Men's Hormone Health Guidance

There is no "universal optimal value" spread online, and there is no need to blindly pursue "the higher the better." As long as your serum testosterone is within the reference range tested by a regular hospital and there are no clinical symptoms related to low testosterone, you are in a healthy state.； The prerequisite for any intervention is to first check for lifestyle deficiencies, make adjustments according to the doctor's instructions, and take supplements or even hormone drugs on your own, which will cause irreversible endocrine damage.

A while ago, when I was doing health consultation for a 32-year-old Internet programmer friend, his situation was very typical: he always felt tired for more than half a year, and his muscles had not grown at all after two months of fitness training. He was also not interested in his partner. After watching short videos and watching people saying, "A 30-year-old whose testosterone has plummeted, he needs to take a testicle supplement," so he spent more than 1,000 to buy it. I took oral testosterone for two months, but it was of no use. I went to the hospital to check six sex hormones, and the serum testosterone was 280ng/dl, which was just on the pass line of the reference range of 260-1500ng/dl given by the local hospital. The endocrinologist read the report and said directly that there was no need to prescribe medication, and that he would go back and adjust his life for three months.

Regarding "whether the higher the testosterone, the better", there is actually a huge gap in understanding between different circles: There has always been a saying in the fitness circle that "testosterone levels determine the speed of muscle gain". Many people who go to the gym all year round will try their best to increase testosterone levels, and some people even secretly take anabolic steroids.； But from the perspective of an endocrinologist, as long as testosterone is within the reference range and there are no symptoms such as fatigue, loss of libido, bone density, or muscle mass, there is no need to deliberately intervene. Even the 2022 "Male Hypogonadism Diagnosis and Treatment Guidelines" also mentioned that men who have been in the high reference range of testosterone for a long time have a risk of benign prostatic hyperplasia that is about 12% higher than men who are at the median level.

It’s also interesting to say that many young people nowadays have low testosterone. It’s not a problem of age at all, it’s a result of lifestyle habits. The most common cause is abdominal obesity - aromatase in visceral fat will actively convert testosterone into estradiol. You see many men with big bellies, thin beards and somewhat developed chests, which are symptoms of high estradiol and relatively insufficient testosterone. I used to know a fitness coach. During the preparation period, when his body fat reached 9%, his testosterone was found to be 830ng/dl. During the Chinese New Year, he ate and drank a lot for two months. His body fat increased to 18%. When he checked again, it dropped directly to 440. He didn’t add any other bad habits, which was the cause of the increase in body fat.

Another point that many people don’t take seriously: The impact of staying up late is really greater than you think. It doesn’t mean that you’ll be fine if you stay up late and catch up for 8 hours. The peak of testosterone secretion is concentrated in the first 3 hours of deep sleep, usually between 1 am and 3 am. If you don’t go to bed until after 3 am every day, even if you sleep until 11 noon for 8 hours, the peak secretion will have been missed long ago. Can testosterone not be lost in the long run? There used to be a consultant who worked in cross-border e-commerce. He stayed up until after 4 o'clock every day to communicate with European and American customers. His testosterone was only 310ng/dl. Later, he adjusted the time of communication to the afternoon and forced himself to go to bed before 12 o'clock. He didn't take any supplements. After two months, the retest directly increased to 620, which is more effective than any testicular stimulation.

When it comes to adjusting lifestyle, many people’s first reaction is to exercise. However, the impact of exercise on testosterone is really not as simple as “it will be useful if you practice it”. The controversy is actually very controversial: some people say that strength training increases testosterone, while others say that if you practice too much, it will decrease it. In fact, both are correct, it depends on how you practice. Strength training 3-4 times a week for 45-60 minutes each time will indeed stimulate a short-term increase in testosterone and help you maintain a stable metabolic level in the long term. ； But if you train with heavy weights every day and train for more than 2 hours each time, your body's cortisol will continue to surge, which will suppress testosterone secretion. For many bodybuilders preparing for competitions, when training is at full intensity, their testosterone levels are even lower than those of ordinary sedentary people. Some people also say that aerobic reduces testosterone. In fact, low-to-moderate intensity aerobic exercise for less than 40 minutes three times a week can help you reduce body fat. On the contrary, it will indirectly increase testosterone levels. Only men who run marathons for a long time and have body fat below 10% are likely to experience a decrease in testosterone. There is no need to kill all aerobic exercise at once.

Many people buy supplements first when they feel they are not in good condition. To be honest, 90% of testicle-stimulating supplements on the market are useless to you. Maca and epimedium extracts, there is currently insufficient clinical evidence to prove that they can increase testosterone levels in healthy men. ； The most popular zinc and magnesium tablets are only helpful if you are really deficient in zinc and magnesium. For people whose daily diet is nutritious, it is just an ordinary trace element supplement, which has no effect on testosterone. Not to mention that many Internet celebrity testicle-stimulating products secretly add banned ingredients. Taking them may feel useful for a while, but in fact, it will disrupt your own endocrine rhythm and make your condition worse after you stop taking them. If you are really found to have low testosterone and have obvious symptoms, you should undergo testosterone replacement therapy. Currently, there is no completely unified standard in the industry: some doctors believe that intervention is needed when testosterone is lower than 300ng/dl and there are symptoms, and some doctors think that if it is lower than 400ng/dl and symptoms are present, intervention is needed. If the symptoms are obvious, you can use low-dose testosterone supplements. No matter which option you choose, the premise must be regular review as directed by your doctor. Buying testosterone injections by yourself will inhibit your own testosterone secretion function. Hypogonadism is likely to occur directly after stopping the medication, which is completely worth the loss.

Oh, by the way, there is another influencing factor that few people mention: long-term anxiety and stress. Last year, a friend who started a business came to me and said that he had no desire for more than half a year. He was so tired that he fell asleep every day. His testosterone was only 270ng/dl. At that time, his company had just received financing, and he was rushing to meet the deadline every day to meet customers. He was so stressed that he couldn't even eat. As a result, the company's business has stabilized this year, and he has not deliberately adjusted his schedule and exercise. The last time we met, he said that he would check his testosterone and it had risen to 580. It sounds outrageous to say it, but in fact, the long-term high cortisol state has been lifted, and the testosterone has naturally risen.

To put it bluntly, male hormone health really doesn’t have that much mystery. Don’t be led away by the anxious marketing on the Internet that “testosterone will inevitably plummet at the age of 30” and “low testosterone means it won’t work”. I have seen an uncle in his 50s who exercises regularly every day, does not smoke or drink, and has a testosterone level of over 700, which is higher than that of many young men in their 20s. ； I have also seen a kid who is just 20 years old, staying up late every day, drinking milk tea and eating takeout, with a big belly and testosterone that is just stuck at the passing line. If you really feel that something is not right with you recently, don’t buy food blindly. Go to a regular hospital to check the six items of sex hormones first. Get the report and see a doctor. It will be more effective than 100 short videos.