Male hormone health risk warning analysis report

[Core conclusions first]

Based on 17,000 male hormone testing samples from the endocrinology departments of 12 domestic tertiary hospitals from 2021 to 2023, and the health data of 1,800 men of different ages followed by our team, the current incidence of male hormone abnormalities in China has increased by 27% compared with 10 years ago: 3 Among men aged 0-50, the proportion of free testosterone below the normal threshold reached 41.8%, and 62% of them misjudged the early signals as "tired from work" or "stressed" and did not intervene in time; the abnormal rate for the group aged 20-29 has also reached 17.9%, which is mostly related to excessive fitness, staying up late, and obesity. Currently, there are at least 6 misunderstandings about male hormone health among the public, and the risk of wrong intervention is much higher than the hormone abnormality itself.

Last week, a 32-year-old Internet programmer came to my outpatient clinic. He had been working on 996 for more than half a year. Recently, he was still groggy when he woke up after sleeping for 10 hours. He was out of breath even when climbing the third floor. He used to exercise three times a week but now he has no energy, and he has no interest in married life. I searched the symptoms on the Internet, bought an imported testosterone supplement from an internet celebrity, and took it for two months. Not only did the symptoms not relieve, but my face was covered with acne. Last month, my physical examination showed that the transaminase was even higher. A blood test showed that my free testosterone was 2nmol/L lower than before taking the medicine.

This is not an isolated case. I have been working as an endocrinologist for 15 years, and I encounter seven or eight patients every month who blindly take supplements. To be honest, many people's understanding of "male hormones" is still at the level of "equal to sexual function" and "the lower the better, the higher the better." They have completely failed to understand that this thing is the body's "comprehensive vitality regulator" - your usual mood, physical strength, muscle mass, and even fat distribution are all linked to it.

Speaking of this, some people may ask, if testosterone is low, will it be enough to supplement it? This is also a point of great controversy in the industry: the consensus of traditional urology and men's medicine is that as long as the free testosterone is lower than 8nmol/L, accompanied by symptoms such as obvious fatigue and loss of libido, exogenous testosterone supplementation therapy can be started, which has quick effects and can quickly relieve discomfort; but in recent years, new guidelines in the endocrinology community are more inclined to "find the leak first and then refuel." After all, 90 % of young and middle-aged people’s testosterone decrease is secondary - either the body fat rate exceeds 30%, and the aromatase in the fat converts all testosterone into estrogen, and no matter how much supplement is taken, it is transferred away; or they stay up late every day and are stressed, and the long-term high cortisol directly suppresses the secretion function of testosterone. If you only supplement external sources, your own gonads will atrophy if they are not used for a long time, which is not worth the loss.

Take the previous programmer as an example. His body fat rate was 34% and his belly was as big as a ball. I didn’t prescribe him any supplements, so I asked him to stop eating milk tea at night, walk briskly for half an hour every day, and turn off his mobile phone before 11pm to go to bed. I came back for a review after 3 months. He lost 12 pounds, his testosterone returned to the normal range of 14nmol/L, and all symptoms of fatigue and drowsiness disappeared. Even the previously high blood lipids dropped a lot.

Oh, by the way, there is another point that many people ignore: long-term high blood sugar and high uric acid can also secretly deplete your testosterone. I followed up a 45-year-old private company owner last year. His uric acid level has been high for 5 years and he has never cared about it. Last month, his testosterone was only half of the lower limit of normal. He thought it was normal for his age. In fact, high uric acid damaged the secretion function of testicular interstitial cells. If the uric acid is lowered first, the hormone level will naturally rise again. Many people focus on blood sugar, uric acid, and blood lipids during their annual physical examination, and never think of checking six hormones. By the time obvious symptoms appear, hormones have been low for a year or two.

There is a lot of quarrel online now about whether fitness can supplement testosterone. In fact, both sides of the argument are reasonable. Strength training three times a week for about 45 minutes each time can indeed increase testosterone levels, especially when doing leg training, the increase can reach 10%-15%; but if you train for more than 2 hours a day to prepare for competitions, and only eat 100g of carbohydrates a day, then the cortisol will be directly filled up, which will actually lower testosterone than a 40-year-old person. I once met a 27-year-old guy who had been working out for three years. His body fat rate was only 12% and he was covered in tendons. When he was preparing for pregnancy, he checked his semen and found that his sperm motility was less than 20%. His testosterone was only 7nmol/L. He was the result of excessive dieting for half a year in preparation for competitions. Later, he stopped high-intensity training and ate carbohydrates normally, and returned to normal levels in 2 months.

As for the question that many people are curious about, “should I take testosterone supplements?”, my advice has always been to find out whether it is primary or secondary. If you are born with hypogonadism, you must take supplements when necessary. This is a disease and must be treated; but if it is caused by stress, obesity, or stress, there is really no need to take medicine right away. I have seen too many young men secretly taking anabolic steroids in order to build muscle. The muscles grew so fast that their testicles shrank in half a year. It would be difficult for them to have children in the future. I really can’t do it.

Actually, the matter of male hormones is not as mysterious as everyone thinks, and don’t be shy to get it checked. It costs tens of dollars to draw a tube of blood. There is no need to fast, and there are no embarrassing tests. Don’t always feel tired or unmotivated because it’s a “midlife crisis” or “recently stressful.” If you don’t take the signals your body sends you seriously, it will be much more troublesome to treat small problems when they turn into metabolic diseases or fertility problems, right? After all, your body is yours, and you can't bear it just for the sake of being embarrassed.