Early warning analysis of male hormone health risks

The biggest risk for men's hormonal health, with testosterone as the core, has never been the natural decline with age (the annual decline after the age of 30 is only 1%-2%), but three types of factors: poor lifestyle, chronic underlying diseases, and wrong intervention that drag physiological decline into a pathological state. There is still obvious controversy in the academic community about the threshold of testosterone intervention. The harm of blind supplementation is much higher than mild low testosterone itself.

Last week, I met a 32-year-old Internet programmer at the andrology clinic. When he entered the door, he said that he had "lost testosterone": in the past three months, he had severe hair loss, always felt sleepy at work, and couldn't even find the energy to have sex with his girlfriend. I read the popular science on the Internet and bought imported testosterone gel and applied it for half a month. The acne broke out all over my face, and I had insomnia all night. The results of six fasting sex hormone tests revealed that the total testosterone level was 10.7nmol/L, which was clearly within the normal reference range, but slightly lower than the average level for people of the same age. It did not meet the standards for pathological intervention at all.

To be honest, I have been in this industry for almost 10 years, and the patients I have encountered account for at least one-third of the outpatient visits. Most of them were frightened by the marketing content on the Internet that "low testosterone means men are not good", and they made up for it without even doing basic examinations. The current academic controversy about testosterone intervention has actually never stopped: the guidelines of the European Society of Urology are very strict, requiring total testosterone to be less than 8nmol/L, and accompanied by more than three typical symptoms such as fatigue, loss of libido, and loss of bone density, before exogenous supplementation can be considered, and patients are required to adjust their lifestyle for 3 months first, and then use medication if it is no longer useful. ； However, the American Association of Anti-Aging Medicine has a much more relaxed view. They believe that as long as an individual's current testosterone level is more than 30% lower than the peak value at age 30, even if it falls within the normal range within the public reference value, low-dose intervention and adjustment can be performed. However, this view has been criticized - after all, too many people regard this "adjustment" as a shortcut to aphrodisiac, muscle growth, and anti-aging, and the risks of abuse far outweigh the benefits.

Don’t think that as long as you have one or two symptoms, you have a testosterone problem. After all, it’s normal to occasionally feel sleepy after staying up late or to not want to have sex due to recent stress. Signs that you really need to be alert to all appear in clusters: For example, you used to practice strength training three times a week, but now you have to wait three or four days to recover after training. Your muscles are falling faster than they have grown. The visceral fat on your belly is rising. You can't open your eyes even though you sleep for 7 hours a day. Your mood is either inexplicably irritable or unmotivated. You don't even have a morning erection for half a month. If you have been in this state for two or three months in a row, you really need to check it out. And you have to choose the right time to check. Testosterone secretion has an obvious circadian rhythm. It peaks at 8-10 am in the morning. If you check it in the afternoon, the value will be 30% lower. There is no need to be nervous when you get the report.

The most regrettable thing is those young men who blindly use anabolic steroids to build muscle. A 28-year-old fitness coach who came for a review a while ago was originally born with a testosterone level that was 30% higher than that of ordinary people. He practiced anabolism privately for half a year in order to compete in competitions. Now his testicular secretion function is almost completely suppressed, and his testosterone level is only 1/5 of the normal range. He has to rely on exogenous testosterone for maintenance throughout his life. His sperm motility is almost 0, and he cannot even reproduce naturally. There are also those supplements sold online that claim to "naturally increase testosterone", such as Tribulus Terrestris and Maca. The academic community has long conducted large-scale double-blind tests. They have no significant effect on improving the testosterone level of healthy men at all. They earn IQ taxes. If they come across banned ingredients, they can cause liver and kidney function problems after half a year.

Don’t think that the higher the testosterone, the better. There was a 45-year-old private company owner who secretly took testosterone supplements for half a year. He felt like he was 20 years old again. The physical examination showed that the prostate-specific antigen was three times higher than the standard. Half a year later, it was discovered that it was prostate cancer. For people with a family history of prostate cancer, high testosterone levels are equivalent to sending nutrients to cancer cells. There are also people with high blood lipids and a history of thrombosis. Indiscriminate testosterone supplementation will also greatly increase the risk of cardiovascular and cerebrovascular accidents.

To put it bluntly, 90% of the patients with testosterone abnormalities I met were not caused by aging or innate problems. They were all caused by enduring, drinking, and gaining weight on their own: staying up until two or three o'clock every day for three or four consecutive years, cortisol remained high all year round, which directly suppressed testosterone secretion.； Drinking milk tea every day and eating foods high in oil and sugar will accumulate visceral fat, and testosterone will be directly converted into estradiol. This is how many men develop abnormal chest development. In this case, it doesn't matter how much testosterone you supplement. You need to adjust your work and rest schedule first, take time to practice lower limb strength for half an hour two or three times a week, and control your weight. Most of them can return to normal levels within half a year at most. It is more effective than any other supplement and has no side effects.

After all, hormones are originally a barometer of physical condition. How you treat your body will be treated by it. There is really no need to mythologize it or be afraid of it.