Four Behaviors that Sabotage Testosterone Levels

by Jason E. Barker, ND

Changing body composition (increased fat mass with decreased lean body mass) is a well-recognized aspect of aging.¹ Loss of lean body mass, primarily skeletal muscle, exerts a negative influence on one’s physical function and long-term health.² Along with this loss comes a rise in body fat levels and more specifically, fat in the abdominal area, which is related to negative health consequences such as suboptimal cardiovascular health and imbalanced blood sugar metabolism.³

Muscle strength peaks in our early 20s and begins to decline in the 40s at a rate of 12-15 percent per decade in men.⁴ Females experience a slightly earlier peak in strength coupled with an earlier decline, but at a slower rate than men. This loss of lean body mass presents a significant health challenge to the aging person. However, there are a handful of ways that lifestyle choices may be sabotaging efforts to achieve a lean body mass and the hormones that support it, namely testosterone. This article will discuss the ways lifestyle impacts lean body mass and testosterone as well as ways to support healthy levels of this hormone.

Low Testosterone: Aging Isn’t the Only Cause

Testosterone is the most significant of all innate factors in maintaining lean body mass. Declining levels in aging people is a well-known contributor to the loss of lean body mass (skeletal muscle tissue) and correspondent increase in body fat; at the same time testosterone exerts positive effects on bone density, the cardiovascular system, prostate gland and mental health.^5-11

Aging alone, however, cannot be blamed for declining testosterone levels. In fact, even men in their early 30s present with a variety of symptoms attributed to less than ideal testosterone levels that include to one degree or another lackluster libido, decreased muscle mass, occasional fatigue, lethargy, mood imbalances, issues with bone integrity, decreased facial and body hair and breast enlargement in males. Similarly, these symptoms are confirmed by laboratory testing to coincide with low total and free testosterone levels.

This now raises the question of why do young men (increasingly, it seems) present with less-than-optimal testosterone? And equally important, what can be suggested to those who may be considered “too young” to be experiencing these concerns and whose less-than-optimal testosterone levels are not caused solely by age-related decline, as well as for older men who want to boost their testosterone levels naturally?

Simply replacing testosterone without addressing lifestyle causes will only buy some time against the ticking clock of lifestyle-related concerns. Addressing lifestyle factors such as diet, exercise, sleep and stressors are the keys to supplanting healthy levels of testosterone in all ages.

Exercise and Lean Body Mass

Exercise, more specifically resistance-type exercise (strength training), is a powerful stimulator of muscle protein synthesis, which in turn counters age-related decline in muscle mass as well as atrophy through disuse.¹²

Newer thinking on the relationship between loss of muscle mass and aging is changing in that prior studies proclaimed muscle loss was a result of aging, where in actuality the observed decline in muscle mass may be more directly a result of disuse atrophy.

A newer study examined masters athletes (40+ years old, training 4-5 times weekly, each week) that eliminated disuse as a confounding variable showing a consistent maintenance of muscle mass and strength, “contradicting the common observation that muscle mass and strength decline as a function of aging alone.”¹³

Resistance training that is high in volume with moderate to high intensity and short rest intervals focusing on the larger muscles will produce the largest hormone (testosterone, growth hormone and cortisol) elevations in comparison to exercise that is low in volume with high intensity and long rest periods.¹⁴

Based on this, the most efficient exercise for raising hormone levels is regular weight training, using moderate to heavier weights for several sets with shorter rest in between. This will acutely raise hormone levels necessary for lean muscle mass production.

However, this is not to say that a person seeking good health should eschew cardiovascular-type fitness. Running, cycling, swimming and other aerobic forms of exercise are vital for cardiovascular health and have innumerable wide-spectrum health benefits that also include maintenance of lean body mass. Long-term exercise and maintenance of fitness serves to maintain higher levels of the anabolic hormones DHEAS (dehydroepiandrosterone-sulfate), IGF-1 (insulin-like growth factor-1), testosterone and lean body mass in aging men as well.^15-16 It should be noted that DHEA is an important precursor for testosterone.

Both resistance exercise (strength training) and aerobic exercise (running, cycling, etc.) should be incorporated to gain the maximal amount of lean body tissue and its attendant health benefits.

Exercise, Fueling and Muscle Mass

Excluding conversation regarding caloric intake and its relation to weight loss and exercise, post-exercise “fueling” is important to discuss from the perspective of lean muscle mass production.

During both resistance and non-resistance exercise, an acute balance exists between muscle protein breakdown and synthesis. A positive balance in the direction of muscle protein synthesis only occurs when amino acids (protein) are readily available immediately following an exercise bout. At the same time, the presence of insulin (stimulated by glucose feeding, i.e. carbohydrate intake) is important to prevent muscle protein breakdown following exercise.¹⁷

This means that immediately following exercise, a meal consisting of both carbohydrate and protein are important for the maintenance and stimulus of muscle protein synthesis, providing a net gain in lean muscle mass as a result of the exercise performed. However, we do recommend consulting with a sports nutritionist who is knowledgeable about meeting dietary objectives for both performance (as discussed above) and exercise-assisted weight loss.

Weight Management

Another way to naturally increase testosterone is by controlling weight. Excess body fat is associated with several known parameters of poor health and abdominal fat is even more closely associated with decreased testosterone levels in men.¹⁸ Increasing body mass index (BMI), waist circumference and percent body fat are all associated with decreased total and free testosterone and altered sex hormone binding globulin levels, while total and free estradiol (a form of estrogen) are increased.^19-20 Losing fat mass not only benefits health in general but will also serve to somewhat limit the amount of testosterone that is aromatized to estrogen.

Consumption of Alcoholic Beverages

The consumption of alcoholic beverages also plays a role in maintaining healthy testosterone levels. Much research points to the cardiovascular benefits of moderate alcohol consumption; however, when consumed in excess, testosterone plasma concentration becomes reduced after the fact.²¹ Of additional importance in maintaining muscle mass, levels of growth hormone are similarly reduced during episodes of excess alcohol intake and subsequent periods. Limiting alcohol intake will also assist in slowing weight gain.

The Importance of Sleep

Sleep itself does not improve lean body mass; however, studies looking at partial sleep deprivation reveal the role of adequate sleep in maintaining normal neuroendocrine function and glucose metabolism. Additionally, healthy oxygen intake levels during sleep supports normal testosterone production.²²

Epidemiologic studies also show that inadequate sleep results in many other metabolic and endocrine disruptions including decreased glucose metabolism, increased evening cortisol, decreased insulin efficiency, increased ghrelin, decreased leptin, increased hunger and appetite.^23-25

Nearly all of these factors are suspect in contributing to the widespread problem of weight gain that can further contribute to lower testosterone levels. Clinically, sleep quantity and quality are one of the first places we look when assisting a person with lasting weight loss.

Stress and Testosterone Levels

Stress is a constant in daily life, and each of us is affected in different ways by it. In relation to maintaining healthy testosterone levels, and in turn lean body mass, stress mitigation is a lifestyle change to be considered. Intense stressors are well known for their testosterone-lowering effects.^26-27 Stress, in fact, is well known for inducing a state of catabolism (breakdown state) across the board; we’ve all probably known a person undergoing very high stress who loses a significant amount of weight, both lean and fat body mass. Often DHEA levels will drop with ongoing stress, which decreases the adrenal precursor contribution to testosterone production.

In my practice, all the younger men who experienced symptoms related to suboptimal testosterone had an extremely stressful lifestyle or recent stressful event.

Carnitine for Muscle Recovery

Beyond the lifestyle factors discussed above, an easy way to support healthy testosterone levels as well as enhance muscle recovery is to take L-carnitine, an amino acid compound found naturally in the body. It’s perhaps best known for its ability to breakdown fats for energy production. It also has several benefits for helping support testosterone levels and exercise performance.

Given to a group of people performing resistance exercise, carnitine supplementation upregulated androgen (testosterone) receptors in muscle tissue, thereby promoting muscle recovery.²⁸ Carnitine supplementation in weight lifters also reduced the amount of exercise-induced muscle damage, leaving more hormonal receptors available for benefit of recovery.^29-30

Supplementing with carnitine may serve to boost the ability of testosterone to help repair muscles, thereby increasing the benefits of training on lean body mass.

Conclusion

There are a number of natural ways to support testosterone production and lean body mass. Addressing lifestyle issues such as getting enough sleep, limiting consumption of alcoholic beverages, losing fat body mass and stress mitigation can all help support lean body mass and hormonal balance. The most effective way to boost testosterone and lean body mass is through resistance exercise; this should be a cornerstone in any plan to stay healthy. Supplementing with L-carnitine can help support muscle mass through its muscular benefits during exercise.

References

1. Evans WJ, Cyr-Campbell D. Nutrition, exercise, and healthy aging. J Am Diet Assoc. 1997 Jun;97(6):632-8.

2. Visser M, Schaap LA. Consequences of sarcopenia. Clin Geriatr Med. 2011 Aug;27(3):387-99.

3. Nowak M, Grzywa M. [Metabolic obesity in normal weight individuals and cardiovascular disease]. Pol Merkur Lekarski. 2011 Aug;31(182):118-21.

4. Hurley BF. Age, gender, and muscular strength. J Gerontol A Biol Sci Med Sci. 1995 Nov;50 Spec No:41-4.

5. Bassil N, Alkaade S, Morley JE. The benefits and risks of testosterone replacement therapy: a review. Ther Clin Risk Manag. 2009 Jun;5(3):427-48.

6. Jones RD, Nettleship JE, Kapoor D, Jones HT, Channer KS. Testosterone and atherosclerosis in aging men: purported association and clinical implications. Am J Cardiovasc Drugs. 2005;5(3):141-54.

7. Hak AE, Witteman JC, de Jong FH, et al. Low levels of endogenous androgens increase the risk of atherosclerosis in elderly men: the Rotterdam study. J Clin Endocrinol Metab. 2002 Aug;87(8):3632-9.

8. Rinnab L, Gust K, Hautmann RE, et al. [Testosterone replacement therapy and prostate cancer. The current position 67 years after the Huggins myth. Urologe A. 2009 May;48(5):516-22.

9. Morgentaler A, Schulman C. Testosterone and prostate safety. Front Horm Res. 2009;37:197-203.

10. Zarrouf FA, Artz S, Griffith J. Testosterone and depression: systematic review and meta-analysis. J Psychiatr Pract. 2009 Jul;15(4):289-305.

11. Almeida OP, Yeap BB, Hankey GJ, Jamrozik K, Flicker L. Low free testosterone concentration as a potentially treatable cause of depressive symptoms in older men. Arch Gen Psychiatry. 2008 Mar;65(3):283-9.

12. Phillips SM. Physiologic and molecular bases of muscle hypertrophy and atrophy: impact of resistance exercise on human skeletal muscle (protein and exercise dose effects). Appl Physiol Nutr Metab. 2009 Jun;34(3):403-10.

13. Wroblewski AP, Amati F, Smiley MA, et al. Chronic exercise preserves lean muscle mass in master’s athletes. Phys Sportsmed. 2011 Sep;39(3):172-8.

14. Kraemer WJ, Ratamess NA. Hormonal responses and adaptations to resistance exercise and training. Sports Med. 2005;35(4):339-61.

15. Tissandier O, Péres G, Fiet J, et al. Testosterone, dehydroepiandrosterone, insulin-like growth factor 1, and insulin in sedentary and physically trained aged men. Eur J Appl Physiol. 2001 Jul;85(1-2):177-84.

16. Ari Z, Kutlu N, Uyanik BS, Taneli F, et al. Serum testosterone, growth hormone, and insulin-like growth factor-1 levels, mental reaction time, and maximal aerobic exercise in sedentary and long-term physically trained elderly males. Int J Neurosci. 2004 May;114(5):623-37.

17. Kumar V, Atherton P, Smith K, et al. Human muscle protein synthesis and breakdown during and after exercise. J Appl Physiol. 2009 Jun;106(6):2026-39.

18. Hautanen A. Synthesis and regulation of sex hormone-binding globulin in obesity. Int J Obes Relat Metab Disord. 2000 Jun;24 Suppl 2:S64-70.

19. Rohrmann S, Shiels MS, Lopez DS, et al. Body fatness and sex steroid hormone concentrations in US men: results from NHANES III. Cancer Causes Control. 2011 Aug;22(8):1141-51.

20. Håkonsen LB, Thulstrup AM, Aggerholm AS, et al. Does weight loss improve semen quality and reproductive hormones? Results from a cohort of severely obese men. Reprod Health. 2011 Aug 17;8:24.

21. Ylikahri RH, Huttunen MO, Härkönen M. Hormonal changes during alcohol intoxication and withdrawal. Pharmacol Biochem Behav. 1980;13 Suppl 1:131-7.

22. Hammoud AO, Carrell DT, Gibson M, Matthew Peterson C, Wayne Meikle A. Updates on the relation of weight excess and reproductive function in men: sleep apnea as a new area of interest. Asian J Androl. 2011 Dec 5. Published Online Ahead of Print.

23. Leproult R, Van Cauter E. Role of sleep and sleep loss in hormonal release and metabolism. Endocr Dev. 2010;17:11-21.

24. Van Cauter E, Spiegel K, Tasali E, et al. Metabolic consequences of sleep and sleep loss. Sleep Med. 2008 Sep;9 Suppl 1:S23-8.

25. Copinschi G. Metabolic and endocrine effects of sleep deprivation. Essent Psychopharmacol. 2005;6(6):341-7.

26. Chichinadze K, Chichinadze N. Stress-induced increase of testosterone: contributions of social status and sympathetic reactivity. Physiol Behav. 2008 Jul 5;94(4):595-603.

27. Gomez-Merino D, Drogou C, Chennaoui M, et al. Effects of combined stress during intense training on cellular immunity, hormones and respiratory infections. Neuroimmunomodulation. 2005;12(3):164-72.

28. Kraemer WJ, Spiering BA, Volek JS, et al. Androgenic responses to resistance exercise: effects of feeding and L-carnitine. Med Sci Sports Exerc. 2006 Jul;38(7):1288-96.

29. Kraemer WJ, Volek JS, French DN, , et al. The effects of L-carnitine L-tartrate supplementation on hormonal responses to resistance exercise and recovery. J Strength Cond Res. 2003 Aug;17(3):455-62.

30. Karlic H, Lohninger A. Supplementation of L-carnitine in athletes: does it make sense? Nutrition. 2004 Jul-Aug;20(7-8):709-15.