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Understanding Low Testosterone in Men: Causes and Insights

Are men’s testosterone levels decreasing over time? Is it true that our grandfathers had higher testosterone levels? As it turns out, the answer unfortunately is yes. Research indicates that on average, men's testosterone levels have declined significantly over the past several decades, a trend that poses important health implications. A study published in the Journal of Clinical Endocrinology and Metabolism in 2007 found that average testosterone levels in American men had declined significantly from 1987 to 2004, even when adjusting for age and other health factors.

This decline is evident in multiple longitudinal and population studies on males declining testosterone levels from various countries, revealing a consistent drop in average testosterone levels even when accounting for age and health factors. Contributing factors to this decline include lifestyle changes such as rising obesity rates, poor diets, and physical inactivity, as well as increased exposure to endocrine disruptors and environmental pollutants. Additionally, the prevalence of chronic diseases, sleep disorders, and higher levels of chronic stress in modern life are significant contributors. Understanding these causes is crucial for addressing the broader issue of low testosterone in men and promoting better overall health and well-being.

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Why is this important? Testosterone is a vital hormone in men, playing a crucial role in physical development, maintaining muscle mass, bone density, and sex drive. Low testosterone, or hypogonadism, can significantly impact a man's health and well-being. Understanding the causes of low testosterone is essential for addressing and managing this condition effectively and can help improve the overall health and quality of life for men as they age. In this article, we will discuss some of the various factors that can contribute to low testosterone levels in men as well as ways to optimize their hormone production.

Aging:

Growing older is one of the most common causes of low T in men. Testosterone levels will naturally decline as men age, typically starting in the 20’s to 30’s. This gradual decrease of about 1-2% per year is a normal part of the aging process, yet the decline is so subtle that before you know it, you’re in your mid 40’s and feel like a shell of your former self and can’t figure out why. By the time men reach their 70s or 80s, testosterone levels can be significantly lower than they were in their younger years. Most doctors wont even address the differences in age and lump all patients together regarding where their testosterone levels should be which is a problem for younger men with subclinical hypogonadism or relative androgen deficiency. Its important for a healthcare provider to know the differences in testosterone levels in men of varying ages to determine if treatment is needed.

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Medical Conditions:

Several medical conditions can contribute to low testosterone levels. These include things like Hypothyroidism.  An underactive thyroid can lead to hormonal imbalances that affect testosterone production and result in several unwanted signs and symptoms such as weight gain, fatigue and decreased libido.

Diabetes is another typical medical condition that can cause a decline in hormone levels.  Type 2 diabetes is often associated with lower testosterone levels, possibly due to insulin resistance and obesity can help exacerbate a decline in hormone levels, health and quality of life.

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Obesity is a major problem in the United States and one that has a major impact on endocrine levels. An excess body of fat can convert testosterone into estrogen, reducing overall testosterone levels and creates a spiral effect that worsens over time. Lower T levels can increase unwanted weight gain which in turn lowers testosterone levels and the cycle continues until there is some form of intervention.

Klinefelter Syndrome is a rare genetic condition which involves an extra X chromosome in males and can result in underdeveloped testicles and lower testosterone production.

Pituitary Disorders occur when the pituitary gland regulates hormone production, including testosterone. Tumors or other issues with the pituitary can disrupt this process and typically need to be uncovered through tests such as blood, urine and imaging like MRI’s or CT scans.

Chronic Illnesses such as liver or kidney disease can affect hormone production and metabolism. These conditions must be addressed in order for the full extent of hormone disruption to be determined.

Medications:

Certain medications can interfere with testosterone production or function. These include both prescription medications or even illegal recreational drugs. Obviously, a physician needs to discuss all of the possible side effects of certain medications and help weigh out the risks and benefits associated with each prescription prior to taking them.

1. Opioids: Long-term use of opioid painkillers can suppress testosterone production. This can include prescription or illegal pain medications. It’s common for recovering addicts to have sub-optimal hormone levels when starting recovery.
2. Glucocorticoids: Medications like prednisone, used to treat inflammatory conditions, can reduce testosterone levels by suppression of the HPA axis which then can inhibit the HPG axis.
3. Chemotherapy and Radiation: Treatments for cancer can damage the testicles and impair testosterone production. May chemotherapeutic drugs are cytotoxic and can damage the Leydig cells of the testes or disrupt the hypothalamus and pituitary functioning. Unfortunately, this may be a necessary risk for someone undergoing treatment of a potentially terminal illness.
4. Antidepressants: Some antidepressants may affect hormonal balance and reduce testosterone levels. SSRI’s like Prozac and Zoloft can influence the HPG axis and inhibit testosterone production.

Lifestyle Factors can also play a significant role in testosterone levels. Key factors include Lack of Exercise and working out. Regular physical activity, particularly strength training, can help maintain healthy testosterone levels. Sedentary lifestyles, on the other hand, can contribute to lower levels and increase weight gain which decreases hormone production at a faster rate. Poor Diet/Nutrition can cause decreases in T production.  

Diets that are high in processed foods, sugars, and unhealthy fats can negatively impact testosterone production. Nutrient deficiencies, such as zinc and vitamin D, are also linked to low testosterone. Hormone tests show that people with natural healthy diets have much higher testosterone levels than those individuals with poor nutritional habits.

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Chronic Stress has been linked to poor hormonal health.  Prolonged stress leads to elevated cortisol levels, which can suppress testosterone production in men. Whether its from Job, financial woes or marital/family problems, this can be a huge disruption to one’s endocrine health. Sleep Deprivation. Quality sleep is crucial for hormone production, including testosterone. Chronic sleep deprivation or sleep disorders like sleep apnea can lead to lower testosterone levels. Men produce testosterone when they sleep, and studies have shown that an additional hour a night can have a significant improvement in how males produce testosterone.

Excessive Alcohol Consumption: Heavy drinking can impair liver function and disrupt the hormonal balance, leading to reduced testosterone levels. Drinking in moderation is ok, however when alcohol use becomes habitual, hormone levels will start to decline.

Environmental Factors:

Exposure to certain environmental factors can also contribute to low testosterone levels. With all the chemicals we use and take for granted on a daily basis, there is bound to be some negative effects from their use. As it turns out, some of these products can have a significant influence on hormone production. An example of one such product is Axe body spray, which the website mamavation.com discusses a study out of Massachusetts that linked paternal exposure to phthalates, a chemical found in Axe with diminished embryo quality. Many air fresheners, scented candles, and products labeled with the ambiguous "perfume" contain phthalates, chemicals also used to make plastics more flexible. These compounds are prevalent in various cosmetics and personal care products.

To reduce exposure, avoid:

• Non-organic or non-essential oil-based scented candles
• Body sprays
• Most commercial perfumes
• Air fresheners
• Scented bathroom sprays
• Aromatic personal care products

Other Endocrine Disruptors are chemicals found in plastics, pesticides, and other products that can interfere with hormone production and regulation.  Bisphenol A, or BPA is one such example. It’s probably the most well-known chemical used in the production of polycarbonate plastics for its hardening effect and is also found in epoxy resins. This chemical has been linked to low testosterone levels, erectile dysfunction, and cancers, including prostate and breast cancer. Common sources of exposure include reusable plastic bottles, kid’s sippy cups, clear, hard plastic items and the linings of some food cans.

Parabens are a large family of chemicals commonly used as preservatives in personal care products. The most prevalent forms are methyl-, butyl-, propyl-, and heptyl-parabens, all of which have a weak affinity for estrogen receptors. They are especially abundant in sunscreens, where their potential for harm is heightened due to the extensive surface area of the body that these lotions cover. When spending time in the sun, it's advisable to opt for gradual exposure or use paraben-free sunscreen to minimize potential risks.

Triclosan is the primary antibacterial agent found in antibacterial soaps. Along with its counterpart triclocarban, it can lower testosterone levels by altering testicular function. Additionally, these compounds are ineffective at killing bacteria and contribute to the development of antibiotic-resistant strains. You can find triclosan in:

• Toothpaste
• Antibacterial soaps
• Antibacterial detergents
• Kids' toys
• Surgical cleaning treatments

Benzophenones are another large family of compounds that affect testosterone production, with BP1, BP2, and BP3 being the most commonly encountered. These chemicals act as stabilizers in many personal care items, especially sunscreens. They can also be found in:

• Inks (particularly on cashier's receipts)
• Clear glass or plastic containers that filter UV light

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Pollution is another possible cause of decreased testosterone levels. Air pollution and exposure to heavy metals can negatively impact overall health, including testosterone levels. Many pollutants can induce oxidative stress, which damages cells, including those in the testes where testosterone is produced. Heavy metals like lead, cadmium, and mercury are known to generate reactive oxygen species (ROS), leading to cellular damage and impaired testosterone synthesis. Exposure to air pollutants, such as particulate matter (PM), can cause systemic inflammation. Chronic inflammation can negatively affect the hypothalamus-pituitary-gonadal (HPG) axis, the hormonal system responsible for regulating testosterone production.

Some pollutants can cause genetic mutations and damage to the DNA within cells, including those in the reproductive system. This damage can lead to a decrease in the number and function of testosterone-producing cells. Some Examples of Pollutants Affecting Testosterone are Air Pollution, Heavy Metals and Pesticides and Herbicides. Studies have shown that men exposed to high levels of air pollution, including particulate matter and traffic-related pollutants, have lower testosterone levels.  Exposure to heavy metals such as lead and cadmium has been linked to reduced testosterone levels. Pesticides and Herbicides: Agricultural chemicals can act as endocrine disruptors and negatively affect hormone production.

Injury or Trauma to the testicles can directly impact testosterone production. This includes Testicular Injury, which could occur playing certain sports. Physical trauma to the testicles can damage the tissue responsible for testosterone production so players in sports like baseball,  are boxing, martial arts, hockey etc.… are encouraged to wear a protective cup/jock strap to prevent injury. Mumps Orchitis is a condition, caused by the mumps virus, which can lead to inflammation and damage to the testicles.

Genetic Factors can also play a role in testosterone levels. Some men may be genetically predisposed to lower testosterone production or have genetic conditions that affect hormone levels. A family history could provide some insight however its rare to have access to medical records from family members dating back far enough to show this to be this case and is often simply inferred to be true.

Secondary Hypogonadism occurs when the problem originates in the brain rather than the testicles. The hypothalamus and pituitary gland in the brain regulate testosterone production. Issues in these areas, such as tumors, radiation, or trauma, can lead to low testosterone levels.

Recognizing the Symptoms of Low Testosterone

Understanding the causes of low testosterone is essential, but recognizing the symptoms is equally important. Symptoms of low testosterone can vary widely among men and may include some of the following signs:

1. Decreased libido and sexual performance
2. Fatigue and low energy levels
3. Depression or mood changes
4. Reduced muscle mass and strength
5. Increased body fat
6. Decreased bone density (osteoporosis)
7. Cognitive issues, such as difficulty concentrating

Diagnosis and Treatment

If you suspect you have low t, it is important to seek the medical advice from an experienced licensed physician. A healthcare provider can perform a blood test to measure testosterone levels and determine the underlying cause. Treatment options will depend on the cause and severity of the condition and may include things like making basic Lifestyle Changes such as improving diet, increasing physical activity, reducing stress, and getting adequate sleep which can all help boost testosterone levels.

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For others, Medications may be needed. In some cases, treating an underlying medical condition or adjusting current medications can improve testosterone levels while still helping to treat the condition. More common than ever is Testosterone Replacement Therapy (TRT). TRT involves the administration of testosterone through injections, patches, gels, or pellets to restore normal levels via the supervision of a licensed healthcare provider. It is essential to discuss the benefits and any potential side effects of TRT with your doctor to see if this is right for you. One of the advantages of TRT is that you can more easily elevate your testosterone levels and monitor and control them, where some of the other methods may not be able to have the impact desired.

Low testosterone in men can result from various factors, including aging, medical conditions, medications, lifestyle choices, environmental factors, injuries, genetic factors, and secondary hypogonadism. Understanding these causes is vital for addressing and managing low testosterone effectively. If you experience symptoms of low testosterone, consult with a healthcare provider like the experts at NovaGenix to determine the underlying cause and appropriate treatment options. Taking proactive steps to maintain a healthy lifestyle can also help support optimal testosterone levels and overall well-being helping men to look, feel and live better through optimized hormones.

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