Science-Backed Ways to Boost Testosterone, Explained by a Urologist

Rena Malik, MD Podcast
19 Jun 202409:44

Summary

TLDRThis transcript discusses the symptoms and levels of testosterone associated with erectile dysfunction and decreased sexual thoughts, highlighting the importance of both blood test results and bothersome symptoms for treatment. It covers the impact of exercise, nutrition, weight loss, sleep, and stress reduction on testosterone levels, as well as the risks and options for testosterone replacement therapy. The summary also addresses misconceptions about prostate cancer and cardiovascular disease related to testosterone use.

Takeaways

  • 📉 Low testosterone levels can lead to erectile dysfunction and decreased sexual thoughts when levels are between 230 to 250 ng/dL.
  • 🌅 A decrease in morning erections frequency is associated with testosterone levels around 320 ng/dL.
  • 😴 At around 370 ng/dL, men may experience a decrease in vigor or energy, highlighting the correlation between testosterone and energy levels.
  • 🩺 Treatment for low testosterone requires both bothersome symptoms and a confirmed low testosterone blood test.
  • 🔒 Testosterone levels alone may not indicate availability, as most is bound to sex hormone binding globulin and cortisol binding globulin, with only a small percentage being free testosterone.
  • 🚫 Contraindications for testosterone replacement therapy include active prostate cancer, untreated sleep apnea, high hematocrit levels, plans for pregnancy, and elevated PSA levels.
  • 🏋️‍♂️ Exercise, particularly resistance training, can naturally boost testosterone levels, but high endurance exercises might have the opposite effect.
  • 🍽️ The Mediterranean diet, rich in poultry, fish, vegetables, and healthy fats, is beneficial for testosterone production.
  • 🏃‍♂️ Weight loss, especially significant reduction or bariatric surgery, can significantly improve testosterone levels.
  • 💤 Sleep is crucial for testosterone levels, with each hour of sleep lost decreasing testosterone by about six points.
  • 🧪 Reducing stress and avoiding endocrine-disrupting chemicals like BPA and phthalates can help maintain healthy testosterone levels.
  • 💊 Testosterone replacement therapy options include injections, transdermal gels, patches, buccal tablets, pellets, long-acting injectables, nasal sprays, and oral options, each with its own set of considerations and side effects.
  • 🔄 Once on testosterone therapy, monitoring is necessary to prevent conditions like erythrocytosis and to manage potential side effects such as acne, oily skin, prostate cancer growth, and infertility.

Q & A

  • At what testosterone levels do we start to see sexual symptoms like erectile dysfunction?

    -Sexual symptoms such as erectile dysfunction and decreased frequency of sexual thoughts begin to appear when total testosterone levels are between 230 to 250 nanog per deciliter.

  • What is the significance of the 320 nanog per deciliter testosterone level?

    -At around 320 nanog per deciliter, a decrease in the frequency of morning erections can be observed.

  • What physical symptoms might one notice at a testosterone level of 370 nanog per deciliter?

    -At approximately 370 nanog per deciliter, individuals may start to experience decreased vigor or energy.

  • Why is it important to consider both symptoms and blood test results when treating low testosterone?

    -It is important because treatment should only be considered when symptoms are bothersome to the individual and low testosterone is confirmed by a blood test.

  • What is the role of sex hormone-binding globulin (SHBG) in testosterone levels?

    -SHBG plays a role in binding the majority of testosterone, leaving only a small percentage available as free testosterone, which is what the body can actually use.

  • Why is it recommended to assess other hormone levels along with testosterone?

    -Assessing other hormone levels helps to identify if there are other factors contributing to low testosterone, such as estrodial, prolactin, LH, FSH, and thyroid hormone levels.

  • What are the contraindications for testosterone replacement therapy?

    -Testosterone replacement therapy is not recommended for individuals with active prostate cancer, untreated or uncontrolled sleep apnea, a hematocrit level over 50, plans for pregnancy, or an elevated PSA level.

  • How can exercise naturally boost testosterone levels?

    -Exercise, particularly resistance training of large muscle groups, can increase testosterone levels, but it needs to be incorporated regularly into a weekly exercise regimen.

  • What dietary approach has been shown to support healthy testosterone levels?

    -The Mediterranean diet, which is high in poultry, fish, vegetables, healthy fats, and unprocessed foods, has been shown to support testosterone levels.

  • How does weight loss impact testosterone levels?

    -Weight loss has been shown to significantly improve testosterone levels, with studies indicating that a 10% reduction in body weight can lead to a notable increase in testosterone.

  • What is the relationship between sleep and testosterone levels?

    -Sleep is crucial for testosterone levels as it allows the body to rejuvenate and surge in testosterone in the morning. Each hour of sleep lost can decrease testosterone levels by about six points.

  • How can reducing stress impact testosterone levels?

    -Reducing stress can have a positive impact on testosterone levels, as high levels of stress, especially in combination with sleep deprivation, have been associated with lower testosterone levels.

  • What are some ways to avoid endocrine-disrupting chemicals that can negatively affect testosterone production?

    -Avoiding BPA and phthalates found in plastic products by using glass or metal water bottles and not microwaving food in plastic containers can help reduce exposure to these chemicals.

  • What are the different forms of testosterone replacement therapy available?

    -Forms of testosterone replacement therapy include injections, transdermal gels, patches, buccal tablets, pellets, long-acting injectables, nasal sprays, and oral options.

  • What are some potential side effects of testosterone replacement therapy?

    -Potential side effects include erythrocytosis, acne, oily skin, prostate cancer growth (if present), infertility, and sperm production issues. There were concerns about cardiovascular disease, but recent data shows no increased risk.

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TestosteroneHealthNutritionExerciseSleepStressHormoneTreatmentTherapyLifestyle
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