Testosterone levels: have I got symptoms of low testosterone?

What is testosterone? Testosterone is usually recognised as being the male sex hormone – even though it is also found in women. The older you get, the less your body produces testosterone. Unhealthy habits also reduce testosterone levels. With a healthy lifestyle and important nutrients, you can increase your testosterone levels naturally.

The hormone testosterone turns an embryo into a full-grown man: in girls and boys, it stimulates muscle and bone growth. During puberty, it causes boys’ voices to deepen and hair to sprout all over their bodies.

But from the age of 30, these bursts of testosterone production slow down. How quickly this happens depends on lifestyle and possible illnesses. This decrease in testosterone production is normal, but sometimes it happens too quickly, which could lead to a variety of health problems.

Gain more insights into what testosterone is, as well as the dangers of low testosterone, what causes low testosterone, low testosterone symptoms and how to test your testosterone levels. 

What is testosterone?

On average, men have ten times more testosterone than women. But in both sexes, the hormone testosterone has important functions.

What does testosterone do?

Testosterone is an androgen – a male sex hormone – and one of the most important male sex hormones. In men, the testes produce 90 per cent of the total testosterone produced in the body, while in women, the ovaries produce the majority. Small amounts are produced in the adrenal cortex.

In the body, testosterone has an anabolic effect; this means it mainly builds up muscle mass. The male sex hormone also helps to reduce fat deposits.

Testosterone is also involved in the following processes:[1]

• Body hair growth
• Sperm production in men
• Increase in libido (sexual desire)
• Muscle strength and bone mass
• Blood formation

Low testosterone in men: what are low testosterone levels?

A total of 20 to 40 per cent of all men have low testosterone levels after the age of 40. Many of the affected men only notice this when the first low testosterone symptoms appear.[2]

What causes low testosterone?

In addition to ageing, diseases or changes in life circumstances can also lower testosterone levels – in both men and women. Possible causes of low testosterone in men and women are:[1]

• Body weight that is too high or too low
• Chronic stress, long endurance training
• Anabolic steroids, alcohol, drug abuse
• Liver cirrhosis, hypogonadism
• Long-term medication with cortisone, birth control pills

Obesity in particular is considered a clear risk factor for low testosterone in men and women. Studies repeatedly show that men have conspicuously low testosterone levels in old age if they are significantly overweight.[11]

Low testosterone levels can also occur in men under 30. Elevated cholesterol levels, high blood pressure and obesity increase the risk of early testosterone deficiency.[3]

What is hypogonadism?

Hypogonadism is when the testicles and ovaries – also known as gonads –  produce too little or no hormones. Older people are most often affected. This disease can be congenital or caused by an excess of iron.[4]

What are anabolic steroids?

Anabolic steroids are substances that accelerate growth processes in the body. Among other things, they make muscles grow significantly faster. Athletes – especially weightlifting athletes – take anabolic steroids to build up more muscle mass. Since 1974, doping with anabolic steroids has been officially banned at the Olympic Games.

Did you know that no substance has been detected more frequently in doping controls than anabolic steroids? Even amateur weightlifters are believed to resort to doping.

The abuse of anabolic steroids reduces testosterone production. In men, they can reduce sperm count and cause the testicles to shrink. Women, on the other hand, have to struggle with excessive body hair and menstrual disorders. In extreme cases, it can lead to enlargement of the heart and calcified arteries.[1, 5]

What are typical low testosterone symptoms?

If the body lacks testosterone, growth processes cannot take place properly. Bone mass decreases and muscle strength diminishes. In addition, men suffer from erectile dysfunction and infertility.

Other symptoms are [6]:

• Depressive moods
• Hair loss
• Anaemia
• Elevated blood sugar levels
• Weight gain around the stomach

Does low testosterone in men cause hair loss?

In some cases, the scalp can react sensitively to testosterone – more precisely, to the by-product dihydrotestosterone. The prostate, the male sex organ, converts testosterone into dihydrotestosterone. Many people possess genes which enables their hair roots to react sensitively to this by-product.

Contact with dihydrotestosterone causes hair on the scalp to fall out. It is important to note that both high and low testosterone levels can promote hair loss if the scalp reacts strongly to dihydrotestosterone.

In women, the paraurethral glands convert testosterone into dihydrotestosterone. These glands are also called the female prostate.[20]

How can I test for low testosterone?

From the age of 30, it is recommended, especially for men, to have their testosterone levels tested. The body’s own testosterone production decreases with age, faster for some, slower for others. Women can also be affected by low testosterone levels.

Is there a low testosterone test?

A testosterone test is used to determine your current testosterone levels. The hormone can be measured with a blood or saliva sample. To diagnose testosterone deficiency with certainty, you should clarify the results of such a test with a doctor.

Even though testosterone is considered a male sex hormone, a testosterone test is suitable for both men and women. Such tests measure the active form of testosterone in your saliva. A saliva test is considered insightful because the free active form of testosterone can be checked. While it is true that only two to five per cent of the testosterone in our body is free and active, the free testosterone circulates and is present throughout the entire body.

The good news is you can now purchase home testing kits, which use modern laboratory analysis methods to check your testosterone levels. In these test kits, you will usually find the necessary equipment to perform the test. To determine your testosterone level, all you need to do is collect small saliva samples, which you then send in to a certified laboratory. After your sample has been analysed, you will receive your results and sometimes even more information about testosterone levels and how you can optimise them further.

Total testosterone can be tested by a blood test. Most of the hormone is found in the blood, but it is bound to proteins there.

You can have your testosterone level determined by a urologist, endocrinologist or andrologist, among others, or with a home health test kit. 

How to treat low testosterone

If there are underlying diseases such as liver cirrhosis or hypogonadism that lower testosterone levels, these must be treated with medication. If you are struggling with a change in your life circumstances, you can also increase your hormone levels naturally.

How can I increase my testosterone levels?

Try to reduce stress in your everyday life. The stress hormone cortisol is the antagonist of testosterone and suppresses its production. So, low cortisol levels usually mean higher testosterone levels. Relaxation techniques and improving the quality of your sleep significantly help to lower your cortisol levels.

You can additionally optimise your testosterone levels by losing weight if you are overweight and by avoiding alcohol and nicotine in your daily life. The more fat tissue there is, the less testosterone there is in the body. If you are very overweight, fatty tissue is inflamed, and more and more of the enzyme aromatase is produced, which breaks down testosterone.

Nicotine and alcohol can inhibit testosterone production where it is produced. In addition to losing weight, abstaining from alcohol and stopping smoking, exercise can help increase testosterone levels. In contrast to long endurance sessions, strength training can boost testosterone production.[7–11]

Testosterone deficiency diet: what nutrients increase testosterone?

If you lack certain nutrients, the body may reduce its production of testosterone. If you suffer from a nutrient deficiency, you can stimulate testosterone production by compensating for the deficiency – that is, with a change in diet or dietary supplements, such as vitamin D and zinc. The following nutrients are related to testosterone production:[12-15]

Nutrient	Where it’s found
Vitamin D	Sunlight, cold-water fish, vitamin D supplements
Magnesium	Wholegrain products, mineral water, legumes
Selenium	Brazil nuts, wheat bran, soybeans, eggs
Zinc	Legumes, wheat germ, nuts, cheese

 

How is testosterone linked to high blood sugar?

Carbohydrates increase our blood sugar levels. In order to lower blood sugar again, our pancreas then releases the hormone insulin. If insulin levels rise sharply because of this, it can cause testosterone levels to drop.

Therefore, if you have low testosterone levels, you should only eat foods that cause your blood sugar level to rise considerably – in moderation. These include white sugar, white bread, fruit juices and sweets.

A better way to boost your testosterone levels if they are low is by incorporating complex carbohydrates, dietary fibres, into your diet. They raise the blood sugar level slowly, meaning the body produces little insulin. You can find these carbohydrates in wholemeal products, pulses, fruit and vegetables.[16]

What is a normal blood sugar level? You can check your long-term blood sugar levels with an hba1c test kit or blood sugar test – either by taking a blood sample at your doctor’s or at home. With your results, you will gain insights into your blood sugar levels, but also your testosterone levels.

Do testosterone supplements really work?

Only use food supplements or medicines containing testosterone if you have consulted your doctor. If you take testosterone without a diagnosed testosterone deficiency, you could run the risk of excessive testosterone levels. Too much testosterone increases the risk of stroke as well as acne and hair loss.[3, 17]

Using ashwaghanda and maca root for low testosterone

Dietary supplement manufacturers advertise that natural remedies such as extracts of ashwaghanda or maca root can be used to increase testosterone levels. However, a 2019 study by the American Journal of Men’s Health found that ashwaghanda has very little effect on testosterone levels. Therefore, more research is needed. Scientists have also claimed that more research needs to be done to find out the exact benefits of maca root for testosterone levels.[18,  19]

What are the side effects of too much testosterone?

Testosterone levels can be elevated in men and women in rare cases when testosterone is administered in the form of tablets or injections or when an adrenal tumour is present.

Cushing’s disease, a condition with greatly increased cortisol levels, can also cause excess testosterone. In women, ovarian cysts and tumours and a congenital disorder of hormone production in the adrenal cortex – and in men, active testicular tumours – can increase testosterone levels.[20]

What is testosterone – at a glance

What is testosterone?

Testosterone is considered the male sex hormone and is also found in small amounts in women. It is produced in large quantities, especially during puberty. It is responsible for muscle and bone formation, the development of male sexual characteristics and sperm formation.

What causes low testosterone?

After the age of 30, testosterone production decreases. Diseases, obesity and drug abuse can increase the risk of a deficiency.

How do I treat a testosterone deficiency?

You can normalise your levels through medication, exercise, weight loss and a balanced diet. Nutrients important for testosterone are fibre, magnesium, zinc, selenium and vitamin D.

Sources

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[2]       ‘Testosteron’, Urologe und Androloge - Urologische Praxis Prof. Dr. Porst, 12 April 2018, available at http://www.porst-hamburg.de/spezielle-andrologie/testosteron.html, accessed on 12 April 2018.

[3]       ‘Testosterone therapy: Potential benefits and risks as you age’, Mayo Clinic, available at http://www.mayoclinic.org/healthy-lifestyle/sexual-health/in-depth/testosterone-therapy/art-20045728, accessed on 16 April 2018.

[4]        Gr, D. ‘Leitlinie Männlicher Hypogonadismus’, p. 15.

[5]       ‘Pschyrembel Online | Anabolika’, available at https://www.pschyrembel.de/Anabolika/K029G/doc/, accessed on 17 April 2018.

[6]        Grober, E. D. ‘Testosterone deficiency and replacement: Myths and realities’, Canadian Urological Association Journal, vol. 8, no. 7–8, pp. 145, August 2014, doi: 10.5489/cuaj.2309.

[7]        Wood, R. I., Stanton, S. J. ‘Testosterone and sport: current perspectives’, Horm Behav, vol. 61, no. 1, pp. 147–155, January 2012, doi: 10.1016/j.yhbeh.2011.09.010.

[8]        Wittert, G. ‘The relationship between sleep disorders and testosterone in men’, Asian J. Androl., vol. 16, no. 2, pp. 262–265, April 2014, doi: 10.4103/1008-682X.122586.

[9]        Traish, A. M. ‘Testosterone and weight loss: the evidence’, Current Opinion in Endocrinology, Diabetes and Obesity, vol. 21, no. 5, p. 313, October 2014, doi: 10.1097/MED.0000000000000086.

[10]      Annweiler, C. ‘Vitamin D and ageing: neurological issues’, Neuropsychobiology, vol. 62, no. 3, pp. 139–150, August 2010, doi: 10.1159/000318570.

[11]      Fui, M. N. T., Dupuis, P., Grossmann, M. ‘Lowered testosterone in male obesity: mechanisms, morbidity and management’, Asian J Androl, vol. 16, no. 2, pp. 223–231, 2014, doi: 10.4103/1008-682X.122365.

[12]      Pilz, S. ‘Effect of vitamin D supplementation on testosterone levels in men’, Horm. Metab. Res., vol. 43, no. 3, pp. 223–225, March 2011, doi: 10.1055/s-0030-1269854.

[13]      Chang, C. S., Choi, J. B., Kim, H. J., Park, S. B. ‘Correlation between serum testosterone level and concentrations of copper and zinc in hair tissue’, Biol Trace Elem Res, vol. 144, no. 1–3, pp. 264–271, December 2011, doi: 10.1007/s12011-011-9085-y.

[14]      Maggio, M. ‘The Interplay between Magnesium and Testosterone in Modulating Physical Function in Men’, Int J Endocrinol, vol. 2014, p. 525249, 2014, doi: 10.1155/2014/525249.

[15]      Shafiei Neek, L.., Gaeini, A. A., Choobineh, S. ‘Effect of zinc and selenium supplementation on serum testosterone and plasma lactate in cyclist after an exhaustive exercise bout’, Biol Trace Elem Res, vol. 144, no. 1–3, pp. 454–462, December 2011, doi: 10.1007/s12011-011-9138-2.

[16]      Grossmann, M. et al., ‘Low testosterone and anaemia in men with type 2 diabetes’, Clin. Endocrinol. (Oxf), vol. 70, no. 4, pp. 547–553, April 2009, doi: 10.1111/j.1365-2265.2008.03357.x.

[17]      Chung, K.-J., Kim, K.-H. ‘Forbidden fruit for athletes, but possible divine blessing for rehabilitation: testosterone’, J Exerc Rehabil, vol. 11, no. 1, pp. 2–4, February 2015, doi: 10.12965/jer.150191.

[18]      Dording, C. M. et al., ‘A Double-Blind Placebo-Controlled Trial of Maca Root as Treatment for Antidepressant-Induced Sexual Dysfunction in Women’, Evidence-Based Complementary and Alternative Medicine, 2015, available at https://www.hindawi.com/journals/ecam/2015/949036/, accessed on 5 August 2019.

[19]      Lopresti, A. L., Drummond, P. D., Smith, S. J. ‘A Randomized, Double-Blind, Placebo-Controlled, Crossover Study Examining the Hormonal and Vitality Effects of Ashwagandha (Withania somnifera) in Aging, Overweight Males’, Am J Mens Health, vol. 13, no. 2, March 2019, doi: 10.1177/1557988319835985.

[20]      Faller, A., Schünke, M. Der Körper des Menschen - Einführung in Bau und Funktion, 17th Edition. Thieme, 2016.