Testosterone and the Metabolic Syndrome
Metabolic Syndrome is a curse on modern society and a risk factor for
cardiovascular disease, erectile dysfunction and many other chronic diseases. It
is extraordinarily common and probably around 50 million Americans have the
condition. We'll discuss just exactly what it is, but, before I go on, I want to
start by saying that below I will give a "miracle solution" for the Metabolic
Sydrome. This solution had an 83% success rate, which means it completely
reversed the Metabolic Syndrome in about 5 out of 6 of the males in the study!
Not bad, eh?
Living in a developed country ain't as easy as it sounds. Our lives of
comparitive luxury lead us (unless we are careful) to a loss of blood sugar and insulin control
in middle age and beyond. Of course, this manifests itself eventually in
the full blown plague of type II diabetes. But long before diabetes sets in,
prediabetes will rear its ugly head. Similar to the way that
prehypertension is now considered a huge warning sign before full-fledged
hypertension, prediabetes was found to be a potent medical condition in and of
Prediabetes is actually insulin resistance, an ugly condition where
insulin receptors and processing lose their sensitivity. This allows blood sugar levels to
build up and eventually damage accumulates to the beta cells of the
pancreas and diabetes results. One curious thing about prediabetes is the
fact that it is usually accompanied by a suite of symptoms including high blood
pressure, stomach/visceral fat, low HDL, and high triglycerides (and elevated glucose).
And even though it sounds somewhat benign because it is termed prediabetes, implying
it's not yet a problem, Metabolic Syndrome has been tied to
an increased risk of cardiovascular death and all-cause mortality.
 As mentioned above, it also been linked to erection issues, a fact I cover in
my link on
Metabolic Syndrome and
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But what does Metabolic Syndrome have to do with low testosterone? Low testosterone
raises insulin levels very significantly and I go into detail about this fact in my
Testosterone and Insulin. And this is the reason that it directly worsens Metabolic Syndrome. For
example, one study of middle-aged men found that those in the lowest fourth of total testosterone
were 1.9-2.5X as likely to develop Metabolic Syndrome over the next 11 years. The threshold for
the quartile of total testosterone was 450 ng/dl (15.6 nmol/l).  450 ng/dl would be considered
reasonable testosterone by most doctors and yet this study indicates that many men may be getting
into trouble near this threshold.
I often have men writing into
The Peak Testosterone Forum in the 400's who just don't feel well. This is undoubtedly one of the primary reasons: they are beginning to lose insulin sensitivity. Some good tests for men to monitor are a post-prandial blood glucose, A1C, and fasting blood glucose.
Reversing Metabolic Syndrome
So we know that Metabolic Syndrome is nasty and can be accelerated by low
testosterone. But is there a solution for men who have already developed
Yes! One study showed that 83% of men who ate a
supervised diet, exercised and went on testosterone therapy completely reversed
their Metabolic Syndrome.  By simply
engaging in various natural and quasi-natural solutions: exercise, diet and adding
Bioidentical Testosterone back to more youthful levels, a man can
(generally) undo this nasty
Think of how difficult it is is to treat and reverse cancer. Or consider
many chronic diseases cannot be reversed at all, such as Parkinson's and Alzheimer's.
But, fortunately, with Metabolic Syndrome, the great majority of men can
actually escape this death trap. And that is good news!
NOTE: See also my link on
Testosterone and Diabetes, where I discuss a
similar anecdotal story on the reversal of diabetes. And how does testosterone work its magic on Metabolic Syndrome and insulin
resistance? One review lists a number of reasons:
1. "Influencing the commitment of pluripotent stem cells" [in muscle, i.e.
accelerating muscle growth].
2. Insulin sensitivity of muscle cells is increased by augmenting mitochondrial
Insulin sensitivity of muscle cells is increased by
"fostering expression of oxidative phosphorylation genes"
4. Protectig pancreatic β cells" [which produce insulin]
5 "Influence of inflammatory cytokines" (See this page on
Inflammation for more information.)
It would be remarkable if a drug or supplement did any one of these five things,
but having one thing doing all five?? Well, no wonder testosterone can
usually produce downright spectacular results for men with Metabolic Sydrome (or adult onset
1) Circulation, 2004, 110:1245-1250, "Impact of the Metabolic Syndrome on Mortality From Coronary Heart Disease, Cardiovascular Disease, and All Causes in United States Adults"
2) JAMA, 2002, 288(21):2709-2716, "The Metabolic Syndrome and Total and Cardiovascular Disease Mortality in Middle-aged Men"
3) Diabetes Care. May 2004 v27 i5 p1036(6), "Testosterone and sex hormone-binding globulin predict the metabolic syndrome and diabetes in middle-aged men"
4) Journal of Andrology, November/December 2009, 30(6), "Fifty-two–Week Treatment
With Diet and Exercise Plus Transdermal Testosterone Reverses the Metabolic
Syndrome and Improves Glycemic Control in Men With Newly Diagnosed Type 2
Diabetes and Subnormal Plasma Testosterone"
5) Nature Reviews Endocrinology, December 2009, 5:673-681, "Testosterone
deficiency, insulin resistance and the metabolic syndrome"
6) The Journal of Urology, Sep 2005, "HYPOGONADISM AND METABOLIC SYNDROME:
IMPLICATIONS FOR TESTOSTERONE THERAPY"