The primary female sex hormones estrogen and progesterone have been studied more when it comes to their effect on digestion compared to the primary male sex hormone testosterone. You can read hundreds of articles on the internet about symptoms of low testosterone (low sex drive, fatigue) and how they affect people but very few talk about the role of testosterone and digestion. There has to be research that exists on how healthy testosterone production drives digestion. Women are reported to suffer from IBS (irritable bowel syndrome) and SIBO (small intestine overgrowth syndrome) more often, is lowered testosterone production the cause? In our modern low-T world, men are having more issues than ever with proper test utilization, is it also affecting our digestion?

All About Testosterone

Testosterone is a steroid from the androstane class. It is the primary male sex hormone, signaled by the hypothalamus and pituitary glands, produced in the testes and prostate, and metabolized by the liver. The hormone is responsible for the male secondary sex characteristics of increased bone density and muscle mass, voice deepening, and increased body hair. Female ovaries also produce testosterone, but in far lesser amounts. The production and utilization of testosterone by males are much higher. However, females are more sensitive to testosterone. Testosterone is biosynthesized from cholesterol and metabolized by the liver. Liver health is vital for the production of the hormone. The metabolites from the liver either circulate throughout the body and activate specific bodily functions to maintain homeostasis or are eliminated.^{1 2}

Proper Testosterone Levels

Here is an accurate guide for males on diagnosing proper testosterone levels.

Here is an accurate guide for females on diagnosing proper testosterone levels.

Why testosterone is important for your overall health:^{3 4 5 6}

• Sperm production
• Enhances muscle growth
• Cardiovascular health
• Advances puberty and aging
• Regulates metabolism and body composition
• Accelerates growth and bone maturation
• Increases bone density and reduces the development of osteoporosis
• Sex drive(the hormone is important for both males and females), nocturnal penile tumescence (also known as morning wood), and orgasm potential(significant for both males and females)
• Motivation and competitiveness
• Regulates energy and mood stabilization
• Reduces anxiety and modulates GABA

Testosterone fulfills many different roles in maintaining and improving our lives. A balance of the hormone is essential, any substantial difference in testosterone production or hindered production can produce different unwanted symptoms. It appears that proper testosterone production in our modern world may be in peril. Testosterone production gradually decreases with age, but should still be appropriately maintained for good health. Testosterone production is higher in the morning and reduces throughout the day and lowers at night. Testosterone levels should be tested in the morning to get the most accurate reading.

Not all of the total testosterone in the body is bioavailable; some are bound until it is needed. In healthy people, some testosterone is properly bound to sex hormone binding globulin, but if you have too much SHBG (sex hormone binding globulin), “free” testosterone can be low causing issues. Testosterone is also lower in males who are married and have children. Stress, obesity, chronic alcoholism, diabetes, statin use, ace inhibitor use, long-term fasting (increasing SHBG), chronic infections, liver disease, pituitary or gonad issues, and poor sleep reduce testosterone levels. Deficiencies in vitamin A, vitamin D, zinc, and boron might cause problems with testosterone metabolism. Finally, unfermented soy controversially may lower testosterone levels. So, what are the symptoms of low levels of the hormone?^{7 8 9 10 11 12}

Symptoms of low testosterone:^{13 14 15 16}

• Obesity
• Insulin resistance
• Hypogonadism
• Lack of motivation
• Fatigue
• Lack of cognition, unstable mood
• Lack of sex drive or orgasm
• Poor cardiovascular health
• Osteoporosis or bone health issues
• Depression
• Anxiety
• Prostate cancer
• Increase in aches and pain
• Reduction in muscular output (strength) and stamina
• Hypothyroidism
• Constipation

Elevated testosterone production by the human body is a rarer occurrence than having lower amounts of the hormone. Most of the time severely elevated testosterone is caused by either anabolic steroid use, too high of a dosage of test replacement medication, polycystic ovary syndrome (females), hyperthyroidism, or androgen-producing tumors. What are the symptoms of elevated testosterone?

Symptoms of elevated testosterone:^{17 18 19 20}

• High blood pressure
• Testicular atrophy
• Over aggression
• Gynecomastia in males
• Increase in risky behavior
• Acne
• Elevated red blood cell count
• Irregular periods
• Increased facial hair growth (females)
• Infertility (females)

Testosterone and Digestion

Progesterone and estrogen are well studied for their effects on our digestion, but what about testosterone? Proper testosterone metabolism is more than just proper sexual vitality. We do need more research to determine precisely how important testosterone is for our digestion but we do have some clues in how adequate testosterone levels can improve digestion.

Testosterone does not seem to influence gastric emptying, while estrogen and progesterone do. Estrogen and progesterone deficiency can cause gastroparesis, while elevated amounts of the sex hormones can also cause slow gastric emptying. However, testosterone does seem to be essential for colonic motility.^{21 22}

“Testosterone and its active metabolite 5α-dihydrotestosterone are potent modulators of colonic motility by stimulating smooth muscle contractions through non-genomic calcium sensitization pathways.”²³

Estrogen and progesterone are also crucial for colonic contractions and motility, but the hormone may have a more significant effect than the two.²⁴

Testosterone also reduces both pains felt within the digestive tract and inflammation. Androgen receptor-mediated actions inhibit the CNS (central nervous system) directly, reducing pain. The hormone might also reduce the adverse effect of excessive cortisol on our gut, by blunting ACTH (adrenocorticotropic hormone) release during stress. Reducing cortisol production during stressful periods allows the gut to maintain better motility, immune function, and triggers less inflammation. Testosterone also decreases the expression of macrophages and monocyte Toll-like receptor 4 (a transmembrane protein that signals the production of inflammatory cytokines and activates NF-kB in reaction to endotoxins), which may help to protect males from endotoxin-induced Th1 dominance, brain fog (neuroinflammation), and leaky gut.^{25 26 27}

Females suffer from IBS and SIBO in the western world at almost a 2:1 ratio. Regular male testosterone production might protect us from developing IBS and SIBO because of increased colonic transportation and the reduction of the effect of elevated cortisol on the gut. However, the lack of estrogen and progesterone may lead us more prone to upper gut overgrowth because of a reduction of gastric emptying. Males are also more prone to develop hydrogen dominant SIBO (diarrhea) over methane dominant SIBO (constipation) because of testosterone increasing colonic stimulation. Testosterone is essential for proper digestion and may shield us from specific digestive disorders while making us more prone to others.^{28 29}

How to Maintain Proper Testosterone Levels

Six things you can do today to increase your testosterone include changing your diet, relieving your stress, reduce porn consumption and ejaculation frequency, exercise more and lose body fat, proper sunlight exposure, and improving your quality of sleep. I recommend for most people who want to increase their testosterone to change their diet to one that increases the intake of healthy fats (which are essential for hormonal production), proper protein intake, reduction of possible inflammatory foods, importance of vegetable and healthy fruit intake, and provides a moderate amount of carbohydrates (ketogenic diets may increase SHBG which can reduce sex hormones). The Perfect Health Diet, in my opinion, is one of the best diets to increase testosterone because it meets or exceeds the above dietary recommendations for healthy hormone production. The Perfect Health Diet has a significant emphasis on healthy saturated fats and Omega 3 ingestion which are both paramount for the proper production of sex hormones.^{30 31 32 33}

Poor sleep quality dramatically reduces proper testosterone production. Men with sleep apnea on average have lower testosterone levels, which may be correlated with obesity, which both affect testosterone production. When stress levels are elevated, or sleep quality is poor, a condition called pregnenolone steal can occur. Pregnenolone steal is when your body “steals” pregnenolone to produce more cortisol to help the body function during the stressful period. Since pregnenolone is used to produce both sex hormones and cortisol, more is used by your body to produce cortisol, and less is used to produce sex hormones, lowering your testosterone over time. Most people suffering from chronic stress (physical and mental) and pregnenolone steal might be suffering from adrenal fatigue. Also, a majority of normal testosterone production occurs when we are falling asleep and during REM (rapid eye movement) sleep, and a reduction in sleep quality or duration reduces the amount of actual hormone produced every night. Reducing your stress, overcoming adrenal fatigue, or improving sleep quality are all things you can do to ensure proper hormonal production.^{34 35}

One of the main aspects of what might be causing an epidemic of the current reduction of testosterone in our modern life is porn consumption and increased ejaculation. The correlation between porn consumption causing a decrease in testosterone is a controversial statement, and I have seen arguments both for (reduction in prostate cancer and toxin load) and against increased ejaculation (decline in testosterone and sex drive). I do believe through my research that over ejaculation maybe one of the leading causes of low testosterone issues. Zinc depletion may occur in the male body from over ejaculation which can lead to reduced testosterone, especially if your diet is low in zinc (up to 9% of daily zinc intake). Zinc is vital for testosterone production and a reduction in zinc stores can lead to reduced testosterone levels. I took lisinopril for “borderline” blood pressure for years that eventually led me to develop low testosterone from it inhibiting zinc absorption and utilization. Combined with taking lisinopril I am sure that my frequent ejaculation during my young adulthood did not help my hormone levels either. With millions of men on ace inhibitors in the United States probably engaging in frequent ejaculation, a reduction in zinc causing hormonal issues could be on the rise, and this is just one correlation.^{36 37}

Aerobic and anaerobic exercise in moderation have both been shown to increase levels of the hormone. Frequent exercise improves muscle mass and reduces fat tissue. Exercise helps to increase testosterone through a positive feedback loop, the hormone is essential for muscle growth and repair and is upregulated after a workout for recovery. Excess fat tissue converts testosterone into estrogen by producing aromatase and aldo-keto reductase 1C. Also, fat tissue affects the secretion of the hormone gonadotropin which interferes with proper testosterone production. Sunlight also increases testosterone by triggering luteinizing hormone production. Afternoon sunlight during the summer would also increase vitamin D production in the body which correlates with upregulation of the hormone until you reach 75–85 nmol/l of saturation. Vitamin D also helps to increase muscle mass, reduces liver inflammation, and sunlight exposure during the day improves sleep from proper serotonin production all which will enhance hormone production. Finally, LLLT (low level laser therapy) and red-light LED (light emitting diode) therapy when done correctly on the testicles have been shown to increase production of the hormone.^{38 39 40}

There are some supplements as well that can be taken to help regulate proper testosterone production. Boron, magnesium, and zinc supplementation are essential for hormone production if you are deficient. Boron supplementation may help by reducing sex hormone binding globulin and in doing so, should increase free testosterone. Boron supplementation takes time to improve testosterone utilization as it needs to accumulate in the testes. Other supplements that may help enhance testosterone production are black cumin seed oil, cinnamon, royal jelly, and ginger. The increase in testosterone from these supplements might be because of their positive effect on the microbiome, improving liver function, improving insulin sensitivity, reducing inflammation, and increasing production. Finally, R-lipoic acid (do not use if you are mercury burdened) in men who have low testosterone and diabetes, may increase testosterone production by reducing inflammation, improving insulin sensitivity, and gut health.^{41 42 43 44 45 46 47 48}

Rarely, the use of DHEA (dehydroepiandrosterone) might be needed to increase testosterone by providing what is required to produce it. If you use DHEA, I would recommend following the supplement recommendations for DIM (diindolylmethane) and calcium D-glucarate to prevent excessive estrogen from being produced as well. DHEA should not be used for a long time it is a supplement stopgap. In a healthy person, enough DHEA is produced from pregnenolone and is converted into testosterone. If your supplement with DHEA long term it may create a negative feedback loop and cause issues with natural production. I do not recommend testosterone replacement therapy unless it is a last resort. Test replacement therapy is just a patch and does not cause the body to naturally produce the hormone on its own again. The testes may atrophy while on it (human growth hormone supplementation may prevent testicular atrophy), requiring you to be on it for the rest of your life if it occurs.^{49 50 51 52}

Sample Protocol to Increase Test

Reduce ejaculation to once or twice week and avoid pornography, if possible.

Moderately exercise during the week.

Follow the Perfect Health Diet.

Supplement with magnesium.

Work on your sleep hygiene, get proper amounts of sunlight, and reduce stress. If needed, use ICES or red light therapy on your gonads.

Thorne zinc picolinate – one capsule with breakfast and one with dinner.

Boron glycinate – one capsule with breakfast.

Amazing Herbs black seed oil – one softgel with breakfast and one with dinner daily.

Royal Jelly – two capsules with breakfast.