Testosterone Deficiency: An Autoimmune Etiology?

The Thyroid Gland

Auto- means self and immune is the system that grants you protection against outside invaders. If the body is in a state of autoimmunity then that means the body’s immune system has gone off the deep end and started attacking the body’s own self by creating antibodies against itself. These antibodies go on a rampage attacking the type of tissue that they are targeted against.

This is what is happening in any autoimmune disease. Typically, the disease is then named based on what tissue in the body is being attacked. Rheumatoid arthritis is an autoimmune disease where the system is attacked cartilage, the padding in between the joints. Sjogren’s syndrome is an autoimmune disease where the system is attacking the tear glands and the saliva glands. Crohn’s disease and Celiac disease are both autoimmune diseases where the immune system is attacking the intestines. There are even antibodies to blood vessels that can cause problems with blood pressure and increased plaque accumulation.

In actuality, no tissue is safe from autoimmune disease. It is possible to develop antibodies against any part of the body including the testes.

If a younger man is experiencing the symptoms of low testosterone then this should be a red flag to you.

First of all, we all know that men are stubborn about going to the doctor. But, they are even less likely to admit to having problems with their testosterone and manliness. That is why if a man in his twenties or thirties or even younger starts complaining about low testosterone then you should think autoimmune. Especially if the person is not stressed out (Because then they might be turning testosterone to DHEA to cortisol) or if the person is not insulin resistant/overweight (Because then they might be aromatizing testosterone into estrogen).

The scariest part is that if someone has an autoimmunity that means that the immune system as already broken the peace. And the chance of having additional autoimmune diseases skyrockets once one is already there. That’s why part of the treatment process for any autoimmune disease is monitoring for other associated autoimmune diseases.

On the other hand, if someone already has an autoimmune disease or has a prevalence of autoimmunity in the family, and then that person gets low testosterone symptoms, it is possible they just picked up their second autoimmunity.

So what do you do?

Get checked.

There are multiple labs out there that test for a variety of antibodies. Be sure to use a doctor who is aware that testicular antibodies and autoimmunity can happen and knows how to test for it. Then you can go your own route with fixing it. Whether that is using medicines to downregulate the overactive immune system or use functional medicine to try to find and take care of whatever is causing the immune system to be over-excited in the first place.

Aromatase: It Turns your Testosterone To Estrogen!

Giving Testosterone: Aiming Short of the Cause

Anyone who wants more testosterone also wants less estrogen. The symptoms of estrogen being too high in men match up to the symptoms of lower testosterone. In addition, a man may have increased emotional lability in addition to the inability to build muscle and burn fat.

When I say emotional lability, just imagine a grown man crying at The Fox and the Hound. The Fox and the Hound was very sad, but estrogen might be a problem if a waterfall of tears comes from a grown man as a result.

So estrogen can be bad if it is too high and low testosterone we know is bad if it is too low.

This fact makes something called aromatase extremely bad for individuals battling low testosterone.

What does aromatase do?

Well, it tries to turn your testosterone into estrogen. Yep, it turns your good hormone into another hormone that the person doesn’t necessarily want more of in their situation. Aromatase isn’t bad. But it is for someone with low testosterone.

Why?

In a nutshell, the reason is inflammation. A lot of times, aromatase activity is worse in obese individuals, and people with insulin resistance and/or reactive hypoglycemia. The reason is because of the differences between brown fat and white fat.

White fat is less metabolically active than brown fat. Brown fat is used to burn for heat so commonly people think of it as ‘good’. It isn’t used for storing fat. The problem can come when the white fat gets too abundant. When this happens, particular white fat cells can be completely surrounded by other white fat cells. The middle cells become ‘quarantined’ so to speak and stop getting nutrients. It basically is getting crowded and strangled by the other cells. This makes the cell become necrotic. It becomes like a leftover that is left in the fridge for too long. It starts smelling and becomes rotten. This necrotic cell just sits there and stirs up the immune system to fight. The immune system starts pumping out NF-kB which is an inflammatory molecule in the body. This inflammation can increase the production of aromatase which will cause an unnatural rise in estrogen.

Worse yet is that rise in estrogen is coming from the stores of testosterone. Aromatase uses the pieces of your testosterone to build up the estrogen amounts. This is most unwelcome for someone with a low test to begin with. Blood glucose problems, stress, and chronic disease can increase the amount of aromatase as well.

The last blog post we talked about lowering cortisol to increase in testosterone. Now we’re talking about lowering aromatase to help out the imbalance of estrogen and testosterone.

Remember that a person can have low testosterone and need help with cortisol, or aromatase, or both. The next blog post we will talk about how inflammation of the testes can cause low testosterone as well.

Low Testosterone: Stress Destroys Test!

Giving Testosterone: Aiming Short of the Cause

We do not want to just give someone testosterone while the thing causing their testosterone is still there. We have already learned that doing that can cause the patient to become resistant to testosterone. This is because their receptors are becoming resistant to the presence of large amounts of the hormone from the injections or suppositories. (Suppositories work but if you don’t need them then why would you use them? They don’t sound comfortable) Let’s avoid all of these ‘band-aid’ measures and try aiming at the possible true causes of low testosterone in men. The first cause is stress.

For the purposes of this discussion let’s thinks of hormones in two different ways. They are either energy hormones for survival or reproductive or sexual hormones. Your main survival hormone is cortisol. If you get stressed out you send out adrenaline from the adrenal glands and about 20-30 minutes later you start getting out cortisol. This is to pump up the body and get you moving so that you can react to a threat.

To put it simply, your body thinks that you are running from a grizzly bear and it is getting you primed to either fight or fly.

However, stressful events that increase your cortisol can happen every day. If you over train you are spiking cortisol. If you are on shift duty you could be spiking cortisol. If you are in a stressful job or relationship you are spiking cortisol. ANYTHING that stresses you out can spike cortisol. So what’s the big deal? How does this affect testosterone?

Because the building blocks of cortisol are the same as the building blocks for testosterone. If you are constantly stressed out then you are using DHEA to make cortisol, the stress hormone, instead of testosterone.

Think of it this way: If you are running from a bear every day of your life, does your body think that you’re in a position to have children?

Nope, it doesn’t. It basically is saying, “well, we’re so stressed out that there is no use in making testosterone. We should just use everything for cortisol.”

Fixing the cause of the stress if the first problem. The problem is that most people’s stress was caused by something that is long gone at this point. That experience or set of experiences was so bad that now the adrenals are in a cycle that feeds itself. The most important thing to do is to stop this cycle. Deep breathing, meditation, proper sleep schedule, light exercise, and B vitamin rich nutrition are all lifestyle factors that can play a role. In addition, there are many anti-aging interventions that can get the adrenals functioning back at 100% very quickly and permanently. The trick is determining which one is right for that individual.

Stay tuned for the next two Blog posts concerning alternative causes of low testosterone in men.

Giving Testosterone: Aiming Short of the Cause

If you are having low testosterone as a man, you are probably extremely frustrated. Any person would be. It not only feels horrible to have lower testosterone, but it also is extremely unhealthy.

Many people think that a man with low testosterone, or T as it can sometimes be called, can have lower energy, lower sexual drive, and softer erections.  This is true, but they also can have depression, anxiety, and other mood disorders. Some health risks include risks to the bone, heart, and brain. A lot of people do not know that this important hormone can affect these other areas.

So, we know that testosterone is important. So if someone is low, shouldn’t we just shoot them up with a big fat needle full of testosterone? Or maybe give some testosterone suppositories since those are so comfortable?

The short answer for most of the time is, NO!

Many testosterone clinics have made big money off of giving testosterone to men in need of help. The man shows up with low testosterone on blood work and they immediately are given testosterone replacement without the doctor ever thinking of looking for the cause.

Many times, the person actually feels better. This is called the ‘hormone honeymoon.’ Why does it make them feel better? Because testosterone makes people feel really good. But then the receptors start getting resistant because of all the testosterone in circulation. This makes it so that the same amount of testosterone doesn’t make them feel good anymore. They need more now. So the doctor gives them even more. Next time they need even more. And even more. And even more. Until the patient no longer gets better from testosterone and the clinic is richer than ever.

It is true, that testosterone lowers as you age. But, you shouldn’t have symptoms of lower testosterone until you are much older in life. If someone is over 70 then it is possible that person would need testosterone replacement. But if every man who has low testosterone on blood work immediately is given lower testosterone then there is a high percentage of them that are being given a disservice. They will have to take testosterone forever until it stops working. At that point, they will have extremely high resistance in their receptors and an even worse ability to take in testosterone.

So they’re worse off because their hormone doctor didn’t really dig for the cause, to put it bluntly.

Over the next couple of blog posts, we’ll discuss the different CAUSES of lower testosterone.