Testosterone Replacement Therapy – More Important Than Ever?


A man’s greatest fear is to be emasculated. Men take pride in their manhood, and the perception or reality of losing it is a devastating proposition. Here is everything you need to know about Testosterone Replacement Therapy.

Low testosterone (or “low T”) affects millions of men around the world, causing such side effects as loss of sex drive and fatigue, which can lead to depression.

Testosterone decline, as unsettling as it is, is a natural process — levels begin to decrease about 1 percent per year starting at about age 60, but it can begin as early as a man’s 30s.

Fortunately, the process can be countered with natural remedies or medical intervention. The crucial first step is to get testosterone levels tested via a blood test.

Here’s everything men should know about low testosterone and testosterone replacement products.  

1 in 4 men over 30 has low testosterone

This stat has been heavily circulated since it published in 2007. The study was done by the Endocrine Society, a hormone research firm that sets standards for testosterone therapy treatment.

The study also found that approximately 30 percent of men ages 40 to 79 are affected by hypogonadism, a condition marked by testosterone levels below 300 ng/dL (nanograms per deciliter). The symptoms of this condition include muscle atrophy, weight gain, exhaustion, depression, poor sleep and disinterest in sex, among other side effects.

An Endocrine Society study from 2012 provided another compelling conclusion.

The study analyzed testosterone measurements in more than 1,500 men and found that declining testosterone was more likely due to lifestyle behaviors than the natural aging process.

The researcher also found that those who were obese, depressed or unmarried were more likely to suffer from low-T.

If you’re experiencing the symptoms of low testosterone, investigate all other possible health issues that may be factors. There are likely several lifestyle changes you can make to be healthier and promote testosterone health.

Low Testosterone is on the rise

Two studies have confirmed a rise in lowering testosterone. One study done in the U.S. showed a 22 percent drop in testosterone over a seventeen-year span. This exceeds the rate of which testosterone levels drop naturally.

Dr. Jason Phan has a hypothesis on why testosterone is on the decline. It is due to epigenetics – how the environment we live in affects genetic makeup. The water we drink, the air we breathe and the foods we consume affect the way we replicate and transcribe genes. This is a possible cause for an increased amount of chronic diseases such as hypogonadism.

Another possible cause of low testosterone in men is the increase in phytoestrogens in our foods – from soy products to genetically modified foods (GMO). These organisms are ingested and change the microbiome of the gastrointestinal system of the human body. 99 percent of our genetic makeup has been found in the bacteria in our digestive system.

The way we assimilate to our environment affects our bodies in numerous ways.

Symptoms of Low-T

Testosterone supports bodily functions like sex drive, sperm production, building muscle, fat distribution, bone density and red blood cell production. Without knowing the symptoms of low-T, it’s obvious that healthy testosterone levels are important.

Here are possible side effects:

  • Sexual function – Reduced sex drive, possible infertility; some men with low-T will also have erectile dysfunction, but a direct correlation hasn’t been proven.
  • Physical changes – As testosterone helps men develop “manly” features like chest hair, muscles, and a lowered voice, some of these features suffer if testosterone levels drop. This could mean weight gain, loss of muscle mass and bone strength, hot flashes and increased fatigue.
  • Sleep disturbances – Despite causing fatigue, low-T can also interrupt sleep by causing insomnia. As with other symptoms, a sleep apnea condition can contribute to testosterone loss.
  • Emotional changes – The cumulations of effects is a natural cause of depression. Lack of sexual activity, muscle mass and energy is tough for any man to overcome without bouts of depression.

Other reasons. It’s important to note that these symptoms may be due to a plethora of other conditions like testicular cancer, diabetes, a thyroid condition or alcohol use. Always consult a medical professional for a diagnosis.

The Importance Of Free Testosterone Levels  

Free, or unattached, testosterone is that which is not attached to sex hormone binding globulin (SHBG), and it’s more important when it comes to overall health.

This testosterone is more readily available for the body to consume.  Free testosterone is used by the body for numerous functions including mental acuity, muscle growth, metabolic health and sexual functions.

One hypothesis of low free testosterone levels is the increase of sex hormone binding globulin (SHBG). SHBG may be elevated due to high exposure to chemicals/pesticides, prolonged electronic use (cell phones), inability to detoxify, BPAs, GMO, and heavy metal exposure.

A recent study found that men with low free testosterone levels but normal total testosterone levels have more low-T symptoms than men with isolated low total testosterone levels. This conclusion was valid despite differences in age or BMI.

How Diet Affects Testosterone

A symptom of low-T is obesity, and the side effects of obesity may speed up deteriorating testosterone rates.

Naturally, men who fear low-T will focus on losing weight. This is good, but there are a few things to consider when deciding on a testosterone diet.

Studies have shown that low-fat, low-carb or low-calorie diets may have adverse effects for those looking to retain testosterone. Feeding the body the adequate amounts of nutrients is important in testosterone production; diets high in fat are actually beneficial in increasing testosterone levels because fats increase cholesterol levels, which is a precursor to hormone production. Diets high in fats have been getting a bad rap, but sugar and inflammation are more likely causing low testosterone in men.

One study showed the concentrations of total and SHBG-bound t-levels were 13 and 15 percent higher than for participants on a high-fat, low-fiber diet opposed to the low-fat, high-fiber diet that is commonly used for weight loss. Additionally, too much stress about losing weight maybe have adverse effects on testosterone levels.

How Stress Affects Testosterone

While the relationship between diet and testosterone is complicated, the adverse effects of stress are scientifically proven time and time again. This has been done by using cortisol implants in animal stress studies. Cortisol is the hormone released from the adrenal cortex during prolonged stress periods. These cortisol implants and the natural release of cortisol has proven to have an adverse effect on testosterone levels.

Cortisol and its relationship with testosterone production are important to understand. Stress causes an increase in cortisol (known in the medical field as a “cortisol shunt”). Cortisol is produced by the same precursors as testosterone, which is again cholesterol (fat). So, the more stress, the more cortisol, the less testosterone production. Learn how to meditate 🙂

This effect has been replicated in humans. Studies have been done on military recruits, firefighters, refugees, patients awaiting surgery and more. This has shown that cortisol and testosterone basically operate on a hormonal axis, which shifts when stress is triggered.

Decades of research has brought the conclusion that prolonged periods of intense stress will negatively impact testosterone levels. So if reading this article is stressing you out… stop!

Low Testosterone Symptoms Long-term

The symptoms of low-T present some clear long-term health effects, such as increased chance of disease due to weight gain and lack of bone strength. However testosterone naturally decreases in men over time, so long-term effects are hard to quantify, as they coincide with the ailments of aging.

However, one study measured testosterone levels in 794 men, ages 50-91, and re-tested when they died. Independent of age, men with the lowest testosterone levels were more likely to die.

This certainly shows that low-T is significant health condition and all treatment options should be explored.

Low testosterone has also been linked to the decline in neurological function. As we age, the oxidative damage becomes rampant in the body, hence the slowing of metabolic function and the increase in wrinkling of the skin. Oxidative damage can occur in the anterior pituitary which houses the signaling system of the human body to produce hormones. As pituitary function decreases, the neurological function also decreases, because the brain uses testosterone to induce growth, produce neurotransmitters, and aid in brain synapses.

How To Increase Testosterone

The most important thing to do when looking to ways of boosting testosterone levels is to visit a doctor and get an official diagnosis. A simple blood test will determine if you have a deficiency and how severe it is.

There are several natural and medical methods for increasing low-T. The natural methods are essentially the reverse of the symptoms but you need to look into the truth about testosterone boosters first. This includes most components of a healthy lifestyle such as getting good sleep, a healthy diet, and regular exercise.

Natural prevention and treatment options include:

  • Get the right nutrients – Zinc, Vitamin D and Ginseng have all shown to have positive effects on reproductive health and testosterone. For instance, Vitamin D increased testosterone in overweight men by up to 30 percent. Combat the zinc deficiency caused by low-T by getting at least the recommended amount for adult males, 11mg.
  • Reduce sugar intake – A study from the Endocrine Society showed testosterone levels can drop up to 25 percent after consuming 75 grams of glucose.
  • Intermittent fastingThis approach seems counterintuitive, but studies have found that testosterone levels increase after fasting. One study found short-term fasting increased luteinizing hormone (LH) levels by 67 percent (LH is the precursor hormone to testosterone). Another study saw a 180 percent increase in testosterone utilization after a short period of fasting by non-obese men. Lastly, a study showed 24 hours of fasting raised t-levels 2000 percent above the baseline.
  • Morning workouts & cold showers – Testosterone levels are usually elevated in the morning, and physical activity increases testosterone levels. Morning cold showers also stimulate catecholamine’s (adrenaline hormones) to in turn improve testosterone levels.

Testosterone Replacement Therapy (TRT)

There is a medical option for replacing testosterone. The hormone can be taken via injection, tablet, gel and more. The procedure offers all the benefits of reversing testosterone declines like muscle mass, energy, and a higher sex drive. This explains why prescriptions for the therapy jumped 500 percent over an 18-year period.

Testosterone replacement therapy is effective for males that are demonstrating symptoms of hypogonadism – low sex drive, muscle atrophy, low energy, sexual dysfunction and increased fat mass. Testosterone replacement therapy increases circulating levels of testosterone in the body and regulates how much testosterone is in the blood.

Once the elevated levels of testosterone are detected, the natural signaling and production of testosterone decrease – this process is called “negative inhibition”. The anterior pituitary slows the stimulating hormones to produce testosterone naturally but the caveat is the aging male is already showing signs of decreasing signaling and production of testosterone.


Yes – you may have to be on testosterone replacement therapy for the rest of your life but checking your labs regularly and optimizing your hormone levels is important in longevity. Regular bloodwork is important when on TRT to inhibit the effects of aromatization (increasing estrogen). Consult with your primary care physician or naturopathic doctor livv@livvnatural.com about testosterone replacement therapy.

Dr. Jason Phan NMD – LIVV Natural Health | Naturopathic Medical Doctor specializing in IV Vitamin Therapy, PRP (platelet rich plasma)/Prolotherapy Regenerative Injections, Men’s and Women’s Health, and Optimal Living.


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Terry Asher

Owner & Founder at Gym Junkies LLC
After changing his best friend’s life by helping him lose over 70lbs, dropping him down to an amazing 7% body fat, Terry was inspired to be a full-time internet trainer knowing he could do the same for many more. In 2010, Terry published his own diet and fitness e-book that can be purchased on this website. Let Terry help you change your body for the better!
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