Testosterone Concerns in Obese Men – Part 3

By: Michael Lam, MD, MPH; Justin Lam, ABAAHP, FMNM; Carrie Lam, MD

Read Part 1 | Part 2

Testosterone Concerns According to Western Medicine

Testosterone concerns and muscle massTraditionally, a man’s testosterone concerns when it comes to lower testosterone levels has been to boost his levels by means of testosterone replacement therapy. Besides boosting your testosterone levels, you may have more energy and a higher sex drive. Other possibilities are that your muscle mass starts building up, and you may even start losing some weight.

There are, however, possible risks with regards to testosterone replacement therapy according to certain research. These include skin problems such as oily skin and acne, premature hair loss, anxiety and panic attacks, a higher risk of blood clots, and a higher chance of getting a heart attack or stroke. More research is being conducted with regards to some of these risks, however, as previous research undertaken was not 100 percent conclusive.

Some studies suggest that men who have had prostate cancer should be very careful before embarking on or stay away from testosterone replacement therapy, although other research suggests that men who have had prostate cancer could have this treatment if conditions were controlled.

Other conditions where western medicine suggests you should not have testosterone replacement therapy include when you have:

  • lower urinary tract problems (e.g. where the condition is associated with an enlarged prostate)
  • severe congestive heart failure
  • blood cells counts that are above what is considered normal

Testosterone replacement therapy is also traditionally not recommended for those who have lower testosterone levels due to age unless properly supervised.

Testosterone Replacement Therapy

Testosterone replacement therapy is, traditionally, administered in five possible ways:

Skin implants

Pellets are inserted under the skin. These pellets are effective for between three to six months. Minor surgery is needed each time a new pellet is inserted.

Body patches

These patches may need application more than once a day.

Buccal patch

This testosterone patch is placed on the upper gum of the mouth each day. Some men may get gum disease or experience irritation from this method.

Gel application

Testosterone is available in a gel form that needs to be rubbed into the skin on a daily basis. Care needs to be taken that others do not make contact with the area as it could result in testosterone entering their system. A nasal application is also available, which minimizes this type of risk.


Testosterone concerns and chest painProbably the easiest and most convenient form of testosterone replacement therapy, you would get an injection every two to ten weeks. This method sees testosterone levels decline between treatments, however.

Regular monitoring is needed if you are on testosterone replacement therapy. This includes having your testosterone levels monitored every few months, and undergoing bone density tests every few years.

If you find your speech slurring, have chest pains, encounter weakness on one side of your body, or have shortness of breath, it is advised that you seek immediate medical attention.

Functional Medicine’s Approach to Testosterone Concerns

Functional medicine does not address testosterone concerns only. Instead, functional medicine takes into account the balance between your hormones, as this is what influences your health. All related factors are taken into consideration before any form of testosterone management is suggested.

Functional medicine understands that different so-called illnesses and their symptoms may be part of a deeper, underlying conditions and that in most circumstances, the different symptoms presented are linked to an underlying root cause.

Although testing is necessary in order to get to the bottom of the problem, functional medicine does not necessarily agree with the use of testosterone replacement therapy as the first line of action when managing testosterone concerns. Instead, it relies to a large extent on determining the cause of the problem, seeing testosterone deficiency as a symptom of a larger, underlying issue.

Managing Your Testosterone Concerns Naturally

There are a number of natural ways in which one can boost testosterone levels.

Reduce stress

Stress tends to have an extremely negative impact on the body, affecting all parts of the body’s NeuroEndoMetabolic response system. This means it affects just about all aspects of your metabolic function. This may result in unbalanced hormones, often leading to lower testosterone levels in men.
Getting rid of a stressful situation might not always be possible, but much can be done with regards to how you handle it. Also, taking up a hobby, taking ‘me’ time, socializing, or meditation all help negate the worst effects of stress.

Get enough rest

Many people do not get enough sleep. Sleep is necessary for the body to repair itself. When you do not get enough sleep, the body is not able to carry out this necessary function, adding to the problem. Studies also show that lack of sleep lowers cholesterol levels.

Zinc supplementation

Men with lower testosterone levels often have low zinc levels. Research as to why this is the case is as yet inconclusive.

If incorporating extra zinc into your diet, do consider asking for professional advice on the matter. Zinc stimulates the thyroid, so if you have thyroid problems, it is better to either avoid taking a supplement or to do so under the care of a healthcare professional. It can also trigger adrenal crashes especially for those in advanced stages of adrenal fatigue.


Exercise is a great way to balance your hormones. Short periods of intense exercise, according to studies, naturally boosts testosterone levels. Weight training is especially good in this regards. About twenty minutes of intensive training a day seems to be beneficial, but it can trigger adrenal crashes. The more advanced? the adrenal fatigue, the greater the risk.

Lose the weight

Losing excess weight may address your testosterone concerns naturally. Besides following a healthy diet plan, it includes limiting your intake of sugar. Consider replacing it with natural sweeteners such as stevia or agave. Refined carbohydrates such as white bread and breakfast cereals should also be avoided, as they quickly break down into sugar. Proper timing is key. Those with adrenal fatigue may find losing weight an almost impossible task due to metabolic imbalances, until such time that the adrenal glands are well healed.

Get more vitamin D

Testosterone concerns and vitamin DVitamin D plays a role in increasing testosterone levels and improving sperm. Although vitamin D supplements are readily available, the sun is the key source for the development of this vitamin.

Eat more testosterone boosting foods

Certain foods are great natural testosterone boosters. Fatty fish, such as mackerel and salmon, for example, are rich in omega-3 fatty acids that inhibit estrogen production in men while improving insulin sensitivity. Take care not to take too much omega-3 – as it has been linked to incidents of prostate cancer.

Certain types of seafood, such as shrimp and tuna are great vitamin D sources. Low-fat milk is also rich in this vitamin plus it has all the nutrients present in full-fat milk without the fat content. Eggs are another rich source of vitamin D while the cholesterol in eggs may help the body produce more pregnenolone and thereby aid in testosterone production.

Pumpkin seeds are rich in zinc, while the high magnesium levels in wheat bran, almonds, beans, and sunflower seeds are high in magnesium, which helps with testosterone production. Oysters, long spoken of as an aphrodisiac, are full of zinc, as is most shellfish.

Saturated fats are beneficial for testosterone production and are a lower health risk than polyunsaturated fats. A great source is coconut oil which does not change its chemical structure when heated.

Healing your adrenals

Optimizing adrenal function is perhaps the most frequently overlooked and underappreciated natural testosterone boosting approach. It is almost impossible to have optimal testosterone function if the adrenal glands are weak. Those into the advanced stages of adrenal fatigue frequently complain of low sex drive, erectile dysfunction, and loss of vitality for good reasons.

It is easy to be misled by laboratory tests that testosterone replacement is the only option. Premature and overly aggressive testosterone replacement therapy has many complications and long-term negative consequences, even when properly supervised. There is much we do not know about the body’s internal feedback and regulatory system when it comes to testosterone long term.

Manipulating male hormones with external medication as well as natural compounds with stimulatory properties such as maca, ginseng, ashwagandha, licorice, tribulus, or deer antler may work well in the beginning – giving the sufferer a false sense of security. However, in reality, it is nothing more than a temporary patch and energy boost, while the underlying reason for low testosterone goes unattended.

Testosterone concerns and insomniaOvertime time, many report a return of fatigue. As the testosterone, glandular, or herbal dosage needed to be increased to achieve the same clinical outcome, the body was metabolically stimulated. This can lead to insomnia, fast resting heart rate, arrhythmia, hyperthyroid function, anxiety, and panic attack. Abrupt withdrawal of testosterone replacement can also lead to rebound effects that can be very devastating.

A functional medicine approach that is holistic in nature should be considered as the first line of defense. It is a far more gentle way to boost testosterone function because the body is given the ultimate control. Regulatory loops are intact without external influence. Energy and vitality so derived are smooth, clean, long term, and powerful. Low libido is gradually reduced as the body deploys the proper raw material to make the necessary amount of testosterone as it sees fit. The risk from cancer is avoided. Energy derived does not feel hyped, artificial, or short term. There is a genuine sense of well-being as vitality returns.

In Conclusion

Testosterone concerns in obese men seem to be a sign of the times. The most common reason for these two conditions seems to be related to lifestyle. People do not necessarily eat more, yet weight gain is on the increase, with testosterone deficiency and its results one of the symptoms.

More often than not, it is not how much we eat that matters, but rather what we eat accompanied by the more sedentary lifestyle we lead these days.

In most instances, it would seem that the two major solutions to this problem are to be found in diet and exercise. By changing our diet, incorporating testosterone boosting food, eliminating fats and refined carbohydrates, and doing about twenty minutes of intense exercise a day, much can be done to address testosterone concerns naturally and effectively.

Read Part 1 | Part 2

© Copyright 2018 Michael Lam, M.D. All Rights Reserved.

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