Testosterone and Asthma
One of the senior poster in the Peak Testosterone Forum,
who happens to have low testosterone,
"Being someone who struggled with severe childhood asthma and exercise and
allergy induced adult asthma, this is a subject near and dear to my heart...The
last link really makes me think if my use of asthma inhalers and corticosteroids
for asthma is part of my current situation.."  What he was noticing is
that there appear to be many links between asthma and testosterone, especially
low testosterone. Isn't asthma all about the lungs and testosterone about
the brains and the groin? Sure, but we will show that they meet in the
middle in many key ways.
The above poster accused his corticosteroid inhalers of causing his low
testosterone. Basically, these drugs are designed as copies of cortisol
and are used because cortisol suppresses the immune system. In asthma the
immune system is "overreacting" and so a (supposedly) localized steroid is
applied in order to help the situation. And, if you've poked around my
site much, you know that almost anything that elevates cortisol is going to
lower testosterone. I have many examples of Cortisol-Raising Stressors
that Lower Testosterone
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And some research suggests that that might be the case. For example, one
older study noted that men with asthma and on corticosteroids tended to have
lower testosterone.  The authors wrote "low blood testosterone was found
mainly in the patients with severe (37.76%) and moderate (40.00%) form of the
disease and very rarely in patients with mild form of bronchial asthma (8.51%).
The basic testosterone level changes are probably due to the stress, hypoxia and
corticosteroid treatment. The possibility of a direct suppressive action of exo-
and endoallergens on the testes are discussed.."
But is this really the case? Why aren't physicians noting
the connection, considering the number of patients on these sort of asthma
medications, if this is really a significant issue? And some research shows no real suppression
of the HPAor testosterone with inhaled corticosteroids.  One study found
that, while powerful oral steroids like prednisolone decreased testosterone by
33%, the inhaled version caused no significant drop in testosterone or
leutinizing hormone. 
However, the real answer may lie somewhere in the middle: one study found
that testosterone was suppressed by long term inhaled corticosteroid therapy,
but only to a small degree. In this study average testosterone was only
decreased by 18%.  So, yes, corticosteroids are not going to help, but
they may not be the major factor at play here. So it may be the length of
time that the inhalers are used, but it's difficult to say at this point.
So are there any other factors that could be causing the issues? Going back to the study correlating low
testosterone and asthma , the authors suggest that asthma is in
and of itself a stressor and thus may lower testosterone through increased
cortisol or other negative effects of stress. However, I found not
found much research corroborating this idea and, it should be pointed out, that
nighttime (nocturnal) asthma is actually associated with lower cortisol levels,
not higher. 
The authors also mentioned hypoxia, clinically low oxygen levels, as a possible
issue that could drive down testosterone levels. One study on
glucosteroids did indeed show a correlation between the degree of hypoxia and
testosterone suppression.  A number of medical conditions, such as sleep
apnea and COPD are linked to hypoxia. Sleep apnea has definitely been
found to lower many key hormones, something I cover in my link on
In addition, asthma and testosterone are probably correlated through mitochondrial
dysfunction. Loss of mitochondrial function is a whole theory of aging and
there are definitely connections to both hypogonadism and asthma. Note the
conclusions of this 2005 study in the journal Diabetes Care:
"These data indicate that low serum testosterone levels are associated with an
adverse metabolic profile and suggest a novel unifying mechanism for the
previously independent observations that low testosterone levels and impaired
mitochondrial function promote insulin resistance in men.."  In other
words, low T and mitochondrial issue go hand-in-hand and seem to help promote
insulin resistance. The paper goes to actually explain that low
testosterone itself may lead to mitochondrial dysfunction.
Furthermore, a number of studies have shown that mitochondrial dysfunction could
lead to asthma or make it worse. One set of researchers stated clearly
that "aging and animal model studies have revealed that mitochondrial
dysfunction and oxidative stress are involved and play a large role in asthma."
 Yet another study showed that giving subjects a compound that improves
mitochondrial dysfunction also improved asthma. 
So all of this could conceivably lead to a worse case scenario
where asthma, through
medications and hypoxia, may lower testosterone and lower testosterone may worsen asthma
through mitochondrial dysfunction, i.e. a vicious circle would be created.
Let's hope there is more study work done as time goes on.
2) Vutr Boles, 1988, 27(4):29-32, "The serum testosterone level of patients with
bronchial asthma treated with corticosteroids and untreated"
3) Respiratory Medicine, Nov 1992, 86(6):495–497, "Highdose inhaled steroid
therapy and the cortisol stress response to acute severe asthma"
4) Respir Med, 1994 Oct, 88(9):659-63, "Testosterone levels during systemic and
inhaled corticosteroid therapy"
5) American Journal of Respiratory and Critical Care Medicine, 2002,
165(5):708-712, "Role of Serum Cortisol Levels in Children with Asthma"
6) Respiratory Medicine, Oct 1994, 88*(9):659–663, "Testosterone levels during
systemic and inhaled corticosteroid therapy"
7) Diabetes Care, Jul 2005, 28(7):1636-1642, "Relationship Between
Testosterone Levels, Insulin Sensitivity, and Mitochondrial Function in Men"
Dysfunction and Oxidative Stress in Asthma: Implications for
Mitochondria-Targeted Antioxidant Therapeutics"
9) J Immunol, 2009 Aug 1, 183(3):2059-67, "Esculetin restores mitochondrial
dysfunction and reduces allergic asthma features in experimental murine model"
10) British Med Journal, Oct 1985, Vol 291, "Plasma testosterone concentrations
in asthmatic men treated with glucocorticoids", p. 1051
11) Circulation, 2005, 112:2660-2667, "Selective Activation of Inflammatory
Pathways by Intermittent Hypoxia in Obstructive Sleep Apnea Syndrome"