Does this sound like you you?
We are all familiar with the term and condition of menopause.
However, have you ever heard of the term Andropause? Do you or any men in your life struggle with several or all of the following symptoms?
Have you found the following on your blood work and/or physical exam?:
- Increase in total cholesterol
- Decrease in HDL cholesterol
- Increasing fasting blood glucose
- Blood pressure elevation
- Decreased bone density
If so, there is a good chance that you or they are experiencing unnecessary and symptomatic testosterone decline. Andropause is the term for this gradual decline in androgen (sex) hormones that men may lose as they age. This decline, unlike in women, occurs much more gradually and without the overt loss of something like a menses to get our attention. Far too often it goes unidentified and therefore unaddressed. So quality of life at home and work suffers as well as the increased health risks from obesity, insulin insensitivity, increased risk for stroke and heart attack as well as osteoporosis and diabetes. Not a pretty picture. According to the US Census Bureau, approximately 4 -5 million men suffer from low testosterone levels while only 5-10 percent of them will seek treatment.
There are many different forms of low-testosterone syndromes. These include genetic disorders, primary, secondary, and functional Andropause (which happens to be the most common). Functional Andropause takes place when the ratios between testosterone and other hormones shift. The most common cause of functional Andropause occurs when there is a difference in the ratio between serum levels of testosterone and estrogen.
Lifestyle and dietary habits are often to blame and by correcting them we are able to shift the balance of hormones dramatically improving quality of life. Although we may be able to easily identify “bad” habits we most often don’t really know the full implications of our choices and thus can remain in blissful ignorance until our quality of life suffers enough to really grab our attention.
The Big Culprits include:
1) The Standard American Diet (SAD), which is devoid of the necessary amounts of essential fatty acids, dietary fibers and loaded with stimulants of sugar and caffeine from sodas and coffee.
- Our bodies require Omega-3 fatty acids. These are called essential because our bodies cannot synthesize them. We must get them from our food. Omega-3, Omega-6 and Omega-9 oils are the basis of our cholesterol. Cholesterol is the backbone of what will become all of our hormones including sex hormones. Our SAD diet offers a grossly imbalanced ratio of omega-3 to omega-6 to omega-9 fatty acids as well as includes hydrogenated oils and trans fats completely altering the structure of our hormone precursors. Fast foods full of hydrogenated oils, trans fats and sugar significantly alter our fatty acid ratios impacting all major processes needed to promote optimal androgen production as well as our gastrointestinal health. Fast food consumption on a regular basis will make the successful treatment for Andropause impossible.
- Dietary fibers help allow our liver to eliminate excess estrogen as well as prevent our gut from reabsorbing the estrogens on their way out.
- Caffeine has an adverse impact on Andropause on multiple levels. Caffeine is an adrenal stimulant promoting over-activity and creating a shift in androgen physiology away from testosterone and towards stress hormones and excess estrogens. Over abundance of estrogen in men is a cardiovascular risk factor. Caffeine also places a demand on liver detoxification risking depletion of nutrients needed for the multiple detoxification processes. Caffeine has also been shown to have multiple adverse impacts the gastrointestinal health from reflux, increased gallbladder contraction, increased colon stimulation.
2) Also of note is exposure to chemicals found in plastic water bottles and food containers. Some of these plastics may even be labeled as “safe” to microwave in plastic. Among other problems the chemicals in plastics have a cumulative estrogenic effect. Some of these chemicals have been tested. Many have not. It has taken over 40 years before “experts” were finally willing to admit that there is enough evidence to remove this BPA from some of our plastics. Unfortunately, there are still many other chemicals in plastics the have yet to be tested and proven safe. Likely these will be found to be unsafe in the future.
3) Chronic stress causes functional adrenal dysregulation and a pattern known as pregnenolone steal. Chronic chemical, emotional and /or physical stressors set in motion viscous physiologic cycles. Stressors such as lack of sleep, too much alcohol and or other drugs, environmental toxins (the plastics mentioned above), ongoing relationship stress, and underdoing or even overdoing physical activity can each eventually impact your adrenal glands ability to compensate creating a physiologic shift away from synthesizing sex hormones like testosterone towards making the stress hormone cortisol. Cortisol in turn raises your blood sugar. When this becomes a continual state you will get increased belly fat, depressed immune system, suppressed metabolic thyroid hormones, increased estrogen levels and increase insulin resistance. Anyone suffering from chronic stress especially if also having difficulties with sleep and or energy regulation must assess how well your adrenals are able to maintain adequate function and support the rest of your body. A salivary hormone panel can obtain objective levels of cortisol, DHEA and determine if these is a pattern of pregnenolone steal occuring.
Our Gastrointestinal tract is the entry point for our nutrients and eventual fuel. Our GI tract has a large influence on how our hormones can and will ultimately function. Gastrointestinal health and function is another required area that must to be properly assessed and addressed to successfully fix Andropause. Any symptoms in the GI area, i.e. constipation (less then 1 bowel movement /day, straining with bowel movements or a feeling of incompleteness with bowel movements), diarrhea, abdominal pain, GERD (gastro-esophageal reflux disease), excessive flatulence, burping, nausea, bloating etc. are all indicative that there are problems that need correcting. The changes taking place in the gut directly and intensely impact our whole bodies function. Any conditions such as too little stomach acid, pancreatic enzyme insufficiency, biliary stasis, bacterial microflora imbalance, yeast overgrowth, gastric or duodenal ulcers will directly impact your body’s ability to move out of Andropause.
Some medications adversely impact androgen synthesis and liver enzymatic activity. Antifungals, thiazide diuretics, and other heart medications actually slow down the synthesis of testosterone and act as testosterone receptor inhibitors. Speak with your doctor about this concern especially if you are already experiencing the signs and symptoms mentioned at the beginning of this article.
To successfully and safely correct this potentially complicated condition due to the many confounding factors and hormonal players a thorough holistic approach including assessment of dietary and lifestyle, gastrointestinal health status, and medications needs to be the initial step. Depending on the findings there are many specific recommendations that will greatly aide your body to restore its balance.
I strongly caution against taking testosterone replacement based solely on serum levels without considering and properly assessing the causes for your decline. Inappropriate testosterone replacement carries with it serious potential risk factors including Benign Prostate Hypertrophy (BPH), Prostate cancer, worsening of sleep apnea, Congestive Heart failure and most recently the FDA has now warned that testosterone supplementation can cause venous blood clots even in the absence of a condition called polycythemia which offers extra risk for this side effect. Testosterone replacement based on laboratory values of testosterone alone is inadequate and may not offer the prevention or the protection from further illness.
Basic Recommendations to Improve and Fix Andropause include:
1) Decrease meat intake and increase fiber intake 3-6 servings of vegetables per day.
2) Avoid coffee and processed foods, which will be high in caffeine, sugars, and bad fats. Note that decaffeinated coffee still has 60% caffeine and will not work as alternative.
3) Avoid a high carbohydrate diet
4) Avoid “fast food”
1) No Plastic DO not drink from plastic. Even if it says BPA free. The chemical alternative being used has not been adequately evaluated just as BPA had not been before it was put into use. Drink your daily water from either stainless steel and or glass bottles and or glasses.
2) Completely avoid microwaving in plastic. Instead use glass or a microwave safe ceramic.
3) Store food in glass containers.
Regular exercise – minimum of 30 minutes 3-4 x/week of aerobic exercise
1) A verified high quality omega-3 fatty acid. I like the product Omega-Co 3 from Apex Energetics. 1-2 TBS per day. It has a verifiably clean source of omega 3 oils as well as co-factors that enhance absorption and utilization.
2) Probiotics – The probiotics must be of a verifiable high quality. These should be taken daily with meals to restore and maintain your optimal gut flora. My favorite general probiotic has been HMF from Genestra.
3) Fiber – 1-2 TBS /day of organic flax seed. Make sure to keep this in a dark, in air tight container in small enough amounts that you will go through it quickly. This should be along with the fibers you will also get your high vegetable diet.
These and many more effective recommendations based on your individual whole hormone picture and lifestyle will get the job done and have you off to feeling your best in short order. If you have concerns about this or related issues talk with your doctor. There is much more to know about this topic. Don’t resign to your symptoms. It may take some work on your part. But what is more important than your health?