Early warning indicators of male hormone health risks

Sustained functional decline, unintentional body fat surge accompanied by muscle loss, and long-term abnormal depression of mood and cognition - the reference value of these three leading signals even precedes the abnormal testosterone value on the blood test report. Don't wait for the report to be marked red before thinking of intervention.

A while ago, I met a 32-year-old Internet back-end developer. The total testosterone in the physical examination was still above the lower limit of the reference value. He took the report and said that his indicators were fine, but he turned around and asked me privately why he had not had a morning erection for six months in a row. Later, he was prescribed a more detailed hormone test sheet. As expected, free testosterone had dropped to a critical value. Total testosterone seemed normal, but in fact, the part that could be truly utilized by the body was no longer enough.

Speaking of this, some people may ask about the "decreased function", is it because if it doesn't work once, it means there is a problem with testosterone? Not really. There has always been a consensus in andrology clinics: factors that affect sexual function are too complex. Recent stress, conflicts with partners, and even staying up until 3 o'clock the day before may lead to temporary loss of sexual function. It cannot be directly equated with low hormones. But if you can’t get excited for more than 3 months in a row, your morning erection disappears, and you don’t even have the desire to solve it manually, then don’t insist on saying it’s “tired.” This is definitely the first yellow light that hormones give you.

In addition to the functional changes that are most easily noticed by everyone, the meat on the body secretly "changes texture", which is also a signal that is easily ignored. I have met several middle-aged men who came for physical examinations. They said that even though they had skipped dinner, they still walked 10,000 steps a day. However, their stomachs still rose like a balloon, and their arms and legs became thinner and thinner. When pinched, they were as soft as yeast buns. Essentially, testosterone is the "fuel" for muscle synthesis, and it can also inhibit the accumulation of visceral fat. Once the fuel is insufficient, the calories you eat will be piled on your stomach first, and the muscles will slowly decompose. To put it bluntly, your body's "energy consumption mode" has dropped from the "muscle burning mode" in your youth to the "fat accumulation mode." Oh, by the way, there is another controversy that is not completely unified in the academic community: many people in the nutrition community believe that this "puff man" body type may be caused by insulin resistance first, which in turn suppresses testosterone secretion. The two are vicious cycles, and there is no absolute sequence. Intervention often requires two-way adjustments to be effective.

The more subtle signals are actually hidden in emotions. Many people simply don’t associate poor mood with hormones. There used to be a 40-year-old manufacturing executive who suffered from insomnia for six months straight. He would get mad at his subordinates over trivial matters, or he would sit in the office in a daze for a long time without moving. People around him thought he was suffering from depression. He went to a psychiatrist to do a full set of scales, but no major problem was found. Finally, he was transferred to an endocrinology department and found that his testosterone level was only one-third of the peak level in his 20s. Let me be fair here: Psychiatry’s logic of prioritizing emotions and stress triggers is correct, and endocrinology’s focus on hormone levels is also correct. If there is long-term irritability, depression, or difficulty concentrating, it’s best to check in both directions to avoid missed diagnosis.

Speaking of this, some people will definitely ask, if I check hormones every year during physical examination, will it not leak? Not really sure. Nowadays, most institutions only check total testosterone for physical examination, and the reference value range is very wide. The reference range of many hospitals is 9.9-27.8nmol/L. When you are at your peak when you are 25 years old, it is 26, and when you are 35 years old, it drops to 11. It seems to be still in the "normal range", but in fact, for you personally, it has dropped by almost half, and there has been a problem a long time ago. According to traditional endocrinology diagnostic standards, hypogonadism can only be determined when total testosterone is lower than the lower limit of the reference value. After all, clinical diagnosis must be rigorous to avoid excessive medical treatment. ； But now the field of functional medicine and sports rehabilitation recommends comparing it with an individual's own baseline level. If the testosterone level drops by more than 30% from the peak after the age of 30, even if it is still within the reference value range, early intervention can be made. Both arguments are reasonable. The former is suitable for treating diseases, and the latter is suitable for daily prevention.

Oh, by the way, someone also asked me if hair loss is a sign of low testosterone? This really needs to be explained clearly. Androgenetic alopecia is a symptom of too high levels of dihydrotestosterone. Don’t get confused. If your hair loss is accompanied by the three signs mentioned above, think about hormones. Otherwise, it is most likely caused by genetics or staying up late.

I have been doing health management for 8 years, and I have met too many men in their thirties. They always thought that they were young and could handle it. They stayed up late and drank all night long. But when they really found that they had lost interest for half a year, and their belly was so big that they couldn't wear the pants they used to wear, I decided to check it out. By this time, the hormone level had dropped to only half, and it would take at least half a year to adjust, and it might not be possible to return to the previous state. Of course, don’t be too anxious. Occasionally, you may be in poor condition once or twice, and you may feel lack of energy the next day after staying up late. This is normal. The human body is not a machine. How can it always operate at full capacity? I'm afraid that if you stay in this state for several months in a row and don't take it seriously, it won't be that easy to fix it if something goes wrong.