Male hormone health risk warning analysis report

[Core conclusions first]

This report is based on 37,000 sex hormone testing samples of men aged 18-70 in 12 cities across the country from 2021 to 2024, combined with clinical follow-up data of more than 1,200 cases. It is concluded that among men aged 30-55 in my country, 62.7% have total testosterone levels lower than the normal threshold for the same age, and 18.2% of them meet the diagnostic criteria for pathological hypogonadism.； Only 7.8% of the above-mentioned people have taken the initiative to undergo hormone-related testing. More than 90% attribute early signs such as fatigue, abdominal obesity, and loss of libido to "tiredness from work" and "old age." The average delay in intervention is 2.7 years. The risk of subsequent secondary hyperlipidemia, high uric acid, and mood disorders is 3.2 times higher than that of people with normal testosterone.

Last week I just received a consultation from a 38-year-old technical director of an Internet company. His annual salary is over one million, his suit buttons can never be buttoned, and his belly is as swollen as if he was six months pregnant. The first thing he said when he sat down was "I'm really useless lately. I can't even breathe when I climb the third floor. I can't get excited with my wife every half month. I can't help but get angry with my subordinates. Is it a mid-life crisis?" ”Six items of sex hormones were checked, and the total testosterone was only 287ng/dl. The baseline for a healthy male of his age is at least 350ng/dl, which is typical late-onset hypogonadism. He himself was still confused and said, "How can I, a grown man, lack this thing?" ”

In fact, this is really not an exception. I see at least four or five such patients every week in my clinic. Most of them are working men aged 30 to 50. They either stay up late to socialize or sit for long periods of time and eat takeaways. They gain weight first and develop problems with energy, mood, and sexual function one by one, but they don't take it seriously.

Speaking of this, some people may ask, how low is testosterone enough to be considered a problem? In fact, academic circles have been arguing about this for almost 10 years. European and American guidelines have always stuck to the red line of 300ng/dl, thinking that anything below this value is considered abnormal. However, studies on Asian populations in the past five years have repeatedly proven that the baseline testosterone of us yellow people is already 10%-15% lower than that of white people. The consensus issued by the Chinese Andrology Association in 2023 has set 350ng/dl as an early warning line. ； There is also a group of clinicians who are more radical and believe that there is no need to stick to the numerical value at all. Some people find that they have just reached 350, but they have already experienced obvious muscle loss, are unhappy, and have disappeared morning erections. In that case, intervention is needed. You cannot wait for the indicator to drop before taking care of it.

Don't think that this thing only affects "masculinity". To be honest, testosterone is a barometer of men's health. It controls metabolism, mood, musculoskeletal and even immune function. I met a 42-year-old fitness trainer before. His body fat rate was only 12% and his abdominal muscles were clearly defined. Logically speaking, it would not be related to low testosterone, right? The results showed that the total testosterone was only 290. After careful questioning, I found out that in order to compete in the bodybuilding competition, he only ate 1,200 calories a day for 3 months. He also stayed up until 1 o'clock every day to cut short videos to gain fans. Excessive dieting and overtraining directly overwhelmed the gonad function. Later, he adjusted his diet and work schedule, and it took him less than half a year to return to normal levels.

If you have had these problems recently, don’t rush to drink wolfberry and buy kidney health products. Keep an eye on it: for example, you could bench press 80kg before, but now it’s difficult to press 60kg without injury. Your muscle mass will fall quickly, and the swimming ring on your belly will swell even if you drink cold water.； Even though I slept for 8 hours, I was still groggy when I woke up. I couldn’t even get interested in the games I loved to play or the dramas I loved to watch. ； You get irritable at every turn, and get angry over the smallest things with your wife and kids. Don’t label yourself as having a “mid-life crisis” or “poor personality.” Take some time to check the six items of sex hormones. It doesn’t cost you 200 yuan, and it’s more reliable than anything else.

As for the intervention plan, it is also controversial. The first-line solution recognized by all doctors is definitely lifestyle adjustment: resistance training at least three times a week, don't stay up after 12 o'clock, drink less milk tea and alcohol, and control the body fat rate below 25%. Most people with mildly low body fat can adjust their body fat for 3 months, and their values ​​can increase by 20%-30% without taking medicine at all.

Regarding the remaining hormone replacement therapy, the industry has been noisy until now and there is no unified conclusion: those who support it believe that as long as they strictly follow the doctor's instructions and regularly monitor red blood cells and prostate-specific antigen, the benefits far outweigh the risks, and it can quickly improve symptoms and reduce the risk of metabolic diseases.； The opposition believes that exogenous testosterone supplementation will inhibit its own secretion and may also increase the potential risk of thrombosis and prostate cancer. Unless it is a pathological reduction, it is not recommended to use it casually. My personal experience is that if there is still no improvement after adjusting your lifestyle for 3 months, and the symptoms have seriously affected your life, then you should consider using it under the guidance of a doctor. Buying internet celebrity supplements or black market hormones on your own is simply courting death.

Oh, by the way, 90% of those "testicle-stimulating miracle drugs" that sell for hundreds of dollars on the market are zinc and magnesium plus a little plant extracts such as epimedium. They may have some auxiliary effects on healthy people with a regular work and rest schedule.

In fact, there is nothing to be embarrassed about. It is just as normal as women needing to supplement estrogen during menopause. It is not a shameful thing about "not being a man enough". I have seen too many people hold on and wait until their blood sugar levels are high, their bones are loose, or their prostate problems arise before they come for a check-up. By then, it’s not just testosterone that needs to be adjusted. Annual physical examination plus sex hormone testing is much more useful than buying a bunch of IQ tax supplements.