Low Testosterone? It's not that simple!
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- Опубліковано 29 січ 2013
- www.DrKrupka.com Dr. Patrick Krupka takes a look at male hormones from a functional medicine perspective. He explains the implications of testosterone, DHEA, estrogen, DHT, pregnenolone, androstenedione, cortisol, progesterone, and cholesterol in male hormone balance and low testosterone or "low T". Before you consider bio-identical hormone replacement, or supplemental testosterone, you should understand the functional medicine approach to assessing male hormones. You can also check out his books on Amazon at www.amazon.com/author/drkrupka
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Thanks for posting this! I wish I had found a good doc like you years ago. I'm 46 now and have had hormone problems over 20 plus years now! I now have a good doctor who explains it like you do.
thank you so much . Everything sound so clear here .
Brilliant video Dr!! Really appreciate how you made this so easy to understand. Thank you!!!
You're the man, thank you so much for this informative video!
Excellent presentation. I wish my schooling was this good. Thanks.
Excellent video, very helpful for me. I have been taking DHEA sub-lingually, and I recently mixed DHEA and DMSO so as to get better sub-lingual absorption, and my prostate enlarged the next day. So, this video helped me understand the pathways, and... that I need an aromatase inhibitor, great stuff. Thank you.
Thanks for the lecture and the flowchart!!. It was informative.
You're welcome!
the best "Low T" video i have ever watched. great job Dr.
Great video man, very informative.
Excellent explanation! Thank you!
excellent video could you recommend a book or books on this thanks
Thanks a million it’s really amazing ,,,
So how ur presentation match with primary or secondary hypogonadism ???
Thank you Dr. I never heard it broken down like that!
Brilliant. Subscribed. Many thanks
Thank you so much for making this video. There are several male members of my extended family currently on the testosterone replacement kick. Two of which are under 40 and live the lifestyle you said that causes it. (over weight, stressed, etc.) I've been trying to tell them that there must be a reason if they really do have low T and that they shouldn't just be taking pills to try and feel better. I think this video may help because it's coming from a guy and explains the whole thing very well. Thanks again.
Excellent video..
Insightful. Thank you!
Very well spoken and easy to understand.
I'm sure it was missed off for a reason but It'd be good to know the relationship between low Testosterone and the pituitary hormones and how that would fit in with the flow chart in discussion. great video
great lesson, thanks
very helpful! thank you
Thanks for the video Dr. Krupka, I have a question about my hormone levels which were not specifically covered in your discussion. I've had a male hormone profile test, and not even the lab can figure out what it means. I'm low in testosterone and all estrogen metabolites, as well as pregnanediol and pregnanetriol. However, I'm really high in androsterone and androstanediol.
I'm hoping you might have some insight or have seen this before - my functional medicine dr is at a loss. Thanks!!
ill check out this functionalmedicine site to see whos local, thanks
excellant video
Cool thanks for letting me know about your channel :)
Very informative!
Thanks for sharing!
Try redoing this video with the volume turned on. Smh
I am also a Chiropractor and enjoyed this video. One of the few good explanations on the endocrinology of testosterone. Recently I have shown many symptoms to low testosterone and got tested showing a low total testosterone. I admitting flew in head first using an MD specializing in bioidentical hormone replacement therapy, My compound prescription contains Chyrsin which is an aromatase inhibitor to prevent estrogen formation. I am just starting the therapy hopefully will comment on its effect.
I saved this in my playlist called "Functional and Integrative Medicine" Just thought you should know. You deserve it....
A great contribution into the understanding of the relationship within the cascade and the pathway. I would like to see a diagram of this as a down-loadable file.
There is no mention about bound/unbound testosterone. You can have plenty of testosterone but if it is bound, you are not able to use it. Thank you for your presentation.
good job
Great video. What are your feelings about taking finasteride for hair loss? As a physician do you feel it is not worth the side effects? Would you take it yourself? Why or why not? I am curious to get your opinion and how you feel about it as I am considering it for my own hair loss.
Doc, plus you missed the most important part when it comes to testosterone production..
Which is the HYPOTHALAMIC PITUITARY GONADAL AXIS and its processes in the hormonal feedback loop...
Its effects on GnRH, LH, FSH and determining if a patient has primary or secondary Hypogonadism...
Not only is this key to determining their testosterone levels but it could be evident that a more serious condition is at play, such as pituitary tumor...
You talked about the pathways in which testosterone is created but if the hypothalamus is not secreting GnRH to stimulate the release of LH and FSH there will be low testosterone production nonetheless...
So in a lot of cases, it isn't just about bad diet and lifestyle...There is many other serious medical conditions causing secondary hypogonadism, as well as primary hypogonadism...
So rather then just assuming it has to do with diet, stress, or lifestyle...Your first step should be to take a closer look at the HPTA and looking at LH and FSH levels to determine primary or secondary shutdown...
Again, there could be many other serious issues causing the low testosterone production..
Well, I suppose I could have made a 2 hour video with all the details of the entire system...but no one would have watched it. I stuck with what was provided on the lab test I was discussing. HPA / HPG axis are very important in the process, yes!
+DrPatrickKrupka I would happily watch a 2 hour video on this subject :D
so true!
nice contribution.
Theres ppl that changed diets, exercise as best they can and still have a mix of secondary and primary hypogonadism. ..many times its not even clearly a case of primary or secondary hypogonadism. ..lots of males have a bit of both...
+nattylightlight You're right...but in the video I mention that the test I use includes FSH and LH from the pituitary. I avoided going into the influence of the hypothalamus because that wasn't the focus of this particular video...but the HPT, HPA, and HPG axis are all important to hormonal balance.
@@DrPatrickKrupka I have tested my hormones cause I thought I may have to much testosterone. But what happened is that I'm out off testo, dheas and androstendion? I was used to work out 2times a day and keep my diet now almost a year I'm having a fight will all. Do u think it has to do with that. I work and sleep always tiered no motivation no passion for nothing... May I can help. E understand??? Please
From a strict medical / diagnostic approach, I see what you're saying, but from a functional medicine perspective (which is the whole reason for this video) there ARE other options. First of all "old age" is a common term used when there isn't obvious pathology involved...but what about "old age" causes dysfunction? Why would it occur in 1 patient but not another? Over time, we can develop processes that don't work as robustly as they once did...in many cases these can be restored.
The lab name that I mention in the video is "Diagnos-Techs" and can be found at Diagnostechs.com.
Hey Doc have you heard of Ganoderma and if so what are the health benefits?
Would it help this particular issue?
what if TT is 412 and Bio Avail . Testosterone is 3.2 nmol/l (range:3.5-13 nmol/l)..and the person has low Testosterone symptoms?
+kemarod not true with high testosterone y can restart yr puberty! and make ur self weaker to disease with high estrogen ur more imune to disease which proves why women live longer stupid ass
+Jim F symptoms is a pussed of mood and a constant crave for yngealthy food
+Jim F pissed off mood lol
Great video! I have been working in this area for years, and I discovered that a prominent issue among aging males is their inability to get the cholesterol into the mitochondria for conversion into, ultimately testosterone. The problem is cyclooxygenase 2 (COX2) indirectly reducing acute steroidogenic response protein. This is why we find elevated levels of Luteinizing hormone, but low T levels. The solution was certain food extracts that work to reduce COX2 in the leydig cells. I've seen many examples of men in their 60's who go from 450 to 1000 ng/dl in total T within a month of taking my "Time Machine" nutritional mix. It tastes horrible, but the results have been astounding. This is turning out to be a real alternative to HRT.
What’s the nutritional mix in your time machine
Can you recommend a good functional medicine doc in Denver? One who has a good understanding of these pathways. Thank you.
aw man wata awsum vid, thanks for the info
This is gold! Definitely cleared up some of my questions.
I realize it's kinda randomly asking but does anyone know of a good website to stream new series online?
@Elisha Mario I would suggest FlixZone. Just search on google for it :)
@Caspian Fox Definitely, I have been watching on Flixzone for months myself :D
@Caspian Fox thanks, I signed up and it seems like a nice service =) I really appreciate it!
@Elisha Mario glad I could help :)
This really helped me understand why Ive had the problems I've had and very low testosterone around 70 before androgel now over 500 on androgel 1.62 40mg a day. Great video
excellent video.
Thanks
I just started on androgel 1% ...Had Low T all my life .....won't get into details ....but after the first 4 days of 3 pumps (3.75g) 37.5 mg I have felt bloated and gassy, brain fog, and major anxiety..... and nervousness .....I then stopped for a couple days and now I feel great .....I hope my Doc knows what he is doing .....My guess is that much of the T in the gel cranked my Estradiol levels .......hopefully when I go to see him he understands .....He also never told me why my levels might be low .....My FSH was 1 IU/L and my LH was 2 IU/L .....Prolactin 5 ug/L and free test 136 pmol/L .....looks like secondary hypogonadism to me ...... My last labs were also showing vitamin D at 39 nmol/L ....just wondered what your thoughts were .....
Awesome video. I was on trt it was a nightmare . My first blood test was 356 last year ago . Now when I stopped testosterone replacement after 2 months I start having bed bed anxiety couldn't do anything . I still can't do anything I am 25 years workout every day eating right and my test is 456 . Help
androgel got me to 300 test I got test level over 500 by working out and tribules tetris, vitamins, fenugreek & calcium magnesium zinc supplement. but my low t from a injury. im 38 6,3 180 been on the A-gel 10 yrs
what if you have hight dht and estrogen?
What's the logic behind not aromatizing enough estradiol? My current problem
(continued) She blew me away when she openly discussed the MTHFR gene. May I ask a question? What separates functional and integrative medicine? What is the difference? I'm sorry for the long post but this is an important subject to me... I'll certainly check out your website because I have complete respect for alternative/natural forms of healing.
Awesome lecture... Take good care...
Interesting video. I’m 38 and my free T came back at 60% the lowest normal level… wondering what to do. I’m Thin and in great shape. Endurance athlete.
What is the best way to increase DHT? I don't care what people "think" it does I want to increase it without just applying it dermaly.
i am enjoying DHT (dihydrotestosterone) and its effects on my body. now losing my hair and developing a nice bald spot while my ears are growing dark/coarse hairs i must remove every few days via tweezing. my strength is also dropping as well as depression (various levels) as well as agitation are now common.
Hello ! Did you solve your DHT problem?
So do you recommend an AI if you convert to much testosterone to oestradiol, iam talking if you are on trt, and do you recommend taking hcg to back fill up stream hormones or is that not nessasary to do so if your on trt.
Great video Doc, very helpful. I am on TRT. But I am estrogen sensitive, I get sides like acne, bloating etc. For a person like me do you think rather than taking exogenous testosterone which will readily convert to DHT and Estrogen, taking DHEA or may be go up and take Pregnenolone - will it help?
How about a great doc in NC or SC?
Have you ever heard of a vasectomy affecting this? My testosterone levels went from 900 to 300 within 2 months and the only thing I can relate is I had that done in between the levels were checked
Hi Sir, My DHEA is high, T level is low, any idea unrare situation?
did u use clomid after stopping trt? just my watching videos i did trt myself , i used injections and felt great and after stopping nothing really happened just back to my old levels.
Hi doctor , i'm married 29 yrs old, i'm suffering from low T for more than 5 yrs, i take testosterone injection every month for more than 3 yrs bu still i have a low T, please what can i do, show me a way out, this video was very interesting, what shall i do, which investigations shall i do?
EXCELLENT!!!!
i need to speak with you privately please. my docs dont understand
*Thanks. Subscribed.*
so how do u plug the leaks b4 u take testosterone? by takin nolvadex?
Doesn' t Progesterone reduce DHT though?
Dr. Patrick could you explain more about the "plugs" you mentioned that naturally lessen testosterone from converting to estrogen and DHT? Thank you!!
peaceinstead
do you have any vids about failure to go through pubity
OK so I have an important question. If your body goes both ways and produces some DHT and then Estrone/Estrodiol. How to you keep both in balance and keep a good testosterone level? Like naturally how do you reduce DHT and estrone/estodiol. Without taking finasteroide to destroy DHT. Can you take Saw Palmetto and Myomin. Mymin for Estrogen balance and Saw Palmetto for DHT balance?
Some foods that can help raise Testosterone levels are raw organic pumpkin seeds, sunflower seeds, sesame seeds, raw almonds, bananas, celery, raw brazil nuts, Goji/Wolf berries, pumpkin seed oil...just to name a few. Zinc, magnesium, vitamin D3, selenium and lycopene are most important vitamins and minerals when trying to raise testosterone but take in moderation.
Thank you Doc for this talk. I was bothered by this problem a lot as my T level was very low. Thankfully, it has been vastly mitigated by a booster my trainer recommended.
What booster? I'm interested.
Geraldine Weaver It's called "test shock" bit.ly/testshock
I have sleep apnea. I had a pituitary tumor respected. I have low testosterone results. What course of action do I take?
NICE VIDEO. YOU MADE I SOOOOOO EASY
Hey Dr. Patrick.
How can i contact you personally so i could send you my Testosterone Level Blood Test, i have some issues.
Thank you
Thank You for your video, I am taking Testosterone for Andropause symptoms, such as depression, no energy, lack of sleep etc, although i have not had any improvements and have put on like 20 lbs some of it fat, should i take an anti estrogen such as nolvadex or what can i do to get the most benefits and feel energetic again, please help, your response would be greatly appreciated.
Are doing better now?
Is it possible to have high Free Testosterone level and very high SHBG at the same time? Lab-test results: FreeTestosterone17pg/ml and SHBG 163.9 nmol/L. Total Testosterone 951ng/dl What do you make of this info?
If you're a guy over 60 and do weight training does that make a difference in what path the andro takes [testosterone or estrone], the amount of andro or testosterone that's converted to estrogen, or the build up of DHT?
+director92110 Yes, it can definitely make a difference, but that difference is not entirely predictable...it needs to be tested to be verified.
Hallo..i became bipolar after using steroids in 2000...now if i am away from the gym for a while, when i start again i first feel awesome (think hypo mania) and balloon for like 3 days, then my bipolar agitation kicks in and i feel terrible then i start to lose strenght and that initial balloon size i gained goes down....i have a decent amount of fat, that i never had before taking the steroids
Although there are people who probably need "T" therapy, it's being blown out of proportion. IMO, what we eat has a lot to do with our system imbalances. Most of us think we are eating healthy; we are not. Processed foods are a big part of depression, anxiety, and the conditions of "low test". Processed sugar, which is in most of our foods these days, is a poison. The vegetables, which are treated with pesticides are causing high estrogens. I started to experience some low libido and symptoms of depression.
I have now cut out all sugars. I eaten a lot of "free range" eggs. I juice a lot of organic vegetables. I eat 4 to six pieces of fruit per day. I am 53 years old and I feel great now. I took up weight lifting 10 months ago and gained approx 10 lbs of muscle. I don't think it would have been possible without a major diet change.
you gained 10 pounds of lean muscle in 10 months?
show us a video of your work out routine and your gains...
u gained 10 pounds for sure but I'm not convinced its all muscle.
+Jim F: And another 5lbs over the last 1-1/2 years, staying between 20% and 18% bodyfat. I am 18% bodyfat now. From 188lbs to 203lbs of muscle in 2-1/2 years. I stay with compound heavy movements (squats, rows, benches, shoulder presses). I do 10 sets of each, in the 5 rep range. And I add 5 sets of bicep curls and tricep extensions. At the end of my 10 sets of heavy compound movements, I add 2 to 3 sets of lighter (8 to 12 reps) dumbell flies on my bench day, Chins on my row day, dumbell presses on my shoulder press day. I workout every second day, so each compound movement and my arm day is done every eight days. Gains are quite a bit slower now, but I'm pretty happy with the results. I'll be 55 yrs old soon, and I'll be happy if I can gain gain another 5 to 10 lbs of muscle over the next 5 years. I am now focusing on maintaining my muscle and dieting down to 14% bodyfat, then stay between 14% and 16% so that I can possibly decrease estrogens due to my higher bodyfat right now. I follow a very strict diet that involves 3000 to 3500 calories of good whole foods. My only supplimentaion is whey protein with no sugars; only stevia. It has been a very slow climb, but I'm happy with it. I have a lot of energy to perform well at work. My job gets quite physical at times. BTW, I started this routine to get in shape and stay in shape for my job. CHEERS !
How is it possible to have low testosterone, too high DHEA, little too high cortisol and low or normal estrogen/estradiol... it does not make any sense to me. Maybe you have an answer. Genetic issues?
Good video! But I didn't hear anything about thyroid. There is a lot of thyroid problems these days from crappy food and pollution, and as I know from personal experience, correcting thyroid can have a huge positive effect on hormone production.
+Ed Arnold, You're right...but thyroid wasn't the subject of that video. If you look through the other videos I have posted here there are three or four that go through thyroid problems in detail.
I have hypothyroidism and low testsosterone.. I just got diagnosed last week, anything i can do to help?
Make sure you're not going to a doc who uses only TSH for diagnosis. The full suite TSH,FT3,FT4,rT3,TPOAb,TGAb should be used to diagnose primary hypothyroidism and Hashi's. After huge diet changes (esp. gluten free), along with adding DHEA, T3, and T4 ( NDT can be used in place of T3+T4), I'm doing quite well. No, I don't have to take T ... keeps it simple.
I've run into trouble with my testosterone and when my doctor said he wanted to raise it I ignorantly said it was fine at 238. He rolled his eyes and gave me a long leash and during that time I discovered all kinds of health issues exist at levels below 500. He's extremely qualified, he practices integrative medicine. When I first saw him I was taking 3 grams of niacin a day and it drove my cholesterol to 92 if I remember correctly.
Im only 19 and my total test was 450ng/dl, estrone was high, estradiol was on the higher end, and progrsterone was high. Should i get what u have on the board tested also?
How accurate can saliva testing be next to a blood sample? From things I have seen blood is far more accurate then Saliva. Thank you for the video.
Wow way easier to understand
I also feel like 80 years old ! I have very heavy body, weak muscles
(gym doesnt help!). Alot of dizziness, brainfog. Energy drains after 40
minutes. Simple tasks as just putting on clothes drains my energy 4
times more than normal people. I cant build muscles et.c. Even drinking
tea knocks me out! I have done all bloodtests and i have no infections
at all. Doctors dont find shit on me. They claim my T levels are normal
and wont treat me. IMO my levels are low!Is this low testesteron
symptoms??
Pretty solid vid and info for being 9 yo. Thank you.
I have watched other videos on UA-cam where there is a potential for a "Pregnenolone Steal" if your Pregnenolone is low. So, if you take DHEA and your Pregnenolone is low, the DHEA will be converted to Pregnenolone to support the Pregnenolone branch process. Is this possible? If so, should someone who is taking DHEA also take a small amount of Pregnenolone to ensure no "stealing" of DHEA is happening? BTW, I am 60 and once I started taking DHEA, I was able to workout with weights again and have lost weight. Before DHEA, I was depressed and could not do 2 push ups - literally. My joints hurt and now they don't with DHEA supplementation. I take between 50mg to 100mg of DHEA daily. I am thinking of adding 50mg of Pregnenolone.
However a healthy diet and lifestyle could prevent hormonal imbalances, could it not?
mine just came back at 270ng/dL and I'm only 28! no wonder my gains are lacking in the gym
Additionally, what about adrenal fatigue? This can result in a lower-than-normal DHEA or Androstenedione level and decrease testosterone production.
What about low cholesterol? Without adequate levels of cholesterol you can't synthesize appropriate steroid hormones.
It's also common knowledge that increased body fat, poor sugar metabolism, and increased cortisol all increase the action of the aromatase enzyme leading to ihncreased estrogen and at least a relative testosterone deficiency.
Doc Krupka,
Does flaxseeds increase estrogen? And what about chia seeds?
yes and yes stop all nuts and seeds for a few months and u will see
Why he got less subscriber Infact he deserve much more
How can I find a Dr in my area that uses that lab or tests. If I can't find one, can I have you order, read it and perscribe?
+Rick Holland You can contact DiagnosTechs directly and tell them where you are...they will give you a list of doctors in your area that use their testing.
One of the best ways to find FUnctional MEdicine docto near you is to go to FunctionalMedicine . ORG and in the upper right corner you can click on "Find a practitioner" and search with your zip code. I suggest calling their office and asking a few questions to make sure their philosophy fits what you're looking for.
A 2016 meta-analysis
Trusted Source
of research found no relationship between a man’s testosterone level and his risk of developing prostate cancer. Another review of studies showed that testosterone therapy doesn’t increase the risk of prostate cancer or make it more severe in men who have already been diagnosed.
Didn't overweight made me store estrogens and stress make me produce cortisol? Weren't those two hormones the ones that blocked me off of testosterone? And aren't high impact sports suitable to produce more testosterone? I'm seriously curious.
Great video but.... this is only part of the puzzle. Granted it’s quite a few years ago. Ahead of its time actually.
I am 27 male. I have low androstenedione but other tests are normal. Don't know what to make of it. Here are my numbers:
Test name Value Reference range
CORTISOL 16.5 mcg/dl 5 - 23
ANDROSTENEDIONE 60.87 ng/dl 75 - 205
ESTRADIOL 40 pg/ml 11 - 44
17-HYDROXYPROGESTERONE 73.76 ng/dl 27 - 199
ALDOSTERONE 9.29 ng/dl 2.21 - 35.3
DHEA 462.39 mcg/dl 180 - 1250
DHEAS 159.87 mcg/dl 125 - 619
TESTOSTERONE 746.96 ng/dl 260 - 1000
PROGESTERONE 0.07 ng/ml
hello.... am from mumbai.... i have low testosterone i.e. 3.13 ng/ml and
normal values are 4-9 ng/ml.... My doctor did not go for hormone
replacemnet.. he just gave me CHOLECALCIFEROL TABLET 60,000 I.U. . 1
TABLET A WEEK FOR 7 WEEKS. AND AGAIN ASKED ME TO DO A TEST AFTER 2
MONTHS.... I ASKED HIM WILL IT INCREASE TESTOSTERONE HE SAID YES....I
WENT TO ENDOCRINOLOGIST AND HE IS A GOOD DOCTOR.. WHAT DO YOU THINK
WILL TESTO WILL INCREASE..???
Hey Dr, your video was very informative, thank you for making this video!
However, I have a question regarding the conversion of testosterone to DHT, would there be any type of behaviour/diet that would promote that conversion? And is there a way to mitigate that conversion naturally? I would really appreciate it if you could help me on that aspect, thank you!
+bowss111 Many people have used good quality Saw Palmetto, or Chrisyn to slow the conversion. Cruciferous veggies speed the removal of estrogen through the liver, and a diet high in refined sugar is a huge promoter of the conversion to DHT and estrogen. Also having a high % of body fat increases those same conversions.
+bowss111, That conversion is done by the aromatase enzyme...it is promoted by sugar intake, stress, high % of body fat, and certain environmental toxins. To slow the conversion many people use a paleo-ish diet, interval exercise, and liver support.
thank you for the update!