So, your testosterone levels are testing normal but you’re still not getting aroused the way you used to? It might be all about lifestyle, says functional medicine practitioner Miles Price.
So, you’ve been to see the doctor about your libido issues, and he’s done some blood tests on your sex hormones, including testosterone, and he tells you your total testosterone count is fine, that’s it’s all in your head and instead refers you to a psychologist. At which point you go ‘Arghhhh no way!’ Unfortunately, for many men this is the frustrating and reoccurring issue which bugs them, especially in their thirties and forties.
What is Testosterone and How Important is it for Libido?
Testosterone is classed as a steroid hormone and is produced in the testes of men throughout their life, from puberty onwards. However, it starts to decline with age, about 1-2 percent per year from the age of 30. This process can be sped up through poor lifestyle habits, like too much alcohol, poor sleep, little exercise, too much stress, and a poor diet.
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Testosterone is responsible for regulating not just the sex drive (libido), but also bone mass, body fat and muscle mass as well as the production of red blood cells. When testosterone levels fall below normal levels this can result in reduced muscle mass, low libido, irritability, depression, poor concentration, loss of body hair, fatigue and an increased risk of brittle bones.
It’s important to remember that libido is not just driven by hormones. If your lifestyle habits are out of balance, like you’re doing too much or too little exercise or drinking too much alcohol or having psychological issues like depression or anxiety for example, they can all influence your libido too. So, finding the root cause of your libido reduction is important, rather than just thinking it’s a testosterone deficiency.
Why You Should Check Sex Hormone Binding Globulin (SHBG)
All hormones are carried around both men’s and women’s bodies by carrier proteins. Testosterone is carried through the body by SHBG predominantly and also by albumin. SHBG binds more to testosterone than to estrogen. The main role of SHBG is to control the availability of sex hormones to cells and to transport them through the body. So, in order to determine how much testosterone is getting into the cells, aka the ‘free testosterone’, we need to know your SHBG and your total testosterone levels and calculate the difference. Laboratories now do this calculation on your behalf to gauge the free testosterone. Measuring free testosterone levels is a more accurate measure of testosterone status than that of total testosterone.
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The normal range for SHBG is 10-57mmol/L. An all too common situation – that SHBG begins to rise to high levels, blocking the availability of free testosterone to cells – occurs as men as they get older. And you guessed it, the symptoms of high SHBG are similar to those of low testosterone.
So, we need to identify what causes high SHBG, in order to reduce it. For men, it could be related to high thyroid levels (hyperthyroidism), or low growth hormone. Other issues could be related to the liver, where SHBG is produced; if you someone has diseases of the liver like NAFLD (nonalcoholic fatty liver disease), hepatitis infections, or cirrhosis, then SHBG can be high.
Lifestyle factors, like drinking too much alcohol, smoking, or high-stress levels, can also play a role. This stress can also come from overexertion during workouts.
Long Term Implications of Too Much SHBG
There are potential long term disease risks associated with too much SHBG. It is linked to bone loss and reduced bone density in a number of studies. There’s also an increased risk of Alzheimers disease and prostate cancer, so this can be fairly serious.
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What Can be Done to Reduce it?
There are some dietary changes that can help; high protein diets are associated with reduced SHBG. How much protein? As long as you’re getting your baseline 1.2 g/kg of bodyweight protein you should be fine, although some people may need more based upon their training regimes. A liver function test can help determine your total protein levels as a first-line blood check. Getting the body fat down to healthy levels also helps to reduce SHBG. For women, that’s below 22% body fat and for men, that’s below 20%.
Additionally, some supplement minerals and vitamins can lower SHBG. Boron tops the list with researchers recommending an intake of up to 10mg a day to lower SHBG. The best forms of boron are Boron Glycinate or citrate. Boron is especially powerful in lowering your SHBG and if your total testosterone is already high, you’re naturally going to have higher than normal SHBG, so it would be safer to start on a lower dosage of 3mg or 6mg per day and then follow up with a ‘free’ testosterone test 2-4 weeks later and see where your levels are at. Having your free testosterone levels between 2-4% is ideal.
Vitamin D3 lowers SHBG and raises testosterone, and optimal levels to aim for are around 50ng/dL. There is an additional synergy between boron and Vitamin D3 in that boron extends the half-life of vitamin D3 in the blood, providing even more time for vitamin D3 to exert its long-ranging effects. Fish oil also reduces SHBG and the safest way to get your omegas is by eating fish. Having four portions a week of either sardines, mackerel, wild salmon, herring or anchovy should be sufficient. The tinned versions have comparable if not higher levels of omega-3s.
So, depending on your circumstances, you may need to look at your lifestyle, your diet and your training regime to help you lower your SHBG, and working with a functional medicine specialist will help you find your sweet spot so that you’ll feel great and get your Va Va Voom back!
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