticides, plastics, seafood and other types of meat. WebMD has plenty of information on causes of low testosterone and the unfortunate often resulting Testosterone Replacement Therapy.
Anti-Aging Hormone Myths
For many years, hormone replacement therapy was regularly prescribed for women experiencing various hormone-related symptoms. However, when extensive data revealed an increased risk of breast cancer, heart attacks, strokes and embolisms, physicians began weaning their patients off of their estrogen. Unfortunately, the same mistake is being made regarding testosterone therapy in men. Physicians are prescribing hormone therapy without sufficient scientific research weighing the benefits against the risks. Between 2001 and 2011, prescriptions rates for low-T have tripled. This increase is largely due to it being prescribed for many men that do not have confirmed low testosterone levels.
Higher Testosterone Levels Associated with Prostate Cancer
In Dr. Fuhrman's article The Myth of Anti-Aging Hormones: Doctors Repeating Mistakes, Fuhrman writes, "Indicating a startling trend, a recent study on testosterone by the Institute of Medicine found that prescriptions written for 'treatment' of middle-aged and older men whose hormone levels were near normal were rising rapidly. More than 1.75 million prescriptions for testosterone products were written in 2002, a 170 percent increase in three years. Many studies have shown that higher testosterone levels, promoted by a diet rich in animal products, are strongly linked with both breast and prostate cancer. This link is stronger than the link between estrogen and its related health problems. For older men, studies indicate that higher levels of testosterone fuel the growth of prostate tumors, which is why chemical castration is one means of treating the disease in the advanced stages. The problem is that prostate cancer begins many years before it can be detected by blood tests or examination. So, taking testosterone can change a hidden and slow-growing cancer into a more aggressive one. While the U.S. Food and Drug Administration has approved testosterone therapy for men who suffer from hypogonadism (a condition in which the body makes very little testosterone) it has not passed it for other uses. Their concern is that, unless there is a profound testosterone deficiency, the disadvantages may outweigh the advantages. Yet this is not the way testosterone is being prescribed today. Doctors are prescribing testosterone for men who are experiencing a normal age-related decline in testosterone in an attempt to enhance their virility and strength. It is rarely successful." More information on the possible cancer connection and excess testosterone can be seen in this study: Study Links Low T Drugs to Prostate Cancer in Rats.
Testosterone Therapy - Associated with Increased Risk for Cardiovascular Disease
Sometimes testosterone levels can drop too low, producing negative health effects such as type-2 diabetes, insulin resistance, inflammation, obesity, and elevated triglycerides and cholesterol. These risk factors are associated with an increased incidence of heart disease. Testosterone therapy improved these conditions. However Dr. Fuhrman says that testosterone therapy increases the risk of cardiovascular disease:
- "A clinical trial investigating testosterone therapy in a population of older men with a high prevalence of cardiovascular disease was halted in 2009 because of a high rate of heart attacks and strokes."
- "Another study published in 2013 retrospectively studied elderly male veterans with low testosterone who either received or did not receive testosterone therapy. In this study, testosterone use was associated with greater risk of all-cause mortality, heart attack and stroke."
- "A meta-analysis of placebo-controlled, randomized controlled trials of testosterone therapy found an 54 percent increased risk of cardiovascular events. The FDA now requires that testosterone products be labeled to warn consumers about the possible increase in heart attack and stroke risk."
For more information regarding testosterone therapy and its association with heart disease read this Drugwatch article, Testosterone Therapy Side Effects.
"The evidence supports moderate levels of testosterone as opposed to low or high levels for good health. Over a 7-year follow-up, older men with midrange levels of testosterone had lower death rates compared to highest or lowest quartiles."
Is it Possible to Prevent Low Testosterone with Healthy Lifestyle Habits?
While advancing age is a contributing factor for declining testosterone levels, higher levels are seen in men who practice healthier lifestyle habits. "The healthiest thing to do would be to prevent testosterone from becoming too low by living healthfully, so you will not need to take hormones" Dr. Fuhrman notes. Men who consume a plant-centered diet and exercise regularly age more slowly and are able to keep their testosterone levels from going too low. In fact, according to Dr. Michael Greger, "Vegan men tend to have significantly higher testosterone levels, than both vegetarians and meat eaters." Likewise, Dr. John McDougall writes: "The male hormone testosterone that determines sexual development and interest has been found to be 13% higher in vegans."
Doctor Fuhrman continues by saying, "The current research does suggest that men can increase testosterone naturally. Two studies of overweight and obese men who participated in a 12-week diet and exercise intervention found that they lost weight, improved their blood pressure, and increased circulating testosterone levels. Vigorous exercise and adequate vitamin D and zinc status help to maintain healthy testosterone levels."
Achieving a youthful physique and optimal health is not found in the form of a pill. Men can safely and naturally maintain their testosterone levels as they age by exercising regularly, maintaining low levels of body fat, and eating a whole-food, high-nutrient, plant-centered diet which significantly limits or excludes packaged/refined foods and animal products. As mentioned above, studies show that moderate testosterone levels supports optimal health and is associated with lower mortality rates. Thus, higher levels in aging men should not be considered a measure of good health and could be a serious mistake. Disastrous outcomes may not be seen for many years. Hormone replacement therapy should be reserved for a small percentage of men (with a notable deficiency) and used judiciously in addition to aggressive diet and lifestyle changes.
Dr. Fuhrman concludes by saying, "Aging does not guarantee that a particular man’s testosterone will decline to a level that affects how he feels. Men who maintain the body weight they had in their twenties and eat healthfully may have very little falloff. When a person eats a healthful plant-centered diet, their hormonal levels (this is true of both testosterone and estrogen) will be lower, not higher, throughout life. Then, as they get older, the percentage of decline will be less dramatic. Additionally, since the body is accustomed to lower than average levels for all those years, the hormonal receptors are increased in number, so the effects of the age-related decline in hormones are hardly noticed. Testosterone replacement may be warranted in the very small subset of men with markedly decreased testosterone levels and symptoms suggesting hypogonadism, and these individuals may experience an increase in the quality of their lives. But even they must be informed that the long-term safety of testosterone supplementation remains uncertain."
For more information concerning the risks related to testosterone therapy (and how weight loss can boost levels) click on the following links: