Erectile Dysfunction

Low T syndrome. Low testosterone. Male sexual dysfunction. Doesn’t matter what you call it, I couldn’t be more against the use of testosterone replacement.

Much to my chagrin, I hear a local clinic advertising on the radio station we have playing at the office several times per day. What I find interesting about this clinic’s advertising is that, as of about 6 months ago, they have been pushing the idea that low testosterone and male sexual dysfunction are two different diagnosis, but I’d pretty much bet treatment for both of these “unique” conditions is the same.

And much like every other clinic that treats “low T syndrome” I’m confident that these clinics don’t know enough about physiology to be treating functional problems.

And that’s what low testosterone levels indicate. While testosterone levels will decline with age, the lab ranges indicate normal for the age and gender of the person being tested. If your values come back abnormally low, it’s because something is WRONG.

And it’s not low testosterone.

Low testosterone is just the marker, not the problem. I picture the scene of a dramatically abdominally overweight man sitting on the couch, watching football, drinking beer and eating a bag of chips. When the “low T syndrome” commercial comes on, he nods knowingly, confident that low T is the reason he is overweight, has fatigue and no sexual drive.

The reason that the aforementioned clinic that I hear advertising on the radio is trying to separate low T levels from male sexual dysfunction is that the clinical studies on this topic has found no consistent relationship between the two. Which makes complete sense (unless, of course, you believe the prior advertising).

In addition to not actually fixing the problem (more on this in a minute), there are grave concerns with testosterone supplementation, especially in males. Mainly the increased risk of developing prostate cancer in a person who has health concerns already (hence the low T in the first place), although recent research puts increased clotting and heart attacks on the list as well.

This particular article is one of the best overviews on the topic of where low T levels come from. In it, the authors give an overview of how lifestyle damages the Leydig cells of the testes, where a chunk of the male production of testosterone comes from.

And maybe I’m just giving this article such raves reviews because the authors note that it all stems from my favorite topic, mitochondrial dysfunction. It takes a large amount of energy to produce testosterone and this energy comes from ATP formation in the mitochondria.

When that process of generating energy is compromised, the Leydig cells production of testosterone suffers. This situation can occur in a variety of ways:

• Environmental chemicals like PCBs, BPA (and most other plastics) and phthalates.
• Low nutritional quality diet devoid of protective antioxidants.
• A sedentary lifestyle with little physical activity.

This list should come as no surprise. But hopefully it will serve as a reminder the next time your doctor checks your testosterone and recommends T replacement therapy, either by injection, creams or pellets under the skin.

Evaluation of lifestyle and addressing problems with your lifestyle is the ONLY way to manage low T symptoms—anything else is missing the real problem and increasing your risk of certain cancers.  Luckily, this article raises the suggestion that antioxidant supplements like CoQ10, alpha lipoic acid, vitamin E (the mixed tocopherol variety–NOT straight up alpha tocopherol) and vitamin C can be strong players in protecting your body’s ability to produce testosterone.

Incidentally, if you’re a female and feeling a little slighted by this article (considering that you don’t have Leydig cells and testicles …), I have addressed the adrenal component of testosterone production in a prior article that can be read by clicking here.

The adrenals are a major contributing factor to testosterone production (via DHEA) in both males and females and also need to be fully addressed and treated if someone has low T levels.