He came to me looking worried. “I’m not that Old, fit as a fiddle, got a lot of irons in the fire at work, happy to be married with kids all grown up… but my sex life is in the toilet.’ Indeed, he looked as advertised: well muscled, no daddy belly to speak of, graying nicely, nimble in movement and nimble in thought. But his sex drive was low and his erections weren’t what they were a few years ago. “My doctor checked my T level and said it was very low, but everything else was fine. What’s wrong with me?’ He wondered if his hormones were “checking out for good or what.”
Check the Oil
Testosterone is a fairly important molecule for men’s health. Think of it like oil in a car. When they are low or missing, many parts are affected and things don’t run as smoothly. Normal testosterone balance is critical in life. In the womb, it determines anatomical masculinity. In adolescence, I don’t need to tell you what it does: it fuels growth, breaks the voice, encourages hair growth, acne, stronger muscles, and is the ultimate ruler of adolescent thought and action. In men, it is essential for normal growth, reproductive and sexual function. Although more commonly known as a “sex steroid,” testosterone affects many functions in the body. In the brain, it affects mood, memory and intellect as well as sex drive. “Vitamin T” maintains muscle strength and growth and helps keep blood counts and bone strength at normal levels. It may also be good for cholesterol and insulin balance. Testosterone keeps erections strong and supports normal fertility and prostate function. In summary, as has been said about vitamins, testosterone is equally a “necessary” hormone for a healthy body.
Origin Analysis
So I went to work for this gentleman. When T levels are low, one of the key questions to answer is: Why? This root cause analysis is critical for several reasons. It can reveal medical issues such as diabetes, thyroid disorders, or prolactin problems that can be treated and reversed. It can also tell us if ‘menopause’ or andropause has arrived. This age-related condition occurs when testosterone levels drop hard and for good. Usually occurring in the seventh or eighth decade of life, it marks the time when the testicles are spent and complete the production of hormones and sperm. It is the basis for men to have a true “biological clock”, as has been said for menopausal women. Finally, low T may simply reflect the effects of a stressful life, whether due to worry, stress, poor sleep, overwork, or too much travel. Figuring out which of these causes is simply a matter of checking the hormones that control testosterone balance, such as luteinizing hormone, estradiol, cortisol and prolactin. Easy-pickles.
Cro-Magnon elements
Our fast-moving gentleman was a prime example of the modern, stressed-out man. Otherwise healthy, he was burning the candle at both ends, working long days and weekends, sleeping poorly and traveling a lot. You might think that testosterone would increase with stress, but unfortunately, this is not true. To understand this hormonal paradox, let’s go back to the caveman days. For Neanderthal or Cro-Magnon men, what kind of stress did they have? How about being cold, starving or being chased by woolly mammoths. I’m glad there’s this fight-or-flight nervous system, full of adrenaline (cortisol), to help them survive. In times like these, testosterone takes a backseat, as the mind and body need heightened awareness and quick, explosive energy to respond to threats. Once the stress has passed and relaxation has taken place, that’s when testosterone increases, recovering and rebuilding muscle, bone and blood. A “rest and recovery” hormone at its finest. So our antiquated “fight or flight” nervous system, perfectly suited to us as cavemen 50,000 years ago, is now just an overused reflex. Although we needed it to live longer then, we must turn it off to live longer now.
Fortunately his treatment was simple, but I made a deal with him. I would push his “lazy” (from stress) pituitary gland harder to make more testosterone by giving him a daily pill called clomiphene citrate (or aclomiphene, both off label) and restore his testosterone balance. And he would examine his life, figure out what haunts him (stresses him) the most, and try to lessen its impact. And, this deal, I reminded him, would likely lead him to a longer, healthier life.
