Stress and low testosterone

Depressed Men Have Lower Testosterone Levels

November 14, 2006 (Toronto) — Middle-aged men with depression have reduced levels of bioavailable testosterone as well as circulating total testosterone compared with their counterparts without depression, according to a study published in the October issue of Psychoneuroendocrinology.
Presented here as a poster at the annual meeting of the Canadian Psychiatric Association, the study aimed to elucidate the role of reproductive hormones in mood disorders and define the base hormonal state of depressed men and nondepressed men, explained Sidney Kennedy, MD, FRCPC, senior investigator of the study and a professor of psychiatry at the University of Toronto in Ontario, Canada.
“There has been an interest for many years in regards to the question of reproductive hormones in relationship to depression,” said Dr. Kennedy, also the psychiatrist-in-chief at the University Health Network of Toronto. “There is a logic to this in that the loss of libido is thought to be associated with low testosterone, but there hasn’t been much robust research done in the area.”
The study recruited 94 men: 44 untreated depressed men, aged 45 to 60 years, who met the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR)–defined criteria for a major depressive episode typical of major depressive disorder, and 50 matched control subjects who did not have depression.
The study did not include subjects who had a clinically unstable comorbid medical or psychiatric disorder. Subjects who had a history of drug or alcohol dependence in the last 6 months, as defined by the DSM-IV-TR, were excluded. In addition, subjects with uncorrected thyroid disease, those using other psychotropic medications, herbal preparations like St. John’s wort, or electroconvulsive therapy within the previous 3 months, were all excluded. Subjects’ body mass index ranged between 20 and 29 kg/m2, but being overweight was not a basis for exclusion.
Depressed subjects were untreated at the time of enrollment, but they underwent a washout period in the event they had received an antidepressant drug during the index period or for a previous episode of illness.
Investigators measured circulating total testosterone (TT) and bioavailable testosterone (BT), the more physiologically active component of testosterone. They found depressed men had decreased mean BT levels compared with nondepressed men: 3.51 nmol/L vs 4.69 nmol/L (P = .008). In addition, they had significantly lower TT levels than control subjects: 11.94 nmol/L vs 17.64 nmol/L (P < .001).
Investigators also found biochemical hypogonadism, defined as BT levels of 2.4 nmol/L or less or TT levels of 12.14 nmol/L or less, was more common in depressed subjects than in controls. A total of 34% of depressed men vs 6% of control patients had BT levels measuring 2.4 nmol/L or less (P < .001). A total of 61% of depressed men had TT levels measuring 12.14 nmol/L or less while 14% of controls had such TT levels, a difference that was also significant at P < .001.
“Low testosterone is associated with depression, even when you control for the effects of age,” said Dr. Kennedy. “It supports a trend that was generally uninformed by research, that there may be some merit in adding a testosterone supplement in the treatment of depression, particularly if men report low libido.”
Organon Canada, which manufactures an orally active testosterone preparation, funded the study.
Mark Berber, MD, FRCPC, a lecturer in the Department of Psychiatry at the University of Toronto and a consultant psychiatrist at Markham Stouffville Hospital in Markham, Ontario, Canada, said the results show a link between decreased hormonal levels and depression, but it is too premature to support hormonal therapy in the way of a testosterone supplement for depressed men.
“It is an association,” said Dr. Berber. “This does not mean patients should be on testosterone. The next step in research would look at whether treating men with testosterone makes them less depressed. This study did not address that.”
Dr. Berber added that the finding of reduced bioavailable testosterone does not establish if the decreased expression of testosterone caused depression or was a consequence of the depression, noting depression can cause changes in how hormones are processed in the body.
“The depression itself may be lowering the bioavailable testosterone, rather than the other way around,” said Dr. Berber.
A future study would recruit depressed men with low bioavailable testosterone. Subjects would be treated with testosterone or placebo and followed for at least 2 months to evaluate if there is a difference in their depression from baseline, according to Dr. Berber. An open-label study would be insufficient, he stressed.
Dr. Berber cautioned that some physicians fear giving testosterone supplements, noting there is concern of potential risk to the prostate gland, especially in older men.
“Going by the adage to first do no harm, we would want to know that the testosterone is more effective than placebo,” he said.
Because many pharmacologic treatments for depression do not prove effective in clinical practice, researchers are examining novel approaches to therapy, added Dr. Berber.
Dr. Kennedy has received research funding from Organon Canada and has been a member of an advisory board for Organon Canada. Dr. Berber reports no relevant financial relationships.
CPA 2006 Annual Meeting: Poster 22. Presented November 10, 2006.
Psychoneuroendocrinol. 2006;31(9):1029-1035.

Scientists Find Compelling Evidence Depression in Men Could Be Treated With Testosterone

Testosterone treatments could help tackle depression in men, according to a meta-analysis of 27 previous studies – potentially offering hope to tens of millions of affected people worldwide.

The idea of a possible link between testosterone and depression is not a new one: testosterone has long been associated with changes in mood and changes in appetite, and for several decades scientists have been looking at whether the hormone could be useful for treating depression too.

With the new meta-analysis, covering 1,890 men in total, researchers from the Technische Universität (TU) Dresden institute in Germany wanted to try and find a definitive connection between testosterone treatments and the symptoms of depression.

“We wanted really to clear up the picture and try to find out what is really going on, and is testosterone something that might be one day interesting for clinicians for treatment of depressive disorders or not,” one of the team, Andreas Walther from TU Dresden in Germany, told the Guardian.

What they found across the 27 placebo-controlled studies was that testosterone treatments were indeed associated with a “significant” reduction of depressive symptoms, especially when higher doses were given.

Before we start prescribing these treatments as a matter of course though, it’s worth remembering that a meta-study like this covers a lot of different variables and scenarios – it’s not quite as well-controlled as a single study managed by a single team.

For example, some of those 1,890 men had low testosterone levels, while others didn’t; some were on antidepressants, while others weren’t; and some had been diagnosed with a depressive disorder, while others only had symptoms.

Nevertheless, the results suggest that this link is something that’s worth investigating further, the researchers say – adding that at the moment, testosterone is a rather controversial alternative to antidepressants.

Benefits and mood improvements were typically evident within the first six weeks, the meta-study concludes, and were noticeable in both younger and older men.

So while experts aren’t recommending that all men with depression should start taking on testosterone supplements, they are saying more comprehensive studies should happen – particularly as alternative therapies are badly needed.

“This new study shows that testosterone may be helpful in some male patients,” Michael Bloomfield from University College London in the UK, who wasn’t involved in the study, told the Science Media Centre.

“However, we need more medical research to understand which patients might benefit from testosterone treatment and how this might fit in with existing treatments including medicines and psychotherapies.”

Despite previous research into the topic, we’re still lacking a large-scale, long-term study of how testosterone might affect men (and women) with depression. Based on this latest paper, such a study might well be worth the time and effort.

With both depression and suicide rates on the rise, it’s more urgent than ever that new treatments are found for the condition. It’s estimated that antidepressants can be effective in only up to 60 percent of cases, so alternatives are certainly required – and testosterone could be supplied relatively quickly if it was cleared for prescription.

According to Allan Young from King’s College London in the UK, who wasn’t involved in the latest study, the meta-analysis clearly shows a “a signal of benefit for depression in men”, but he also says we should proceed carefully.

“With testosterone, there might be an effect on what one might think of broadly as vitality,” Young told the Guardian. “Men might feel like they have got more energy, might eat more, but that may not be accompanied by an effect on core symptoms of depression such as low mood and loss of interest.”

The research has been published in Jama Psychiatry.

The Ignored Link Between Depression and Low Testosterone

I believe this is one of the most overlooked and undertreated causes of depression today: low testosterone.

When we think of low testosterone, we typically think of men and their sex drive. However, this ignores a large part of the picture. First of all, testosterone is important to women’s health, too. Secondly, it does a lot more in the body than simply regulate sex drive.

The many things testosterone does in the body

Yes, testosterone is important for sex drive and libido, in both men and women. Adequate levels are also important for the following things in both sexes:

• Energy levels and drive –
• Sound sleep
• Healthy weight –
• Muscle tone –
• Stable moods
• Ability to focus and a clear mind
• Cardiovascular health –
• Bone density –

Unsurprisingly, when testosterone levels are too low, it can cause low energy, disrupted sleep, weight gain, reduced muscle tone, mood swings, difficulty concentrating and fuzzy thinking, cardiovascular problems, low bone density, and, of course, low sex drive.

While women produce lower levels of testosterone throughout their lives than men do, they experience the same symptoms as men do as a result of low testosterone, including, sometimes, depression.

The link between low testosterone and depression

As stated above, testosterone has a strong effect on mood. Low testosterone has been linked to depression as well as anxiety and irritability.

Low testosterone levels are related to depression and well-being in women. Androgen levels in women decrease continuously to about 50% before menopause compared to a 20-year-old women. (1)
How do you know if your depression is caused by low testosterone? A simple blood test can determine the levels of testosterone in your blood, including free testosterone, which is available for the body to use. If your testosterone levels are low, you should supplement with bioidentical testosterone and see whether the depression is alleviated along with other symptoms, too.

You may, instead, be told your levels are “normal” and that you don’t have a problem with low testosterone, even though you’re experiencing multiple symptoms listed above, like reduced muscle mass and low sex drive. Please make sure your doctor takes into consideration all of your symptoms and clinical history when evaluating you. Most traditional doctors will check your free testosterone level if you ask, but the problem lies in how they measure the lab tests. The lab ranges are age-adjusted so they are often compared to the testosterone levels of others in your age range. Maybe the level isn’t low for someone who is 55, but who wants the levels of a 55-year-old? You want the testosterone levels that you had when you were in your prime.

Low testosterone levels are related to depression and well-being in women. Androgen levels in women decrease continuously to about 50% before menopause compared to a 20-year-old women. (1) In regard to psychological status, testosterone replacement had a beneficial effect on sense of well-being and depressed moods in women. (2)

Hypogonadal men showed an increased incidence of depressive illness.Hypogonadism is associated with depression. (3) Research suggests that testosterone treatment might improve depressed mood in older men who have low levels of bioavailable testosterone. (4)

Treating low testosterone and depression

For both men and women, symptoms such as reduced sex drive, reduced energy, and memory problems are often put down to the inevitable effects of aging. While we can’t stop the body from aging, we can treat low testosterone where appropriate, and gain back that “spring in the step” while reducing or eliminating associated symptoms.

In my practice, I’ve found great success with bioidentical hormones including testosterone and DHEA (another hormone in the body, which can be used to “boost” testosterone). Because they’re bioidentical, these hormones are the same as those found naturally in the body, and the body knows exactly how to use them. I’ve seen many people improve their quality of life by taking supplemental bioidentical testosterone and DHEA.

Listen as Dr. Hotze explains the importance of optimal testosterone levels for men:

Ready to treat your depression and low testosterone?

If you think you’re experiencing the symptoms of low testosterone and want to get back on the path to wellness, contact us at the Hotze Health & Wellness Center. We will work closely with you to make sure that you’re seeing the results that make a real difference in the quality of your day-to-day life. Why live with the “inevitable” when you can be treated naturally and not only relieve your depression, but experience higher energy levels, better sleep, better stamina and more? Speak with one of our wellness professionals today by calling us at 281.698.8698. We look forward to hearing from you!

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Research
1. The Impact of Testosterone Imbalance on Depression and Women’s Health
2. Transdermal Testosterone Treatment in Women with Impaired Sexual Function after Oophorectomy
3. Increased Incidence of Diagnosed Depressive Illness in Hypogonadal Older Men
4. Bioavailable Testosterone and Depressed Mood in Older Men: The Rancho Bernardo Study

Can Stress Affect Low Testosterone?

Your testosterone level is not a priority for your body when you are in a flight-or-fight situation.

When the stakes are high for survival, what your body needs is the stress hormone cortisol. At least that is what some studies have shown. High stress (cortisol) is associated with low testosterone.

As man evolved, engaging in behaviors encouraged by testosterone, like mating, could have been disastrous if a saber-toothed tiger were bearing down on his man cave.

“That may be true, but there is an old saw in research that you need to remember,” says Daniel Shoskes, MD, a urologist at the Cleveland Clinic. “Association does not equal causality. There is very little evidence that stress lowers testosterone and even less evidence that lowering stress will raise testosterone. That being said, we do know that acute and chronic stress have physiologic effects on the body. So, lowering stress could help with low testosterone symptoms like low libido, low energy, and depression.”

What Some Research Shows About Stress and Low T

Over the years, some studies have suggested that the stress hormone cortisol and the sex hormone testosterone work against each other. This has led to the theory that stress may cause infertility and loss of libido in men by inhibiting testosterone.

A study published in the journal Hormones and Behavior provides new evidence for what’s called the cortisol testosterone hormonal axis. Researchers measured hormone levels in 57 men who were pitted against each other in one-on-one competition. Their cortisol and testosterone levels were measured after competing. The men who lost were asked if they wanted to compete again. All the men who declined had high cortisol levels and had a significant drop in their testosterone. The researchers believe this is a hormonal response that prepares the body to respond to stress by escaping danger.

As Dr. Shoskes says, it is hard to find any hard evidence that raising your testosterone will reduce stress, but it does seem to work for male guinea pigs. A study published in The Journal of Physiology found that high levels of stress in the guinea pigs results in high cortisol, low testosterone, and increased anxiety behavior. When they were given testosterone replacement therapy, their anxiety behaviors went away.

RELATED: The United States of Stress

Low T and Stress Share Symptoms

Symptoms that are common to stress and low testosterone include:

  • Loss of interest in sex
  • Fatigue
  • Trouble sleeping
  • Feeling depressed
  • Lack of energy and interest
  • Irritability

“It is hard to know if these symptoms are due to stress or low testosterone because testosterone levels have a wide range of normal, and they change throughout the day,” says Shoskes. “There is a popular notion that if you have these common symptoms, and your testosterone is a little low, the symptoms must be caused by low testosterone. But many older men have low testosterone, and they have no symptoms at all.”

Less Stress, Fewer Symptoms of Low T?

“The idea that you can reduce stress, increase your testosterone, and become a beast in bed is probably nonsense, but it is still good for you to reduce stress. My first advice for reducing stress is to stop worrying about your testosterone,” says Shoskes.

Just as stress and low testosterone symptoms are often similar, they also share some lifestyle changes that may help lower stress and improve sexual health:

  • Exercise regularly.
  • Don’t smoke.
  • Avoid too much alcohol and caffeine.
  • Don’t use drugs to relieve stress.
  • Eat a healthy diet.
  • Get enough sleep.
  • Learn ways to relax and reduce stress.
  • Set realistic goals.
  • Ask for help if you are struggling.

You might also try losing some weight if you are overweight and have sexual health issues. Erectile dysfunction may or may not be a symptom of low testosterone, but it sure can cause stress.

A study published in The Journal of Sexual Medicine found that when 31 obese men with type 2 diabetes were put on weight reducing diets for eight weeks, erectile dysfunction decreased and sexual desire increased rapidly. After eight weeks, their waist circumference and weight had decreased by about 5 to 10 percent.

Stress and low testosterone share many symptoms and may be linked by the stress hormone cortisol. There is some evidence that high levels of cortisol depress testosterone, but not much evidence that taking testosterone will reduce stress or that reducing stress will elevate testosterone. But reducing stress with healthy lifestyle changes is always a good idea, and it may even improve your sex life.

High levels of the stress hormone cortisol play a critical role in blocking testosterone’s influence on competition and domination, according to new psychology research at The University of Texas at Austin.

The study, led by Robert Josephs, professor of psychology at The University of Texas at Austin, and Pranjal Mehta, assistant professor of psychology at the University of Oregon, is the first to show that two hormones–testosterone and cortisol–jointly regulate dominance.

The findings, available online in Hormones and Behavior, show that when cortisol–a hormone released in the body in response to threat–increases, the body is mobilized to escape danger, rather than respond to any influence that testosterone is having on behavior.

The study provides new evidence that hormonal axes (complex feedback networks between hormones and particular brain areas that regulate testosterone levels and cortisol) work against each other to regulate dominant and competitive behaviors.

“It makes good adaptive sense that testosterone’s behavioral influence during an emergency situation gets blocked because engaging in behaviors that are encouraged by testosterone, such as mating, competition and aggression, during an imminent survival situation could be fatal,” Josephs said. “On the other hand, fight or flight behaviors encouraged by cortisol become more likely during an emergency situation when cortisol levels are high. Thus, it makes sense that the hormonal axes that regulate testosterone levels and cortisol levels are antagonistic.”

As part of the study, the researchers measured hormone levels of saliva samples provided by 57 subjects. The respondents participated in a one-on-one competition and were given the opportunity to compete again after winning or losing. Among those who lost, 100 percent of the subjects with high testosterone and low cortisol requested a rematch to recapture their lost status. However, 100 percent of participants with high testosterone and high cortisol declined to compete again. All subjects who declined a rematch experienced a significant drop in testosterone after defeat, which may help to explain their unwillingness to compete again, Josephs said.

The researchers suggest these findings reveal new insights into the physiological effects of stress and how they may play a role in fertility problems. According to research, chronically elevated cortisol levels can produce impotence and loss of libido by inhibiting testosterone production in men. In women, chronically high levels of cortisol can produce severe fertility problems and result in an abnormal menstrual cycle.

“When cortisol levels remain elevated, as is the case with so many people who are under constant stress, the ability to reproduce can suffer greatly,” Josephs said. “However, these effects of cortisol in both men and women are reversed when stress levels go down.”

How to remove cortisol from the body naturally

If the communication between the brain and the adrenal gland is functioning correctly, the body should be able to increase and reduce cortisol production as necessary.

However, levels of cortisol can sometimes remain high even after the resolution of a stressful situation. This can have a negative impact on health.

The following simple tips may help to moderate cortisol levels:

1. Lowering stress

People trying to lower their cortisol levels should aim to reduce stress.

They can do this by removing themselves from stressful situations, where possible, or learning how to cope with stress better.

People can learn to recognize the triggers for their stress and try to manage these proactively to reduce instances of worry or anxiety and decrease feelings of tension.

People who learn how to cope when stressful thoughts arise will manage their cortisol levels better. In cases where this proves too difficult, some medications can contribute to improved stress tolerance and lower cortisol levels.

2. Eating a good diet

Share on PinterestDark chocolate may help to keep cortisol levels stable.

A person trying to lower their cortisol levels should eat a healthful, balanced diet and pay attention to their sugar intake.

Some foods that may help to keep cortisol levels stable include:

  • dark chocolate
  • bananas and pears
  • black or green tea
  • probiotics in food such as yogurt
  • probiotics in foods containing soluble fiber

Drinking plenty of water to avoid dehydration also helps to keep cortisol levels lower.

3. Sleeping well

The amount of sleep that a person has can affect their cortisol levels.

A bad night’s sleep or more prolonged sleep deprivation can lead to increased levels of cortisol in the bloodstream.

Therefore, it is essential for people to pay attention to the amount and quality of sleep they have and try to limit the chance of disruptions.

4. Trying relaxation techniques

People experiencing stress can try to manage it by experimenting with relaxation techniques.

Meditation, mindfulness, and even simple breathing exercises can help a person deal with stress more effectively.

5. Taking up a hobby

Hobbies can be a rewarding and satisfying way to lead a fuller and healthier life, and they can lead to an increased sense of well-being.

A study on substance abuse treatments found that gardening led to decreased levels of cortisol. It also seemed to improve quality of life more than the conventional occupational therapy.

6. Learning to unwind

People relax in different ways, so understanding what works on a personal level can be beneficial.

Research has shown that relaxation exercises and listening to relaxing music can both reduce cortisol levels, but whatever helps an individual to manage their stress will be beneficial.

7. Laughing and having fun

It is hard to feel stressed when having a good time, so finding time to have fun can also lower a person’s cortisol levels. One study showed cortisol levels decreasing in response to laughter.

Being happy and having a positive outlook appear to be related to lower cortisol levels, and happiness has other benefits too, such as lower blood pressure and a stronger immune system.

8. Exercising

Share on PinterestExercise can help to improve a person’s mood.

Being physically active is beneficial to health and can improve a person’s mood.

Intense exercise can, however, trigger an increase in cortisol levels, as this is the body’s way of coping with the additional stress that the exercise places upon it.

The appropriate amount of exercise depends on various factors, including a person’s physical fitness, and these factors play a part in how much cortisol the body will release during exercise.

9. Avoiding caffeine at night

People trying to lower their cortisol levels should avoid consuming food and beverages containing caffeine in the evening. Caffeine can interfere with a good night’s sleep, and sleeping well can keep cortisol levels low.

10. Maintaining a good bedtime routine

A good bedtime routine usually results in longer and higher-quality sleep. People should get into the habit of turning off all screens and just relaxing before heading to bed.

It will usually also help to keep phones, and any other potential distractions turned off. Limiting fluid intake before bedtime can also minimize the likelihood of disturbed sleep.

11. Having good relationships

Stable, loving relationships with partners, friends, and family can be vital when it comes to leading a happy and fulfilled life, and they can help a person get through stressful periods.

If relationships are unhappy and unhealthy, however, they can cause a great deal of stress.

One study indicated that a person’s cortisol level can rise after an argument with their partner. Another reported that children with a happy and secure family life have lower levels of cortisol than those living in homes where there is regular conflict.

12. Getting a pet

Some studies indicate that having a pet can lower cortisol levels.

One study measured levels of cortisol in children undergoing a standard medical procedure. Those who had a dog present during the procedure had lower cortisol levels than those who did not.

Another found that contact with a dog was more beneficial for cortisol levels than a supportive friend during a stressful situation.

13. Taking supplements

Both fish oil and an Asian herbal supplement called ashwagandha have shown the ability to reduce cortisol levels, so taking these supplements alongside a healthful diet could be beneficial.

The impact of antisocial lifestyle on health

The following is a paper I wrote to explain how societies change
biologically. This includes high testosterone and low cortisol,
characteristics of individuals who have reproductive advantages and,
therefore, increase in percentage with time. These individuals also
exhibit a “set” of characteristics which, in addition to impulsive acts,
cause increasingly disturbing problems in maintaining civility. I think
this is an evolutionary sequence which, ultimately, may affect all
societies.

“Testosterone and Cortisol, the Secular Trend, and the Decline of
Forethought and Individuality in Society and Religion*

It is my hypothesis that civilizations have ascended and declined as
a consequence of the degree of development of the prefrontal lobes of the
brains of the majority of citizens. Development of the prefrontal lobes is
a consequence of growth and development of the individual. A change in
growth and development of the individuals of a population over time is a
“secular trend.” I suggest the secular trend results in increases,
followed by reductions, in size and function of the prefrontal lobes of
many individuals within a population as the population evolves.

The secular trend is the increase in size and earlier puberty in
children. The secular trend in the United States is real and robust and
is likely “an acceleration of maturation” (Archives of Pediatric and
Adolescent Medicine. 2000; 154: 155). Many think the secular trend
results from increased nutrition, especially increased fat in the diet. I
suggest the trend results from differential reproduction of types of
individuals; increased nutrition, mainly increased calories, simply
accelerates the process. Increased nutrition provides a favorable “feed
and breed” situation. Increased nutrition increases the advantages of a
faster breeding group over a slower breeding group. I think the trend
represents the increase in percentage of individuals who produce different
levels of hormones that directly, and positively, affect their rate of
reproduction. Individuals of higher testosterone and lower cortisol have
a reproductive advantage in our society.

Testosterone increases sex drive and aggression in men and women.
Given time, individuals of higher testosterone will reproduce faster than
those of less testosterone. This trend will increase the percentage of
sexier, more aggressive individuals. The population will change and the
characteristics of these individuals will increase accordingly within the
population. Cortisol is the “stress hormone.” When cortisol increases
in response to a stimulus, cortisol reduces the response to that stimulus.

Behaviors that stimulate cortisol do not occur often. Women who produce
less cortisol engage in sexual intercourse at a younger age and produce
less cortisol in response to stress later in life
(Psychoneuroendocrinology 2002; 27: 933). Women of low cortisol and high
testosterone “may” engage in sexual activity much earlier and with
greater frequency than those of higher cortisol and lower testosterone.

Given time, these women and their offspring will increase in percentage
within a population and affect the characteristics of that population.

They are sexy and fearless.

Testosterone affects both the brain and body. From birth until
puberty, the brain and body compete for growth and development. Early in
growth and development, the brain, as a whole, dominates this competition.
As the brain begins to finalize its growth, its ability to compete for
testosterone begins to decrease compared to the body. At this time, the
part of the brain that controls sex drive (lower brain) is complete, but
the final part of brain development (upper brain) is not complete. (This
competition of brain and body development is how the onset of puberty is
delayed until the brain is almost complete.) The part of the brain that
controls sex drive contains more “receptors” for testosterone than the
upper brain. As puberty approaches, this combination of competition for
testosterone from the lower brain and the body adversely affect final
development of the upper brain, specially the prefrontal lobes. In an
individual of higher testosterone, the increased testosterone positively
affects the lower brain during this competition. Puberty occurs early,
the final part of growth and development of the prefrontal lobes is
adversely affected and, in a person of low cortisol, sexual behavior
starts early. The combination of high testosterone and low cortisol
increases the use of testosterone for the behavior controlled by the lower
brain, that is, puberty and sexual activity. These individuals should
exhibit reduced ability to control their behavior because of high
testosterone, low cortisol, and reduced development of their prefrontal
lobes. Outside of their group, they exhibit impulse control problems.

Individuals of high testosterone and low cortisol present real
problems for society. High testosterone is connected with violent,
negative behaviors. “The matched analysis further substantiated the
association between testosterone secretion and learning disabilities.”
(Physiol Behav 1993; 53: 583). “The group of rapists who were judged to
be most violent had a significantly higher mean plasma testosterone level
than normals, child molesters, and other rapists in this study.”
(Psychosom Med 1976; 38: 257). “In the housing unit where peer ratings
were most reliable, inmates rated as tougher by their peers were higher in
testosterone.” (Psychosom Med 1987 49: 174). “Decreased cortisol levels
appear to be most strongly associated with antisocial girls who do not
have other psychiatric disorders.” (Arch Gen Psychiatry. 2001; 58: 297).
“Low cortisol levels were associated with persistence and early onset of
aggression, particularly when measures of cortisol concentrations were
pooled. Boys with low cortisol concentrations at both time points
exhibited triple the number of aggressive symptoms and were named as most
aggressive by peers 3 times as often as boys who had higher cortisol
concentrations at either sampling time.” (Arch Gen Psychiatry 2000; 57:
38). Most importantly to this treatise is the finding that prefrontal
gray matter volume is reduced in a group of people who exhibit
“antisocial personality disorder (APD)” who otherwise “do not have
discernible brain trauma.” “The APD group showed an 11.0% reduction in
prefrontal gray matter volume in the absence of ostensible brain lesions
and reduced autonomic activity during the stressor. These deficits
predicted group membership independent of psychosocial risk factors.”
(Arch Gen Psychiatry 2000; 57: 119). These individuals are aggressive,
sexy, do not control their impulses easily, and form into groups.

Mathematics, science, language, and law depend upon real
consequences. “Culture” and “religion” depend upon hypothetical
consequences. “Forethought,” or hypothesis formation, is dependent upon
development of the prefrontal lobes of the brain. Hypothesis formation
consists of two simple questions: “If this happens, what will happen?”
and its immediate accompaniment, “If I do this, what will happen?” I
specifically stated that religion utilizes “hypothetical consequences”
to enforce the hypothesis: “If I do this, what will happen?” Whether
one believes in a God of the present or of the future, the consequences
that result from transgressions of doctrine remain abstract. One has to
wonder (hypothesize) when consequences will happen, soon or upon one’s
death. I have suggested that the prefrontal lobe declines within
civilizations. The last quotation of the paragraph, above, I think,
supports my hypothesis and adds one very significant finding. The
prefrontal lobes of the subjects of the study were actually reduced in
size in “antisocial personality disorder.” This results in loss of
individuality: “These deficits predicted group membership independent of
psychosocial risk factors.” Reductions in the prefrontal lobes result in
loss of ability to anticipate consequences and also increase group
membership. This translates to thinking with the lower brain, emotional
thinking, and groups of emotional thinkers. Religion relies on some
combination of abstract thinking or emotional thinking. The percentages
of individuals who utilize either abstract thinking or emotional thinking
may produce the different religions and denominations. I suggest some
religions rely on emotional thinking because it exerts more control over
their flocks. These religions contain groups of individuals of higher
testosterone and lower cortisol who may be moved to commit acts that are
in direct contrast to the founding religion. Given time, the secular
trend will produce this phenomenon. There are other, natural
circumstances that may accelerate this phenomenon. Though this occurs in
the “West,” there are reasons why religions of the “East” contain more
“zealot” sects. “Western Civilization” and its religions may differ
because of a biological accident.

Again, I think testosterone increases and cortisol decreases in all
civilizations. I think the secular trend is a phenomenon of all human
populations that have succeeded in producing civilizations. Fortuitously
for Europe and the West, another, consequential, negative aspect of too
much testosterone is increased vulnerability to infections. Testosterone
has been connected with increases in all types of infectious agents.

Experimentally, testosterone has been used to prove this connection.
Therefore, populations prior to the advent of anti-microbial agents and
medical care were at increased risk of infections. Where infectious
agents gained entry into high testosterone populations, pandemics
occurred. These plagues of Europe accomplished something “beneficial,”
that is, the plagues removed most of the people of high testosterone. The
surviving people of lower testosterone produced the intellectual
accomplishments known as the “Renaissance.” Since the plagues differed
in effect and timing in the “East,” there was not as large a removal of
people of high testosterone; the Renaissance was limited to Europe.

“Western civilization” is the result of the “good luck” of having plagues
remove the majority of people of high testosterone. Therefore, fewer
sects have evolved out of the paramount religions in the West. It is
beginning to happen here; there were / are religious atrocities in Western
religions, but the atrocities of Eastern religions far surpass those of
the West at this time.

Competing interests:
None declared

Working collaboratively in small groups is one of the primary ways that modern humans accomplish anything. But what explains whether a group succeeds? Previous research on group dynamics has considered things like the demographic and psychological characteristics of individual group members. But a recent study published in PNAS indicates that their biology matters, too. Groups with collectively high testosterone and low cortisol (a stress hormone) show the highest performance in group tasks.

To examine the effects of hormones on group performance, the researchers collected saliva samples from 370 MBA students, then assigned them into groups of three to six members. The groups were then given a group decision-making task, and their performance was evaluated in light of the testosterone and cortisol levels in their saliva samples.

The decision-making task was a computerized exercise that asked the group to manage a fictional computerized laboratory for seven days, with the goal of maximizing profitability. The groups competed against each other to devise the most profitable management scheme. Since the lab required 24-hour monitoring and was too complicated for one person to manage on their own, the task required members to be interdependent and rely on each other to maximize their performance. However, team members were allowed to use any decision-making process they preferred to complete the task.

The researchers found that each group’s mean testosterone levels and cortisol levels (as measured in their saliva samples) significantly predicted their performance on this computerized lab management task. All measures of group performance showed a trend in which performance was highest when testosterone was high and cortisol was low.

The researchers also checked to see if this hormone interaction remained robust when controlling for dominance and anxiety, two traits that are thought to be associated with testosterone and cortisol, respectively. In this population, however, it turned out that neither self-reported dominance nor anxiety was correlated with either testosterone or cortisol.

Since diverse groups often perform better at tasks like this, the team checked whether high levels of hormonal variability within the groups influenced their performance. A within-group analysis showed that no significant effects of variability in either of these two hormones on a group’s performance.

There’s lots of data on how hormone levels influence individual performance. But scientists hadn’t previously looked into whether a group’s collective hormone profile may affect its functioning. The authors of this study suggest that high levels of testosterone and reduced levels of cortisol are likely to produce greater social rapport within a group and therefore boost the effectiveness of interdependent decision making.

However, plenty of details still need to be worked out. Future directions for this type of research may include investigations of how adding in a group member with markedly high testosterone or markedly low cortisol changes group dynamics. We may also want to examine how an individual’s level of various hormones influences their integration into the group. Regardless, this research presents an intriguing way of looking at organizational behavior.

PNAS, 2016. DOI: 10.1073/pnas.1603443113 (About DOIs).

Managing Stress and Low Testosterone

Some of the side effects of stress, such as the lack of motivation to exercise and poor sleep, can also contribute to lower-than-normal testosterone levels, says Elizabeth Kavaler, MD, a urologist at Lenox Hill Hospital in New York City.

On the flip side, managing your stress levels can help improve symptoms of low testosterone. “Lowering stress can help improve sexual function, decrease moodiness, and help men sleep better,” says Gregory Lowe, MD, a urologist at Wexner Medical Center at Ohio State University in Columbus.

The exact physiological connection between stress and low testosterone isn’t known. “We think there are probably certain brain chemicals we secrete in response to stress, which then go to the part of the brain that controls testosterone production,” Dr. Ramin says.

Not only are stress and low testosterone physiologically intertwined, but they share some of the same physical symptoms. “The most prevalent are feeling sluggish and tired — what may be described as feeling ‘old and fat’ by many men,” Dr. Kavaler says. Other symptoms common with both low testosterone and stress include depression, loss of sex drive, and erectile dysfunction, Ramin says.

Coping With Low Testosterone and Stress

Any man can develop low testosterone, but you’re at much higher risk if you are older, overweight, and under a lot of stress, Kavaler says. So, what’s a stressed-out guy who suspects low testosterone to do?

“See your doctor,” Ramin says. Start with your primary care doctor, who may refer you to a urologist or endocrinologist. He or she will review your symptoms and, if they are consistent with low testosterone, check your hormone levels with a blood test.

Normal testosterone levels vary based on the lab but usually fall in the range of 300 to 1,000 ng/dL, according to the U.S. National Library of Medicine. “Men in the region of 300 to 400 are at the low end of normal, and anything below 150 is considered very low,” Kavaler says.

Other blood tests may include those for precursor hormones to testosterone, including prolactin, luteinizing hormone, follicle-stimulating hormone, and thyroid hormones, Ramin says. “If all those levels are normal, you are hormonally healthy and your symptoms are probably due purely to stress,” Kavaler says.

If testosterone levels are indeed low, start with lifestyle changes to manage the symptoms of low testosterone, Ramin recommends. The following may help with both low testosterone and stress management:

  • Lose weight. “Body fat makes estrogen, which can tip the ratio of estrogen to testosterone to make testosterone levels unfavorably low,” Kavaler says. Stress also tends to cause men to exercise less and eat fattening foods more, further contributing to low testosterone, she adds. When you lose weight, the process reverses, and testosterone levels tend to go back up.
  • Get enough sleep. “Men under stress tend to be deficient in sleep, and lack of sleep can lead to low testosterone,” Ramin says. Sleeping better, on the other hand, can cause those levels to go back up. The National Sleep Foundation recommends that adults ages 26 to 64 get seven to nine hours of sleep a night and that those over 65 get seven to eight hours.
  • Change your diet. To help boost testosterone, go for a high-protein, low-fat diet, recommends Ramin. Also limit certain foods — such as those high in refined sugars, salt, and saturated and trans fats — that can elevate triglycerides, cholesterol, and fatty acids.
  • Exercise. “Regular cardiovascular exercise releases endorphins, which can reduce stress and boost testosterone,” Ramin says. “I recommend 30 to 45 minutes of cardiovascular exercise, such as running, swimming, or biking, three to four times a week.” Dr. Lowe also stresses the importance of adding strength training — which builds muscles and therefore may help boost testosterone levels — to your exercise routine.
  • Breathe deep. “A simple breathing technique can instantly lower your stress level,” Ramin says. Take a deep breath through your nose and into your belly, hold it for a few seconds, and then let it out. “Repeat this a few times to calm your body and mind,” he says.
  • Make time for yourself. “I tell my stressed-out patients to take an hour a day to do something for themselves and get their head together, be it exercise, a massage, listening to music, yoga, or a walk,” Kavaler says. “Even if it means getting up an hour earlier, it’s important to have this time to regroup.
  • Consider testosterone replacement therapy. Testosterone replacement therapy (TRT) can help return testosterone to a normal level and may help relieve some of the symptoms of low testosterone. However, TRT is not appropriate for everyone and may cause side effects, including increased risk of heart attacks, blood clots, and stroke, says Ramin. Talk to your doctor about whether TRT is right for you.

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