Men, How Low Is Your T?
6/23/2015
Robert Kachko, ND, LAc
June is Men's Health Month
Tuesday, June 23, 2015
by: Robert Kachko, ND, LAc

Section: Men's Health


About Dr. Robert Kachko

Robert Kachko, ND, LAc is a Naturopathic Doctor and Licensed Acupuncturist at InnerSource Health in New York City. He proudly serves on the Board of Directors of the American Association of Naturopathic Physicians (AANP) and takes an active role in the New York Association of Naturopathic Physicians (NYANP). He graduated Summa Cum Laude with a Doctoral Degree in Naturopathic Medicine and a Masters Degree in Acupuncture from the University of Bridgeport College of Naturopathic Medicine and Acupuncture Institute. He has completed an additional 2 year course of study in Classical Homeopathy at the New England School of Homeopathy. He completed his pre-medical studies with a Bachelor's Degree with honors at the University of Wisconsin, Madison.

Dr. Kachko believes in the importance of expanding access to Naturopathic Medicine and Acupuncture for all patients. At the College of Naturopathic Medicine, he was founding President of the expanded local chapter of the Naturopathic Medical Student Association (NMSA) and received the prestigious award for Outstanding Service to the Profession.


To learn more about Dr. Kachko, please visit him on Facebook and www.innersourcehealth.com/Robert-Kachko.
Men with low testosterone are at greater risk for a myriad of chronic diseases. In a perfect world, disease would result from dysfunction of easily adjusted individual factors. However, the reality is that the majority of chronic disease plaguing Americans is multi-factorial, and it is crucial to look at the whole picture. Men’s Health Month is an excellent opportunity to discuss the health effects of low testosterone (“low T”) and their implications for overall well-being. Often overlooked is the connection between low T and metabolic disorders such as diabetes or heart disease. What’s not clear, at this point, is what the most common initial cause is in this proverbial “chicken or egg” cyclical scenario. The good news is that we have natural ways to increase testosterone and reduce the other risk factors for those very same chronic diseases.

The good news is that we have natural ways to increase testosterone and reduce the other risk factors for those very same chronic diseases.

Low T and low quality of life: a well-researched connection
 
Overall we know that men who have low T are not living as long as they otherwise could.[i] We also know that obese men (measured by waist circumference) tend to have lower levels of testosterone, and that obese men are at higher risk for developing cardiovascular disease and diabetes.[ii] With low T, fat deposition actually occurs around certain key organs (called “visceral adiposity”), which plays a strong role in the function of our endocrine and inflammatory systems and further perpetuates the problem. There have been strong and direct correlations made between low T and insulin resistance, which is the main cause of type 2 diabetes.[iii] So it becomes clear, in the context of a comprehensive approach to men’s health, that we cannot overlook hormonal status as a marker of overall well-being.
 
Steps to take to naturally raise Testosterone
 
As comprehensive and reliable studies are currently lacking on natural ways to simultaneously raise testosterone AND reduce the risk of developing the various chronic diseases mentioned above, it is helpful to assess something of concern to many men and at the crossroads of our discussion: erectile dysfunction (ED). Just as ED may be a sign of low testosterone, it is also an early indicator of cardiovascular health. Let’s review some ways to address this common issue:[iv]
 
1.     Eat a health promoting diet: A diet high in fruit, vegetables, nuts, whole grains, and fish but low in red meat, processed meat, and refined grains is more likely to be consumed in men without ED. The Mediterranean diet has been studied and proven to be more effective than standard American diets in men with ED who also have obesity or metabolic syndrome.[v] In those with insulin resistance, metabolic syndrome, or diabetes (higher prevalence in those with Low T), the Glycemic Index is a useful tool for assessing how quickly a certain food will impact a person’s blood sugar. The higher the “glycemic index” or “glycemic load” of a food, the worse it is for people who have difficulty maintaining appropriate blood sugar levels. These effects are mostly a factor of the content of fiber, healthy fat, and protein of a particular food. In addition, it is prudent to aim for foods high in zinc, as those with low T tend to be deficient in zinc and increased zinc consumption has been shown to raise testosterone levels.[vi]
 
2.     Exercise and lose weight: In the Massachusetts Male Aging Study, physically active men were 30% less likely to develop ED than sedentary men.[vii]We’ve already mentioned the connection between low T and obesity (especially abdominal obesity). Men with Body Mass Index of less than 25 are least likely to have ED, while those with BMI of greater than 30 are as high as 3 times more likely.[viii] The good news is that after a few years of practicing healthy behaviors geared toward losing weight in a sustainable way, men can regain optimal function.[ix] Likewise, increasing testosterone is independently associated with weight loss.[x]
 
3.     Stop smoking: Smokers are 1.5 times more likely to suffer from ED (due to effects on blood flow, oxidative stress, hormones etc.) than non-smokers, and those who quit smoking can see up to 25% improvement after just 1 year of smoking cessation.[xi] [xii] Quitting smoking, while a difficult process, is possible with the proper motivation. A sustainable approach requires an understanding that in addition to the biochemically addictive nature of cigarettes, there is a habitual addiction involved. Learning to break those habits in a systematic way, under the guidance of a trained professional, is essential.
 
4.     Maintain a positive mental outlook: Our ability to maintain an optimistic mindset affects us on a physical level in a very real way.Men shown sad clips prior to exercising produce less testosterone than they otherwise would, and less than when they are shown more uplifting clips.[xiii] Meditation is a great tool to help us maintain an appropriate stress response, which is intimately tied to hormones such as testosterone.[xiv] Make sure to schedule opportunities for joy and reflection in your life.
 
5.     Have sex: Men who have sex more than once per week are less likely to experience symptoms of ED than those who do not.[xv] As testosterone plays a central role in both our ability and our desire to have intercourse, regular sexual activity may help to improve low T. Not to mention, it can be a great workout!
 
While testosterone status is just one piece of the puzzle of holistic wellness, it provides a useful indicator of overall well-being. For some men with low T, natural hormone replacement may be indicated. This is something which should be discussed with your Naturopathic Physician, in addition to individualized ways to improve your hormonal status and reduce your other risk factors for chronic disease.
 


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[ii]Svartberg J, von Muhlen D, Sundsfjord J, et al.Waist circumference and testosterone levels in community dwelling men. The Tromso study. European Journal of Epidemiology 2004;19:657–663.
[iii]Traish AM, Saad F, Guay A. The Dark Side of Testosterone Review Deficiency: II. Type 2 Diabetes and Insulin Resistance. J Androl 2009;30:23–32.
[iv]Glina S, Sharlip ID, Hellstrom WJG. Modifying Risk Factors to Prevent and Treat Erectile Dysfunction. J Sex Med 2013;10:115–119.
[v]Esposito K, Giugliano F, Maiorino MI, Giugliano D. Dietary factors, Mediterranean diet and erectile dysfunction. J Sex
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[vi]Prasad AS, Mantzoros CS, Beck FW, et al. Zinc status and serum testosterone levels of healthy adults. Nutrition 1996;12(5):344-8.
[vii]Johannes CB, Araujo AB, Feldman HA, et al. Incidence of erectile dysfunction in men 40 to 69 years old: Longitudinal results from the Massachusetts male aging study. J Urol 2000;163:460–3.
[viii]Chitaley K, Kupelian V, Subak L, Wessells H. Diabetes, obesity and erectile dysfunction: Field overview and research priorities. J Urol 2009;182(6 suppl):S45–50.
[ix]Esposito K, Giugliano F, Di Palo C, et al. Effect of lifestyle changes on erectile dysfunction in obese men: A randomized controlled trial. JAMA 2004;291:2978–84.
[x]Traish AM.Testosterone and weight loss: the evidence. Curr Opin Endocrinol Diabetes Obes. 2014;21(5):313-22.
[xi]Dorey G. Is smoking a cause of erectile dysfunction? A literature review. Br J Nurs 2001;10:455–65.
[xii]Pourmand G, Alidaee MR, Rasuli S, et al. Do cigarette smokers with erectile dysfunction benefit from stopping?: A prospective study. BJU Int 2004;94:1310–3.
[xiii]Cook CJ, Crewther BT. Changes in salivary testosterone concentrations and subsequent voluntary squat performance following the presentation of short video clips. Horm Behav. 2012;61(1):17-22.
 
[xiv]MacLean CR1, Walton KG, Wenneberg SR, et al. Effects of the Transcendental Meditation program on adaptive mechanisms: changes in hormone levels and responses to stress after 4 months of practice. Psychoneuroendocrinology 1997;22(4):277-95.
[xv]Koskimäki J, Shiri R, Tammela T, et al. Regular intercourse protects against erectile dysfunction: Tampere Aging Male Urologic Study. Am J Med 2008;121:592–6.
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