Testosterone Replacement Therapy & Fertility (Side Effects of TRT)

Hey everyone, welcome to the Dr. Josh Axe Show. I am your host, Dr. Axe, and each and every week I explore the science and principles and how to grow in body, mind, spirit, and take your health and your life to the next level. On today's episode, I'll be sharing the research behind TRT, that's testosterone replacement therapy, the side effects, and the natural ways to boost testosterone.

This is an important topic for men especially, also women. By the way, in a future episode, I'll be covering Hormone replacement therapy for women, my views on that, and some natural things you can do. I do want to mention testosterone replacement therapy is actually a contraceptive and lowers sperm count greatly, leading to male infertility, which is already on the rise.

Before we dive into all the content though, make sure to subscribe to the channel and hit the notification bell so you don't miss a single episode. Now, here's the reality. In midlife, testosterone levels start to slowly dip at about a rate of 1 to 1.5% per year for men. But for an increasingly large number of men, the drop is more rapid than that.

According to a 2022 study, population-wide testosterone is decreasing. On average, testosterone levels in men aged 15 to 39 years old saw a 25% decrease in just 15 years. And men in their 20s today have the same levels of testosterone as men in their late 60s in the 2000s.

In this chart, you can see the testosterone levels in the US being that sort of mid-600, about 650 range, dropping now down to the closer to 450 range, or actually closer to 400 and lower. So we see this dip consistently over time. I do want to mention in a previous episode I covered the testosterone decline and get into more depth of exactly why it's happening.

And part of it has to do with the hormones in our food supply, endocrine disrupting phthalates, uh, you know, BPAs, all of these toxins in our environment and in our food. Uh, and you can click, uh, at the top of the screen if you want to watch that right after this episode. But Your, your testosterone levels, here's the reality, when they start to drop, here are the most common symptoms you have.

And so for instance, you might be watching this and you've never had your testosterone levels tested, or you might be a woman watching this. And by the way, it's important to know your testosterone amongst estrogen and, and progesterone levels as well. But for men, you, you may have never had your levels tested. Well, here are some warning signs that you have low testosterone.

If you have exhaustion, you're just tired all the time. If you lack motivation, let's, let's say for instance, you should be more motivated, wanna go take on the world and, and do big things with your life, and you feel like, yeah, I don't really wanna do that. You just don't feel motivated. If you have a lot of sleep disturbances, you don't really sleep through the night.

If you have to constantly urinate or, uh, just basically just don't sleep well. Mood swings, increased body fat. Um, you start to, you know, just hold on more of that fat around your midsection. Decreased sex drive. That's another big one. So these are some of the biggest warning signs that you have low testosterone.

And TRT therapy is a type of hormone replacement therapy that supplements the testosterone that your body isn't producing. And this can be done with testosterone injections, topical creams, gels, patches, even dissolvable lozenges. So this is a form of hormone replacement therapy that many, many men are doing today.

The problem is there are major side effects, many of which men and women are not aware of, including acne or oily skin, worsening sleep like sleep apnea, breast swelling and tenderness, infertility due to a decreased sperm count, shrinkage of the testicles, prostate disorders, and permanent loss of libido. TRT can decrease the number and quality of your sperm.

So sperm count slowly starts to decrease and can even reach zero after 2 to 4 months on TRT therapy on average. In one study, it took the participants 4 months to return to baseline and become fertile again, and 9 months for their sperm count to finally get back to normal. However, many men never got their sperm counts back to normal after testosterone replacement therapy.

Here's what most concerns me about testosterone replacement therapy. Research has shown that more and more men in their 20s and 30s are taking testosterone, and the studies indicate that men in their 20s doing testosterone replacement therapy Then have trouble having kids in their 30s. So TRT is causing male infertility.

And this is true, listen, if you're a male in your 20s, 30s, 40s, and you want to have kids sometime in your life, then you do not want to take testosterone replacement therapy. You have to know the side effects. You have to think about your future in that case. And here's the reality, there are natural things you can do.

Absolutely natural, that can increase your testosterone significantly, helping you feel more motivated, increasing your sex drive, increasing your energy, helping build muscle mass, and overall helping you get healthier. Because the studies also indicate if your body's not producing testosterone on its own, or if you have low testosterone, it can take years off your life.

So you really want to support your body in creating testosterone on its own. Yeah. Now, I want to go over some other side effects. In some cases, TRT can cause the body to overproduce hemoglobin and hematocrit, a condition called polycythemia or ethrocytosis.

And men on TRT have up to a 315% higher risk of developing polycythemia compared to those not on TRT, possibly because Testosterone increases EPO, a protein that stimulates red blood cell production in the bone marrow. And when there are more red blood cells, your blood becomes thicker.

If your blood becomes too thick and sticky, you're at higher risk of high blood pressure, myocarditis, blood clots, stroke, and heart attack. Now, we saw similar symptoms from this same thing happening with COVID or long COVID as a result of that as well. But TRT has that same correlation. Men on TRT also have almost a 4 times higher risk of obstructive sleep apnea.

And this can raise your risk for high blood pressure, heart attack, and stroke, which again, heart disease is the number one killer of men today. Now, here's, here's another major side effect. In up to 25%, think about this, this is 1 in 4 men. TRT can cause gynecomastia, making breast tissue grow, because TRT disrupts the estrogen-testosterone balance.

So now, because most people would think, well, I'm taking testosterone, it's only going to lead to more masculine qualities, but the reality is it actually can cause increased breast tissue. Because remember, here's the thing, certain areas of your body are getting more testosterone. Other areas are getting less, like your testes, because your body isn't producing it on its own anymore.

It's not happening on the inside. You're bringing it in from the outside, which is foreign to the body. So there are always going to be negative side effects. In addition, another major side effect of testosterone replacement therapy is your body believes that now you have plenty of testosterone, so it starts to dial down its own production of testosterone. So again, remember this.

When you take testosterone replacement from the outside, your body now says, oh, well, I'm going to stop producing it on the inside. And the pituitary gland doesn't release FSH and LH, so the testicles don't get the message to produce sperm. So essentially what happens is your testes stop producing sperm on its own, so your testicles shrink.

It's another major side effect that every male has when they get on testosterone. Testosterone replacement therapy. So I want to share some ways to naturally boost your testosterone levels. And I believe based on the advice I'm about to give you, you could double, triple, in some cases even more, increase your levels of testosterone naturally. And that's what you want.

You want your body naturally producing these things because when you take it on the outside, there are side effects. Your body doesn't produce it on its own. And it's— again, you don't want to be dependent on a medication the rest of your life. Because of all the side effects. So the first thing you want to do to increase your testosterone levels is get higher quality sleep.

Now, the ideal amount of sleep does vary from person to person, but there was a small study done in 2011 that found that if you sleep only around 5 hours a night, your testosterone levels will drop 10% to 15%. I believe it actually could be even higher than that, but getting quality sleep is important.

Another study found that men that slept over 9 hours of sleep or got about 9 hours of sleep had much higher levels of testosterone than others. And so we know getting that 8 hours of sleep to 9 hours of sleep or more is ideal for naturally boosting testosterone levels. Here's another thing you can do. Lift heavy weights 3 times a week.

Some of the ideal exercises to do in order to boost testosterone include squats, Deadlifts, rows, pull-ups, bench press, shoulder press, and planks. And these are exercises where you're using larger muscle groups, especially squats.

You know, doing something where you're using your butt and your legs, those, those, uh, those really, uh, qualify as your largest muscle groups, including your back after that. And so, and then your chest. And so doing things where you're working these larger muscle groups doing heavier weights will help you boost testosterone.

And listen, even if it's only 2 days a week for 30 minutes, you know, now the more the better, generally speaking. But again, lifting heavy weights, using large muscle groups is going to help you boost testosterone according to studies.

Now, I want to talk about something that blew my mind when I read it in terms of testosterone replacement therapy and recommendations by our government and the U.S. Department of Veterans Affairs. And again, here's the message: don't listen to the government when it comes to your health.

The U.S. Department of Veterans Affairs has an article in their Whole Health Library titled Improving Low Testosterone Naturally. Here's what they say. They suggested avoiding and eliminating red meat and other sources of animal fat and increasing consumption of soy products. They specifically suggest replacing cow's milk with soy milk.

Soy contains estrogen-like compounds that actually may lower your body's testosterone levels. But again, it's definitely not going to boost it drinking a lot of soy milk. So again, the moral of the story here is do not listen to the government. Do not listen to mainstream medicine when it comes of— when it comes to Doing what's best for your health.

Here's the truth of what you should be eating and doing if you want to naturally boost your testosterone levels. 1, Eat foods that are high in protein. You know, you want to be getting a lot of grass-fed beef, wild-caught fish, pastured chicken, organic pastured eggs. That should be the big basis of your diet.

In addition, organ meats like liver and adrenal and kidney and heart, uh, nuts like Brazil nuts contain large amounts of Nutrients like selenium, which improve testosterone and sperm production. Also, consume moderate amounts of healthy fats from things like olives and coconut. So you do want to get some healthy fats in your diet. Almond butter can be good.

Avoid excessive sugar and excessive caffeine. Also, avoid processed foods, hydrogenated oils, and food dyes. All of these are going to hurt your testosterone levels. But again, The ideal meal is going to be protein, a carbohydrate like sweet potato or rice or oats, and then maybe some healthy fat. Berries are great as well, but do a lot of real whole food to boost your testosterone levels.

Now, I want to get into some natural supplements and herbs and vitamins and minerals that can increase testosterone naturally. The first is fenugreek. Fenugreek has been shown in studies that it could increase testosterone by as much as 46%. Ashwagandha by 14.7% increase. And both of these herbs, fenugreek, ashwagandha as a combo, were recommended to increase testosterone in Ayurvedic medicine.

Zinc is also an amazing mineral that can boost testosterone levels. There was a study done where men were given zinc supplements for 6 months, and after 24 weeks, their serum testosterone levels had improved. Their average T level went from 8.3 to 16, within the normal range for healthy adults, which is nearly doubling serum testosterone levels.

So again, if you're going to take a nutrient, taking zinc, ideally combined with a little bit of copper, is really, really important for naturally boosting your testosterone levels. I also want to talk about another herb that was used in Chinese medicine to increase testosterone, and that is Panax ginseng.

In a study compared to the control group, the men that consumed a ginseng supplement that had a 1% concentration had an 8.82% increase in testosterone levels, where the men who had a 5% concentration level of a ginseng supplement had a 62.7% increase in testosterone levels.

Now, I do want to mention in Chinese medicine, They typically only recommend men start doing ginseng after the age of 50 because there is a little bit of dependence, not as much in testosterone therapy, but a little bit once you get older. So ginseng is typically only recommended if you're very sick or for men over the age of 50 years old.

Now, in addition, other supplements that have some good quality studies and have been used historically include Tongkat Ali. Tribulus and L-arginine are also known to be beneficial. An incredibly important nutrient in order to boost testosterone naturally is vitamin D. A 2011 study found that men who took vitamin D daily for 1 year saw their testosterone levels significantly increase.

Additionally, a 2017 study found vitamin D supplementation has shown some potential to increase testosterone levels. Now, some studies have found a positive correlation like the 2 I mentioned, and others have shown there may not be as strong of a correlation between vitamin D levels and testosterone.

But overall, I believe based on looking at the full body of research, vitamin D is a plus and does help increase testosterone levels. I want to mention in the 2017 study I referenced how significantly it improved testosterone levels. After three months of supplementing with vitamin D, there was a 110% improvement. After six months, 145% improvement.

After nine months, 196, and 12 months later, a 219% improvement in testosterone levels. In addition, supplementing with vitamin D also increased free testosterone levels by 28%. It improved. Erectile dysfunction by 45%. It lowered estradiol in the body by 20%. It also helped fight diabetes. The A1C1 levels by the participants lowered by 10%.

And body mass index, that's BMI, also decreased significantly by 2.27%. So the reality is vitamin D Really is beneficial. But let me say this, you ideally are going to be getting your vitamin D outdoors. So as much time, men, as you can spend outdoors, women as well. Vitamin D is not just a vitamin, it's a prohormone that impacts testosterone and estrogen and all of the hormones in your body.

Get a lot of time outside with sun on your skin. But most of you need to be taking 5,000 IUs of vitamin D a day along with magnesium and vitamin K2. Those have been shown together when you consume them to increase absorption and usability.

Also, take your vitamin D supplement when you're getting some healthy fat during a meal, whether it be eating wild-caught salmon or avocado or coconut or olive oil or whatever you're having. Take your vitamin D with your meals.

Now, I want to talk about a more cutting-edge therapy that has been shown to improve testosterone levels and is much safer than TRT therapy, and it's called peptide therapy. And the great thing about peptide therapy is you're gonna have much less of the side effects, and also it's much better for anti-aging.

Some of the benefits of using peptide therapy, and the peptides I'm talking about are BPC-157 and TB-500. These are peptides. Now, peptides are, they're very similar to protein.

They're just shorter chains of amino acids that we can consume In our diets, in fact, you're going to find the largest amount of peptides typically in things like healing peptides and things like organ meats, glandulars, and even things like colostrum.

And the benefits of peptides include muscle growth, increased muscle mass and strength, fat loss, improved athletic performance, anti-aging effects such as promoting skin elasticity, reducing wrinkles, improving skin health, increased libido. And better sexual performance. And then just overall well-being, better sleep, it regulates mood, reduces stress.

So if you're looking for something that's more natural that is going to help increase testosterone naturally, I would highly recommend BPC-157 and TB-500. Now, I want to mention, you know, these forms of peptides, the research is limited. It's very early on.

But generally, when you're looking at the big picture and looking at the actual chemical structure of these things, they're more natural for our body, very similar to things we get in our diet, than testosterone. And it's not going to cause your body to produce less testosterone on its own.

In fact, you're giving your body the building blocks it needs to create more testosterone when you're using peptides. But if you want to be as natural as possible, in getting more peptides in your diet, then what you want to do is consume organ meats.

And if you're consuming a glandular supplement or organ supplement that has testes and adrenal and pituitary and liver and heart and has multiple organs, it can help increase your testosterone, I believe. There's no clinical research for that, but ancient wisdom of Chinese medicine and Ayurveda that will tell you that yes, it will naturally support your testosterone production.

And so look for an organ or glandular supplement that has things like testes and other glands and organs from animals to naturally support your testosterone level. And here's the reality, with peptides, your health is likely to naturally improve, where with TRT, you might actually be increasing your risk of heart disease.

So I want to encourage you, if you want to boost your testosterone levels, really, really consider and weigh the costs of TRT and turn to the natural ways to boost your testosterone by eating a diet rich in protein, healthy fats, vegetables, fruits, and real foods. Start exercising with heavy weights. Take vitamin D and zinc and natural herbs like fenugreek and ashwagandha.

Get better sleep and consider consuming organ and glandulars to help take your testosterone level to a healthy place. I want to say thanks so much for tuning in here to the Dr. Josh Axe Show. Remember, each and every week you're going to learn the science and the principles and how to take your life and your health to the next level. Make sure to subscribe, like, and share this podcast.

Listen, this This is a crisis today. The amount of men that are taking testosterone in their 20s and 30s, and they don't know they are going to cause themselves to be infertile in the near future. This is a real crisis. You might transform someone's life, save someone's life by sharing this episode. And, and think about that.

There are men that they weren't fully told the negative consequences and side effects Of this. And, and also, a lot of people don't know there's a natural way— there are all-natural ways to boost your testosterone. So thanks so much for being on mission with me and helping me change the world, uh, with this message. Thanks so much for listening to this episode.