Mens Health

Andropause, also known as male menopause, manopause, testosterone deficiency, androgen deficiency in the aging male (ADAM) and a few other names refers to reduced testosterone and accompanying symptoms.

Are you or a man you know experiencing any of the symptoms of low T?

🍆Sexual Symptoms: Reduced libido, erectile dysfunction, fewer spontaneous erections
💪 Other Physical Symptoms: Reduced energy, disrupted sleep, more fat, less muscle
🧠Mental Symptoms: Brain fog, difficulty concentrating & focusing, poor memory
💞Emotional Symptoms: Reduced passion, interest, drive and motivation, variable mood

If yes, are you consuming any soy? It is in lots of places. Soy protein in protein blends and bars. Soybean oil in many processed foods and meat alternatives. Also of course in tofu, tempeh and the type of soy hardly anyone actually eats (outside Japan), Natto.

🫘 If you are eating soy, could it be reducing your testosterone?

The idea that it might be is due to soy having significant isoflavone content, which are phytoestrogens that bind to estrogen receptors with the potential for triggering estrogen-like effects.

🐀If you are a rodent, then yes, you should be worried. There is good evidence that soy can reduce your testosterone. However, congrats on learning to read!

🏋️If you are a man, then meta-analyses of human trials report no negative effect and also that soy protein is effective at supporting muscle growth in response to training. That said, whey is even better at this, so soy is only one of the better choices if you are restricting dairy and animal foods.

If you are going to eat soy, why not choose the best kinds? They would be tempeh and natto, both of which are fermented soybean products with none of the negative associations of highly processed soy and numerous health benefits, including the potential to reduce blood pressure, preserve bone density & support gut health.

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Link goes to a full size image on Instagram. Message me there, or here via WhatsApp to ask me anything or connect if you welcome help to optimise your health and healthspan.

Andropause, also known as male menopause, manopause, testosterone deficiency, androgen deficiency in the aging male (ADAM) and a few other names refers to reduced testosterone and accompanying symptoms.

Are you or a man you know experiencing any of the symptoms of low T?

If so, are you eating right to support natural testosterone production?

The overall dietary pattern, more so than any individual foods or supplements, has a significant impact on testosterone.

A ketogenic diet is a diet with approximately 75% fat, 20% protein and just 5% carbs, and which enables you to remain in nutritional ketosis. Hence a very high fat diet.

Several studies, and accompanying media headlines, have reported that a “high fat diet” is associated with lower T. However, dig just a little, and the “high fat” in these studies is often only around 40-50%, and predominantly from polyunsatured fats.. It is “high fat” relative to a conventional diet, but not even close to being ketogenic, and is often part of a poor quality ‘standard american diet’ (SAD).

At least two human trials which compared a fully ketogenic diet to a standard diet have found increased total and free testosterone within the subjects following the ketogenic diet. It is speculated that the high intake of dietary cholesterol enables an increase in testosterone.

Ketogenic diets can also support brain health and prevent or even reverse prediabetes and type II diabetes. They are not for everyone, but could they be for you?

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Link goes to a full size image on Instagram. Message me there, or here via WhatsApp to ask me anything or connect if you welcome help to optimise your health and healthspan.

Andropause, also known as male menopause, manopause, testosterone deficiency, androgen deficiency in the aging male (ADAM) and a few other names refers to reduced testosterone and accompanying symptoms.

What are the differences in T for single men, sexually active men and men in relationships?

🙋Being single is associated with higher T. This does not mean that being single drives higher T. Demographic factors may explain it entirely, with younger males both having more testosterone and being more likely to be single. Of course, it could also be an evolved state that helps facilitate mating behaviour through increased libido and erectile function.

🌋*Sexual activity*, regardless of whether it is with a partner or masturbation temporarily elevates testosterone and the rise is statistically significant BUT because it is also very short-lived, this is not clinically significant. In this distinction, it is like resistance exercise. Yes, there is a boost to testosterone but that has no persistent functional implication.

🌹*Beginning a new relationship* is associated with higher testosterone. The direction of causality could be either way, or could be bi-directional. Having higher T and matching higher libido may drive relationship-seeking behaviour. Beginning a relationship may contribute towards a rise in T for many reasons, including different dietary and lifestyle behaviours that enable better health generally.

💑Being in a *long-term relationship* is associated with lower T. Again, the causality could run in either direction or be bi-directional. For example, becoming a parent, with the common implications for less sleep, more fragmented sleep and more stress, could account for a reduction in T. Having lower T may contribute to lower likelihood of polyamorous behaviours.

The real takeaway is that this is *not* a variable to manipulate in order to address testosterone. There are plenty of others to use!

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Link goes to a full size image on Instagram. Message me there, or here via WhatsApp to ask me anything or connect if you welcome help to optimise your health and healthspan.

Andropause, also known as male menopause, manopause, testosterone deficiency, androgen deficiency in the aging male (ADAM) and a few other names refers to reduced testosterone and accompanying symptoms.

Some of the most common physical symptoms of reducing and lower testosterone are less muscle, more fat and worse exercise performance.

So how important is exercise for preserving and increasing testosterone?

Intense exercise, such as resistance exercise, produces large increases in testosterone but only for very short periods of time, around 30 minutes. So whilst the rises are statistically significant, they are not clinically significant. Hence if you read or listen to someone pointing towards one or another form of exercise as testosterone boosting, be wary. It may well be true, but not meaningful.

Moderate exercise has far less of an effect and mild exercise little to none.

Conversely, overarching and overtraining definitely *can* reduce testosterone. This is more common with high-volume endurance exercise but possible with anyone performed too often, too intensely, for too long.

So can exercise help with healthy levels of testosterone?

Absolutely yes! This is because one of the strongest influences on natural testosterone is lean mass and fat mass. More muscle and less fat, within normal physiology, often means more testosterone. Exercise is the only effective way to build more muscle, so using exercise to build muscle is a cornerstone of supporting natural testosterone.

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Link goes to a full size image on Instagram. Message me there, or here via WhatsApp to ask me anything or connect if you want to work with me as a client.

Andropause, also known as male menopause, manopause, testosterone deficiency, androgen deficiency in the aging male (ADAM) and a few other names refers to reduced testosterone and accompanying symptoms.

Whilst testosterone is a steroid hormone, made using cholesterol, sex hormone binding globulin is a transport protein. SHBG plays a huge role in how much of your total testosterone is available as free testosterone for actual use.

SHBG binds to testosterone. Imagine testosterone is the red strands within the image and SHBG is the rest of the structure. SHBG very tightly binds the testosterone, rendering it unavailable for use.


It is entirely possible for a man to have “normal” levels of total testosterone whilst also suffering from the symptoms of low testosterone. Symptoms such as:

🍆Sexual Symptoms: Reduced libido, erectile dysfunction, fewer spontaneous erections
💪 Other Physical Symptoms: Reduced energy, disrupted sleep, more fat, less muscle
🧠Mental Symptoms: Brain fog, difficulty concentrating & focusing, poor memory
💞Emotional Symptoms: Reduced passion, interest, drive and motivation, variable mood

Hence it is extremely important to consider your SHBG alongside your total testosterone and any symptoms. Knowing only your total testosterone does not tell you whether you have enough freely circulating testosterone and SHBG does typically increase with age.

If you have both your total testosterone and SHBG measured but your labs do not tell you free testosterone you can estimate it directly using an online calculator, and the estimation is clinically validated as a useful marker.

Enter your total T and SHBG here (both US and Rest of World Units accepted)

https://www.issam.ch/freetesto.htm

There *are* some diet, supplementation and lifestyle interventions which can reduce SHBG, and they are almost entirely things which lead to other good health outcomes, like resistance training, sleep optimisation and stress mitigation, but there are also some more surprising potentials, such as tactical carbohydrate intake and some minerals and herbs.

Link goes to the free testosterone calculator

Andropause, also known as male menopause, manopause, testosterone deficiency, androgen deficiency in the aging male (ADAM) and a few other names refers to reduced testosterone and accompanying symptoms. Key amongst those symptoms are libido and erectile function, but also other physical symptoms, and brain and emotional symptoms like passion for life, drive, concentration, memory and mood.

💥Of all the nutrition and lifestyle interventions that can help avoid reduced testosterone, body composition, and bodyfat, appears to be the most powerful.

📉 For males between 10% and 30% bodyfat each additional 1% bodyfat may decrease total testosterone by around 0.34 nmol/L (12 ng/dL)

📈The converse is also true. Reducing bodyfat is effective at enabling an increase in natural testosterone

🔄The effects are bi-directional. Increased bodyfat lowers testosterone, and lower testosterone makes increased bodyfat and reduced muscle more likely.

🧈Bodyfat is effectively an endocrine organ. It produces hormones, including pro-inflammatory adipocytokines and leptin that can raise chronic inflammation, promote fat accumulation and increase the rate at which testosterone is converted to estradiol via aromatisation.

Hence for many men, and entirely separate from aesthetics, reducing bodyfat and increasing muscle mass may be the number one most impactful thing they can do to enable their natural testosterone production and enjoy the many positive impacts of healthy testosterone levels.

💉The chart pictured is using US style ng/dl units. 200 ng/dl is around 7 nmol/L and 600 ng/dl is around 21 nmol/L

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Link goes to this same post and a larger image on Insta. You can contact me via the WhatsApp button on my homepage or on Insta, if you welcome help to understand and manage your own hormonal health.

What is Andropause? Also known as male menopause & manopause it further overlaps with more clinical terms such as androgen deficiency in the aging male (ADAM) and testosterone deficiency syndrome.

Some key things to understand if you are starting to consider this for yourself or a partner:

1. Andropause is very different to Menopause. There is no milestone like the cessation of ovulation. Andropause refers to a persistent decline of testosterone in the absence of any major endocrine organ dysfunction. Hence medical investigation will often seek to rule out specific disorders first.

2. Symptoms of andropause are broad and also non-specific, so easily ignored or attributed to other factors. These include reduced sexual desire, erectile dysfunction, decreased energy, mood, concentration, motivation, poor sleep and loss of bone and lean body mass.

3. It is often written that testosterone declines by 1-2% on average per year, starting sometime around after age 30.

Whilst this is not untrue, this obscures the reality that whilst some men maintain more or less the same testosterone from age 30 to 70+, others experience a far greater than 1-2% per year decline.

4. Normal, natural testosterone levels vary widely between men. Levels can also vary significantly for any *one* man from one test to another.

Hence identifying low testosterone combines at least two tests and the presence of low testosterone symptoms

5. Naturally robust levels of testosterone support normal sexual function and libido and appear to be protective against diabetes, bone-loss, muscle loss and potentially cardiovascular health, so being aware of Andropause and ones own personal norms & changes over time is hugely important for male health

Link goes to this same post and a larger image on Insta. You can contact me via the WhatsApp button on my homepage or on Insta, if you welcome help to understand and manage your own hormonal health.

Why test at all? I have a separate post dedicated to that, and in brief, the value includes establishing your own personalised norms, highlighting potential root causes, creating baselines for test-change-retest protocols, validating intervention outcomes, and offering novel personalised insights.

These are the tests and biomarkers I would often consider for a client seeking to improve their natural testosterone:

1. Total and Free Testosterone

The ‘free’ testosterone is critical, since only this is actually available for active use, and knowing both provides two signals. One on testosterone production, and the other on testosterone availability.

2. Sex Hormone-Binding Globulin

If total testosterone is okay but free testosterone is low, this is often a root cause. SHBG binds to testosterone, making it unavailable for active use. If this is true, interventions to reduce SHBG may be high value.

3. Luteinizing Hormone (LH) & Follicle-Stimulating Hormone (FSH)

These hormones regulate testosterone production within the male testes, so if their levels are exceptionally lower or higher in the presence of low testosterone they are suggestive of a root cause, and a target for intervention.

4. Estrogen

Males and females both produce and need estrogen(s) and testosterone, whilst the levels of course are very different. Testosterone may be converted to estrogen via aromatisation, and if the fraction being converted is excessive it can result in too little of the former and too much of the latter.

5. DHEA-Sulfate

DHEA-S is a precursor building block for both testosterone and estrogen. Just as with testosterone, normal levels decline with age and low levels can indicate issues, and opportunities, with diet, lifestyle and body composition.

6. 24-Hour Cortisol

Used to inform whether the daily oscillating pattern of cortisol has peaks and troughs at the appropriate times, and whether its activity may be suppressing testosterone production

7. Vitamin D3, Magnesium & Zinc

By no means the only essential micronutrients, but those for which insufficiency may be common, and with strong links to testosterone production.

8. Omega-3 Index

Omega-3 fatty acids are essential (hence essential fatty acids) for cellular activity including hormone production. If this is below optimal, it is very easily addressed via diet and supplementation.

9. Inflammatory Markers

Chronic inflammation, regardless of source, can impair endocrine organ function, including and not limited to testosterone production. If present, identifying and addressing the root cause is a high priority.

10. HbA1C Blood Glucose

Poor blood glucose regulation, leading toward prediabetes and diabetes, can impair testosterone production, with the good news being that insulin sensitivity is highly manageable, for most people, via diet and lifestyle practices.

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Together with lifestyle factors, your dietary approach can hugely influence your natural testosterone production, male or female, and most ages.

Doing *all the right things* within your diet will not raise your natural testosterone to super-physiological levels but if your dietary approach is currently not addressing most or all of the key points then it could be a significant contributory factor if you have lower testosterone.

I personally went through a period of several years on a relative-energy deficit ketogenic diet combined with high intensity exercise where my testosterone fell to below even the standard reference ranges. I say “below even” as those ranges are not based on optimal health, and the normal reflects the results from a population containing many people with metabolic syndrome, high stress, high toxic exposures, and other factors that may be impacting upon their natural testosterone production.

After multiple tests confirming below-reference testosterone, and with disease factors ruled out, I was offered testosterone-replacement therapy (TRT) Before taking up TRT I made some major changes to my diet, lifestyle and supplementation, including reintroducing more carbohydrates, more total calories, reducing the frequency of very intense exercise, and adding in some specific supplements. This was enough to raise my free testosterone by several mmol/L, back at least into the “normal” range.

Even if you are considering testosterone therapy, putting in place all the supportive lifestyle and dietary approaches is a great first priority to ensure that your natural production has all the opportunity you can possibly give it.

Decoding those chemical symbols - the key minerals are Boron (B), Magnesium (Mg), Selenium (Se), Zinc (Zn) and Iron (Fe) and Copper (Cu) with the latter two in specific balance with one another, with males and females both often struggling to have appropriate levels of iron, not too much and not too little.

In practice, whilst the vitamins and minerals indicated are those that most often, if insufficient or deficient have a negative impact on testosterone, ensuring regular intake of all required vitamins and minerals, and trace minerals, through diet and where helpful or necessary, supplementation, is more effective than following a reductionist approach.

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When seeking to support your best possible *naturally* produced testosterone your overall diet and lifestyle are likely to have far more significant impact than supplements. If your sleep quality or quantity is poor, if you are highly stressed, if your toxins exposure is high, if you have a high processed foods or nutrient poor diet, these are by far the most fertile grounds for intervention.

If you bring your diet and lifestyle to a place where most of the boxes are ticked for the things that support a healthy hormonal environment, what else? This is where some supplements, some of the time, for some people, do show some evidence for positive effect. Caveat that none of these compare to testosterone replacement therapy (TRT) but the combination of diet + lifestyle + supplementation all together can absolutely provide enough support for very desirable levels of natural testosterone production. Since most of the interventions are also broadly supportive of vitality, energy and healthspan, they have a strong case for action that goes beyond testosterone alone.

By reference to multiple systematic reviews and some smaller studies, and my own experience supporting male clients, these are the top 10 supplements worth considering in pursuit of improving natural testosterone production. Note that this is not a recommendation for anyone to simply take these as a full stack. The appropriate approach is to personalise, considering your diet, other supplements, supplement cycling and appropriate dosing.

#1. Vitamin D3+K2
Vitamin D3 supports testosterone synthesis by influencing the activity of Leydig cells within the male testes. When you are supplementing with D3, K2 is very important to use in combination to assist with appropriate utilisation of the D3. Sunlight exposure during the months with sufficient UVB light to enable skin cell synthesis of vitamin D is a great alternative, with supplementation during other months to maintain or improve your target Vitamin D levels.

#2. Magnesium
The format does not matter hugely but by glycinate, bygylcinate, taurate and orotate are highly absorbable forms with fewer potential side effects. Mg has multiple pathways to support testosterone including reducing the amount of testosterone which is bound to sex-hormone binding globulin (SHBG)

#3. Zinc
Essential cofactor for testosterone synthesis and definitely possible from dietary sources too, but if your intakes are low, temporary supplementation may help close the gap whilst you add more into the diet.

#4. Boron
A trace mineral required a lower quantities than magnesium and zinc, but may be very important for improving free testosterone via reducing binding to SHBG

#5. Omega-3 Fatty Acids
If for any reason your diet is not already rich in omega-3s from fatty fish then supplementation can be used, ideally choosing a phospholipid form, such as from herring caviar & krill oil, for superb absorbability.

#6. Ahwaganda
Appears to mitigate stress hormone (cortisol), support Leydig cell activity and result in increased testosterone (and sperm quality)

#7. Tongkat Ali
May improve testosterone by stimulating luteinising hormone which in turn stimulates testosterone production

#8. Shilajit
The mechanisms are little known, but some trials have demonstrated positive impact.

#9. Fenugreek
Another compound which appears to improve free testosterone via reducing the amount of testosterone bound to SHBG. You can also consume fenugreek in the diet, in many ways but the dosing found to have significant impact requires a specific amount of saponins.

#10. DHEA
DHEA is a precursor to testosterone with its own direct health supporting effects. In the UK, DHEA is a Class C drug, unavailable to buy or import. Hence within my own professional scope I cannot recommend it. Some countries, including the US, have free distribution of DHEA, hence the mention here rather than omitting it from consideration.

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For males and females, supporting optimal natural testosterone production can have an incredible positive impact on quality of life, short term and long-term, including extending healthspan.

Many of my male clients are experiencing the andropause. Unlike menopause, this is not a single moment in time and is instead a steady, incremental reduction in key male health related hormones, including testosterone, often beginning from sometime between 30-40 years old.

Before analysing diet, considering supplements or even testosterone replacement therapy there are often key lifestyle factors which have a major impact and are highly modifiable.

Sometimes these lifestyle factors alone, especially if several are absent or in a poor state, can be the root cause for low testosterone and general poor health. To a large extent, they are highly modifiable and at minimal cost, except for effort!

Hence this is the place I often start with my clients, so that we establish a strong basis on which to build upon with diet and supplementation interventions.

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Your organs are body parts with specific functions, and endocrine organs are the specific types of organs that produce and release hormones into circulation via blood, with broad ranging effects. For example, our adrenal glands release adrenaline and noradrenaline, and specific cells within our pancreas release insulin.

Your muscle is also an organ. It is made of specialised cells and because of benefit #3, it functions as an endocrine organ. So long as it is gained *drug-free* more muscle is almost always more beneficial, both for enjoyment of life now, later, and much later. More muscle is protective against almost many major chronic diseases, including cardiovascular disease, diabetes and dementia, and even some forms of cancer.

So what does muscle do for us?

#1 Movement and function.

It is what lets you move, dance, run, lift, and all the mundane but essential activities for daily living. This is why there are tests like sitting up from a chair, from the floor, and grip-strength, that are strongly predictive of quality of life and health

#2 Metabolic Health.

Muscle helps regulate the clearance of both sugar and fats from our blood circulation, reducing the risk of developing diabetes or fatty liver.

#3 Myokines.

Muscle produces myokines during exercise, which help reduce inflammation, improve insulin sensitivity and promote the growth and repair of other tissues.

#4 Mental Health.

Muscle enables *living*, which helps keep us younger, but it also stimulates the increased production of neurotransmitters, like brain-derived neurotrophic factor (BDNF) that contribute directly to brain and mental health, reducing anxiety, depression and enhancing mood and memory.

It is *never* too late, or too early, to begin building more muscle. For inspiration, link goes to a meta analysis reporting on muscle gains by female subjects of up to 80 years old.