What’s Going on with my Testosterone?
By Dr. David Pollack
Many men struggle with low testosterone levels. Historically, this has been seen as an issue for men in their 50s and beyond, but I often see patients in their 20s, 30s, and 40s facing this problem. What’s going on? Why is this happening to so many men? Is testosterone replacement a good idea? And what can be done to reverse this process?
Testosterone is a steroid hormone produced by both the testes and the adrenal glands. The adrenal glands create all the direct precursors for testosterone. This suggests that adrenal function is a key component in testosterone production.
What many men don’t realize is that testosterone can be converted directly into estrogen with just one small chemical change. It’s normal for men to have a small amount of estrogen, just as women have a small amount of testosterone. While steroids have a bad reputation due to their abuse by athletes, our bodies naturally produce these essential hormones.
Steroids are unique because they can penetrate the nucleus of our cells, directly activating our DNA and gene expression. Within the adrenal gland, all our steroid hormones can be converted and transformed into each other as needed. This leads to our first issue with testosterone production: a lack of production because other adrenal hormones are being prioritized, with the most classic example being the overproduction of cortisol.
Cortisol is one of our primary stress hormones. People living stressful lives or struggling with anxiety or depression end up producing excess cortisol. The body prioritizes cortisol production and decreases testosterone output as a result. Chronic inflammation also increases cortisol levels. Therefore, chronic stress or inflammation can significantly impair our testosterone production.
For various reasons, some men convert their testosterone into estrogen. For these individuals, taking supplemental testosterone or precursors like DHEA can have detrimental effects. They may excessively produce estrogen, leading to unintended consequences such as weight gain, decreased energy, and mood imbalances. This happens due to excess weight (adipose tissue), hormone mimickers like BPA and phthalates, and plasticizers that act like estrogens in the body.
A significant factor in reduced testosterone production has been evident all along: cholesterol. Cholesterol serves as the backbone for testosterone and other steroids produced by the adrenal glands. However, conventional wisdom has urged us to lower our cholesterol through diet and medication without considering its essential functions in the body.
Cholesterol serves three primary functions in the human body:
It constitutes 80 percent of the 1 to 1.5 liters of bile produced by the liver daily. Poor digestion, particularly in gallbladder function, can contribute to increased LDL cholesterol.
Cholesterol is the direct precursor to all steroid hormones. It serves as the first and rate-limiting step for adrenal gland function. If the adrenals are weak or insufficient, they struggle with this critical step. Hormone production relies on HDL cholesterol, so low levels can impair this process.
Despite its negative reputation, cholesterol plays a vital role in healing. When blood vessel damage occurs, cholesterol acts as a repair mechanism. However, chronic damage, often driven by excessive sugar consumption, can lead to continuous repair needs, causing cholesterol to accumulate.
There are effective, science-based strategies to naturally boost testosterone levels. The real long-term solution involves addressing underlying health issues, such as chronic inflammation and stress. By tackling these root causes, our bodies can take care of the rest, without the need for synthetic hormones.
Dr. David L. Pollack is the founder of Pollack Wellness, located at 66 Commack Rd., #204, Commack, NY. For appointments or information, call 631-462-0801 or visit PollackWellness.com.
