Low testosterone and dizziness

I first noticed I had much smaller wrists than my peers when I was 13. I was playing a pickup game of basketball with a few friends, two of whom could wrap their long fingers around the ball and control it with ease. When I tried to imitate them, though, the ball immediately slipped from my grasp. After a fellow player and I compared our arms afterwards, the disparity was obvious: I had normal hands (more or less), but my wrists were noticeably slighter in comparison, which he pointed out with a laugh.

Middle school is riddled with insecurity for almost everyone, and I’d already collected my fair share: I was short and scrawny with peach fuzz all over my face. But while I was lucky enough to eventually fill out to a fairly average 5-foot-9, 160 pounds, my wrists and forearms have remained quite slender, even after I began regularly lifting weights in high school. To this day, my wrists have a circumference of between 6.5 and 6.75 inches, a bit below the apparent male average of 7.25 inches. In practice, this means I can almost wrap my thumb and index finger around one of them. (According to several women I asked, in middle and high school they’d do the same to see who had the skinniest wrist, which was perceived as a desirable trait.) And when I wear watches with a leather strap, I always have to use the hole nearest to the watch face. On one particular band, I even had to punch out a new hole with the awl on a Swiss Army knife.

Now admittedly, as an adult, I don’t think about my wrists very often. But if you spend an evening perusing online forums dedicated to masculine self-improvement, you’ll find a litany of men who are deeply concerned about them — and to a worrisome extent. “When I wear a long-sleeved shirt with only my hands and wrists sticking out, I look like skin and bones,” notes one concerned redditor.

Over on bodybuilding forums, men with frames similar to mine often ask if their slender wrists will prevent them from bulking up. And while commenters frequently reply that smaller wrists make the “taper” from the forearm to the bulging bicep all the more dramatic, it doesn’t always wholly assuage fears. (The same can be said for the comfort wrapped in gentle chidding: “Usually, it means your bones are hollow. On the plus side, you should have a natural affinity for flight,” one poster jokes.)

Is there anything I can do about super thin wrists? from bodyweightfitness

Naturally, the tone is darker on incel forums, where small wrists are part of a self-identified stigma that proves that these men are fundamentally unfuckable at a genetic level. The exact form of bizarre incel slang varies from user to user, but the focus on wrist size is part and parcel of incels’ greater obsession with traits that they view as wholly natural — e.g., the shape of their jawline, their height and their overall size. If any of these are insufficient, they’re considered a “manlet” or a “framelet,” and destined to an eternity of loneliness.

Ladies how do you feel about guys with small wrists/thin “delicate” forearms? from AskWomen

From the outside, it’s easy to poke holes in this sort of self-defeating worldview, but lurking insecurities like tiny wrists can seep into the lives of seemingly well-adjusted men, too — men such as Michael Piscatelli, a watch buff with a wrist circumference of around 6.25 inches. Like me, Piscatelli first became aware of his “condition” in middle school, when a few of his friends noticed his wrist size and would crack wise about it, even grabbing at them for dramatic effect. Also like me, as an adult, he says that he’s never had a friend or colleague mention his slender wrists in his daily life. Still, they manage to take up valuable mindshare, which he realizes is completely silly. “When I mention to my wife that I was insecure about them when I was younger, she always just laughs,” Piscatelli explains. “Since I’m 5-foot-11 now, it’s not the sort of thing that most people notice, if they’re even looking for it.”

Piscatelli is, of course, a special case: He engages almost daily in a hobby that heaps tons of attention onto his wrist. As a devoted watch collector with dozens of timepieces — I found him on r/watches — he says that he’s become well-known in his local horological community for having the smallest wrists at their various meet-ups. Since the design of popular timepieces like Rolexes and Omegas has tended toward bigger faces and hulking lugs in recent years, Piscatelli says they look “absolutely ridiculous” on him; instead then, he’s come to specialize in vintage pieces.

“It’s just become one of those things at meet-ups,” he explains. “Somebody will be showing off some kind of massive, expensive watch — one that’s 45 millimeters or bigger — and somebody will tell me to try it on. They very rarely say anything to me about it, but it’s pretty obvious. It looks way, way too big on me. There’s one watch I particularly like by IWC, called Top Gun, which is 45 millimeters or bigger. I’d love to own it, but I put on my friend’s, and it’s just so oversized. I tend to stick to around 34 millimeters myself.” (While you could argue that he could employ women’s watches as an alternative, on watch forums, women’s pieces are considered their own aesthetic category.)

Though Piscatelli admits that he’s spent more time thinking about his wrist size than the average guy, he remains adamant that he doesn’t consider it a source of anxiety. Even still, he says that if he had a choice, he’d definitely prefer to have larger wrists, if only to have slightly more freedom in the types of watches he could flaunt. That’s partly why he started using a hand gripper to try to strengthen (and embiggen) his tendons every night when he watches TV. “I don’t actually expect it to work, and my wife always laughs when I do it,” he says. “But still, I told myself I’d do it for a year and see what happens. So I’m sticking with it. I’m three months in, though, and I don’t see a difference.”

Within online discussions of the benefits and drawbacks of different wrist sizes, you’ll often find armchair MDs who claim that slimmer-framed men are more likely to suffer from joint pain or carpal tunnel syndrome than those with larger wrists. Since I have occasional wrist pain myself, I couldn’t help but wonder if these seemingly-logical ideas held up to any sort of professional scrutiny.

“There are problems associated with big wrists, and problems associated with small wrists,” explains Steven Beldner, a well-known hand and wrist surgeon serving the New York City area. “People with smaller wrists are more likely to get tendonitis, because the compartments where the tendons live are smaller. So they’re at an increased risk for carpal tunnel, because all of the tendons pass through the wrist, and if there’s not a lot of room in there, they’re more likely to pinch the nerve. The disadvantage of having a bigger wrist is that those people are generally larger, which means that when they fall, they fall with a lot more force. That means that although they’re less likely to get tendonitis, they’re more likely to break a bone or tear ligaments in their wrist.”

As far as the gripper that Piscatelli pumps away with every evening, Beldner urges caution. “If you can get stronger and bigger with no pain, it’s fine,” he says. “But the larger you make the tendons, the more likely the compartments in the wrist won’t be large enough to accommodate them, which means you might run into tendon-entrapment syndromes like carpal tunnel.”

More largely, while you can’t change how you feel about your body overnight, when it comes to slim wrists, it’s clear that this is one insecurity that exists almost entirely in the minds of people who suffer from it. To that end, Piscatelli puts it best: “Other people just don’t care about your wrist size. It’s not a thing that people notice. It’s that simple. Once I realized that, my life became a lot easier.”

If you’re like me, you’ve been blessed with small wrists. I have 6 inch wrists – well they’re more like 5.9 inch. So what can you do when you love watches and have small wrists? Are you cursed to not being able to wear whatever you like?

Having small wrists is not a problem in and of itself. The size of most modern watches is! I don’t know about you, but every time I come across a design that I really like, the watch has a 41+ mm case. That is to say: too big for me (most of the time).

But not to fear. Here are 5 ways to deal with small wrists when you’re a watch enthusiast. I tried them all, and while they all work, the last one is definitely my favorite.

1. Buy smaller watches

You might think yourself: “ok, thank you very much Alessandro. I already knew that!”.

Hear me out.

There are many, many men’s watches that are smaller and still look great! If you know what to look for, you will find plenty of great timepieces that look manly on smaller wrists.

Because guess what: you don’t have to prove anything. And certainly not by wearing a watch that is (too) big for you.

Actually, smaller watches are back in style. Baselworld 2018 has proved it, with the release of brand new smaller watches by many manufacturers including Tudor and Oris (just to name a few).

Do some research (or again, check the list of my favorite men’s watches for small wrists I put together just for you) and try to find a piece that you like and that is smaller in size. It’s pretty easy, actually.

My beloved Seiko SARB035 measures 38 mm. But on my 6 inch wrist, a 36 mm (or even 34 mm) watch will still look great, no problem. And it can on your wrist too!

And because it’s so small, you don’t have to think about your watch being too big (obviously). Meaning, it will not overpower your wrist, it will just look good and proportionate.

And I’m not even talking about the comfort: a smaller watch with a metal bracelet will wrap around my wrist like no other watch. Try it! My Seiko SARB035 is the most comfortable watch in my collection. (Read my full review of the Seiko SARB035.)

Here is the punchline: getting a smaller piece is a very great way to deal with your small wrists. And I can assure you that there are a ton of men’s watches out there that look the business and are smaller in size.

The Seiko SARB035 on my 6 inch wrist. – Check it on Amazon

So as you can see, this 38 mm piece looks absolutely perfect on my wrist. And that’s because the lug to lug distance is smaller as well – about 44-45 mm. This watch will suit pretty much every single wrist on the planet.

You can go even smaller than that! Actually, one of my favorite everyday watches is the Tudor Black Bay 36. And, as its name implies, it’s a (gorgeous!) 36 mm watch.

The Seiko SKX013 on my 6 inch wrist. – Check it on Amazon

Here is another shot with my Seiko SKX013. It’s also a 38 mm piece (read my full review of the Seiko SKX013).

This is the smaller version of the Seiko SKX007 (which is a 42 mm watch). As you can see, it looks perfectly proportionate to my wrist. Would you say that this diver watch doesn’t look like a man’s watch? I certainly wouldn’t! It’s bulky, it’s sporty, it’s it’s a tool watch and it looks very good.

So do not overlook smaller watches, and don’t fall for the big watch trend. Because I can assure you that you can find something that you like in these smaller watches too.

Getting a smaller piece is probably the easiest way to get away with your small wrists. Don’t worry, you’ll still find plenty of watches because you can find very nice small watches that still look great and manly on your wrist.

2. Wear your watch lower on your wrist

In other words: wear your watch closer to your hand.

The position where your watch will naturally fall, if you prefer atighter fit.

So this Hamilton watch is a pretty big piece: it’s a 42 mm beast, which is mostly the dial (learn why this matters). As you can see, the usual spot where men wear their watches is the smaller part of their wrist. On the left and on the right of my watch, you can clearly see that my wrist starts to widen again.

So why do people wear their watches there, then? Well, even if the average wrist size for a man is smaller than you think, watches just tend to naturally fall on this spot.

But what if you could change that?

Make your wrist appear bigger by wearing your watch closer to your hand. Make your bracelet a little looser.

If you loosen your bracelet or band just a little bit, you can place your watch lower on the wrist. See the difference?

So by wearing your watch – not where it naturally falls – but a little lower, the difference in look is quite dramatic. Your hand is way wider than your wrist is. So thanks to a simple optical contrast, you create the illusion that your watch is smaller. Or rather, your wrist will appear bigger.

I happen to love how a watch wears lower on the wrist. I find it way more comfortable! Letting the watch where it naturally falls feels really awkward to me. But then again, this is a matter of preferences.

A bracelet that is too loose will give this look. The watch is too low on your hand, and it doesn’t look good.

Now, a word of caution: of course, you don’t want to wear your watch so low and your bracelet so loose that the watch is too low on your wrist, almost in the middle of your hand! That looks pretty sloppy. You just want it to be just before your wrist bone.

This is one of the most effective tricks to pull off if you have small wrists but still want to wear bigger watches. Just don’t go overboard – with the watch placement and size!

3. Wear long sleeves

In conjunction with the previous point, you can actually wear long sleeves to hide the part of your wrist that’s the thinnest.

Obviously, if you cover your forearm and wrist (up to half of your watch) with your sleeve, you will not see your wrist at all.

Wearing long sleeves is a great way to hide your wrist and wear a watch that might a little too large at first sight.

I certainly wouldn’t advise anyone to wear long sleeves all year long, especially in the summer. You don’t want to be sweating all day long just to hide your small wrist, right? You don’t want to be so hot that it becomes comfortable.

But if you’re “lucky” like me, Belgium has a cold weather cold the major part of the year – granted, I don’t wish you that luck (it’s often raining, too). But if that’s the case, use this to your advantage and wear long sleeves to your heart’s content.

The good thing is: by using this simple technique, it’s really impossible to tell the size of your wrist. I bet nobody on Earth will ever notice, and that includes you as well! It’s true – over time even you will not notice your smaller wrists anymore… until summer comes back!

4. Wear bracelets

The good thing is: watches and bracelets work very well together! It looks fashionable, it looks cool, and that’s a great way to deal with your small wrist at the same time!

Why? Well, not so much because bracelets hide your wrist. Rather, people will look at your watch and your bracelets… and not so much at your wrist. So their eyes will be drawn to the watch and the bracelets because there’s so much look at!

Wearing bracelets will give your wrist a great style while keeping the focus on your watch. This is how I wear bracelets: watch near the hand, bracelets higher on the forearm.

People just won’t notice your wrist!

Both the watch and the bracelets will hide your wrist, leaving you the choice of where to wear your watch. So here, your watch doesn’t need to be closer to your hand. I tend to wear it there, but just because I feel it’s more comfortable for me.

If you prefer a tighter fit, or just want your wrist to have a better range of motion, you can also wear watch where it’s supposed to be: at the thinnest part of your wrist. That’s fine!

There’s just one thing to keep in mind regarding the relative position of the watch and the bracelets.

On the first picture (where I wear my watch closer to my hand) I’m wearing 4 bracelets. You don’t have to wear exactly 4 bracelets, it’s just an example. Whereas on the picture below (where I wear my watch higher on the wrist), I’m only wearing 3 bracelets (again, it’s just an example – read on).

If you prefer a tighter fit, you can wear your watch on the forearm and wear bracelets on your actual wrist.

The reason is simple: when you wear your watch low, you have plenty of room on your forearm to wear as many bracelets as you like. (Just don’t go overboard, it looks a bit weird and childish.) Whereas when you wear your watch high, there is only so much room to fit bracelets between your watch and your hand.

That space right there is smaller and you don’t want to be wearing way too many bracelets, overpowering your hand and ruining the whole look. Too many bracelets will not look good. In my case, I think that 3 thin bracelets look fine but your mileage may vary – depending on your wrist, tastes and bracelets.

Now, for the cool part!

People around -who don’t tend to be that interested in watches in general – won’t be looking at your wrist. But if they do, they’ll see your watch and bracelets, and only that. And I even bet that you will not even notice your small wrist anymore!

5. Just don’t care

And here is my favorite way of dealing with my small wrists; it’s actually not dealing with them. Or rather, just don’t think about them.

I used all the tips and tricks above in this article, and truth be told, it works. But I find it way more enjoyable to not have to think about all that and just be myself.

This might come as a surprise, but here’s the deal: people do not notice your watch, let alone your wrists. They couldn’t care less! And so should you.

The only times when a discussion arose about my wrists is because I was the one to bring the subject to the table. Nobody told point blank: “dude, you have small wrists!”. It just never happened. Never ever.

So of course, I’m not telling you that you can wear anything! You can get away with some bigger watches, that’s true… but not all of them. You’ll have to decide for yourself what an appropriate watch for your wrist is and make some educated guesses (with a little help from my watch size guide if need be).

But if a watch is stretching it a little for your wrist size, but yet still looks good: just don’t care about what people will say. Wear it in good health and don’t think about it twice! Get that piece that you always loved! And remember, they won’t notice anyway…

A little hope: your wrist looks wider to others!

Let me tell you something: I can still pull off my Hamilton Khaki Pilot Day Date 42 mm – the biggest piece of my collection. It actually also comes in a 46 mm case that I would never wear because it will look huge on my wrist. But the 42 mm? No problem.


When you look at your watch or check the time, you rotate your forearm (you already knew that, I know). But doing so, the actual width of your wrists decreases. Not its size (or circumference), its width!

Don’t believe me? Check the picture below:

Your wrist has a different width depending on if it’s rotated or in the rest position. 48 mm vs 57 mm, that’s a bug difference!

As you can see, I use my digital calipers to measure the width of my wrist in both positions, barely touching my skin in both cases. The result? When I rotate my forearm, my wrist measures almost 48 mm. So I shouldn’t get any watch that has a lug to lug distance greater than 48 mm.

But when I let my forearm hang or rest – that is to say, pretty much all the time when I’m not typing at the computer – I get almost 57 mm. That’s almost one full centimeter of difference! This is because the way the bones cross over each other when you rotate your wrist, yet they stay parallel when you don’t.

Understand this: you are pretty much the only person seeing your wrist in that rotated position. People most often see your wrist with your arm resting by your side. So to them, your wrists look wider than how they look to you. If that’s not cool, I don’t know what is!

This is how your wrist and watch look to all the people expect you. It’s all good, relax!

So, why do you care so much about that? About what the others might see, thing or say? Does it make you feel better or worse? I think we can all agree that it just serves no purpose.

One last thought…

I’m here to tell you that having smaller wrists doesn’t mean that you’re weak or that you’re not man enough. Let me put this into quotes because it’s so important:

Having smaller wrists doesn’t mean that you’re weak or that you’re not man enough.

I invite you not to care about your wrist… or even better: be proud of your smaller wrists! You’re different, and this is just the way you are.

And you have other options when it comes watches, too! Some people would die to have smaller wrists and being able to enjoy vintage watches, because most of them are smaller pieces. People with 8 inch wrists can’t enjoy vintage most watches, because they look so small on them. But we definitely can!

Choose to see the positive. Because actually, there’s not much you can do about it. Even training to get bigger wrists will barely add any size to your wrist.

Now, I’m not gonna lie: the real problem lies in your head, and fixing it is gonna take some time and mental practice. But you will, eventually.

When I noticed my wrists were small, I felt bad about them. I wanted them to get bigger. I hated my bigger watches… and then it all came back to where it should be: letting go and not caring about other people’s look.

Your wrists are fine. There are plenty of killer smaller watches for men. So pick your favorite one, use one of those tricks if need be, and enjoy yourself!

Struggling to find men’s watches for small wrists? We’ll give you the low-down on what to look for when buying a watch so that you can wear it confidently. Read more Men’s Style Guide features. B.D. Baggies – Shirt.
£79 Daniel Wellington – Watch.

Watches for Small Wrists

Finding small men’s watches isn’t the easiest task in the world. Although most watches have an adjustable strap, the width of the band or the face can be too big and dominate the hand. To make things even easier for you, we’ve listed a few options of small watches in different styles that’ll be perfect for you if you have small wrists.

Timex Classic Digital Bracelet Watch

Timex – Watch

Timex -Watch

Converse – Trainers
£49Champion – Sweatshirt

The Idle Man – Jeans

Timex Weekender Slip Through Strap Watch

This retro design by Timex has grown in popularity in recent years and can be worn with an everyday outfit. These small face watches still command style. It has a digital face and a silver classic case so it’s modern but looks stylish all the same. It’s also 38mm wide so it isn’t too big for smaller wrists and will look proportional to your arm. Making this the perfect budget watch for a small wrist. If you’re a little more quirky and like to own things that are quite unique then go for this Timex strap watch. The nylon thin slip-through strap means it won’t be chunky on your wrist either. Overall it’s colourful and fun but doesn’t compromise on the high quality and detailing. Timex – Watch.
£49 Timex – Watch.
£49 Timberland – Boat Shoes
£104 B.D. Baggies – Shirt
£75 Dickies – Trousers

Larsson & Jennings C|M Collection

This minimal watch can be beautiful. The black on black design means it’s low-key and can slot it’s way into most outfits. The other colours are more traditional, picture the gold design with a suave suit. With an adjustable strap this design is one size fits all, so it perfect for the gentleman with dainty wrists. Larsson & Jennings – Watch
£225 Larsson & Jennings – Watch
£225 Larsson & Jennings – Watch
£225 The Idle Man – Blazer
£70 The Idle Man – T-Shirt

Daniel Wellington Leather Strap Watches

If you’re looking for a subtle and sophisticated timepiece, then Daniel Wellington’s collection of small faced men’s watches is perfect. Reasonably priced at under £200 you can wear these versatile watches is pretty much any outfit. Team them with a suit for a professional work outfit, or with a polo shirt for a smart casual style. Daniel Wellington – Watch
£178 The latest news from style, life, arts, and culture and everything in between. Whether it’s a new brand arriving into our style, our latest drops and editorials. You will never miss a beat with us.

Low Testosterone Can Cause Declines Throughout the Body

By Laura Drucker

Our bodies are complex centers of communication. And testosterone is a hormone with a lot to say.

Almost every tissue in a man’s body has testosterone receptors, says Laurence A. Levine, MD, a urologist and professor of urology at Rush University Medical Center. That means that testosterone has some say in what goes on in each of those systems including the brain, muscles, bones, bone marrow, kidneys, liver, hair follicles, genitalia and sperm.

Low levels of testosterone mean less communication. An empty testosterone receptor has turned quiet, no longer voicing a command and activating the cellular activity that it is supposed to. During June, Men’s Health Month, the goal is to raise awareness of preventable health problems among men including issues associated with low testosterone.

Functional failures

Signs of low testosterone present themselves throughout the body, causing declines in many of the functions that make a man feel physically and mentally himself.

Symptoms include fatigue, frailty, weakened cognitive functioning, loss of sexual drive or inability to achieve an erection. Men with a loss in testosterone may experience sarcopenia (decreased muscle mass) or osteoporosis (diminished bone density). They could also develop decreased body hair and enlarged breasts, says Kavitha Srinivasan, MD, an internal medicine physician at NorthShore University HealthSystem.

Unlike with women, where estrogen levels drop dramatically at the onset of menopause, a man’s loss of testosterone with age is often a slow drift; not a steep drop. Stress and chronic or acute illnesses also can affect testosterone levels, Levine says, sometimes causing sudden drops. Diabetes, obesity, hypertension, chronic pulmonary disease, inflammatory bowel disease and kidney disease all have the potential side effect of diminished testosterone levels.

Another common trigger is opioid treatment for chronic pain. “Vicodin can knock out your testosterone for an entire day, right down to almost no detectable levels,” says Levine, adding that about 70 percent of men will experience very low levels of testosterone if they are taking an opioid medication on a regular basis.

Replenishing the system

A patient doesn’t usually turn up in his doctor’s office saying that he thinks he has low testosterone. Instead, he might say that he feels chronically fatigued or has lost interest in things that he used to enjoy. In many cases, it’s erectile dysfunction and low libido that finally bring a man to the doctor.

Testosterone levels are assessed with a blood test in the morning, usually between 8 and 10 a.m., Srinivasan says. Testosterone levels naturally decline during the day, so it’s important to check them early, when they are at their peak.

Physicians look at the total level of testosterone and also at the level of free testosterone. “Free testosterone is the biologically active hormone. It’s only about 1 to 2 percent of the total,” Levine says. “That’s what really acts on all the tissue.”

Levine also tests a pituitary hormone called LH, which is responsible for stimulating the testicles to produce testosterone. The test helps determine whether the testicles are failing or whether the testicles aren’t being properly stimulated to produce testosterone. In about 95 percent of cases he sees, Levine notes, the problem is that the pituitary is not properly stimulating the testicles, or the testicles are not responding properly.

Testosterone replacement therapy, also known as androgen replacement therapy, is available as injections, implants, gels or patches. The most popular treatment is gels, which must be applied daily. The aim is for men to return to normal levels, as too much testosterone can have its own negative side effects.

Levine encourages men who are considering testosterone replacement therapy to ignore the scare campaigns, referring to a couple of contentiously debated studies—one published by the Journal of the American Medical Association in 2013 and another in PLOS ONE in 2014—that purported a link between testosterone replacement therapy and increased risk of heart attack or stroke. He worries that studies like these, which have been accused of questionable analysis, deter men from seeking treatment for a problem that is rather simple to fix.

“Ten years ago, doctors would say that if you have a history of prostate cancer or are concerned about a risk of prostate cancer, you should never take testosterone. This has absolutely shown to be wrong,” Levine says. “There’s no evidence whatsoever that testosterone causes prostate cancer, and there’s no clear evidence that testosterone causes cardiac disease.”

Low levels of testosterone can cause increased side effects over time, so don’t delay in getting potential problems addressed. By seeking early treatment for symptoms, men can quickly and easily go back to enjoying life as they used to.

Originally published June 14, 2016

Overweight Man (Copyright 2006, Mike Watson Images Limited.)

If your sex drive isn’t as strong as it used to be, you can’t focus at work or you’re tired all the time, low testosterone could be to blame.

Approximately 4 out of 10 men over age 45 have low testosterone, according to the Urology Care Foundation.

Although it can affect your sex life, some men with the condition also have high blood pressure, high cholesterol and obesity. Low testosterone can also increase your risk for type 2 diabetes, according to a study in the journal Cell Metabolism.

If you suspect you have low testosterone, here are 10 are warning signs to keep an eye on and talk about with your doctor.

1. Low libido

Although some men will notice their libido decreases as they get older, the most significant and obvious sign of low testosterone is a sudden decline in sex drive, said Dr. Joseph Alukal, an assistant professor in the departments of urology and obstetrics and gynecology and director of Male Reproductive Health at NYU Langone Medical Center in New York City.

2. Extra weight

Carrying extra pounds can affect testosterone because fat cells convert testosterone to estrogen, which decreases circulating testosterone, said Dr. Philip Werthman, a urologist and director of the Center for Male Reproductive Medicine and Vasectomy Reversal in Los Angeles.

Although men who are overweight or obese can have low testosterone, it’s not clear whether they gain weight because their testosterone is low or if their testosterone is low because they’re overweight. Either way, eating healthy, exercising and losing weight is often enough for them to feel better, he said.

3. Erectile dysfunction

As many as 30 million men have erectile dysfunction and low testosterone could be to blame. In order to get and keep a strong erection, it’s necessary to have adequate blood flow, circulation, functioning valves, normal sensations and sex drive and testosterone is responsible for all of it, Werthman said.

4. Fatigue

If you’re exhausted by lunchtime, crash on the couch after work and find it challenging to get motivated to do anything, low testosterone could be zapping your energy.

5. Sleep problems

Men with low testosterone can experience insomnia but it’s also associated with obstructive sleep apnea, a sleep disorder which affects more than 18 million Americans and can lead to high blood pressure, heart disease and problems with mood and memory.

Although low testosterone doesn’t cause obstructive sleep apnea, many men who have sleep apnea are also overweight, which can lead to low testosterone, Werthman said. The bottom line: If your partner says you snore, or you feel tired after sleeping all night, see your doctor for a sleep study.

6. Lack of concentration

Since testosterone is responsible for focus, if the hormone is low, you can experience brain fog, have trouble concentrating and even have memory problems.

7. Depression

A study in the Journal of Sexual Medicine found that 56 percent of men who had borderline low testosterone also had significant symptoms of depression, were already diagnosed with depression and/or were taking antidepressant medication.

When men receive testosterone replacement therapy, they often see an improvement in their depression, and it’s more effective than the anti-depressants they were taking, Werthman said.

8. Breast growth

Since low testosterone causes the ratio of estrogen and testosterone in the body to become unbalanced, some men may grow breast tissue, a condition known as gynecomastia.

9. Aches and pains
Low testosterone can decrease muscle mass and strength so some men may experience joint pain, muscle aches and be more prone to injury.

10. Bone problems

Although osteoporosis is usually thought to affect women only, it can be a problem for men with low testosterone because it decreases bone density.

If you suspect you have low testosterone, make an appointment with your doctor who can diagnose it with a simple blood test and suggest several types of testosterone replacement therapy.

Testosterone and Its Importance For Proper Digestive Health

The primary female sex hormones estrogen and progesterone have been studied more when it comes to their effect on digestion compared to the primary male sex hormone testosterone. You can read hundreds of articles on the internet about symptoms of low testosterone (low sex drive, fatigue) and how they affect people but very few talk about the role of testosterone and digestion. There has to be research that exists on how healthy testosterone production drives digestion. Women are reported to suffer from IBS (irritable bowel syndrome) and SIBO (small intestine overgrowth syndrome) more often, is lowered testosterone production the cause? In our modern low-T world, men are having more issues than ever with proper test utilization, is it also affecting our digestion?

All About Testosterone

Testosterone is a steroid from the androstane class. It is the primary male sex hormone, signaled by the hypothalamus and pituitary glands, produced in the testes and prostate, and metabolized by the liver. The hormone is responsible for the male secondary sex characteristics of increased bone density and muscle mass, voice deepening, and increased body hair. Female ovaries also produce testosterone, but in far lesser amounts. The production and utilization of testosterone by males are much higher. However, females are more sensitive to testosterone. Testosterone is biosynthesized from cholesterol and metabolized by the liver. Liver health is vital for the production of the hormone. The metabolites from the liver either circulate throughout the body and activate specific bodily functions to maintain homeostasis or are eliminated.1 2

Proper Testosterone Levels

Here is an accurate guide for males on diagnosing proper testosterone levels.

Here is an accurate guide for females on diagnosing proper testosterone levels.

Why testosterone is important for your overall health:3 4 5 6

  • Sperm production
  • Enhances muscle growth
  • Cardiovascular health
  • Advances puberty and aging
  • Regulates metabolism and body composition
  • Accelerates growth and bone maturation
  • Increases bone density and reduces the development of osteoporosis
  • Sex drive(the hormone is important for both males and females), nocturnal penile tumescence (also known as morning wood), and orgasm potential(significant for both males and females)
  • Motivation and competitiveness
  • Regulates energy and mood stabilization
  • Reduces anxiety and modulates GABA

Testosterone fulfills many different roles in maintaining and improving our lives. A balance of the hormone is essential, any substantial difference in testosterone production or hindered production can produce different unwanted symptoms. It appears that proper testosterone production in our modern world may be in peril. Testosterone production gradually decreases with age, but should still be appropriately maintained for good health. Testosterone production is higher in the morning and reduces throughout the day and lowers at night. Testosterone levels should be tested in the morning to get the most accurate reading.

Not all of the total testosterone in the body is bioavailable; some are bound until it is needed. In healthy people, some testosterone is properly bound to sex hormone binding globulin, but if you have too much SHBG (sex hormone binding globulin), “free” testosterone can be low causing issues. Testosterone is also lower in males who are married and have children. Stress, obesity, chronic alcoholism, diabetes, statin use, ace inhibitor use, long-term fasting (increasing SHBG), chronic infections, liver disease, pituitary or gonad issues, and poor sleep reduce testosterone levels. Deficiencies in vitamin A, vitamin D, zinc, and boron might cause problems with testosterone metabolism. Finally, unfermented soy controversially may lower testosterone levels. So, what are the symptoms of low levels of the hormone?7 8 9 10 11 12

Symptoms of low testosterone:13 14 15 16

  • Obesity
  • Insulin resistance
  • Hypogonadism
  • Lack of motivation
  • Fatigue
  • Lack of cognition, unstable mood
  • Lack of sex drive or orgasm
  • Poor cardiovascular health
  • Osteoporosis or bone health issues
  • Depression
  • Anxiety
  • Prostate cancer
  • Increase in aches and pain
  • Reduction in muscular output (strength) and stamina
  • Hypothyroidism
  • Constipation

Elevated testosterone production by the human body is a rarer occurrence than having lower amounts of the hormone. Most of the time severely elevated testosterone is caused by either anabolic steroid use, too high of a dosage of test replacement medication, polycystic ovary syndrome (females), hyperthyroidism, or androgen-producing tumors. What are the symptoms of elevated testosterone?

Symptoms of elevated testosterone:17 18 19 20

  • High blood pressure
  • Testicular atrophy
  • Over aggression
  • Gynecomastia in males
  • Increase in risky behavior
  • Acne
  • Elevated red blood cell count
  • Irregular periods
  • Increased facial hair growth (females)
  • Infertility (females)

Testosterone and Digestion

Progesterone and estrogen are well studied for their effects on our digestion, but what about testosterone? Proper testosterone metabolism is more than just proper sexual vitality. We do need more research to determine precisely how important testosterone is for our digestion but we do have some clues in how adequate testosterone levels can improve digestion.

Testosterone does not seem to influence gastric emptying, while estrogen and progesterone do. Estrogen and progesterone deficiency can cause gastroparesis, while elevated amounts of the sex hormones can also cause slow gastric emptying. However, testosterone does seem to be essential for colonic motility.21 22

“Testosterone and its active metabolite 5α-dihydrotestosterone are potent modulators of colonic motility by stimulating smooth muscle contractions through non-genomic calcium sensitization pathways.”23

Estrogen and progesterone are also crucial for colonic contractions and motility, but the hormone may have a more significant effect than the two.24

Testosterone also reduces both pains felt within the digestive tract and inflammation. Androgen receptor-mediated actions inhibit the CNS (central nervous system) directly, reducing pain. The hormone might also reduce the adverse effect of excessive cortisol on our gut, by blunting ACTH (adrenocorticotropic hormone) release during stress. Reducing cortisol production during stressful periods allows the gut to maintain better motility, immune function, and triggers less inflammation. Testosterone also decreases the expression of macrophages and monocyte Toll-like receptor 4 (a transmembrane protein that signals the production of inflammatory cytokines and activates NF-kB in reaction to endotoxins), which may help to protect males from endotoxin-induced Th1 dominance, brain fog (neuroinflammation), and leaky gut.25 26 27

Females suffer from IBS and SIBO in the western world at almost a 2:1 ratio. Regular male testosterone production might protect us from developing IBS and SIBO because of increased colonic transportation and the reduction of the effect of elevated cortisol on the gut. However, the lack of estrogen and progesterone may lead us more prone to upper gut overgrowth because of a reduction of gastric emptying. Males are also more prone to develop hydrogen dominant SIBO (diarrhea) over methane dominant SIBO (constipation) because of testosterone increasing colonic stimulation. Testosterone is essential for proper digestion and may shield us from specific digestive disorders while making us more prone to others.28 29

How to Maintain Proper Testosterone Levels

Six things you can do today to increase your testosterone include changing your diet, relieving your stress, reduce porn consumption and ejaculation frequency, exercise more and lose body fat, proper sunlight exposure, and improving your quality of sleep. I recommend for most people who want to increase their testosterone to change their diet to one that increases the intake of healthy fats (which are essential for hormonal production), proper protein intake, reduction of possible inflammatory foods, importance of vegetable and healthy fruit intake, and provides a moderate amount of carbohydrates (ketogenic diets may increase SHBG which can reduce sex hormones). The Perfect Health Diet, in my opinion, is one of the best diets to increase testosterone because it meets or exceeds the above dietary recommendations for healthy hormone production. The Perfect Health Diet has a significant emphasis on healthy saturated fats and Omega 3 ingestion which are both paramount for the proper production of sex hormones.30 31 32 33

Poor sleep quality dramatically reduces proper testosterone production. Men with sleep apnea on average have lower testosterone levels, which may be correlated with obesity, which both affect testosterone production. When stress levels are elevated, or sleep quality is poor, a condition called pregnenolone steal can occur. Pregnenolone steal is when your body “steals” pregnenolone to produce more cortisol to help the body function during the stressful period. Since pregnenolone is used to produce both sex hormones and cortisol, more is used by your body to produce cortisol, and less is used to produce sex hormones, lowering your testosterone over time. Most people suffering from chronic stress (physical and mental) and pregnenolone steal might be suffering from adrenal fatigue. Also, a majority of normal testosterone production occurs when we are falling asleep and during REM (rapid eye movement) sleep, and a reduction in sleep quality or duration reduces the amount of actual hormone produced every night. Reducing your stress, overcoming adrenal fatigue, or improving sleep quality are all things you can do to ensure proper hormonal production.34 35

One of the main aspects of what might be causing an epidemic of the current reduction of testosterone in our modern life is porn consumption and increased ejaculation. The correlation between porn consumption causing a decrease in testosterone is a controversial statement, and I have seen arguments both for (reduction in prostate cancer and toxin load) and against increased ejaculation (decline in testosterone and sex drive). I do believe through my research that over ejaculation maybe one of the leading causes of low testosterone issues. Zinc depletion may occur in the male body from over ejaculation which can lead to reduced testosterone, especially if your diet is low in zinc (up to 9% of daily zinc intake). Zinc is vital for testosterone production and a reduction in zinc stores can lead to reduced testosterone levels. I took lisinopril for “borderline” blood pressure for years that eventually led me to develop low testosterone from it inhibiting zinc absorption and utilization. Combined with taking lisinopril I am sure that my frequent ejaculation during my young adulthood did not help my hormone levels either. With millions of men on ace inhibitors in the United States probably engaging in frequent ejaculation, a reduction in zinc causing hormonal issues could be on the rise, and this is just one correlation.36 37

Aerobic and anaerobic exercise in moderation have both been shown to increase levels of the hormone. Frequent exercise improves muscle mass and reduces fat tissue. Exercise helps to increase testosterone through a positive feedback loop, the hormone is essential for muscle growth and repair and is upregulated after a workout for recovery. Excess fat tissue converts testosterone into estrogen by producing aromatase and aldo-keto reductase 1C. Also, fat tissue affects the secretion of the hormone gonadotropin which interferes with proper testosterone production. Sunlight also increases testosterone by triggering luteinizing hormone production. Afternoon sunlight during the summer would also increase vitamin D production in the body which correlates with upregulation of the hormone until you reach 75–85 nmol/l of saturation. Vitamin D also helps to increase muscle mass, reduces liver inflammation, and sunlight exposure during the day improves sleep from proper serotonin production all which will enhance hormone production. Finally, LLLT (low level laser therapy) and red-light LED (light emitting diode) therapy when done correctly on the testicles have been shown to increase production of the hormone.38 39 40

There are some supplements as well that can be taken to help regulate proper testosterone production. Boron, magnesium, and zinc supplementation are essential for hormone production if you are deficient. Boron supplementation may help by reducing sex hormone binding globulin and in doing so, should increase free testosterone. Boron supplementation takes time to improve testosterone utilization as it needs to accumulate in the testes. Other supplements that may help enhance testosterone production are black cumin seed oil, cinnamon, royal jelly, and ginger. The increase in testosterone from these supplements might be because of their positive effect on the microbiome, improving liver function, improving insulin sensitivity, reducing inflammation, and increasing production. Finally, R-lipoic acid (do not use if you are mercury burdened) in men who have low testosterone and diabetes, may increase testosterone production by reducing inflammation, improving insulin sensitivity, and gut health.41 42 43 44 45 46 47 48

Rarely, the use of DHEA (dehydroepiandrosterone) might be needed to increase testosterone by providing what is required to produce it. If you use DHEA, I would recommend following the supplement recommendations for DIM (diindolylmethane) and calcium D-glucarate to prevent excessive estrogen from being produced as well. DHEA should not be used for a long time it is a supplement stopgap. In a healthy person, enough DHEA is produced from pregnenolone and is converted into testosterone. If your supplement with DHEA long term it may create a negative feedback loop and cause issues with natural production. I do not recommend testosterone replacement therapy unless it is a last resort. Test replacement therapy is just a patch and does not cause the body to naturally produce the hormone on its own again. The testes may atrophy while on it (human growth hormone supplementation may prevent testicular atrophy), requiring you to be on it for the rest of your life if it occurs.49 50 51 52

Sample Protocol to Increase Test

Reduce ejaculation to once or twice week and avoid pornography, if possible.

Moderately exercise during the week.

Follow the Perfect Health Diet.

Supplement with magnesium.

Work on your sleep hygiene, get proper amounts of sunlight, and reduce stress. If needed, use ICES or red light therapy on your gonads.

Thorne zinc picolinate – one capsule with breakfast and one with dinner.

Boron glycinate – one capsule with breakfast.

Amazing Herbs black seed oil – one softgel with breakfast and one with dinner daily.

Royal Jelly – two capsules with breakfast.

Facebook Twitter LinkedIn Google Pinterest By John Brisson on February 21, 2018 / Digestive Health, Hormones/Neurotransmitters

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