Issue #200: What Happened to Our Testosterone?
Good morning. It’s Thursday, June 15th.
Today’s Quick Win
From the Lab: Testosterone and TRT
Speed Read: It’s About Time
Thursday Night In: Grilled Salmon with Avocado Salsa
“Greater even than the greatest discovery is to keep open the way to future discovery.”
The projected global Testosterone Replacement Therapy (TRT) market in 2026, that’s a 100% increase from 2020. According to one study, 25% of men who receive TRT did not have their testosterone levels tested prior to initiating therapy. (NIH)
From the Lab
We’re living in an era of low testosterone.
It’s true that testosterone drops about 1% per year starting around age 30.
But…
the average 40-yr old, 50-yr old, 60-yr old (I could keep going) have lower testosterone levels than guys of the same age back when we were partying in 1999. (Cleveland Clinic)
Why is this such a big deal?
Testosterone (T) is essential for us to have energy all day long, to workout, to use our brains, and to have great sex.
Having the right level of T is also critical for bone density and heart health - plus just being in a good mood. It’s normal to go through ups and downs as we manage kids, work, life - but chronic fatigue and being depressed or upset might be a signal of hormonal imbalance.
There are more and more studies and books (“Of Boys and Men”) talking about the struggle of the current “male malaise” - is it a coincidence that this aligns with low T?
Why is T going down?
Here’s the quick hit list:
Stress
Lack of Sleep
Bad Diet
Not Enough Exercise
Toxins
Testosterone - like any hormone - doesn’t exist in a vacuum. It constantly interacts with all of our other hormones. Well one of these hormones is cortisol.
Cortisol stops the production of T. So when we’re living in a state of chronic stress or not getting enough sleep (pretty big problems in 2023) - our cortisol spikes and accelerates the decline of testosterone levels.
Similarly, accumulating fat in our body increases aromatase - an enzyme that converts testosterone to estrogen. The lower T then increases the resistance to insulin (metabolic problems) and leptin (we just keep eating). It’s a pretty vicious cycle.
Another problem is endocrine disruptors. Plastic water bottles (BPA) and other food containers, and fertilizers (such as atrazine) known to cause hormonal issues in animals, are more prevalent than ever before.
A note on endocrine disruptors - nearly 50 million women in the U.S. use birth control. Dr. Tracy Gapin writes in his book, “Male 2.0,” that this gets back into our water supply as treatment plants don’t effectively remove estradiol (estrogen).
So what’s “low T”?
Here’s a chart of ranges from the 10th to 90th percentile by age range:
There’s obviously a MASSIVE range here. The key is to see if you’re both low AND have symptoms.
But there is another important point. 97% of our testosterone is tied up to a binding agent, such as sex hormone-binding globulin (SHBG), and can’t get into our cells and power us up. What’s really important is to measure “free testosterone.”
When you get tested for low T make sure you get results for:
Total Testosterone
Free Testosterone
Thyroid Stimulating Hormone (TSH)
T3 & T4 (thyroid function connected to T)
See optimal results for thyroid here:
Is testosterone replacement therapy (TRT) the solution?
Most of the time low T is a symptom, not a cause, of bad health. The first place to start is everything we preach at Thrive25. Here are 5 practical tips to do whether you decide to get more T or not:
Optimize your Waist-to-Height ratio (0.5) (Issue #36) and Waist-to-Hip ratio (0.9)
Strength training at least 2-3x per week to boost lean mass
Get Omega-3 in diet or supplement - it lowers aromatase and thus the conversion to estrogen (Issue #22)
Avoid plastic food containers and water bottles
Filter your water (Issue #28)
After that’s done, if you still have symptoms and low T - then find a qualified functional medicine doc that isn’t just jumping at the chance to give you an injection, but rather is focused on your health and thinks TRT can be a part of the solution.
There are multiple ways to get TRT - creams, injections, pellets.
NOTE: creams can be dangerous to anyone around you. If you don’t wash your hands and hug your kids, they will get some of the testosterone to absorb in their skin.
Pellets seem to be a top choice - but again, this is what’s best for you. I’ll be honest in that I haven’t gone through TRT, but recognize that it might be something I’ll need in the future.
Final note - when taken in the right amount, most research now suggests that TRT is safe and should not increase any risks of prostate cancer or other health problems.
But…if taking too much, you’ll revisit puberty and can have significant problems with acne, hormonal rages, and other problems. If taking too long without a break, then the body stops functioning on it’s own:
“Men get started on testosterone replacement and they feel better, but then it's hard to come off of it. On treatment, the body stops making testosterone. Men can often feel a big difference when they stop therapy because their body's testosterone production has not yet recovered." - Dr. Carl Pallais
Bottom Line - don’t accept low T, but find the right way for you to get what you need to live how you want for as long as possible.
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Speed Read
Health & Longevity in the News
A Quick Reminder on Time: We know you read Four Thousand Weeks, but just in case you haven’t, here are some more ways people are changing their relationship with time to avoid optimizing it and just be. (WSJ)
Longtermism Part II - More on Time: Roughly 117B people have ever lived on Earth - 8B (6.8%) of us are alive at this very moment (the most ever, until tomorrow). The sun has 5B more years of energy and the universe will exist for trillions of years. But how about humanity? What decisions are we making today, positive and negative, that affect our existence? With great power comes great responsibility. What will the next 117B think about us? (Big Think)
Finally, the Silver Bullet: It’s not NMN, TRT, metformin, rapamycin, cold plunges or breathing less. While we’re fascinated by all of this research, exercise is still the #1 way to slow your biological age and stave off a host of diseases. Check out our Best of 2022 Issue on Movement (Issue #96) for a summary of the science on why and what you can do to up your exercise. (WSJ)
Thursday Night In | Grilled Salmon with Avocado Salsa
We love salmon for the omega-3 and protein and avocado for the monounsaturated fat, potassium and fiber - so this recipe is a no-brainer. It also tastes great…enjoy!
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We’re 40-something dads that felt our bodies and minds start to slow down and we’re not ready for that. We found too much information on every subject. So we started Thrive25 to transform what we’ve learned into something useful for the rest of us to spend just 3-5 min a day to optimize our health & longevity.
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The information in this newsletter is for informational purposes only and may not be appropriate or applicable based on your individual circumstances. Thrive25 Labs LLC does not provide medical, professional, or licensed advice. Please connect with your healthcare professional for medical advice specific to your health needs.