"I love my beer belly and man boobs", said no man, EVER! However, the reality is that men age, they witness their bodies morphing into something that they no longer recognise, and they are not entirely sure how they got there.
Well, the best place to start is in understanding that it isn't just because of all those beers (although they did play their part), but a lot more to do declining testosterone and increasing estrogen. Yes, men have estrogen too.
Where to start
Measure your waist to hip circumference - if your waist measurement is greater than your hip measurement, then you have a beer belly which is an estrogen factory that could result in you being estrogen dominant. Time to take charge!
In Functional Medicine, we talk about hormones using the acronym PSTD (Production, Transport, Sensitivity, Detox)
|Production||This refers to where in the body the hormone is made. If there is an issue here, then you may not be producing enough of the hormone.|
|Transport||This refers to how the hormone is transported to the target tissues. If there is a problem with the blood proteins responsible for this task, then the target tissues may not receive enough of the hormone.|
|Sensitivity||This refers to the cellular response of the target tissue to the hormone.|
|Detox||Once the hormone has done its job, it needs to be detoxified through your liver, to bile to be excreted. It is often here that we pinpoint lots of issues.|
A "breakdown" or weakness in any one of the above can result in hormone imbalances.
The role of genetics
It is great to start with a DNA test so that you can determine, based on your unique genotype, how well you produce, transport, receive and detox your hormones. Having information on your unique DNA and biochemistry will help you personalize the above choices and take the ‘guesswork’ out it!
These are the key genes that we look at to determine your genetic predisposition to hormonal imbalances:
|Production||FSHB||The FSHB gene controls the production of follicle-stimulating hormone subunit beta (FSHB) in the brain (pituitary gland) which, in combination with T, drives sperm production and development in the Sertoli cells of the testicles.||VitaMEN|
|Production||HSD3ß2||HSD3ß2 belongs to the HSD family of enzymes that are involved in the production of various steroid hormones, particularly androgens. HSD3ß2 is expressed almost exclusively in the adrenal glands and testes and is thought to be involved in regulating systemic (circulating) androgen levels.||VitaMEN|
|Transport||SHBG||The role of SHBG in the body is to bind the hormones T, DHT and estrogen to carry them in the blood to target tissue. While bound to SHBG, hormones are inactive.||VitaMEN|
|Sensitivity | Receiving tissue||5aR1||5aR1 (also known as SRD5A1) is an enzyme responsible for converting T into DHT mostly in tissue outside of the prostate such as the adrenal glands, brain, skin, digestive tract, liver, kidney, and thyroid.||VitaMEN|
|Sensitivity | Receiving tissue||5aR2||5aR2 (also known as SRD5A2) is an enzyme responsible for converting T to DHT in target cells, particularly the prostate and testes.||VitaMEN|
GSTM1 (Glutathione S-transferase M1) is the most biologically active member of the GST superfamily and is involved in Phase II detoxification in the liver. It is responsible for the removal of xenobiotics, carcinogens, and products of oxidative stress by conjugating reactive intermediates with glutathione to produce less reactive, water-soluble metabolite that can be readily excreted.
Oxidative stress is a risk factor shared by most disorders, and it appears that the efficiency of the GSTP1 enzyme may have an impact on the development and prognosis of diseases influenced by oxidative stress. GSTP1 is the most abundant glutathione-s-transferase subtype in the lungs and is known to metabolise many carcinogenic compounds.
The MnSOD or SOD2 gene is vital for antioxidant activity within the cell, especially within the mitochondria. It encodes the genetic pathway responsible for scavenging 'oxidants' (free radicals) and protects cells against oxidative stress. Oxidants can cause DNA and cellular damage, leading to an increase in oxidative stress (high amount of oxidants and their resulting damage). This biochemical action has been linked to accelerated ageing.
One of the most well-researched genes, your MTHFR gene provides instructions for making an enzyme called methylenetetrahydrofolate reductase. This enzyme plays a role in processing amino acids, the building blocks of proteins
The UGT2B15 gene encodes an enzyme responsible for glucuronidation, a phase II metabolic reaction that transforms small lipophilic molecules into water-soluble, excretable hormone metabolites.
Men's Hormones 101
Generally speaking, understanding hormones can get a little confusing, even for me! Why? Because your hormones are your body's communicators and they are all elegantly interconnected in a beautifully, complexed symphony and sometimes it's difficult to pinpoint who is out of tune!
So, let's try to interpret this "music sheet".
Testosterone is the main steroid hormone in men responsible for sex drive, enlargement of the penis, sperm production & development, increased muscle mass, fat distribution, red blood cell production and lowering of the voice. Most of the testosterone in men is produced in the testes, while a smaller amount is made by the adrenal glands. That is "why" too much stress and cortisol steal can result in your hormones going out of balance. Cortisol steal robs your body from all the important precursor hormones pregnenolone and DHEA involved in testosterone production. If your DHEA level is low, it may mean that your adrenal glands are not making enough hormones. This can be because of too much, prolonged stress.
Luteinizing hormone (LH) and follicle-stimulating hormone (FSH) are two hormones produced in the brain which stimulate the production of testosterone and sperm respectively. Once produced, testosterone is bound and transported in the blood by the protein, sex hormone-binding globulin (SHBG). To become active, testosterone must be released from SHBG and bind to androgen receptors (ARs) in target tissues. Testosterone is also converted into two other important hormones: 5adihydrotestosterone (DHT) and estrogen. DHT is about 3-5 times more potent than testosterone because it binds more strongly to the ARs.
While DHT is important for developing and driving normal male characteristics, its strong androgenic action is also responsible for increased hair growth and eventually loss, acne, and enlargement of the prostate gland in later life and therefore to needs to be kept in check!
What if testosterone is out of tune?
Testosterone levels above or below the normal range are considered by many to be out of balance.
The main culprits are:
Ageing: Advancing or even premature ageing is associated with an increase in aromatase, the enzyme that converts testosterone to estrogen. Older men can actually have higher estrogen levels than postmenopausal women! Making daily choices that support ageing well can definitely prevent this. These include making nutrition, supplementation, environment and lifestyle choices that increase antioxidants, reduced inflammation, help with stress transformation, support healthy detoxification and methylation.
Increased fat relative to muscle: A loss of lean muscle tissue and an increase in fat tissue also typically occurs with advancing age, as well as with metabolic disorders such as obesity and type 2 diabetes. Fat tissue contains aromatase which converts testosterone to estrogen. Fat also serves as a reservoir for storing estradiol. Both of these factors lead to increased estrogen levels in men. Research has shown that 30 mins of cardio every day can help prevent these types of lifestyle-related chronic diseases by 50%. However, we now know that this ‘one size fits all’ approach is no longer valuable and that the type and intensity of exercise required are dependent on your unique genetic variations for fat storage.
Testosterone therapy: For all the gym bunnies. Men who are treated with injectable forms of synthetic or bio-identical testosterone can make too much estrogen! If you have medium to high impact genetic variations for the key genes involved in estrogen metabolism, you may find that you are not a candidate for the type of therapy. If fact, you could place yourself at risk for nasty problems such as estrogen positive prostate cancer.
“Faulty feedback”: Once a man has too much estrogen in his system, a vicious cycle can ensue in which the high estrogen levels lead to a faulty feedback system, tricking the brain and testes into producing even less testosterone. This can lead to even higher levels of estrogen and more severe estrogen dominance, magnifying the high estrogen symptoms.
What if estrogen is out of tune?
There are many causes of high estrogen in men – from medium to high impact genetic variations in key estrogen metabolism and detox genes, to being overweight (fat makes estrogen), to the increased exposure to xenoestrogens from highly-processed and preserved foods, unfiltered tap water and men’s beauty products that have chemical ingredients that are known to cause DNA mutations and endocrine disruption.
Men produce estrogen in their adrenal glands and testes. During their teens, these levels are low, with testosterone being higher. However, as men age, testosterone can decrease and estrogen increases.
Testosterone will begin to convert to estrogen in men as they age due to the aromatase reaction. Aromatase is found most prevalently in fat cells, so the more body fat a man has, especially around the tummy area, the more aromatase and hence the more estrogen. It becomes a bit of a vicious cycle with a beer belly becoming an estrogen factory that makes more fat!
Due to the ‘estrogen-izing’ of the world, men are exposed to estrogens in their food, water, and personal care products! The metro man is being exposed to many chemical ingredients in his beauty regime. Research has shown that these chemicals act like estrogens in the body, raising the levels of estrogen in men and boys. This is one of the biggest culprits of ‘man boobs’ or ‘moobs’ (the correct name being Gynecomastia).
What are the signs of being out of tune?
It’s important to note that when testosterone is low, your estrogen level may still be within the reference range, however, it will be dominant over testosterone and this could still result in you having estrogen symptoms.
If you are in an estrogen dominant state or have too much estrogen, you run the risk of stimulated breast tissue growth as well as erectile dysfunction (ED).
So what does estrogen do in males? The most common symptoms of high estrogen in men include these eight:
- Sexual dysfunction (low libido, decreased morning erections, decreased erectile function)
- Enlarged breasts
- Lower urinary tract symptoms associated with benign prostatic hyperplasia
- Increased abdominal fat (can also be a symptom of low estrogen)
- Feeling tired
- Loss of muscle mass
- Emotional disturbances, especially depression
- Type 2 diabetes
As you can see from the list above, men with too much estrogen aren’t just at risk for non-serious symptoms like decreased sexual function and enlarged breasts. They are also at high risk for more serious problems such as type 2 diabetes.
The latest research shows that increased diabetes risk is independent of testosterone levels—that is, high estrogen raises diabetes risk whether testosterone is low or not. High estrogen in men also increases the risk of prostate cancer and autoimmune diseases.
Surprisingly, you can also have too little estrogen and suffer from symptoms of estrogen deficiency.
Men with decreased estrogen showed higher levels of the type of intraabdominal fat known to increase the risk of cardiovascular disease, diabetes, and metabolic syndrome. Men with estrogen deficiency also have decreased bone strength, hearing loss and are at increased risk for fractures.
So, as you can see it is more about balancing these two hormones – testosterone and estrogen – limiting the estrogen coming in from the outside in the form of toxins and then making sure that you metabolise them well and get them out of your body.
It's a good idea to know what healthy hormone levels should be in men. This table is helpful:
|Estradiol||21.80 - 30.11 pg/ml|
0.3 to 2 pg/ml (0.1 to 0.3% of your total testosterone levels)
|Total testosterone||300-1070 ng/dL with an average level of 679 ng/dL. With 300 being the cut-off point for being low|
Ages 18 to 19: 108 to 441 µg/dL or 2.92 to 11.91 µmol/L. Ages 20 to 29: 280 to 640 µg/dL or 7.56 to 17.28 µmol/L. Ages 30 to 39: 120 to 520 µg/dL or 3.24 to 14.04 µmol/L
I recommend the DUTCH COMPLETE for checking the above:
Good nutrients for getting back into tune
Fortunately, making better diet, supplement, environment, and lifestyle, choices can help you achieve this “in-out’ equation:
Here are general recommendations, we believe that you should develop your own personalised plan from your DNA up!
- Eat cruciferous vegetables multiple times per week. Cruciferous vegetables, such as broccoli, cauliflower, cabbage, Brussels sprouts, bok choy, and turnip greens, contain high amounts of glucosinolates, which the body transforms into bioactive compounds that help to decrease estrogen activity and increase estrogen detoxification.
- If you can’t eat enough of these veggies daily, then we recommend that you supplement with sulforaphane, indole-3-carbinol (I3C) and 3,3′-diindolylmethane (DIM).
- Get enough vitamin B12, folate, betaine, and choline. These nutrients, known as methyl donors, help to improve the biochemical process known as methylation, which is an important function in estrogen metabolism and detoxification. Good dietary sources include meat, fish, shellfish, eggs, spinach, beets, and quinoa. We also recommend a daily green juice or smoothie containing these nutrients.
- Increasing fiber, exercising, and reducing weight are also important natural treatments for reducing high estrogen symptoms in men.
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If you would like some help in putting this incredible "hormone orchestra" together, I would be happy to help you to set better health and diet goals for optimal hormone health.
CEO of MY DNA CHOICES
BA (Speech, Hearing & Lang Therapy) Hons | FMCHC | ReCODE Coach | Men's Health | HMX Genomics & Biochemistry (Candidate)