What Causes Low Testosterone in Men?

MEN'S HEALTH & WELLNESS

Elite Health HRT

Published: December 17, 2023

Est. Reading Time: 4 Mins

In men’s health, testosterone is key, influencing everything from muscle mass to mood. However, it’s subject to decline due to various causes. While a decrease in testosterone is a natural part of aging, it’s crucial to understand the specific causes of low testosterone in men. This awareness helps in managing these influences to maintain well-being and vitality at any age.

What Levels are Considered 'Normal'?

If we’re going to review the causes of low testosterone in men, it’s worth addressing the question, “What are normal levels?”

It’s a simple question, yet the answer can vary. For what it’s worth, modern medicine asserts that 300-1,000 ng/mL (nanograms/deciliter) is the ‘normal’ accepted range.

Anything below the 300 mark is medically considered ‘hypogonadism.’ This means the body is unable to produce adequate levels of testosterone on its own.
When levels surpass 1,000, this is generally considered as ‘superphysiological’ levels. If you follow individuals like Andrew Huberman and Peter Attia, you’ve probably heard them use this term to describe levels which are in excess of normal production.

While there’s rare exceptions, men with levels over 1,000 ng/dL typically achieve this with the help of exogenous testosterone through treatments like Testosterone Replacement Therapy.

Before we move on, it’s worth noting that anything beyond the 1,200 ng/dL mark can be quite detrimental to longevity. We cover this in detail in the article, “Is TRT Safe for Men?”

Here's the Real Question: What Levels are Considered 'Optimal'?

As we just established, the ‘normal’ range is quite broad. When we focus on optimal health, longevity, and performance – the idea of optimal testosterone levels becomes more personalized.

It’s not just about a number on a lab test result. Instead, it’s about finding the level that supports each individual’s best health. This includes things like energy levels, muscle strength, sexual health, and mental clarity.

FOR GENERAL REFERENCE: At Elite Health HRT, our male patients tend to report they feel their best when they’re in the ~700-950 ng/dL range. The exact threshold is different for every patient, which is exactly why it’s so important to work with a trained medical provider when it comes to any form of hormone replacement therapy.

Examining the Leading Causes of Low Testosterone in Men

1) Aging: The Natural, Gradual Change

All men experience natural declines in testosterone as they get older. For most, this starts around 30. As the years go by, levels taper down at a rate of ~1% year over year.

While you can chalk this up to being ‘part of life’, it certainly doesn’t make it any easier to manage the symptoms of low testosterone!

2) Weight & Lifestyle Choices

For various reasons, men who are overweight are more prone to having low testosterone levels.

This can be extremely frustrating, especially given that low testosterone also makes it harder for you to burn body fat in the first place!

Let’s briefly examine why higher body fat can cause this:

Increased Estrogen Production: Fat cells contain an enzyme called aromatase, which converts testosterone into estrogen (thus lowering overall testosterone levels)
Insulin Resistance: Higher levels of body fat lead to higher levels of insulin resistance. This can lower testosterone by disrupting hormone regulation in the brain
Chronic Inflammation: Excess fat leads to a state of inflammation, which interferes with the production of testosterone

3) Stress & Rising Cortisol Levels

To little surprise, long-term stress leads to elevated cortisol levels.

Cortisol, which is the body’s stress hormone, then has various negative effects on the production of testosterone.
In turn, this can make it harder for men to regulate their mood & emotions.
And for this very reason, low testosterone is linked to feelings of anxiety & depression in men.

The (Quick) Science Behind the Impact of Stress

Here’s a brief practical breakdown:

Hormonal Interference: Elevated cortisol from stress disrupts the hypothalamic-pituitary-gonadal (HPG) axis, which is the hormonal system responsible for testosterone production.

Resource Diversion: Chronic stress leads the body to prioritize cortisol production. This diverts precursors, like cholesterol, away from testosterone synthesis. This basically measure you’re diverting the building blocks of testosterone towards fueling stress with cortisol
Reduced Gonadotropin Release: High cortisol levels can also suppress the release of gonadotropins (like LH and FSH) from the pituitary gland. These hormones are crucial for stimulating testosterone production in the testes.

Prolonged high cortisol can negatively affect the health and function of Leydig cells in the testes, which are responsible for producing testosterone.

Think of Leydig cells like tiny factories in the testes that work to produce testosterone, helping with things like muscle growth, deepening of the voice, and facial hair during puberty and maintaining men’s health and fertility.

4) Over-the-Counter & Prescription Medications

In the intricate symphony of the body’s hormonal system, testosterone plays a key role, especially in men. It’s not just a matter of producing this hormone; it’s about maintaining a delicate balance. Medications, both OTC and prescription, can sometimes be the equivalent of a wrong note in this symphony, disrupting the balance.

Out of Alignment: How Medications Potentially Cause Low Testosterone in Men

We could spend endless amounts of time examining the various reasons why this can happen. For now, let’s keep things high level:

Direct Impact on Hormone Production: Some medications can directly affect the testes’ ability to produce testosterone. For instance, opioids are notorious for this. They can inhibit the release of gonadotropin-releasing hormone (GnRH) from the hypothalamus, which in turn reduces the production of the hormones that stimulate testosterone production.
Alteration of Hormone Metabolism: Certain drugs might alter the way testosterone is metabolized in the body. They can either increase the rate at which testosterone is broken down or change its conversion into other hormones, like estrogen.
Impact on SHBG Levels: Some medications can influence levels of sex hormone-binding globulin (SHBG), a protein that carries testosterone in the blood. Altered SHBG levels can affect the amount of free, active testosterone available.

5) Endocrine Disrupting Chemicals (EDC’s)

To start, the endocrine system is a network of glands throughout the body that produce and release hormones, which then regulate many important body functions.

Specifically, this refers to glands such as the thyroid, adrenals, pancreas, and pituitary gland – all of which influence functions like growth, metabolism, and reproduction.

What is an Endocrine Disrupting Chemical?

An Endocrine Disrupting Chemical (EDC) is a substance, either natural or man-made, that interferes with the normal function of the endocrine system.

On a molecular level, these chemicals mimic the structure of hormones like estrogen.
This ‘tricks’ your body into thinking it doesn’t need to make its own hormones (despite the fact your body can’t actually use the substance for cellular function)
In turn, this causes hormone imbalances & deficiencies.
Ultimately, this leads to unwanted side effects

Where are EDC's Found?

So what does this mean for you? Unfortunately, EDC’s are extremely prevalent in our day-to-day environment. This is why it’s so important to be mindful of the food you eat, the water you drink, and the products you use.

Here’s a few examples of EDC’s that are common causes of low testosterone in men:

Bisphenol A (BPA): Commonly found in plastics and resins.
Parabens Phthalates: Found in plastics, packaging and personal care products.
Polychlorinated biphenyls (PCBs): Industrial chemicals found in older electrical equipment and building materials.
Pesticides (like DDT & Glyphosate): Chemicals used in agriculture and pest control
Perfluoroalkyl substances (PFAS): Used in non-stick cookware, waterproof clothing, and food packaging.

Have You Explored Testosterone Replacement Therapy?

Curious about potential solutions for low testosterone? Learn more about how TRT can effectively restore hormonal balance, improve energy levels, enhance muscle strength, and boost overall quality of life. Click below to explore your options and get expert guidance tailored to your individual needs.

6) Long-Term Alcohol Use

Regular heavy drinking can drop your testosterone levels for men of any age. While we’re not necessarily advocating that you never have a drink for the rest of your life, it’s important to be mindful of the unintended effects:

Testicular Damage: Long-term alcohol consumption can directly damage the Leydig cells in the testes that produce testosterone, leading to decreased testosterone synthesis.
Increased Conversion to Estrogen: Alcohol can increase the activity of the enzyme aromatase, which converts testosterone into estrogen. In turn, this leads to lower levels of testosterone and higher levels of estrogen.
Liver Damage: Chronic alcohol use can damage the liver, which is responsible for metabolizing hormones, including testosterone. Liver diseases such as cirrhosis can disrupt hormone metabolism and lead to hormonal imbalances, including reduced testosterone levels.

While a beer or glass of bourbon can be a stress relief at the end of a long day, alcohol actually promotes the production of the stress hormone, cortisol. This can impact sleep patterns, which leads us to the next cause of low testosterone in men.

TIP: For most, eliminating alcohol altogether isn’t necessarily realistic. To start, try reducing weekly volume to 2-3 drinks in total. When you can, avoid sugary, calorie dense drinks. And wherever possible, avoid having multiple drinks in one hour to give your liver ample time to metabolize alcohol. When in doubt, moderation wins!

7) Poor Sleep Quality

This will probably come as no surprise. We all intuitively know the impact that a good night’s rest can have on overall health.

It’s important to note that testosterone production follows a daily rhythm and peaks during sleep. So, when poor sleep disrupts this cycle, overall levels will taper down.

The Role of Sleep on Hormonal Health

Here’s a further examination of why poor sleep is one of the biggest causes of low testosterone in men:

Increased Stress Hormones: Lack of sleep raises cortisol levels, a stress hormone that can inhibit testosterone production when chronically elevated.
Reduced Glucose Metabolism: Poor sleep affects glucose metabolism, which can lead to conditions like obesity and type 2 diabetes, both of which are associated with lower testosterone levels.
Decreased Overall Health: Chronic sleep deprivation is linked to various health issues, including cardiovascular problems and weakened immune function, which can indirectly affect testosterone production.
HPA Axis Disruption: Sleep is crucial for the proper functioning of the pituitary gland, which releases luteinizing hormone (LH), a key hormone in stimulating testosterone production. Disrupted sleep can impair LH release.

TIP: If you have trouble sleeping, you might consider taking a magnesium glycinate supplement. While there are multiple forms of magnesium, glycinate has been shown to help relax muscles and calm the central nervous system to promote higher quality sleep. Also, magnesium happens to be one of the many precursors to testosterone!

8) Insufficient Micronutrient Intake

What you eat plays a huge role in your hormones. Missing out on vital nutrients like Vitamin D, zinc, and Omega-3s can cause low testosterone in men, regardless of age.

Precursors to Testosterone Production

Several micronutrients play crucial roles as precursors or ‘building blocks’ in the production of testosterone. Here are a few of the key micronutrients involved:

Zinc: Zinc is perhaps one of the most critical micronutrients for testosterone production. It is directly involved in the synthesis of testosterone in the testes. A deficiency in zinc can lead to reduced testosterone levels.
B Vitamins: Certain B vitamins, like B6 and B12, have roles in hormone production and regulation. While they don’t directly synthesize testosterone, their overall support of metabolism and cellular processes is crucial.
Boron: This trace mineral has been linked to the increased natural production of testosterone and the reduction of excessive estrogen levels when supplemented. The study, “Nothing Boring About Boron” goes into extensive detail if you’re interested to learn more

IMPORTANT NOTES

Balanced Diet: A balanced diet is key. Over-supplementing a single nutrient without regard to others can be counterproductive.
Lifestyle Factors: Micronutrient intake should be part of a broader focus on a healthy lifestyle, including regular exercise, sufficient sleep, stress management, and maintaining a healthy body weight.
Consult Healthcare Providers: Before starting any supplement regimen, it’s always advisable to consult with healthcare providers, especially if you have underlying health conditions or are taking other medications.

Conclusion

As we conclude our exploration of the top causes of low testosterone in men, it’s crucial to remember that understanding these causes is the first step towards addressing any issues you might be facing. Low testosterone can significantly impact your quality of life, but with the right knowledge and approach, it’s a challenge that can be managed effectively!

About Elite Health HRT

The journey of managing testosterone levels is highly individualized. This is exactly why the Elite Health HRT team guides every patient through a targeted, evidence-based treatment plan to help them optimize their hormone levels so they can truly feel their best.

If you’re experiencing symptoms that might indicate low testosterone, or if you’re simply proactive about maintaining optimal hormonal balance, we encourage you to reach out. You can also learn more about our Testosterone Replacement Therapy treatments here.

Thanks for reading!

What Causes Low Testosterone in Men?

Leading Causes of Low Testosterone in Men

What Levels are Considered 'Normal'?

Here's the Real Question: What Levels are Considered 'Optimal'?