At the turn of the 20th century, most diseases were caused by a single organism and then cured by a single treatment. In contrast, for the past many decades, many health concerns developed due to a complex interplay between nature (our genetics) and nurture (our environment and lifestyle).
Conditions now have multiple risk factors that are best addressed with multiple approaches to care, such as in the case of anxiety and depression and hormone imbalances.
Low testosterone can contribute to anxiety and depression, and vice versa, yet it’s imperative to explore various treatment options as more than one concern (even other health issues) tend to be present.
Testosterone, synthesized from cholesterol, is the main sex hormone in men that peaks around age 20 and slowly declines around age 35, though present to a lesser extent in women especially after a drop off period around menopause.
In males, it is responsible for secondary sex characteristics like body hair, deepening voice, and growth of testicles and penis, while both genders benefit from its boost* libido, memory, mood, energy, bone and muscle mass, and fat distribution.
The adrenal glands, two glands that sit on top of each kidney and the Leydig cells in the testes of men and the ovaries in women produce testosterone when signaled by the brain.
A drop in testosterone signals the hypothalamus to secrete Gonadotropin Releasing Hormone (GnRH), which tells the pituitary to release luteinizing hormone (LH) to trigger the gonads (ovaries and testes), and to a small extent the adrenal glands, to make testosterone.
Low testosterone may be due to inadequate production or signaling from any gland, increased conversion to estrogen (due to aromatase enzyme), or increased amount of sex hormone binding globulin (SHBG), which binds up too much estrogen or testosterone.
The latter two help keep our hormones in balance, though problems can arise when even these mechanisms aren’t functioning properly.
Increased conversion to estrogen may be due to age, weight gain, poor diet, lack of exercise, high stress, and hypothyroidism, and increased SHBG may occur from increased estrogen exposure (e.g., weight gain, birth control, plastics/environmental endocrine disrupting chemicals), cigarette smoking, hyperthyroid (increased production) stress, and poor liver health (e.g. elevated liver enzymes).
It can also contribute to osteoporosis (it helps build bone) , anemia, and heart disease, as solely replacing testosterone has not been shown to reduce* the risk of cardiovascular events like a stroke or heart attack. Furthermore, testosterone therapy also increases* risk of cardiovascular events and heart disease.
Anxiety and depression and low testosterone are closely linked, though remains unsure which came first.
It was first discovered in men with hypogonadism, reduced* function of gonads resulting in lower testosterone production, who tend to be more prone to developing mood disorders compared to those with normal levels.
Testosterone hormone replacement improves* mood for the majority of men and women due to physiologically enhancing* neurotransmitters dopamine (our reward and pleasure center), serotonin (our happy hormone), and GABA (or calming neurotransmitter).
Mood can also be affected by many of the same factors that lower testosterone such as lack of exercise, poor diet, stress, and sometimes birth control in women as a side effect. In addition, it can also raise cortisol, our stress hormone, that also needs cholesterol to be made, utilizes those resources and shunts them away from testosterone production.
Therefore, it’s important to consider just as many viable contributing factors to mood concerns (e.g., life event, poor sleep, substance abuse) as well as low testosterone.
There are many organ systems involved in testosterone production and how it’s metabolized, though nutrition and lifestyle are imperative for a foundation if someone prefers non-pharmaceutical therapies as supplements will then supplement, not replace, an unhealthy lifestyle.
Nutritionally, dark leafy green and cruciferous (e.g., brussels sprouts, cauliflower, broccoli) vegetables contain many important vitamins and minerals for hormonal and neurotransmitter health, and great for liver and gut health (most of our serotonin is made in the gut).
Healthy fats provide the building blocks of sex hormones; so also emphasize foods like fish (wild caught), olive oil, coconut oil, nuts, and avocado, all of which also help balance blood sugar, heart health, and more.
More specifically, zinc is an important mineral to improving* testosterone levels (though unsure of exact mechanism) and found in foods such as pumpkin seeds, and sesame seeds.
Sleep is imperative to allow our body to synthesize new experiences and memories, as well as regenerate and renew. Our cortisol is highest in the morning (around 6-8am) and declines throughout the day as melatonin, our body’s most potent endogenous antioxidant, begins to rise and eventually puts us to sleep.
Optimal production is between 11pm-3am, so ideally be in bed before then, and achieve about 7-8 hours of sleep, otherwise underlying chronic elevations of cortisol eventually add up and affect many aspects of health and wellness. Regular exercise, especially strength training, has also been shown to boost* testosterone.
Environmentally, switching to clean products (e.g., cleaning products, beauty products), further helps eliminate* the strain of toxins and stress from altering hormone balance.
Supplements can be effective options, especially when working with a knowledgeable practitioner who understands the various forms and doses, as well as how they are combined to specifically relate to the individual.
Optimized vitamin D levels, around 50 ng/mL, are closely linked to improved* mood and hormonal health, so best to get levels tested and supplement as needed, as it’s difficult to get enough through food or being outdoors. B vitamins and magnesium are involved in over 1000 reactions in the human body, many of which are co-factors for making hormones and neurotransmitters.
Herbally, Astragalus root is very nutritive, can boost* testosterone, and improve* overall healing and blood sugar concerns. Ginkgo biloba may benefit those whose sexual dysfunction is due to depression because it promotes* circulation, neurotransmitter, and nitric oxide (expands blood vessels) effects, and boost* testosterone levels.
Tribulus Terrestris is a very common herb that may boost* testosterone, like Longjack root (commonly known as ‘Tongkat Ali’), which can also help improve* sports performance, in turn being of further benefit to increased testosterone and mood levels.
Passiflora is another herb that serves a two-fold purpose in raising testosterone levels and potentiates GABAA receptors to create a calming effect. Moreover, it contains chrysin (bioflavonoid), which inhibits the conversion of testosterone in men and women and enhanced* by piperine, an extract of black pepper. 
There are many other remedies that may indirectly or directly boost* testosterone and mood, but the underlying reasons may be different for everyone.
Discussing concerns with a knowledgeable healthcare professional will also afford the ability to have an individualized plan that accommodates the main issues and risk factors, as well as potential herb/drug/nutrient interactions.
The body is interconnected in a myriad of ways and why disease occurs is usually not as straightforward one expects (goes beyond searching a single symptom). However, many of the strategies implemented help address overall health and double as preventative care.
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