Diet, Inflammation, and Low Testosterone
In recent years, low testosterone (low T) has become a big business. “Low T” is promoted in television commercials, radio spots, and print/internet news sources. Not surprisingly, “low T” ads have led to a surge in testosterone prescriptions (1). But is this the way to go?
Alternative Treatments
The alternative/complementary medicine field has also responded by providing alternatives to treating low testosterone. This is part of the problem, as it represents a “low T” treatment attempt that is similar to the medical approach, which does not take into consideration the biochemical nature of a man with low levels of testosterone. For example, one popular “natural medicine” website promotes the notion that liver cleansing can improve “low T,” as liver cirrhosis is associated with reduced testosterone. While cirrhosis is associated with “low T” (2), there is no evidence that liver cleansing, such as consuming olive oil potions, has any metabolic effect other than causing one to eliminate insoluble olive oil soaps in the stool that are shaped like gallstones (3). Other foolishness is also promoted at these websites, such as the notion that supplementing with vitamin D will increase your testosterone levels by 30%, which can be interpreted as being quite substantial depending on one’s statistical viewpoint. Actually, after one year of supplementing with 3,332 IU per day of vitamin D, total testosterone increased from an average of 10.7 to 13.4 nmol/l (4). In other words, after one year of supplementation, testosterone remained in the low range of normal (9-55 nmol/l), which means that just supplementing with vitamin D has essentially no significant effect on testosterone levels.
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The proper way to view low testosterone is to understand that it is a pro-inflammatory state, which is true for most chronic conditions (5). It is now very clear that the over-consumption of sugar, flour, and refined oils, which represent close to 60% of the average American’s caloric intake, is associated with the development of chronic inflammation, which involves the accumulation of excess body fat (6,7), which in turn promotes “low T.”
Body Fat
Historically, accumulating body fat has been viewed merely as a storage source of excess calories, but now we know that as fat cells swell in size, a substantial change occurs in the cellular anatomy and metabolic activity of adipose tissue. In the lean state, adipose tissue contains a population of anti-inflammatory immune cells that release anti-inflammatory cytokines. As fat cells swell in size, anti-inflammatory immune cells are replaced with pro-inflammatory immune cells that continuously release pro-inflammatory cytokines (7). This is a state of chronic inflammation, in which men live for years, until succumbing to chronic disease. Every time these men overeat sugar, flour, and refined oils, there is a postprandial production of inflammatory chemistry that gets superimposed over the prevailing chronic state. Over time, multiple organs/tissues suffer from being bathed in this chronic inflammatory chemistry, including Leydig cells (8).
Leydig cells produce testosterone in men, and they are sensitive to the prevailing biochemistry to which they are exposed. Ultimately, the chronic inflammatory state described above, which is characteristic of the metabolic syndrome and type 2 diabetes, leads to an inhibition of both Leydig cell and testosterone production (8). This underproduction of testosterone cannot be improved by taking drugs or supplements, as many people have been misled to believe.
The underlying cause of “low T” must be addressed, which is consistent with how all chiropractic physicians are trained to think. The most common cause of “low T” is the pro-inflammatory metabolic syndrome, which can easily be addressed by chiropractic physicians via diet, supplementation, stress management, and exercise (7,9). I have also created a YouTube video to help educate laymen about this process, which can be watched at DeFlame Nutrition.
References
1. Kravitz RL. Direct-to-consumer advertising of androgen replacement therapy. JAMA. 2017;317:1124-25.
2. Sinclair M et al. Testosterone in men with advanced liver disease: abnormalities and implications. J Gastroenterol Hepatol. 2015;30:244-51.
3. Sies CW, Brooker J. Could these be gallstones? Lancet. 2005;365:1388.
4. Pilz S et al. Effect of vitamin D supplementation on testosterone levels in men. Horm Metab Res. 2011;43(3):223-25.
5. Seaman DR. The diet-induced proinflammatory state: a cause of chronic pain and other degenerative diseases? J Manipulative Physiol Ther. 2002;25(3):168-79.
6. Seaman DR. Weight gain as a consequence of living a modern lifestyle: a discussion of barriers to effective weight control and how to overcome them. J Chiro Human. 2013;20:27-35.
7. Seaman DR. The DeFlame Diet. Shadow Panther Press, ILM. 2016. ISBN: 9781523957705
8. Wang C et al. Low testosterone associated with obesity and the metabolic syndrome contributes to sexual dysfunction and cardiovascular disease risk in men with type 2 diabetes. Diabetes Care. 2011;34(7):1669-75.
9. Seaman DR, Palombo AD. An overview of the identification and management of the metabolic syndrome in chiropractic practice. J Chiropr Med. 2014;13(3):210-9.
