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

Summary

This 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.

Outlines

00:00

🚫 Low Testosterone Symptoms and Treatment Considerations

The paragraph discusses the onset of symptoms related to low testosterone levels, which typically appear when total testosterone levels are between 230 to 250 ng/dL, causing erectile dysfunction and reduced sexual thoughts. As levels rise to around 320 ng/dL, morning erections decrease. At 370 ng/dL, a decrease in energy is noticeable. The importance of not just relying on total testosterone levels but also considering free testosterone and sex hormone-binding globulin is highlighted. Other hormone levels and thyroid function may also affect testosterone. Contraindications for testosterone replacement therapy include active prostate cancer, untreated sleep apnea, high hematocrit levels, pregnancy plans, and elevated PSA levels. Natural ways to boost testosterone include resistance training, avoiding endurance exercises that increase cortisol, following a Mediterranean diet rich in healthy fats, weight loss, and ensuring adequate sleep. Sleep apnea and stress reduction can significantly improve testosterone levels.

05:03

💉 Options for Testosterone Replacement Therapy and Lifestyle Adjustments

This paragraph explores various methods of testosterone replacement therapy, including injections with flexible dosing, transdermal gels, patches, buccal tablets, pellets, long-acting injectables, a nasal spray, and oral options. Each method has its benefits and potential side effects, such as skin irritation, gum-related issues, fluctuations in hormone levels, and nasal side effects. The importance of monitoring blood counts to prevent erythrocytosis and the potential side effects of acne, oily skin, prostate cancer growth (in those already affected), and infertility is emphasized. Recent data dispels the myth of increased cardiovascular disease risk with testosterone replacement. Less common side effects include breast enlargement, hair loss, breast cancer, and worsening sleep apnea. Lifestyle adjustments such as reducing stress, avoiding endocrine-disrupting chemicals found in plastics, and using glass or metal containers for food and drink are recommended to naturally boost testosterone levels.

Keywords

💡Testosterone

Testosterone is the primary male sex hormone responsible for the development of male reproductive tissues and secondary sexual characteristics. In the video, it is discussed as a key indicator of male health, with levels between 230 to 250 ng/dL associated with erectile dysfunction and decreased sexual thoughts, and levels around 320 ng/dL linked to a decrease in morning erections frequency.

💡Erectile Dysfunction

Erectile dysfunction refers to the inability to achieve or maintain an erection sufficient for sexual intercourse. The script mentions that men start to see erectile dysfunction when their testosterone levels fall between 230 to 250 ng/dL.

💡Morning Erections

Morning erections, also known as nocturnal penile tumescence, are erections that occur during sleep and are a sign of healthy sexual function. The video script indicates that a decrease in the frequency of morning erections can be observed when testosterone levels are around 320 ng/dL.

💡Vigor

Vigor refers to the level of energy and vitality a person possesses. The script notes that at a testosterone level of about 370 ng/dL, men may start to notice a decrease in vigor or energy, illustrating the hormone's impact on overall physical vitality.

💡Sex Hormone Binding Globulin (SHBG)

Sex Hormone Binding Globulin is a protein that binds to sex hormones, such as testosterone, and affects their availability in the body. The script explains that while total testosterone levels are measured, the amount of free testosterone, which is not bound to SHBG, is what is actually available to the body.

💡Estrodial

Estrodial, or estradiol, is the primary female sex hormone but is also present in men. The script mentions that levels of estradiol, along with other hormones like prolactin, LH, and FSH, can be assessed to determine factors contributing to low testosterone.

💡Thyroid Hormone

The thyroid hormone is critical for metabolism and can influence various bodily functions, including testosterone levels. The video script suggests that thyroid hormone assessment is important as it can play a role in testosterone production.

💡Testosterone Replacement Therapy (TRT)

Testosterone Replacement Therapy is a medical treatment for men with low testosterone levels. The script outlines conditions under which TRT is contraindicated, such as active prostate cancer, untreated sleep apnea, high hematocrit levels, and plans for pregnancy due to potential infertility.

💡Exercise

Exercise, particularly resistance training, is highlighted in the script as a natural way to boost testosterone levels. It is noted that high-intensity interval training can also be beneficial, but long endurance exercises might have the opposite effect by increasing cortisol levels.

💡Mediterranean Diet

The Mediterranean diet, rich in poultry, fish, vegetables, healthy fats, and unprocessed foods, is mentioned in the script as beneficial for testosterone production. It contrasts with very low-fat diets, which are not recommended as testosterone is produced through cholesterol pathways.

💡Sleep Apnea

Sleep apnea is a sleep disorder characterized by pauses in breathing during sleep. The script connects sleep apnea with lower testosterone levels and suggests that using a CPAP machine can significantly improve testosterone levels.

💡Stress

Stress is discussed in the context of its negative impact on testosterone levels. High levels of work stress and poor sleep quality, as experienced by resident doctors in the script's example, are associated with significantly lower testosterone levels.

💡Endocrine Disrupting Chemicals

Endocrine disrupting chemicals, such as BPA and phthalates found in plastic products, are mentioned as having a negative impact on hormone production, including testosterone. The script advises avoiding these chemicals by using alternatives like glass water bottles and plates.

💡Bariatric Surgery

Bariatric surgery is weight loss surgery for obesity. The script cites studies showing significant increases in testosterone levels after bariatric surgery, highlighting the connection between weight loss and hormonal health.

💡Erythrocytosis

Erythrocytosis is a condition where the blood has a high number of red blood cells, leading to thickened blood. The script mentions that monitoring for erythrocytosis is necessary for those on testosterone replacement therapy due to the risk of stroke or blood clots.

Highlights

Symptoms of low testosterone begin to appear at levels between 230 to 250 ng/dL, with erectile dysfunction and decreased sexual thoughts.

At around 320 ng/dL, there is a decrease in the frequency of morning erections.

A testosterone level of about 370 ng/dL can lead to decreased vigor or energy.

Treatment for low testosterone requires bothersome symptoms and low testosterone levels on a blood test.

Total testosterone levels may not fully indicate available testosterone due to binding with globulins.

Free testosterone and sex hormone-binding globulin can be evaluated to assess actual available testosterone.

Other hormone levels, such as estradiol, prolactin, LH, and FSH, may affect testosterone and should be assessed.

Thyroid hormone levels can influence testosterone and should be checked.

Testosterone replacement therapy is contraindicated with active prostate cancer, untreated sleep apnea, high hematocrit, or plans for pregnancy.

Exercise, particularly resistance training, can increase testosterone levels.

High-intensity interval training has been shown to be beneficial for testosterone.

The Mediterranean diet, rich in poultry, fish, vegetables, and healthy fats, supports testosterone production.

Weight loss, especially a 10% reduction in body weight, can significantly improve testosterone levels.

Sleep is crucial for testosterone levels, with each hour of sleep lost decreasing testosterone by about six points.

Stress reduction can have a significant impact on testosterone levels.

Avoiding endocrine-disrupting chemicals, such as BPA and phthalates, can help improve testosterone production.

Various forms of testosterone replacement therapy are available, including injections, gels, patches, and oral options.

Monitoring is necessary when on testosterone replacement therapy to prevent complications like erythrocytosis.

Recent data shows no increased risk of cardiovascular disease with testosterone replacement.

Transcripts

when do we start seeing these symptoms

so when you look at data on what levels

we're starting to see sexual symptoms

with related to Total testosterone

levels which is a blood test and

essentially how we test for low

testosterone you find that somewhere

between

230 to 250 nanog per deciliter you're

starting to see erectile dysfunction and

decrease frequency of sexual thoughts

when you get a little higher than that

around 320 you'll start seeing a

decreased frequency of morning erections

in terms of physical symptoms at about

370 you will start noticing that you're

having decreased Vigor or energy and so

very you know it's very correlated with

the amount of testosterone that you have

when you develop these symptoms so when

do we treat as I mentioned you must have

symptoms that are bothersome to you as

well as low testosterone on a blood test

so typically you'll do a total

testosterone level but it's important to

realize the testosterone by itself is

not the indicator of how much

testosterone is actually available to

your body because a lot of it is bound

the large majority of it is bound with

something called sex hormone binding

globulin as well as cortisol binding

globulin and so it only remains a very

small percentage that's available for

free testosterone so that can also be

evaluated as well as a sex hormone

binding globulin to assess your total

testosterone or actual free testosterone

level you can also assess other hormone

levels that could be affecting

testosterone that can include estrodial

prolactin maybe your LH and FSH to sort

of assess if there are other factors

that are contributing to low

testosterone as well as your thyroid

hormone because that can also play a

role now if you are wondering about

testosterone replacement therapy which

we're going to talk about you cannot get

testosterone replacement therapy if you

have active prostate cancer if you have

untreated sleep apnea or uncontrolled

sleep apnea if you have a hematocrit or

blood count of over 50 if you're

planning to be uh have pregnancy or have

a child because it can cause infertility

and then if you have an elevated PSA or

blood test that's testing for screening

for prostate cancer that may be

concerning you need to get that

evaluated before you start any sort of

testosterone replacement now how do you

boost your testosterone naturally the

first thing is exercise so we know that

exercise particularly resistance

training of large muscle groups can

cause an increase in testosterone now

it's not a prolonged increase in

testosterone so typically you have to

incorporate this resistance training in

your regular week to week exercise

regimen now you want to be careful not

to do really high endurance like

ultramarathons marathons if you're

having symptoms because those sorts of

exercises actually increase your body's

cortisol which increases stress and can

actually reduce your testosterone

they've also done some studies that have

shown that high-intensity interval

training can be beneficial for

testosterone now nutrition the best data

we have on nutrition is with the

Mediterranean diet and so that's

generally a diet that's high in poultry

and fish vegetables healthy fats

including sort of lowfat dairy olive

oils avocados and nuts as well as trying

to get like sort of healthy and

unprocessed Foods so you want to avoid

processed foods and include healthy fats

in your diet sometimes people go for a

very lowfat diet and that actually is

not beneficial for testosterone because

testosterone is made through the

cholesterol Pathways and you need some

healthy fat in order to get good

testosterone production now weight loss

so there's a whole host of studies that

have shown that weight loss improves

testosterone so some Studies have shown

that you need quite a large amount of

weight loss like 46 lb weight loss or if

you incorporate physical activity it can

be 26 lbs but the best study is about a

10% reduction in body weight can show a

pretty significant Improvement in

testosterone levels they've also shown

studies that people have had quite

tremendous increases in testosterone

after bariatric surgery for those who

are obese and candidates for bariatric

surgery and even an improvement in your

body mass index of five points for those

who are overweight or obese can be quite

uh remarkable in terms of significantly

improving testosterone now sleep is

another really important area and this

is because during the night is when our

body our bodies work in a circadian

rhythm and during the night time is when

we sort of allow the body to rest and

rejuvenate and then allow the surge in

the morning of early testosterone and so

each hour of sleep lost decreases your

testosterone by about six points and

they've shown that when they compare men

who sleep about 5 hours a night versus

those who sleep about eight or more

hours a night they will see a 10 to 15%

decrease in testosterone now if you have

sleep apnea that's also correlated with

lowest testosterone and using a c app

has also shown to significantly improve

testosterone levels by about 90 to 100

points reducing stress now stress is

unavoidable but we've seen that people

who have high levels of work stress

meaning they're commuting more than an

hour to work they may be working for

more than one job they may have more

deadlines or sales quotas or they have

stressors about layoffs tend to have

lower levels of testosterone also they

did one study where they looked at

resident doctors who were stressed and

also sleeping less meaning sleeping

about every four nights they' be on call

that they found that their testosterones

were significantly lower despite being

typically young healthy men compared to

other Hospital workers when it came to

testosterone levels so if it's possible

reducing stress can be very impactful in

terms of testosterone avoiding endocrine

disrupting chemicals so things like uh

bpas which are found in Plastic Products

or phalates which are found in plastic

tubing uh have been shown to

significantly negatively impact the

hormone production of testosterone and

sperm production so ultimately trying to

avoid those as much as possible what I

tell people is drinking from a glass

water bottle or a metal bottle water

bottle of plastic heat your food up in

um glass plates instead of using the

plastic containers don't use plastic

Tupperware those are sort of the things

that we can control and can help improve

our exposures but unfortunately everyone

is exposed and has some degree of these

endocrine disrupting chemicals in their

blood levels or urine that we can

measure there are a whole host of

different types of testosterones that

are available for testosterone

replacement therapy if these other

Alternatives do not work they can

include injections which can be done

every other day to twice a week to

weekly to every 10 days depending on

your preference the nice thing about

this is there is flexibility on how

often you get the dosing It's relatively

afford able however it is an injection

so normally the male body makes about 5

Mig of testosterone every day but when

you take it injected you're not getting

that daily dose you're getting sort of a

a larger dose at one time and then that

sort of goes up and comes down there's

transdermal gels which are you put on

your arm typically daily there's patches

you put on your body daily now these

have some risk of the gels of

transferring the testosterone to other

people the patches sometimes people get

skin irritation from the patches there's

also Buckle tablets which means you like

sort of rub them on your gums but you

can have gum related side effects you

can get pellets implanted and these

essentially are implanted every 4 months

or so and they release testas for an

extend a period of time however they do

have sort of Peaks and valleys of

testosterone so very early when you get

the pellets you may feel a very high

rate of testosterone which will then

sort of fizzle out over that course of 4

months there's also long acting

injectables which are injected usually

every 4 weeks and then every 10 weeks

and again same thing with the levels

going sort of up and down there's a

nasal spray that you can do about three

times a day and that can have some nasal

side effects and there's now oral

options available as well which are

twice daily now both the nasal and oral

have a rapid onset so you typically see

symptom relief very quickly when you

take the medication but it also wears

off pretty quickly and the oral has to

be taken with food so there are some

obviously side effects the one thing is

you need to be monitored once you're on

testosterone you need to be monitored

with your blood count to make sure you

don't develop something called

erythrocytosis and this essentially

causes your your red blood cells and

your blood to thicken putting you at

higher risk for stroke or blood clots

which is why we have to monitor that if

you have sort of Peaks and Valley

sometimes when your testosterone goes

too high you may noce acne or oily skin

and if you have prostate cancer and you

start testosterone it will cause that

prostate cancer to grow however there is

new data showing that there is really no

risk of developing prostate cancer from

testosterone testosterone does not cause

prostate cancer but if you have prostate

cancer it will cause it to grow also it

can cause infertility and sperm

production there was a whole concern

about cardiovascular disease with

testosterone replacement and very

recently we've had some very strong data

showing that actually that's not true we

do not see an increased risk of

cardiovascular disease with testosterone

replacement there are some other sort of

less common side effects which are like

having breast enlargement hair loss

breast cancer and worsening of sleep

apnea which we don't often see all the

time but there is some concern of that