TESTOSTERONE LEVELS IN MEN: UNDERSTANDING THE FACTORS BEHIND THEIR DECLINE
By Dr Angela Servis BMBS MRCGP
Introduction
Testosterone is a hormone that plays a crucial role in male development, physiology and performance. However, research has shown that the average testosterone level in men has been declining for decades. This article aims to explore the factors behind this trend and discuss what can be done to maintain healthy testosterone levels.
The Massachusetts Male Aging Study
The Massachusetts Male Aging Study was instrumental in identifying the declining trend in testosterone levels in men. This study involved randomly selected men aged between 45 and 79 years, living in Boston. The study was conducted in two phases between 1987 and 1989 and between 1995 and 1997. A total of 1,374 men were sampled, resulting in 2,769 observations from 1,532 men.
The study revealed that testosterone levels were decreasing and that these changes were not attributable to changes in health or lifestyle factors such as smoking or obesity.
Factors Behind Declining Testosterone Levels
Age is a key factor in the gradual decline of testosterone levels in men. Typically, testosterone levels reduce by about 1% per year from the age of 30.
However, the Male Aging Study revealed that there was a more significant reduction in testosterone levels than what could be attributed to ageing alone. Other factors that can accelerate this decline include obesity, inactivity, opiate use, and high alcohol intake.
Sleep also plays an essential role in testosterone production, with sleep apnea and poor sleep patterns linked to disrupted testosterone production. Normally, testosterone peaks in the morning between 0700-1100, which can be disrupted by shift work.
Endocrine-disrupting chemicals (EDCs) are another significant factor believed to be negatively impacting testosterone levels. Over 800 EDCs have been identified, but how they affect testosterone levels is still unclear. Exposure to bisphenol A (BPA), commonly found in plastics, has been found to bind to androgen receptors, reducing testosterone levels and fertility. Research suggests that high exposure to phthalates, which are also found in plastics, is associated with reduced testosterone levels.
Men who have used steroids, selective androgen receptor modulators (SARMs), and other hormone-disrupting drugs are also at risk of developing low testosterone due to the disruption that exogenous hormones cause to their own production of testosterone.
What Can Be Done?
Testing and Tracking
Knowing your testosterone levels is useful for tracking changes as you age and understanding what is normal for you. To obtain meaningful blood results, it is important to check testosterone levels when fasted from midnight the day before and between 0700 and 1100 in the morning. It is also not advisable to take a test straight after or during an acute illness as this can make levels dip, which would not be representative of your normal state.
It is important to remember that testosterone “normal ranges” are often not specific to the age range or demographic of the individual. These ranges are based on the average testosterone levels of men across all ages, meaning that a 20-year-old male would be expected to be in the same “normal range” as a 70-year-old male. As a clinician assessing someone with low testosterone, it is crucial to look at blood results alongside clinical symptoms. Historical blood tests can be helpful in understanding what “normal” levels were when the individual was asymptomatic.
It’s recommended to get your blood tested at least once a year from a general health tracking perspective or more frequently if you are going through periods of chronic high stress. This will give you an insight into your current key health indicators and essential nutrient levels such as if you are deficient in any vitamins or minerals. Doing this will allow you to see any trends in your key health indicators so you can proactively adjust your lifestyle if needed but will also allow you to supplement any deficiencies (Link to Blog: OUR TOP 3 SUPPLEMENTS FOR OPERATORS AND SOLDIERS) with far more accuracy.
Methods to help maintain and improve Testosterone levels
Weight Lifting and Resistance Training
Weight lifting has been shown to give an almost immediate boost in testosterone levels and consistently demonstrates a significant impact on increasing testosterone levels. This method is widely regarded as one of the most effective ways to naturally boost testosterone.
Proper Nutrition and Caloric Intake
Maintaining a balanced diet that includes an adequate intake of essential nutrients, healthy fats, lean proteins, and whole grains is crucial for supporting optimal hormone production, including testosterone. Maintaining a good body composition is helpful, as increased body fat is associated with low testosterone.
Vitamin D3 Supplementation and Sun Exposure
Ensuring sufficient vitamin D3 levels, either through exposure to natural sunlight or through supplementation, has been linked to higher testosterone levels. Adequate vitamin D3 intake is essential for people already with deficiencies.
Quality Sleep and Stress Management
Establishing healthy sleep patterns is essential as sleep has been consistently proven to be one of the best performance enhancers you can implement into your routine. Getting enough quality sleep will also help with managing stress levels and is important for overall hormone balance.
Cardiovascular Exercise
Both interval work and steady-state work can contribute to a moderate increase in testosterone levels. While not as effective as weight lifting, incorporating regular cardio exercise into your routine can still provide some direct benefits as well as indirect benefits such as maintaining good body composition and vascularity.
Limiting Alcohol Consumption
Excessive alcohol intake has been associated with lower testosterone levels. If you’re looking to improve your performance a lot, limiting alcohol consumption or avoiding it altogether can help maintain a healthy hormone balance and improve your sleep and digestion.
Avoiding Endocrine Disruptors
As mentioned above, minimising your exposure to EDCs found in plastics, pesticides, and certain household products is advisable. While the impact on testosterone levels may be relatively minor compared to other factors, it is still beneficial for overall hormonal health.
Conclusion
The declining trend in testosterone levels in men is concerning and requires further research to understand the factors behind it. Nevertheless, by making lifestyle changes and maintaining healthy habits you can ward off the exponential loss of testosterone that society is seeing.
Dr Angela Servis BMBS MRCGP – www.edenclinicformen.com
After graduating from Peninsula Medical School, I started my Army career in Germany with an armoured engineer regiment and travelled to various countries supporting their activities finishing my time with them with a deployment to Afghanistan.
Following that I completed my GP training in Plymouth before getting posted to 29 Commando and after a brief stint with a signals Regt, I left the army after 17 years in 2022.
I developed an interest in Men’s Health after seeing changes in a soldier who was struggling with low mood and checking his testosterone levels on a whim and then realising I wasn’t sure how to manage his testosterone deficiency. This set me off on an educational journey, getting mentored by Professor Hackett from the British Society for sexual medicine and finally setting up my own CQC registered clinic in Plymouth City Centre.
I now offer in-person and remote treatment for men who have testosterone deficiency or erectile dysfunction and for people who need support with weight loss.
Having witnessed the devastating impact that testosterone deficiency can have on men and how underserved it is within the NHS, I feel passionate about offering a wholistic approach to management through Eden Clinic. Offering lifestyle support, and exercise and nutrition advice for our patients in partnership with my husband Guy Servis who’s a strength and conditioning coach and health adviser.
