Two conditions that adults should know and understand are low testosterone and metabolic syndrome.
These issues are especially important for anyone who is diagnosed with or concerned about any of the following:
- Being overweight
- High levels of cholesterol, triglycerides, blood pressure, or blood sugar
- Prediabetes or type 2 diabetes
- Heart disease or other cardiac issues
In this review of testosterone and metabolic syndrome, we are going to examine the following subject matter:
- What is metabolic syndrome, including its causes, symptoms, and risk factors
- The role of testosterone in metabolic syndrome
- How testosterone therapy impacts metabolic syndrome
- The best way to use testosterone therapy to improve metabolic syndrome risks and symptoms
Let us start with some staggering statistics about metabolic syndrome:
- Having metabolic syndrome increases the risk of diabetes development fivefold
- Risk of stroke or heart attack increases threefold
- As many as 47 million people in the US have metabolic syndrome per the American Heart Association
The connection between testosterone deficiency, metabolic syndrome, cardiovascular disease, diabetes, and other health concerns is so crucial to understand that we have put together this report to help you make educated decisions to improve your health and well-being.
Low testosterone and metabolic syndrome together can increase the risk of more severe health conditions.
What Is Metabolic Syndrome
The term metabolic syndrome is slightly over twenty years old, entering the medical textbooks for the first time in 1998, even though it was first described in 1923 as an association between gout and hypertension. Like many other medical conditions, metabolic syndrome tends to run in families. As many as one out of every six adults in the US suffer from this metabolic syndrome. What is this condition that also goes by the name “Syndrome X?”
Although you might think metabolic syndrome is a disease itself, it is not. Instead, it is a group of associated factors that, when present together, puts you at a high risk of developing potentially dangerous and life-threatening medical problems.
Low testosterone levels have been linked to many of the factors associated with metabolic syndrome.
To better illustrate this, let us begin by examining the potential causes of metabolic syndrome:
|Causes of Metabolic Syndrome|
|Abdominal obesity||Carrying extra belly fat brings a higher risk that fat located elsewhere in the body|
|Aging||With age comes changes in hormone levels, activity, sleep, weight, and other factors that contribute to metabolic syndrome|
|Genetic predisposition||Some families and ethnicities have higher risks of developing metabolic syndrome (Ethnicities at higher risk include: African Americans, Asians, Hispanics, Native Americans)|
|Hormone imbalance||Hormones, such as testosterone, tend to decline with age and their changes can influence other factors associated with metabolic syndrome|
|Insulin resistance||When the cells are resistant to insulin, blood sugar levels rise, and the pancreas keeps increasing insulin production resulting in weight gain and diabetes|
|Physical inactivity||Lack of exercise and a sedentary lifestyle increase the risk of the changes listed above|
Hormonal imbalance is a significant cause of metabolic syndrome as the hormones in the body control critical functions that keep us well. When we talk about low testosterone and metabolic syndrome, we find that testosterone influences insulin and blood sugar, metabolism (weight gain), and energy (exercise).
Next, let us take a look at the symptoms associated with metabolic syndrome in the chart below:
|Symptoms of Metabolic Syndrome|
|Abdominal obesity||High blood pressure|
|Elevated LDL cholesterol||Low HDL cholesterol|
|Raised triglycerides||High fasting blood glucose|
|Inflammation in the body||Insulin resistance|
If you have at least three of the factors above, you may be diagnosed with metabolic syndrome.
The final chart below shows the factors that put you in a higher degree of risk for developing metabolic syndrome:
|Metabolic Syndrome Risk Factors|
|HDL Cholesterol||Women: Under 50 mg/dL|
Men: Under 40 mg/dL
Or using cholesterol medication
|Triglycerides||150 mg/dL or higher|
|Blood Pressure||Higher than 130/85 mm Hg|
|Waist Circumference||Women: 35 inches or greater|
Men: 40 inches or greater
|Fasting Glucose||100 mg/dL or greater|
If it seems as though the causes, symptoms, and risk factors all point to one another, that is because it is correct. An example is this – high blood pressure is a symptom of metabolic syndrome. It is also a potential cause, as well as one of the risk factors that can increase the possibility of developing metabolic syndrome.
Here are some other points of interest to point out regarding metabolic syndrome risk factors:
- African American women have a 60% higher risk of developing metabolic syndrome than African American men.
- Risk of metabolic syndrome development increases with age (past menopause for women).
- Having a body mass index (BMI) higher than 25 increases the risk.
- Diabetes history in the family or gestational diabetes also increases the risk.
- Lifestyle factors such as lack of exercise, high-fat diet, smoking, stress, and heavy alcohol consumption increase metabolic syndrome risk.
- Although obesity and low testosterone are implicated in metabolic syndrome in men, obesity in women who have polycystic ovarian syndrome or are postmenopausal and have elevated testosterone levels are associated with metabolic syndrome.
Some people with metabolic syndrome may notice darkened skin patches in their armpits, on the back of the neck, or under the breasts. However, most people have no idea they have metabolic syndrome until told so by a doctor.
Metabolic syndrome encompasses several risk factors that increase the incidence of potentially life-threatening medical conditions.
The Role of Testosterone in the Metabolic Syndrome
Now that you have a better understanding of metabolic syndrome, it is time to look at how testosterone levels fit into the equation. The connection between low testosterone and metabolic syndrome has been studied for many years.
According to a 2011 article in Diabetes Care, men diagnosed with metabolic syndrome, obesity, and type 2 diabetes tend to have low free and total testosterone and sex hormone-binding globulin (SHBG) levels. SHBG is the primary transporter of testosterone through the bloodstream. Doctors also use low testosterone and SHBG levels to predict metabolic syndrome development. Low testosterone is often associated with increased central obesity (belly fat), high LDL cholesterol, and insulin resistance.
Low testosterone, also known as hypogonadism or Low T, occurs because testosterone levels naturally decline throughout adulthood, often beginning while men and women are still in their twenties. The decrease happens slowly, only about one to one and a half percent each year. However, over time, that decline adds up, sometimes causing changes in functions regulated or impacted by testosterone. Individuals who lead sedentary lives, have a lot of stress, do not get enough sleep, and consume unhealthy diets are more likely to experience the effects of Low T.
A further connection between low testosterone and the metabolic syndrome occurs as men with type 2 diabetes are often diagnosed with hypogonadism. The incidence of low free serum testosterone levels is higher in men with diabetes than those without diabetes.
Testosterone is also a hormone that helps reduce inflammation buildup in the body. Low testosterone levels equal increased inflammatory responses resulting in the release and secretion of free fatty acids, estrogen, and proinflammatory adipokines and cytokines. These factors further increase peripheral and systemic vascular inflammation and dysfunction. Additionally, as testosterone levels decline, an imbalance in the testosterone to estrogen ratio results in the elevated activity of the enzyme aromatase, which converts testosterone into estradiol (estrogen). As that occurs, the estrogen increases the production of fat cells, which produce more aromatase, often leading to further weight gain and central obesity. The more central or abdominal fat a person has, the greater the aromatase activity converting testosterone into estrogen.
While all of this occurs, insulin resistance, impaired glucose uptake and metabolism, and elevated LDL cholesterol and triglycerides worsen. In one two-week study of hypogonadal men, withdrawal of testosterone reduced insulin sensitivity.
As we delve into the connection between type 2 diabetes, metabolic syndrome, and testosterone deficiency, we find that men with diabetes and/or metabolic syndrome have a higher risk of low testosterone levels. Testosterone levels in the higher normal range were associated with a 42% decrease in risk of developing type 2 diabetes. Increased fat deposition, as is common with Low T, promotes insulin resistance. Low testosterone levels impair mitochondrial oxidative phosphorylation, which becomes problematic as up to 70 percent of the insulin sensitivity in the body impacts muscle tissue.
For women, abdominal fat can increase without any weight gain due to changes that occur in the body associated with the menopausal transition. The increase in visceral fat further influences hormone levels and puts the body at risk of developing cardiovascular disease (CVD). PCOS is a risk factor for the development of cardiovascular disease in later years.
Elevated LDL and total cholesterol are common in type 2 diabetes, as well as with low testosterone. Excess lipids in the arteries adhere to the arterial wall as plaque, increasing the risk of atherosclerosis. Since low testosterone is often associated with high estrogen levels, there is also more circulating cholesterol due to accumulated fat. Because testosterone also stimulates red blood cell production in bone marrow, hypogonadism can lead to impaired circulation due to anemia. With arterial blockage occurring, and low red blood cell levels reducing circulation, cardiovascular risk factors increase. That is also why many males with these conditions suffer from erectile dysfunction as the blood supply to the penis declines.
Androgen deprivation therapy, often used to treat prostate cancer, can cause an increase in abdominal obesity and hyperglycemia. Elevated triglyceride and LDL cholesterol levels may also occur. Men treated with androgen deprivation therapy have a higher incidence of developing ischemic heart disease, diabetes, myocardial infarction (heart attacks), and sudden death from CVD.
As you can see, low testosterone and metabolic syndrome have quite an impact on the body as a whole, and how well it functions.
Low testosterone’s influence on metabolic syndrome includes fat retention, high cholesterol, insulin resistance, and other factors.
Impact of Testosterone Therapy on Metabolic Syndrome
It is important to note that research points to an increase in morbidity and all-cause mortality when low testosterone is present. In men with cardiovascular disease, Low T further increases the mortality risk. Hypogonadism and CVD are associated with type 2 diabetes, metabolic syndrome, and increased inflammatory cytokines. That is only part of the reason to look at testosterone replacement, metabolic syndrome, and how to improve one’s health.
Testosterone is crucial for inhibiting adipocyte (fat cells) development and promoting myocyte (muscle cells) production. Additionally, testosterone increases the number of beta-adrenergic receptors that promote lipolysis (the breakdown of fats) and reduce fatty acid synthesis.
Numerous studies have been done on the benefits of testosterone replacement therapy for men with low testosterone and metabolic syndrome, as well as those who also have type 2 diabetes. Here are two of interest:
- In one study of 48 men with type 2 diabetes and Low T symptoms, three months of testosterone therapy resulted in significant reductions in waist-hip ratio, body fat percentage, weight, and blood glucose levels.
- Another study of 220 men with low testosterone and either type 2 diabetes and/or metabolic syndrome resulted in total and LDL cholesterol and body fat reductions as well as better sexual function after six months of treatment.
Other studies have backed up the benefits of testosterone therapy for metabolic syndrome and type 2 diabetes, including:
- Decreasing visceral fat mass
- Reducing waist circumference
- Lowering free fatty acid exposure to the liver by decreasing insulin resistance
- Reducing lipoprotein lipase activity
- Decreasing LDL and total cholesterol
- Improving blood pressure levels
- Enhancing blood circulation
- Promoting lipolysis
Because testosterone replacement therapy (TRT) also helps increase energy and cardiac output, it improves exercise capacity, which further aids in weight reduction and testosterone production. For people with chronic heart failure (CHF), testosterone therapy has been found to improve insulin sensitivity to aid in glucose uptake. TRT helps to reduce the production of inflammatory cytokines, which cause insulin resistance.
The impact of testosterone therapy on metabolic syndrome can help reduce the risks associated with type 2 diabetes and cardiovascular disease.
How to Use Testosterone Therapy to Best Improve the Symptoms of Metabolic Syndrome
The goal of low testosterone metabolic syndrome treatment is to improve general well-being, sexual health, body composition, insulin sensitivity, glycemic control, lipid profile, CVD risk factors, and blood pressure levels.
Yet, even testosterone therapy has limitations. Yes, it will bring benefits in many areas, although if poor lifestyle habits do not change, the results will be slower to attain. However, there are ways a person can improve their results by making some changes in their daily lives.
With a diagnosis of metabolic syndrome or low testosterone, one can benefit from significant lifestyle changes, including:
- Healthy eating, such as adopting a Mediterranean-style diet – more lean protein, vegetables, fruit, whole grains, and heart-healthy fats
- Decreasing consumption of sugar, refined carbohydrates, and solid fats
- Increasing daily physical activity and exercise
- Reducing stress levels which can influence hormone production
- Getting enough sleep
- Quitting smoking
- Decreasing alcohol intake
These same actions can help improve testosterone production. Weight loss and intermittent fasting are excellent ways of stimulating the body to produce testosterone naturally.
Testosterone therapy can have a dramatic effect on metabolic syndrome by reducing and reversing the many factors contributing to this condition. For more information on low testosterone and metabolic syndrome, please contact HGH Doctor hormone clinic for a free and confidential consultation.
- Wiley: Low testosterone and the metabolic syndrome: a high-risk combination
- American Diabetes Association: Low Testosterone Associated With Obesity and the Metabolic Syndrome Contributes to Sexual Dysfunction and Cardiovascular Disease Risk in Men With Type 2 Diabetes
- National Center for Biotechnology information: Testosterone and the metabolic syndrome
- National Center for Biotechnology information: Testosterone and metabolic syndrome: The link
- BMC Endocrine Disorders: Effect of 12 months of testosterone replacement therapy on metabolic syndrome
- Jhons Hopkins Medicine: What is metabolic syndrome?