中年男人的煩惱- Testosterone Deficiency 睪固酮低下

The Concerns of Mid-Aged Men-Testosterone Deficiency

近期一位朋友提到印度文化裡熟悉的營養補給品Ashwagandha (又叫印度人參), 有些好奇這個是甚麼有趣的草藥., 之後在逛Costco 時, 也看到好幾牌賣這個草藥的supplements. 查了一下資料 才知道原來這個補給品不僅跟男性在中年可能經歷的更年期有關, 對於整體的身體健康來說更是有很大的影響呢! Recently a friend of mine mentioned Ashwagandha, a familiar nutritional supplement in Indian culture also known as Indian ginseng. I became so curious about this interesting herb. Later at Costco, I kinda noticed several brands selling supplements of this herb. After looking into it, I found that this supplement is not only associated with male midlife experiences, possibly related to menopause but also has a significant impact on overall physical health!

先來講講這個在男性身體內最主要的賀爾蒙睪固酮吧! 睪固酮是一種雄性激素, 男生女生都有. 在男生生理上主要由睪丸分泌, 女生則由腎上腺和卵巢產生. 由腦下垂體從上游調控體內睪固酮的製造與代謝. 睪固酮主宰著生理系統功能正常運作. 當睪固酮不足時, 男性容易出現性慾下降, 性功能障礙, 情緒不穩, 嚴重可能導致憂鬱,還有骨密度下降, 肌肉量下降, 肥胖, 從而增加得到心血管疾病的機會等等. 女生則是也有性欲降低, 心情不佳, 以及影響到維持骨骼強度與瘦肌肉量等. Let’s talk about the primary hormone in the male body, testosterone. Testosterone is a type of male hormone present in both males and females. In males, it’s primarily produced by the testes, while in females, it’s produced by the adrenal glands and ovaries. Its production and metabolism within the body are regulated upstream by the pituitary gland. Testosterone governs the normal functioning of physiological systems. When there’s a testosterone deficiency, males may experience decreased libido, sexual dysfunction, mood swings, and in severe cases, it could lead to depression. It can also result in decreased bone density, reduced muscle mass, obesity, and an increased risk of cardiovascular diseases. In females, it can lead to decreased libido, and mood disturbances, and affect the maintenance of bone strength and lean muscle mass.

那麼是甚麼原因造成了睪固酮低下(Low T) 呢? 除了早發性原因(先天因為內分泌失調造成年輕就出現了睪固酮不足), 大部分則是由於年紀增長造成的睪固酮低下. 這也就可以解釋睪固酮低下與男生中年更年期症狀有密切相關. 當年紀漸長, 如果又出現這以下兩個重量級影響因子, 睪固酮不足就更容易找上門了.So, what causes low testosterone (Low T)? Apart from congenital factors causing hormonal imbalances leading to early-onset deficiencies, most cases of low testosterone are attributed to aging. This explains the close association between low testosterone and the symptoms of male menopause. As individuals age, the gradual decline in testosterone becomes more apparent. If combined with the following two significant influencing factors associated with aging, the likelihood of low testosterone becomes even higher.

1. 肥胖: 體重過重與肥胖跟睪固酮低下是個很糟糕的惡循環. 當我們變胖了, 身體的發炎細胞激素就會增加從而抑制腦下垂體的功能, 使得睪丸減少睪固酮生產, 睪固酮低下又容易造成脂肪堆積進而變成肥胖問題.Obesity: Being overweight or obese contributes to a detrimental cycle with low testosterone. When we gain weight, inflammatory cytokines in the body increase, which suppresses the function of the pituitary gland, leading to reduced testosterone production in the testes. Low testosterone, in turn, promotes fat accumulation, further exacerbating the issue of obesity

2 壓力: 當壓力過大時，身體會釋放皮質醇（也稱為壓力荷爾蒙）以幫助回復身體平衡。皮質醇過高可能會導致睪固酮水平下降. Stress: When we are under too much stress, our body releases cortisol (also known as the stress hormone) to restore bodily balance. Elevated cortisol levels can lead to a decrease in testosterone levels.

好了. 萬一很遺憾真的出現睪固酮低下的問題, 有甚麼辦法能幫助提高這個重要的激素指數呢? What are some ways to help increase our T?

1.肌力運動: 深蹲跟硬舉可增強肌力. 尤其是深蹲這個動作鍛鍊大腿周邊的肌肉群, 會刺激睪固酮增生. Strength Training (Resistance Training): Squats and deadlifts are effective in enhancing muscle strength. Specifically, squats, which target muscles around the thighs, stimulate testosterone production.

2.飲食調整: 保持均衡的飲食也有助于增加睾酮的分泌. 兩個最大的原則是攝取足够的蛋白質和低碳飲食。當我們攝取充足的蛋白質有助保持健康, 减少脂肪並且促進升糖素和肌肉生成的激素釋放. 這兩種激素是睾固酮分泌的重要因素，因此身體吃進足够的蛋白質非常重要。另外, 減少攝取精製糖與澱粉類食物(高GI碳水化合物）則是可以避免脂肪迅速累積，並且從而促進睾固酮的分泌. 建議攝取的食物有香蕉, 魚類, 大蒜, 雞蛋. 另外, 好的油, 核果, 大量深綠蔬菜, 黃豆等也是很好的飲食選擇. Dietary Adjustments: Maintaining a balanced diet also helps increase testosterone secretion. The two main principles involve consuming sufficient protein and adopting a low-carb diet. Adequate protein intake supports overall health, reduces fat, and promotes the release of hormones like insulin and those involved in muscle generation. These hormones play a crucial role in testosterone secretion, emphasizing the importance of consuming enough protein. Additionally, reducing the intake of refined sugars and starchy foods (high-GI carbohydrates) can prevent rapid fat accumulation and further stimulate testosterone secretion. Recommended foods include bananas, fish, garlic, and eggs. In addition, healthy oils, nuts, plenty of dark green vegetables, and soybeans are also excellent dietary choices.

3.減壓跟充足的睡眠: 很多人壓力抒發會以抽菸跟喝酒來釋放壓力. 可惜的是, 抽菸與喝過量的酒會降低身體內的睪固酮. 所以, 找到壓力的來源還有健康的減壓方式, 如泡澡聽音樂放鬆, 睡前不看手機與使用其他3C產品等等式非常要緊的. 另外, 長期處於壓力之下也會造成睡眠不足, 長時間的睡眠缺乏會導致睪固酮低下. 因此, 找到對身體健康有益的心情放鬆的方式也才能進而幫助睡眠, 促進身體睪固酮增加喔!. Stress Reduction: Many people tend to relieve stress by smoking and drinking. Unfortunately, smoking and excessive alcohol consumption can lower testosterone levels in the body. Therefore, identifying the sources of stress and adopting healthy stress-relief methods, such as taking a relaxing bath, listening to music, and avoiding smartphones and other electronic devices before bedtime, is crucial. In addition, being under long-term stress can also result in insufficient sleep, and prolonged sleep deprivation can lead to a decrease in testosterone. Therefore, finding healthy ways to relax is crucial in aiding sleep and promoting an increase in the body’s testosterone levels.

4.營養補給品: 這就要回到一開頭提到的南非醉茄 ashwagandha. 這個在印度隨處可見的植物, 是一種適應元. 具有很強的抗氧化與增加免疫力功能, 所以又被叫印度人參. 主要能紓緩壓力, 改善焦慮, 幫助睡眠, 抗發炎, 抗癌, 降低血壓, 提高性功能, 提高男性生育能力以及增強體能等等. 也因為解壓助眠增加體能, 就可以間接幫助與支持維持睪固酮指數, 因此市面上也逐漸出現不少含ashwagandha精萃的營養補給品, 如Costco 販賣的Weider Prime Testosterone Support 還有Youtheory 的純ashwagandha. 不過值得注意的是畢竟這是屬於天然草藥營養補給品, 雖然目前短期的研究指出ashwagandha對幫助睡眠與減輕壓力跟焦慮上有幫助, 但是卻沒有甚麼強有力的持續追蹤研究證明長期使用Ashwagandha是否無害. NIH (National Institutes of Health)也指出它可能會對肝以及甲狀腺功能有反影響, 攝護腺癌患者與正在哺乳的婦女使用恐怕是不安全的.

另外, 除了上面提到的ashwagandha, 也要補充足夠的維他命D, B群, 鋅, 鎂 等. 這些重要維生素都對身體增進睪固酮有幫助喲. Nutritional Supplements: This brings us back to the South African herb, Ashwagandha, mentioned at the beginning. This plant, commonly found in India, is an adaptogen. It possesses strong antioxidant properties and boosts immunity, hence its nickname “Indian ginseng.” Primarily known for stress relief, anxiety reduction, improved sleep, anti-inflammatory and anti-cancer effects, lowered blood pressure, enhanced sexual function, increased male fertility, and improved stamina. Because it aids in stress relief, sleep, and stamina, indirectly supporting testosterone levels, several nutritional supplements containing Ashwagandha extracts have emerged in the market, such as Weider Prime Testosterone Support and Youtheory’s pure Ashwagandha, both can be found at Costco. However, it’s important to note that since this is a natural herbal supplement, while short-term studies suggest Ashwagandha may aid in improving sleep and reducing stress and anxiety, there isn’t robust long-term research confirming its safety for extended use. The NIH (National Institutes of Health) also notes potential adverse effects on liver and thyroid function, indicating that it might be unsafe for individuals with prostate cancer or breastfeeding women to use.

Furthermore, in addition to the ashwagandha mentioned above, it is important to supplement adequate amounts of vitamin D, B-complex, zinc, and magnesium. These essential vitamins play a vital and helpful role in enhancing testosterone levels in our body.

5.藥物治療直接補充: 目前有口服藥物、針劑補充、外用塗抹式凝膠等等，各有其優缺點. 這個部分就要依據個人身體狀況跟醫生諮詢比較好了. Medical Treatments – Direct Supplementation: Currently, there are oral medications, injections, topical gels, and more available for supplementation, each with its own pros and cons. This aspect should be discussed and considered based on individual health conditions in consultation with a doctor.

看起來睪固酮雖然對廣大中年男性具有很大的影響力, 但是還是有解救辦法的. 而且上面提到的低碳少糖及足夠的蛋百質飲食指南, 還有深蹲等肌力運動等對於維持一個健康的身體也是很有助益喲! It seems that while testosterone has a significant impact on a large portion of middle-aged men, there are remedies available (thank god!). I also want to emphasize the importance of the dietary suggestions mentioned earlier—adopting a low-carb with adequate protein intake, and incorporating muscle-strengthening exercises such as deep squats and deadlifts. These will contribute significantly to our overall health. 🙂

文獻參考 Reference:

1. A Chinese blog written by Uncle Ben regarding supplements to enhance the level of T in our body includes much research. 這篇由班叔叔寫的介紹促進睪固酮的營養品有很詳細的內容跟文獻研究參考.
2. An article from US Department of Veterans Affairs talked about ways to improve low T naturally. 美國退伍軍人事務部網站談到天然健康的方式增加睪固酮.
3. A video from Dr. Berg explained the reasons that cause the lower T. 伯格醫生解說造成低睪固酮的原因.