Hey Guys! Where are Your Hormones?

Megan commented the other day on John’s memory. It’s usually as sharp as a tack, but it’s been slipping lately. He’s forgetting the odd word, grasping for the name of a movie or forgetting what the kids told him they were doing the next day. No, it isn’t Alzheimers or dementia, for a guy its far worse…..andropause, the male equivalent to menopause.

I can’t blame all his memory blips on hormones, after all, most of it is a normal process of pruning neurons and learned selectivity. I mean really, does he need to know the name of that movie? And is it a matter of life or death that he recalls one word? And hey, the kids can always repeat what they said, it’s not as though we didn’t repeat the same things over and over to the kids!

Fact is; there are other things that go along with andropause that affect the brain. Guys, take it as a wake up call to start taking care of your marbles and your muscles!

There’s a new term I’m seeing in the literature on aging and the brain, it’s called ‘successful aging.’ It’s defined as a process of getting older and being healthy. I’m sure a good comedian could have a hey day with the phrase, but I’m no comedian so I’ll leave it alone. Suffice it to say, the goal of growing older is to age successfully, without disease or impediment. Though both menopause and andropause are natural processes, they can sometimes feel like a disease you want to get rid of.

There’s no fixing nature though, she’s perfection already. But, with all that we know about endocrinology, aging and the brain, we certainly can work with her to smooth the process out.

BHRT For Him
Before we dive in to BHRT for men, let’s take a refresher on sex ed, it will make the discussion of hormone decline a bit easier to understand.
Androgenic hormones, namely testosterone and dihydrotestosterone, are what produce male characteristics, like facial hair, muscles, selective hearing and an inability to multitask. Okay, so I’m stretching a bit with the last two. Testosterone is also responsible for sperm production, ability to sustain an erection, and pubertal growth of the penis, scrotum and prostate. It also plays a major role in heart health, sex drive, a sense o f well being, blood sugar control, muscle mass and skin elasticity.

95% of testosterone is produced in the testes, yet it is most active in the brain, heart and skeletal muscles. Testosterone is attracted to androgen receptors in these areas but not all testosterone is available. Some testosterone binds to a protein called Sex Hormone Binding Globulin or SHBG. Once it’s bound to SHBG it becomes too large to enter into cells and therefore cannot connect with the androgen receptors.

SHBG levels in the male body increase from several factors:
• Age
• Alcoholic cirrhosis
• Severe liver disease
• High levels of estrogen
• High levels of thyroid hormone

What this means is that even though total testosterone levels look normal, the amount available for cells to use is much lower.
Basically, there are two types of testosterone roaming around the male body. Free testosterone that’s lightly bound to albumin and the SHBG Bound testosterone. The former is also called bio-available testosterone as the albumin can easily become detached making the testosterone available to the cells.

Androgen deficiency or low levels of bio available testosterone are:
• Fatigue
• Low libido
• Decreased endurance
• Muscle aches
• Muscle stiffness
• Penis shrinkage
• Sense of humour declines
• Increased sweating
• Decrease in enthusiasm
• Bone loss
• Depression

Excessive levels of androgens include:
• Acne
• Increase aggressiveness
• Oily skin
• Increased stroke risk
• High cholesterol
• Crankiness

We usually pair estrogen with women, but this hormone is important for a guys well-being too and keeping the right balance between androgens and estrogens is vital for good health.

Estrogen can get quite aggressive with testosterone, vying for receptor sites and weakening the effect of testosterone. And unfortunately, a higher estrogen level also means higher levels of SHBG making it even harder for testosterone to get to the cells.

A major concern is that as we age it becomes more difficult for our body to absorb trace minerals like zinc. Zinc blocks the conversion of androgens to estrogen so a zinc deficiency can just pile on the troubles.

This balance between testosterone and estrogen is sensitive and complex, involving several other compounds and factors. If you are concerned about the consequences of andropause talk to your naturopathic doctor about specific tests. These involve checking the blood for total testosterone and SHBG. From these two tests a simple calculation can determine the amount of testosterone available to tissues. Make sure the blood test occurs in the morning as levels of testosterone can fluctuate throughout the day.

Once your Free Androgen Index has been determined there are several options to choose from if the results show an imbalance. Compounded creams with the addition of testosterone deliver the hormone through the blood stream directly to cells. However, if symptoms do not resolve after treatment, rather than increasing the dosage, check with your naturopathic doctor about looking at estrogen and cortisol levels as both may impede proper assimilation of testosterone.

Mind Medicine Method Prescription
Okay, now you know. What are you going to do about it? Are you concerned about the increased risk of developing Alzheimer’s or dementia from decreased levels of bio available testosterone? Then follow this simple Mind Medicine Prescription:
1. See your naturopathic doctor about your symptoms
2. Get a blood test or salivary hormone test to determine ratios and availability of hormones.
3. Get a prescription from your naturopath for the proper dose and delivery system.
4. Get retested in three months to ensure hormone levels are increasing.
5. If levels have stayed the same, ask your doctor to look at estrogen and cortisol levels.

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