The Testosterone Conspiracy

Photo credit: Palmer, Alfred T., photographer. (Farm Security Administration – Office of War Information Collection) / Foter / Public domain

We can measure the relative profit potential of a health problem by an onslaught of advertising in the mass media. Fresh off the great successes with “E.D.” (short for erectile dysfunction), the pharmaceutical industry has created a slick term for another awkward topic: “Low T”.

Just as most men feel uncomfortable telling their doctors they’re having trouble getting an erection, many would also have difficulty questioning their own manliness as reflected in a low testosterone level.

During my medical training, I was taught that low testosterone was a common issue as men aged. The term “male menopause” was used so men wouldn’t feel left out when their wives were getting hot flashes.

As with many aspects of conventional wisdom, this paradigm is likely too simplistic. I have come to find that Low T is incredibly common in men of all ages, shapes and sizes. If I see a male with low libido, fatigue, muscle weakness or unexplained sweats, it is typical to find low testosterone levels on a blood test.

For years, this burgeoning issue did not add up for me. I then came across a review article in Holistic Primary Care. To my surprise, the piece described perfectly what I was seeing in practice. It turns out that testosterone levels, sperm counts and male fertility have been in steady decline in industrialized countries over the past 25-30 years.

Testosterone production, like many health issues, is complex. The causes for this epidemic are multi-factorial. Stress, excess fat/adipose tissue and age play a role. If we had all the answers though, we might find that chemical and toxin exposure in our environment is the primary reason why we’re seeing low testosterone in young, thin and otherwise healthy males.

The article and other sources have posited that chemicals that mimic estrogen are causing a relative imbalance of female to male hormone levels in millions of men. Herbicides used in food production and phthalates from plastics could be the primary culprits.

Another contributor may be iodine deficiency. Based on the books of David Brownstein, MD, I have come to understand that iodine deficiency has become more common over the same 25-30 years. Iodine is primarily needed for thyroid gland functioning, but also supports the other hormonal and glandular tissue of the body including the adrenal glands and testes that are essential for normal testosterone production.

I have a small group of male patients who are taking iodine supplements to raise their testosterone levels. They have not done well with the pharmaceutical options to raise testosterone. They are also wary of the potential that testosterone gels, patches and shots can increase the risk of a cardiovascular event.

The final piece to the testosterone puzzle may involve our adrenal glands. These small glands play a central role in testosterone production and the longer I’m in practice, the more I believe in a concept called “adrenal fatigue.” The concept is that our modern lives with low quality food, sleep deprivation and excessive physical, emotional, psychological, spiritual and existential stress suppress the activity of this gland.

Overall, as with most complex issues, we see many potential contributors to an end point. It would be better to figure out the underlying causes for each individual and manage them than to just put every male with low testosterone on testosterone replacement.

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