WHAT DOES TESTOSTERONE REPLACEMENT TREATMENT LOOK LIKE?When practitioners discuss the topic of testosterone treatment with their patients, they talk about replacing it with agents such as gels, creams, and injections or they attempt to encourage a more natural boost to a man’s testosterone by using herbs and nutraceuticals. While these methods are undoubtedly an approach towards addressing the symptoms, these methods do not address the underlying cause of the testosterone deficiency. To really get to the root of the issue, we need to also look at the individual’s diet, lifestyle, stress level, and their overall health. In this article, we will discuss the basics: key areas that influence testosterone production and the interrelated players in the male sex hormone system. Treatment for each of these areas may include a natural, bioidentical, or pharmaceutical method resulting in alteration of the entire system.
THE MALE SEX HORMONE CYCLEThe male sex hormone cycle is incredibly complex and is involved in many processes in the body. If we start in the brain, the simplified sex hormone cycle may look something like this:
- The brain releases a cascade of signals that sends luteinizing hormone (LH) into the blood and down to the testicles.
- LH, in turn, stimulates the testicles to make more testosterone.
- Testosterone is released into the system for the body to meet what the brain (and LH) is telling it to do, giving us measurements for total testosterone (T). As an aside, some testosterone is converted into dihydrotestosterone by an enzyme called 5-alpha-reductase.
- To help carry non-water soluble testosterone, much of it is bound to the carrier protein, Sex Hormone Binding Globulin (SHBG), setting up the ability to calculate free It is the lower level of free testosterone that has the greatest impact with regards to “Low-T” symptoms.
- Testosterone is then converted into its sister hormone, estrogen, by an enzyme called aromatase.
- The cycle continues again from step 1.
ADDITIONAL OPTIONS FOR TESTOSTERONE TREATMENTIt’s apparent that hormones are comprised of a series of complex systems. Thus, they can be adjusted at many different steps in the hormone cycle. Let’s look at a few alternatives:
- Selective Estrogen Receptor Modulators (SERMs) are a class of pharmaceuticals that prevent the brain from seeing how much estrogen is present in the sex hormone cycle. When utilized in testosterone treatment, they assist in encouraging the brain to release more LH and send signals to the testes to produce more testosterone.4
- LH activity can be stimulated by the addition of Human Chorionic Growth Hormone (HCG). The biochemical structure of HCG looks very similar to LH and can ‘unlock’ the cells in the testicle to produce more testosterone, much like LH does naturally. Clinically, it’s noted that younger men tend to respond better to this type of treatment than older men, for unknown reasons.
- Testicular function and production of testosterone can be impacted directly by a number of natural agents including nutrition and herbal compounds. Nutrients are often used for increasing testosterone production while herbs are used to stimulate testosterone-making cells. Both agents assist in removing hormone-disrupting chemicals from a person’s system either in addition to or in replacement of other testosterone-boosting treatments.
- Herbal remedies have shown to reduce SHBG levels, thus increasing the level of ‘active’ testosterone in a man’s system.
This overview is To Be Continued, looking into each area and how it can be impacted, by diet, exercise, supplements, bioidentical hormones and pharmaceuticals.
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