Testosterone therapy in men with testosterone deficiency with or without diet and physical activity not only produced reduction in fat mass but also improvements in cardiometabolic function and reduced carotid intima media thickness (CIMT), epicardial fat and trunk fat 46▪▪,58▪▪,70. This, in part, explains the observed weight loss with testosterone therapy in men treated for long durations with appropriate testosterone formulations producing physiological levels 58▪▪–61▪▪,72. Saad et al. further proposed testosterone therapy as a new potential intervention strategy for managing obesity in hypogonadal men (testosterone deficiency). Testosterone levels are reduced with increased waist circumference and obesity 17,24 and approximately 40% of obese nondiabetic men and 50% of obese diabetic men aged above 45 years have low free testosterone 18,25. The prevalence of testosterone deficiency increases with comorbidities, such as insulin resistance and T2DM, obesity, hypertension, and cardiovascular disease (CVD) ranging from 30 to 50% 18–21. Testosterone is an androgen steroid hormone and the principal male sex hormone, but it is also produced in females. Buy this testosterone test, visit a nearby Quest location, and get fast results. Testosterone is often referred to as "the male sex hormone", but it is also produced in (and important for) females. This test is specifically used to check for an antibody response to the virus, which can take time to develop. Offer valid on first purchase on questhealth.com only and cannot be applied to previous purchases or combined with any other offer. They may order a blood test to check your hormone levels. Glucagon-like peptide 1 agonists (or GLP-1 agonists) are newer drugs used to reduce weight and lower blood sugar levels in people with type 2 diabetes. A 2024 study in Sports Medicine found that aerobic training helped men with obesity and diabetes manage calories and testosterone. Low-fat and high-protein diets also reduce testosterone, making it difficult to choose the right plan. According to the Asian Journal of Andrology, men with obesity and low testosterone may develop sleep apnea, a condition where they stop breathing for short periods. Testosterone and SHBG levels are related to a health condition called metabolic syndrome. With less SHBG, there is also less free testosterone available for body functions. McDevitt says she sees older men who live a healthy lifestyle in their fifties who have the testosterone levels of a man in his thirties. The fact that this therapy has been used over the past 7 decades to treat hypogonadism (testosterone deficiency) and is proven to be well tolerated and effective should be an added tool to the armament for the war on obesity. These factors explain, in part, the neutral effects of testosterone therapy on weight observed in some studies. This may be because adipose tissue, especially when in the inflamed, insulin-resistant state, expresses aromatase which converts testosterone to estradiol (E2). Consistent with this, there is evidence that some individuals may be metabolically healthy despite a BMI in the obese range (MHO), because they have lower amounts of VAT. In addition, obesity, as measured by BMI, is a relatively crude indicator of metabolic risk with waist circumference providing a better indicator of all-cause (HR 1.19 vs 1.10 per standard deviation) and cardiovascular mortality (HR 1.33 vs 1.23 per standard deviation) compared to BMI.8 This is because excess weight stored as visceral adipose tissue (VAT) is more closely linked to cardiovascular outcomes than subcutaneous adipose tissue (SAT). In developed countries including Australia, over 75% of the adult male population is already overweight or obese. By moving beyond BMI and addressing the underlying hormonal disruptions, individuals and healthcare providers can take more informed steps toward improving both metabolic and reproductive health. In obese individuals, enhanced aromatase enzymes produced by adipose tissue reduce the testosterone and increase the oestrogen hormones. The hypogonadal–obesity–adipocytokine hypothesis is an extension of Cohen’s theory, which explains why the body cannot produce compensatory testosterone via increased gonadotrophin secretion and subsequent stimulation of the Leydig cells. If these measures fail to relieve symptoms and to normalise testosterone levels, in appropriately selected men, testosterone replacement therapy could be started. Lifestyle-measures form the cornerstone of management as they can potentially improve androgen deficiency symptoms irrespective of their effect on testosterone levels. Obesity-induced increase in levels of leptin, insulin, proinflammatory cytokines and oestrogen can cause a functional hypogonadotrophic hypogonadism with the defect present at the level of the hypothalamic gonadotrophin-releasing hormone (GnRH) neurons.
