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Causes of Low Testosterone in Men

David Weiler, M.D., ABR, ASBP, AAAAM

*Do you suffer from any of the following low testosterone symptoms?

  • Do you find it hard to build muscle?
  • Do you feel often feel a lack of energy and ambition?
  • Do you feel your sex drive shrinking?
  • Do you feel depressed and unhappy?
  • Do you find no matter what you do you can’t burn off that stubborn belly fat?
  • Do you lack confidence?
  • Do you have memory loss and “fuzzy thinking”?

Here’s why:

*As a man today, you have 50% less testosterone than of a man 50 years ago.  Many studies have come out recently showing that this trend is only continuing and getting worse.

“Researchers in the US are finding testosterone levels to be substantially lower — by about 15 to 20% — than they were fifteen years ago. Scandinavian studies show similar declines and in younger men too. For example, a man born in 1970 had about 20 percent less testosterone at 35 than a man of his father’s generation at the same age.” (Source: ZRT Laboratory)

What is the cause of this?

There are well established reasons for testosterone deficiency. Most of the testosterone men produce comes from the testicles and any injury to the testicles can lead to testosterone deficiency. This may include a previous infection, such as mumps, which can cause orchitis (testicular inflammation) or direct trauma from surgery or accidents. Medications, especially those used in cancer treatment, can injure the testicles or inhibit testosterone production. Statin drugs can lower testosterone. Rarely, genetic diseases, cancer, or a pituitary gland issue will interferes with testosterone production.

More commonly, issues with our overall health and our environment cause low testosterone. It is not always easy to determine why certain patients develop a testosterone deficiency, but there are several common reasons that should be considered in everyone.

Estrogens and Estrogen mimics

One of the most concerning issues regarding testosterone involves chemicals called Xeno-estrogens. Xeno-estrogens are a class of chemicals and toxins that have estrogen like activity in our body. They also cause many health issues, but this blog will focus on how this relates to testosterone production. There are hundreds of chemicals and medications that are considered to be Xeno-estrogens and they are ubiquitous in our environment.

To understand how Xeno-estrogens interfere with testosterone production, it helps to understand a little bit about how the brain controls the majority of our testosterone production. The pituitary gland, which is located in the brain, releases hormones that stimulate production of testosterone by the testicles. Pituitary gland activity is regulated by other hormones, one of which is estrogen.

*High estrogen levels direct the pituitary gland to slow down and hence, testosterone production decreases. Unfortunately, Xeno-estrogens or toxic estrogens can have this same effect and cause testosterone deficiency. So, who is at risk for estrogen toxicity? *Everyone is estrogen toxic. There are so many Xeno-estrogens in our environment, it is impossible to avoid them. Some people have higher toxicity than others and some people are more sensitive to them than others.

The Male Population May Be Decreasing

This is such a huge problem that many scientists believe it is leading to a decrease in the world’s male population. *The ratio of men to women being born each year is shrinking, and many believe toxic estrogens are the cause. It has also been postulated that Xeno-estrogens are causing lower sperm counts in men and higher levels of dysfunctional sperm.

*It is impossible to avoid Xeno-estrogens completely. If you have testosterone deficiency, you need to work with providers who are knowledgeable with bio-identical hormone therapy and can address your specific issues. We at Natural Bio Health are experts in diagnosing and treating testosterone deficiency in men.

Obesity Decreases Testosterone

Another common cause of testosterone deficiency doesn’t involve Xeno-Estrogens, but rather natural estrogen. All men have estrogen, and we need it to stay healthy. *However, when estrogen levels become high it can cause problems.

By the way, low estrogen in men is a problem too, but I am going to focus on estrogen and its relation to testosterone. We get a great deal of our estrogen from our testosterone. Testosterone is chemically converted to estrogen through a process called aromatization. This process uses aromatase, which is an enzyme produced in our body that acts as an accelerator for the chemical reaction that converts testosterone to estrogen. It is an important enzyme that helps maintain a healthy balance between testosterone and estrogen. T

The conversion of testosterone to estrogen occurs most readily in fat because fat cells have a high level of the aromatase enzymes. Unfortunately, in people with excess fat and especially abdominal fat, this production of estrogen from testosterone occurs at an abnormally high rate. High insulin levels and zinc deficiency, which are both common in men with poor health, will contribute further to increased aromatization.

*The result is Testosterone gets used to make estrogen, so testosterone levels decline and estrogen levels go up. However, it doesn’t stop there.  Estrogen slows down the production of testosterone. So, you already have declining levels of testosterone because it’s being converted to estrogen, and all of the newly produced estrogen is putting the brakes on further testosterone production, which only makes the situation worse.

Conversion of Testosterone to Estrogen

As testosterone converts to estrogen, men will start to feel the symptoms of low testosterone, such as fatigue, low libido, loss of muscle strength, and foggy thinking. Some men will even experience hot flashes. *Normally, testosterone is the dominant male hormone, but in severe cases of excessive aromatization, estrogen can start to take over. Men can experience feminine characteristics such as breasts development and loss of body hair.

*This testosterone-estrogen imbalance is only one of many reasons why being overweight drags down your health. Testosterone therapy can help with this, but it must be done carefully. Any testosterone given through hormone replace therapy can go through the same process of aromatization and produce more estrogen, so addressing this type of testosterone deficiency is not as easy as just giving testosterone to raise levels. It is best to work with a provider who has experience in Bio-Identical Hormone Replacement Therapy (BHRT) to manage testosterone deficiency.

At Natural Bio Health we measure and control estrogen production during testosterone therapy in a comprehensive approach to restore normal testosterone levels. Obviously, weight reduction and treatment of the health issues that contribute to obesity play a major role.


*Stress is a constant villain against our health. There is not one system in our body that is safe from the damage stress can inflict and our sexual health is no exception. People who are under a great deal of stress for extended periods of time can develop a variety of symptoms such as fatigue, anxiety, depression, and low libido. The physical and mental symptoms caused by stress can have many sources because it impacts so many bodily systems.

*One thing stress does is reduce testosterone production.  This is one way stress drags down our health. There are multiple animal studies that have shown a relationship between increased stress and decreased testosterone levels. There is also evidence that shows men under prolonged physical stress have significant drops in testosterone levels. And this is not the only effect of stress upon testosterone.

Cortisol Can Block Actions of Testosterone

One study out of The University of Texas displayed that cortisol, one of the main stress hormones, actually blocks some of the actions of testosterone. Therefore, even if you maintain normal testosterone levels under stressful conditions, your testosterone will not work as efficiently, and you’ll feel like you have testosterone deficiency. Stress can affect your health in so many ways that it is difficult to pinpoint which symptoms are solely due to testosterone deficiency and which are from some other aspect of stress. Often the symptoms associated with stress and testosterone deficiency are similar and overlap.

What is important to know is that stress and testosterone deficiency often come together, and both need to be addressed. Removing stress can help to improve testosterone levels and function. *Alternatively, improving deficient testosterone levels with testosterone hormone therapy will help one manage their stress more efficiently. It is always best to address these issues with a comprehensive treatment plan that restores optimal testosterone levels and helps the patient manage stress.

Head Trauma

Control of testosterone levels in men arises from the hypothalamic (a part of the brain)-pituitary-testicular axis. Small veins connect the hypothalamus to the pituitary gland. Gonadotropin releasing hormone is produced and released by the hypothalamus, instructing the pituitary gland to produce follicle stimulating hormone and luteinizing hormone which stimulate the testicles to produce sperm and testosterone. If these tiny veins are torn or disrupted secondary to head trauma the testicles may not receive the necessary stimulus to function normally. Trauma of the type found in sports (football, soccer), accidents (auto, boat, falls, etc.) and war is commonly associated with androgen deficiency. A careful medical history is an important part of the work-up of low T.

In another article I will discuss optimal androgen levels in men. *With so many men affected by this hormonal deficiency it is important not only to supplement testosterone levels but to do it in a way that addresses immediate problems and leads to improved health and function in the long run {hint:  the desired level is higher than most men – and providers – believe).

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