Low Testosterone? It's not that simple!

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  • Published on Jan 30, 2013
  • www.DrKrupka.com Dr. Patrick Krupka takes a look at male hormones from a functional medicine perspective. He explains the implications of testosterone, DHEA, estrogen, DHT, pregnenolone, androstenedione, cortisol, progesterone, and cholesterol in male hormone balance and low testosterone or "low T". Before you consider bio-identical hormone replacement, or supplemental testosterone, you should understand the functional medicine approach to assessing male hormones. You can also check out his books on Amazon at www.amazon.com/author/drkrupka
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Comments • 240

  • Tom Provan
    Tom Provan Month ago

    excellent video could you recommend a book or books on this thanks

  • PSSD PPDSD
    PSSD PPDSD 2 months ago

    Thanks

  • Mr. X
    Mr. X 3 months ago

    Excellent video..

  • D.A. GAMER
    D.A. GAMER 4 months ago

    wtf???? e2 is more important than testosterone for men. ur so behind

  • Trevor Odom
    Trevor Odom 4 months ago

    Have you ever heard of a vasectomy affecting this? My testosterone levels went from 900 to 300 within 2 months and the only thing I can relate is I had that done in between the levels were checked

  • Andrew Mitchell
    Andrew Mitchell 6 months ago

    Try redoing this video with the volume turned on. Smh

  • Tomi Borisov
    Tomi Borisov 8 months ago

    very helpful! thank you

  • Richard Williams
    Richard Williams 8 months ago

    It's so complex

  • eden adam
    eden adam Year ago

    THIS CHART DOES NOT HELP A LAY PERSON ! AND STILL YOU DID NOT STATE THE REMEDY TO STOP CONVERSION THE TESTESTERON TO DHT !! SO HOW TO STOP THE OCNVERSION TO DHT? AND DHT IS VERY IMPORTANT TO HEALTHY SEXUAL LIFE ANYWAY!! HOW TO STOP THE CONVERSION OF TESTESTERON TO DHT WITHOUT THE SYMPTOMS OF SEX DYSFUNCTION AND PROSTATE SWELLING AND UNRINARY PROBLEMS? WHAT IS THE REMEDY? YOUR EXPLANATION IS TOO TECHNICAL AND DOES NOT HELP !! AND: WHY DHT BECOME PROBLEMATIC AFTER 40 OR SO?? HOW TO STOP THE INCREASE IN DHT ? HOW TO CONTROL THE PRODUCTION OF 5 ALPH REDUCTASE FROM GOING ABOVE THE NORMAL LEVEL?? HOW TO STOP THE FORMATION OF EXTRA DHT?? PLEASE GO IN EASY LANGUAGE TO THE POINT!! YOU EXPLANATION IS SO CONFUSING AND DIFFICULT TO FOLLOW FORM A LAY PERSON!! PLEASE ADVISE OF THE REMEDY OF HOW TO STOP FORMATION OF (EXTRA) DHT?

  • Pan Vel
    Pan Vel Year ago

    Is it possible to have high Free Testosterone level and very high SHBG at the same time? Lab-test results: FreeTestosterone17pg/ml and SHBG 163.9 nmol/L. Total Testosterone 951ng/dl What do you make of this info?

  • Bobby Dukes
    Bobby Dukes Year ago

    Where does coffee/caffeine fit into this?

  • Borabora Bora
    Borabora Bora Year ago

    Overactive thyroid and underactive thyroid lower your testosterone level and killed your libido and lower your dopamine level! I got Graves' disease this bloody disease killed my sex drive

  • awat ahmad
    awat ahmad Year ago

    Hi doctor , i'm married 29 yrs old, i'm suffering from low T for more than 5 yrs, i take testosterone injection every month for more than 3 yrs bu still i have a low T, please what can i do, show me a way out, this video was very interesting, what shall i do, which investigations shall i do?

  • Paul R
    Paul R Year ago

    So do you recommend an AI if you convert to much testosterone to oestradiol, iam talking if you are on trt, and do you recommend taking hcg to back fill up stream hormones or is that not nessasary to do so if your on trt.

  • Anthony Shaw
    Anthony Shaw Year ago

    EXCELLENT!!!!

  • mason ward
    mason ward Year ago

    What's the logic behind not aromatizing enough estradiol? My current problem

  • Bill Asmar
    Bill Asmar Year ago

    Brilliant. Subscribed. Many thanks

  • Kurtis Coleman
    Kurtis Coleman 2 years ago

    do you have any vids about failure to go through pubity

  • jakenasty100
    jakenasty100 2 years ago

    huh...pretty vague with lots left out. Dr.? or chiropractor? I call good effort

  • Bobcatt22
    Bobcatt22 2 years ago

    A great contribution into the understanding of the relationship within the cascade and the pathway. I would like to see a diagram of this as a down-loadable file.
    There is no mention about bound/unbound testosterone. You can have plenty of testosterone but if it is bound, you are not able to use it. Thank you for your presentation.

  • Larry Rose
    Larry Rose 2 years ago

    I have sleep apnea. I had a pituitary tumor respected. I have low testosterone results. What course of action do I take?

  • Harshu Jiwani
    Harshu Jiwani 2 years ago

    sir how to reduce estrogen plz reply

    • Raymond Carter
      Raymond Carter 2 years ago

      Lose Weight
      DIM
      Calcium D Glucarate
      White Mushroom Powder
      Resveratrol
      Grape Seed Extract
      Arimidex (Rx)
      Aromisin (Rx)

  • mutonya ngoma
    mutonya ngoma 2 years ago

    that's educational

  • Vinay Chavan
    Vinay Chavan 2 years ago

    hello.... am from mumbai.... i have low testosterone i.e. 3.13 ng/ml and
    normal values are 4-9 ng/ml.... My doctor did not go for hormone
    replacemnet.. he just gave me CHOLECALCIFEROL TABLET 60,000 I.U. . 1
    TABLET A WEEK FOR 7 WEEKS. AND AGAIN ASKED ME TO DO A TEST AFTER 2
    MONTHS.... I ASKED HIM WILL IT INCREASE TESTOSTERONE HE SAID YES....I
    WENT TO ENDOCRINOLOGIST AND HE IS A GOOD DOCTOR.. WHAT DO YOU THINK
    WILL TESTO WILL INCREASE..???

  • wajid khan
    wajid khan 2 years ago

    what if you have hight dht and estrogen?

  • Conor Verbruggen
    Conor Verbruggen 2 years ago +1

    Brilliant. Subscribed. Many thanks

  • fitness_spirit
    fitness_spirit 2 years ago

    the best "Low T" video i have ever watched. great job Dr.

  • j77walker
    j77walker 2 years ago

    I'm 39. Test 459 ng/dL and free was 54.6 pg/mL. Had a crap ton of symptoms: brain fog, pms symptoms, miserable, no energy, sex is okay, also had enlarged prostate. Doc put me on DHEA. Started at 25 mg up to 100mg. Got freaked out after learning some of this and started cutting DHEA back by 25mg. I'm now at 75mg and having hot flashes like a menopausal woman. I am miserable and am realizing my doc did NOT do enough bloodwork. Very frustrated. And.....hot!

    • Luke Loving
      Luke Loving 2 years ago

      You may want to experiment with Pregnenolone. Pregnenolone has a better chance of converting to Testosterone downstream - DHEA over 10mg can likely convert to Estrogen...which is what your symptoms sound like. You should look into Dr. Ray Peat's work...he got me back on the right track

    • j77walker
      j77walker 2 years ago

      Thanks man, I'm doing everything I can. I had to cut the DHEA altogether, man I was having serious hot flashes. I added choline to the mix and that helped with energy. Prostate is giving me fits every now and again, so I'm guessing more may be going on than I know, possibly restricting blood flow or something? I'm not a gym rat but I've started working out, best I know how, and I'm hoping that will help me some as well. Sex drive is really starting to tank which sucks because that hasn't been affected as badly as my energy levels.

    • 40 Lifter
      40 Lifter 2 years ago

      j77walker Hope you start feeling better bro. I have been feeling like crap for awhile and recently had my blood work done. Everything looked good (cholesterol, vitamin d etc) test is 280 though so I have a appointment soon with a urologist for treatment. I am 39 years old and a gym rat. Never taken drugs or anything.

  • chiko's beats
    chiko's beats 2 years ago

    Hallo..i became bipolar after using steroids in 2000...now if i am away from the gym for a while, when i start again i first feel awesome (think hypo mania) and balloon for like 3 days, then my bipolar agitation kicks in and i feel terrible then i start to lose strenght and that initial balloon size i gained goes down....i have a decent amount of fat, that i never had before taking the steroids

  • Bill Gates
    Bill Gates 2 years ago

    how to you increase DHT without getting high female hormones

    • Raymond Carter
      Raymond Carter 2 years ago

      Butea Superba, Sorghum Extract, Creatine, Boron.

  • Ironman4321wow
    Ironman4321wow 3 years ago +4

    I believe that most young guys with low testosterone can simply raise their testosterone back up to high levels by reducing stress. I had low testosterone all through my teen years and early 20's due to overtraining/adrenal fatigue. I had a ripped body as well. Once i stopped working out hard, & started eating a lot of good high calorie foods & sleeping better my libido & quality of life skyrocketed. I feel better at 25 than i ever had before simply by being healthy.

    • Pete
      Pete 2 years ago

      What if your already healthy and your suffering these symptoms and your T level is below normal?

    • MooseNGoose
      MooseNGoose 2 years ago

      what i need to know if there is any tests to find out if i have over training, i started a program where i would play handball and workout in the gym and in the past 2 years lost about 130 lbs, but i always just felt beat up from the workouts and just feel like crap overall so far the only thing i found out is my Testosterone is at 190.

  • Anthony Llabres
    Anthony Llabres 3 years ago +1

    Artificial light, blue light, lack of sun/vitamin A huge playes here

    • Bill Bates
      Bill Bates 5 months ago

      When I lived in Greece, my testosterone was high. Now it's lower. I live in NY now. I only returned here 3 years ago. The sun in Greece, the light it gives off is ridiculous. It's difficult to even open your eyes most of the times, then of course is the food, which does not have all the garbage chemicals and hormones it does here in the states. I plan on retiring to Greece in 5 years. Living in the states is extremely anti-androgenic.

  • LEAVINGWEAKNESS
    LEAVINGWEAKNESS 3 years ago

    If you are considering wasting your money on a test booster, please read this article first. leavingweakness.com/ashwagandha-review/
    Studies have basically disproven the effectiveness of tribulus and the overall results of DAA are scientifically considered 'questionable' at best. Ashwagandha is the only natural supplement that has the solid data to prove its effectiveness at raising testosterone levels.

  • Hisword IsTruth
    Hisword IsTruth 3 years ago +2

    I am wondering if I need estrogen blockers.

    • fitness_spirit
      fitness_spirit 2 years ago

      hi.. i am 34 years old and my total T level is "3.5" ... i have some symptoms of Low T.
      my body fat is 36% . i am thinking to use something like "proviron" along with weight lifting exercise, to block the estrogen effect and helps me losing more body fat. could you please advise ?

    • Avner Chaim
      Avner Chaim 3 years ago +1

      Thanks man. My test is stuck to SHBG for sure. I had health issues my whole life so I figure my SHBG and been elevated a long time. Was considering TRT but my serum levels are too high to qualify I'm thinking. Thanks man I'll have to wait and see what my Doc says.

    • Anthony Llabres
      Anthony Llabres 3 years ago +1

      Hey Vince. Simply low free would not tell the entire picture and not be the sole causative factor for a prImary or secondary diagnosis. A physician would also look at FSH and LH levels. A good physician will also run CBC, CMP, DHEAs, Prolactin, Estrogen panel, organic acids panel, iron panel, MMA, esr, hs crp, shbg do a zinc challenge etc. There are many pieces to this puzzle to include constantly being exposed to PCs and TVs, lack of Vitamin A, Zinc, Cholesterol etc. If your Free T is low it can be bound by SHBG. WHAT'S and WHY'S are important and insulin resistance is certainly a big player. One strategy is to use ketosis strategically to reverse insulin resistance. Long story for sure. But a good practitioner or physician can really make a huge difference in your life. I use the DUTCH test with my folks so I can see the phase 1 and 2 detox pathways to include cortisol and androgen metabolism. All these are tools so we can later make DIET, REST, EXERCISE, SUPPLEMENTATION AND stress reduction changes.

    • Avner Chaim
      Avner Chaim 3 years ago

      Hey Anthony if total T is normal say about 579 but "free" test is low does that qualify as hypogonadism? Or do I need to have a gonad or pituitary issue ?

    • Anthony Llabres
      Anthony Llabres 3 years ago

      And zinc

  • Hisword IsTruth
    Hisword IsTruth 3 years ago

    I suffer from testosterone in the upper 200s horribly low. I have major back problems and I am taking 100 MG of morphine 3x a day. yes a lot. this causes my levels to drop this low. I would think I would need TRT until I get off these drugs which I doubt anytime soon if I want to walk. I'm not doing AN OTHER surgery and become worse because my next step is fusion surgery...I'm not doing it if I have a choice.

  • Charlie Watts
    Charlie Watts 3 years ago +1

    I am 5 points above the level to be considered low Dr. But I haven't woke up with an erection in the past 7 years. I have done the gel , and the patch. When I am aroused I can't maintain it. I don't know what else to do and neither does my Dr.

  • Amandeep Karir
    Amandeep Karir 3 years ago +1

    OK so I have an important question. If your body goes both ways and produces some DHT and then Estrone/Estrodiol. How to you keep both in balance and keep a good testosterone level? Like naturally how do you reduce DHT and estrone/estodiol. Without taking finasteroide to destroy DHT. Can you take Saw Palmetto and Myomin. Mymin for Estrogen balance and Saw Palmetto for DHT balance?

  • Jin Jian Chia
    Jin Jian Chia 3 years ago

    Insightful. Thank you!

  • Leslie Jones
    Leslie Jones 3 years ago

    ginger raw heals this issue

  • Ed Mahone JR.
    Ed Mahone JR. 3 years ago

    most md's are dumber than a box of rocks ,when it concerns hormones and nutrition. dr krupka. is very knowledgeable on both

  • GnosisMan50
    GnosisMan50 3 years ago

    Any chance you will make a video on men of middle age who get hot flashes?

  • Jordan Oliveira
    Jordan Oliveira 3 years ago +1

    Does flaxseeds increase estrogen? And what about chia seeds?

    • MAGNIFICENT MASK
      MAGNIFICENT MASK Year ago

      yes and yes stop all nuts and seeds for a few months and u will see

  • Sarwar Alam
    Sarwar Alam 3 years ago

    i m 25 years old and my testosterone level is below(258ng/dl) where normal value is 270..i also have high levels of chlolesterol and triglysaraid..my fsh level is 3.98 and lh is 7.11(within is 7.6 regarded normal)...i have mumps at 15 and done usg of testis which is normal...my semen tells 60% of mortality rate with maturity(also good i guess)...when i go to doctor he told me it was nothing and gave me vita e tablet for three month and also told me to exercise... what should i do...i have gynocomatia lower body fat...memory problem..dipression...i masterbate every day...i have dispersed beard...what should i do...i have become very very slow...sometimes i feel so bad that i attemt to suicide...gimme some good advice... (my thyroid function is also normal)

    • hellogoodbye40
      hellogoodbye40 2 years ago +1

      you masturbate everyday. that is the problem.

    • Avner Chaim
      Avner Chaim 3 years ago +1

      Take a heavy metal toxicity hair test and make sure your heavy metal counts are low. Low thyroid causes depression, low test and suicidal thoughts. High heavy metal count= slow thyroid.

    • Jordan Oliveira
      Jordan Oliveira 3 years ago +2

      Try using tribulus terrestris, maca root, and increase your intake of healthy fats, like egg yolks and coconut oil. Reduce your intake of suggar, alcohol, soy products, plastic containers, stress. And sleep more, with no lights on., and do squats and big muscle groups.

  • Hans Wurst
    Hans Wurst 3 years ago

    How is it possible to have low testosterone, too high DHEA, little too high cortisol and low or normal estrogen/estradiol... it does not make any sense to me. Maybe you have an answer. Genetic issues?

  • Louis Carroll
    Louis Carroll 3 years ago +1

    Great video! I have been working in this area for years, and I discovered that a prominent issue among aging males is their inability to get the cholesterol into the mitochondria for conversion into, ultimately testosterone. The problem is cyclooxygenase 2 (COX2) indirectly reducing acute steroidogenic response protein. This is why we find elevated levels of Luteinizing hormone, but low T levels. The solution was certain food extracts that work to reduce COX2 in the leydig cells. I've seen many examples of men in their 60's who go from 450 to 1000 ng/dl in total T within a month of taking my "Time Machine" nutritional mix. It tastes horrible, but the results have been astounding. This is turning out to be a real alternative to HRT.

  • Neil Linehan
    Neil Linehan 3 years ago

    Great video man, very informative.

  • Canadian Eh Brewer
    Canadian Eh Brewer 3 years ago

    I just started on androgel 1% ...Had Low T all my life .....won't get into details ....but after the first 4 days of 3 pumps (3.75g) 37.5 mg I have felt bloated and gassy, brain fog, and major anxiety..... and nervousness .....I then stopped for a couple days and now I feel great .....I hope my Doc knows what he is doing .....My guess is that much of the T in the gel cranked my Estradiol levels .......hopefully when I go to see him he understands .....He also never told me why my levels might be low .....My FSH was 1 IU/L and my LH was 2 IU/L .....Prolactin 5 ug/L and free test 136 pmol/L .....looks like secondary hypogonadism to me ...... My last labs were also showing vitamin D at 39 nmol/L ....just wondered what your thoughts were .....

  • A Babbit
    A Babbit 3 years ago

    I have watched other videos on RU-clip where there is a potential for a "Pregnenolone Steal" if your Pregnenolone is low. So, if you take DHEA and your Pregnenolone is low, the DHEA will be converted to Pregnenolone to support the Pregnenolone branch process. Is this possible? If so, should someone who is taking DHEA also take a small amount of Pregnenolone to ensure no "stealing" of DHEA is happening? BTW, I am 60 and once I started taking DHEA, I was able to workout with weights again and have lost weight. Before DHEA, I was depressed and could not do 2 push ups - literally. My joints hurt and now they don't with DHEA supplementation. I take between 50mg to 100mg of DHEA daily. I am thinking of adding 50mg of Pregnenolone.

  • nathaniel aranole
    nathaniel aranole 3 years ago

    Doesn' t Progesterone reduce DHT though?

  • nyGIANTS
    nyGIANTS 3 years ago

    i need to speak with you privately please. my docs dont understand

  • Derrick Glass
    Derrick Glass 3 years ago +1

    androgel got me to 300 test I got test level over 500 by working out and tribules tetris, vitamins, fenugreek & calcium magnesium zinc supplement. but my low t from a injury. im 38 6,3 180 been on the A-gel 10 yrs

  • Derrick Glass
    Derrick Glass 3 years ago

    This really helped me understand why Ive had the problems I've had and very low testosterone around 70 before androgel now over 500 on androgel 1.62 40mg a day. Great video

  • Constantin Jenson
    Constantin Jenson 3 years ago

    Hey Dr. Patrick.
    How can i contact you personally so i could send you my Testosterone Level Blood Test, i have some issues.
    Thank you

  • Ed Arnold
    Ed Arnold 3 years ago +9

    Good video! But I didn't hear anything about thyroid. There is a lot of thyroid problems these days from crappy food and pollution, and as I know from personal experience, correcting thyroid can have a huge positive effect on hormone production.

    • Ed Arnold
      Ed Arnold 3 years ago +1

      Make sure you're not going to a doc who uses only TSH for diagnosis. The full suite TSH,FT3,FT4,rT3,TPOAb,TGAb should be used to diagnose primary hypothyroidism and Hashi's. After huge diet changes (esp. gluten free), along with adding DHEA, T3, and T4 ( NDT can be used in place of T3+T4), I'm doing quite well. No, I don't have to take T ... keeps it simple.

    • Jay Cutler
      Jay Cutler 3 years ago

      I have hypothyroidism and low testsosterone.. I just got diagnosed last week, anything i can do to help?

    • DrPatrickKrupka
      DrPatrickKrupka  3 years ago +2

      +Ed Arnold, You're right...but thyroid wasn't the subject of that video. If you look through the other videos I have posted here there are three or four that go through thyroid problems in detail.

  • JPD
    JPD 3 years ago

    I'm 35 and I'm 5'9" and 165. I work out 4 days a week and I'm always horny and no problems with erections but my test was just measured at 285. I'm totally confused as to how I can be so low but I'm in good shape and no sexual problems.

    • DrPatrickKrupka
      DrPatrickKrupka  3 years ago +1

      +neodeville You might not be that low...as I mention in the video, I use saliva testing for that very reason...it gives a better view of the hormone actually available to the cells...not just what's floating around in the blood.

  • Russle Crowe
    Russle Crowe 3 years ago +2

    You're the man, thank you so much for this informative video!

  • Lorenzo Rivera
    Lorenzo Rivera 4 years ago +1

    Excellent explanation! Thank you!

  • johnny.w
    johnny.w 4 years ago +1

    Excellent presentation. I wish my schooling was this good. Thanks.

  • Saïd
    Saïd 4 years ago

    Hey Dr, your video was very informative, thank you for making this video!
    However, I have a question regarding the conversion of testosterone to DHT, would there be any type of behaviour/diet that would promote that conversion? And is there a way to mitigate that conversion naturally? I would really appreciate it if you could help me on that aspect, thank you!

    • Saïd
      Saïd 3 years ago

      thank you for the update!

    • DrPatrickKrupka
      DrPatrickKrupka  3 years ago

      +bowss111, That conversion is done by the aromatase enzyme...it is promoted by sugar intake, stress, high % of body fat, and certain environmental toxins. To slow the conversion many people use a paleo-ish diet, interval exercise, and liver support.

    • DrPatrickKrupka
      DrPatrickKrupka  3 years ago

      +bowss111 Many people have used good quality Saw Palmetto, or Chrisyn to slow the conversion. Cruciferous veggies speed the removal of estrogen through the liver, and a diet high in refined sugar is a huge promoter of the conversion to DHT and estrogen. Also having a high % of body fat increases those same conversions.

  • director92110
    director92110 4 years ago

    If you're a guy over 60 and do weight training does that make a difference in what path the andro takes [testosterone or estrone], the amount of andro or testosterone that's converted to estrogen, or the build up of DHT?

    • DrPatrickKrupka
      DrPatrickKrupka  3 years ago

      +director92110 Yes, it can definitely make a difference, but that difference is not entirely predictable...it needs to be tested to be verified.