#004 - Before You Consider Testosterone, Read This.
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More high performing athletes in the tactical space are asking if testosterone replacement therapy, or TRT, is the right choice for them.
As we get into our 30s and 40s, and after spending years working in a demanding career field, the question comes up:
"Should I be taking testosterone?"
Energy levels feel lower.
Recovery feels slower.
Belly fat is harder to lose.
Drive and motivation feel farther away.
The truth? Not every symptom is a hormone deficiency.
What is causing low T levels
High-stress careers impact hormone production and efficiency significantly. Often the common lifestyle and cultural norms of the job are the main culprits in surpressing testosterone.
- Chronic sleep disruptions
- Shift work
- Elevated stress hormones (cortisol)
- Sympathetic activation (fight or flight)
- Under-fueling or poor nutrient intake
- Frequent alcohol intake
Many of the athletes who come to me seeking help with improving energy levels, hormones levels, or labs also experience some level of low energy availability. There are not enough calories coming in to support physical activity and optimal metabolic function and hormone production.
In addition to their regular training and jobs, athletes may also engage in high demand sports - ju jit su or MMA is very common.
I have also seen athletes who engage in endurance and ultra distance sports.
While these are often enjoyable activities, underfueling and sleep-deprivation, can decrease recovery leading to unintentional over-training syndrome. In OTS, symptoms often mimick low testosterone.
What do I do if I am having symptoms?
Lab testing should always be completed prior to taking any supplements or medications that claim to have an effect or effect testosterone levels.
At a minimum I would recommend Follicle Stimulating Hormone (FSH), Lutenizing Hormone (LH), total testosterone, sex hormone binding globulin (SHBG), and Estradiol. This paints a more complete picture of your hormone levels and what may be happening in the hormone cascade from the brain to the testes. This system is often referred to as the HPA axis (Hypotholamus - Pituitary - Androgen).
Sex hormones operate on a negative feedback system, meaning what is happening in the last step of the system will dictate what happens further up the chain and in the brain.
Decrease alcohol intake if applicable. More than 8 drinks per week can decrease testosterone levels by as much as 23% - and this effect compounds over time.
Alcohol intake can also increase visceral fat, deep belly fat, which will also decreases testosterone levels further.
This can all be compounded with poor blood sugar control, high triglyceride levels, and high LDL Cholesterol - all common with chronic alcohol intake.
Consume adequate energy. Any physician / PA I have ever worked with will request I see an athlete prior to starting them on TRT because of how important the role of nutrition is in hormone production. Underfueling can also create sleep and hormone disruptions by elevating cortisol and decreasing sleep quality.
Some general recommendations for active, healthy individuals include:
- Consume adequate protein - 80% to 100% of your goal body weight each day.
- Take in a small to moderate amount of carbohydrates prior to training (30 to 60 grams for most)
- Consume adequate calories, protein, and carbs post workout to maximize recovery
Need help with structuring your high energy performance plan? Join the High Energy and Performance Challenge. In 7 days you could experience more energy and better recovery all guided by a performance dietitian. LEARN MORE HERE.
When should I start hormone therapy?
If you are consistently making changes to your nutrition and lifestyle but are still experiencing symptoms of low testosterone you may need to consider hormone therapy.
A doctor will confirm low levels with lab testing. Once therapy starts you should expect to get labs retested every 8 to 12 weeks until you reach the correct dosage for your indiviudal needs.
Don't go it alone or use AI to help you self-medicate. While hormone therapy can help someone with chronically low levels, using an unsupervised plan can set you up for some serious health problems.
Additionally, it becomes much easier to gain weight while on testosterone as it is still an anabolic compound even at low dosages. Knowing how to adequately structure your nutrition plan can ensure that you are improving lifestyle factors rather than working against them.
You need medical oversight. Period.
Have more questions? Contact me HERE.
My choice for hormone and peptide therapy:
Wittmer Rejuvenation Clinic
Wittmer Rejuvenation Clinic is a trusted and reliable clinic that is dedicated to helping patients achieve optimal health and wellness through personalized hormone replacement therapy.
Wittmer is who I currently trust with my own personal hormone therapy. I appreciate their approach to personalized care and the customer experience is top notch!
Wittmer will provide full lab panels, evidenced-based protocols from medical providers, ongoing monitoring, and peptide therapies when needed. Book a free consultation below.
*Some links contained within this article are affiliate links for which I receive compensation. However, I never recommend products that I don't either use or trust. You may also receive special discounts with my links. Win / Win!
Check out the articles below to level up your nutrition and performance knowledge:
- Testosterone replacement for male military personnel - A potential countermeasure to reduce injury and improve performance under extreme conditions. PMID 31405757. This review discusses the extreme conditions related to military service and it's effect on testerosterone levels with recommendations related to testosterone therapy. However, it should be noted that they discuss this in conjunction with semi-starvation diets.
- Association of endogenous testosterone with physical fitness measures during firefighter occupational health evaluations. PMID 38541275. This article looks at the association between natural testosterone and physical fitness levels concluding that testosterone itself is not independently associated with performance. Excess body fat is one of the primary drivers of low fitness and high cardiometabolic risk.
Interesting Articles from the Web:
- Congress demands answers on low testosterone issues among special operators. Article from Task & Purpose. This article discusses the impact of "Operator Syndrome" and chronic low testosterone in Special Operations.
- Testosterone Information Document from International Association of Firefighters. This document dives deep into the subjet of low testosterone particulary in firefighters.
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