Testosterone is a critical hormone for BOTH men and women. Unfortunately, neither men or women are frequently screened for testosterone deficiency despite the clear symptoms and profound potential improvement with optimization. The state of testosterone management is so poor in our health care system that there is actually no definition for deficiency in women and the levels noted as deficient for men are well below the threshold where symptoms can occur! This is unfortunate because the symptoms of low t in men and women include very common things like fatigue, brain fog, loss of vitality and libido, depression, loss of muscle mass and bone quality, weight gain and worsening risk factors for heart disease, diabetes and dementia. Seems like something we should measure!

If the frequency of the symptoms of low T weren’t enough of a reason to test the reality of the situation we find ourselves in should be. Testosterone levels in men have been dropping across the population steadily over the last 20 years. One study showed a 20% decrease over that time frame. Anecdotally I see low testosterone in most men and women when they start. The reasons for the epidemic of low T are many but some of the most important to realize are stress, poor sleep, sleep apnea, obesity, visceral fat and a toxic environment.

At OHH we don’t start most people on testosterone replacement when they test low. The OHH approach is to use lifestyle, nutrition and supplementation first! We do replace hormones in both men and women when needed but we find that once your systems are optimized the amount of replacement you need is reduced and the success of replacement is dramatically improved. When testosterone is optimized both men and women have a greater sense of well being, improved vitality and libido, better skin quality, improved energy, bone density, body composition and reduced anxiety and depression.

The most important thing I can pass on through this email is that lifestyle changes can have the biggest impact in women and in men. For men stress, visceral fat, poor nutrition, lack of exercise and sleep disturbance will tank your T. When your body is inflamed, immune system activated and cortisol elevated your brain shuts off the signal to produce testosterone. If you have visceral fat you may make enough but it’s being converted to estrogen! Unfortunately, this is where most adult men live! We test these metrics and consistently see the triad of elevated cortisol and inflammatory markers with low T.

Women suffer from the same response but the reason is different. Women make half of their testosterone in the ovaries and half in their adrenal glands. The same is true but to a smaller extent with progesterone. When the adrenal glands are busy making cortisol to deal with stress they can’t spend the energy and resources to make testosterone and progesterone. This is true for both pre and post menopausal women. While lifestyle changes will help both population of women a discussion of the risks and benefits of hormone replacement should be had with every peri or post menopausal woman!

If you suffer from ANY of the symptoms listed above we recommend knowing where you are with your hormones so that you can optimized your health. At OHH we use a comprehensive approach and make sure that the thyroid, adrenal glands and sex organs are working appropriately because dysfunction in one can affect the others!

Next week I’ll discuss how specifically you can improve your testosterone through lifestyle and who may want to consider testosterone replacement for men and bioidentical hormone replacement for women!

In Gratitude, Dr. Doug

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