What’s Missing in Testosterone Testing, and What Testing Should Really Include

Introduction to Functional Medicine and Hormones 0:00

with functional medicine and traditional Chinese medicine, we really are looking at the individual. Now, that seems pretty obvious, but there's a saying in European physicians actually that European physicians treat people and Western physicians treat labs. And there's something to be said about that. Now, in functional medicine and traditional medicine, it's not even possible to do that. Hi, and welcome to The Balancing Point. I'm Dr. John Needers, and I'm here to make traditional Chinese medicine, functional medicine, and integrative health simple, practical, and fun, so you can restore balance, boost vitality, and enjoy a healthier life every single day.

Hi, welcome back to another episode of The Balancing Point. Thank you for joining us wherever you're joining us from. We really appreciate it, and we'll try to give you some interesting information today. Now, I'm Dr. John Needers. I'm a doctor of acupuncture and oriental medicine, and I'm certified in functional medicine. Now, what's also important for today's talk is that my doctorate is in gynecological endocrinology. Quite a mouthful. Even though gynecological is in the name of my degree, it's important to remember that men and women have all of the same hormones.

All of them are the same, all humans. They're just at different levels. And those levels change, as you know, from birth until death.

Why Individualized Care Matters 1:32

There's a constant, constant change in those levels. And it's important to really understand how those interact. Now, this is including what we call in common parlance sex hormones, stress hormones, thyroid hormones. adrenal hormones, pituitary hormones. We all have all of them, hopefully. I mean, there are a few individuals who have a genetic problem and they don't produce some of those, but that's very, very, very rare. So basically, we all have all of them. We just have them at different levels.

Now, I've found that hormonal interactions are often critically misunderstood. Now, you've got to understand, I'm often the last resort for people, for women doing fertility work. They usually don't start with me, sometimes they do, but usually they've been through rounds of variety of assisted reproductive techniques, or they've seen other acupuncturists, etc. And so when they get here, I have lots and lots of their prior testing to look at. It's fascinating to me. I want to see everything. Now, one big difference.

in how we function with functional medicine and traditional Chinese medicine, we really are looking at the individual. Now that seems pretty obvious, but there's a saying in European physicians actually, that European physicians treat people and Western physicians treat labs. And there's something to be said about that. Now in functional medicine and traditional medicine, it's not even possible to do that. You are you. That's what we're treating. Now you may have symptoms that we can call a disease, but that's not what's primarily being treated.

It's really imbalances in you. Now, and so in Western medicine, there's generally a focus on single lab values. You know, you get your test and there'll be a little red L meaning it's low or a little red H meaning it's high. And so then the doctor sets out to balance that one lab value, whatever that is.

Testosterone Basics and Lab Interpretation 3:39

You know, maybe they give you some iron, maybe they give you some vitamin B12, whatever. And that's fine. You know, there's value in that. However, in the hormonal system, Every single hormone has either a direct effect or an indirect effect on every other hormone. So if you just hit one of those, what are all the other effects on the other hormones? And likewise, how important is it to test for those other hormones? It's best to have the entire picture. I always want as much information as I can get.

I want to see the entire picture, no matter what endocrinology issue we're treating, whether it's thyroid, adrenal, pituitary, et cetera. We always want the maximum amount of testing. Now, fortunately, we get tests at a very, very low cost, so it doesn't break the bank for us to do all that testing. So again, we want to have the entire picture. And since I'm going to focus on testosterone levels today in men and women, very important for both. Now, many people look at total testosterone in a vacuum.

Your doctor runs a total testosterone level and they'll say, oh, you're fine. But that's only a very small part of the story. Well, it's more than a small part, but it's a moderate amount of the story. Now, if your total testosterone. indicates that it is low. The test indicates it's low. And there's a great deal of disagreement about a low level, what a low level actually is. Then it's probably truly low and you need some assistance in getting it to a higher level. Okay. No argument. I'm going to tell you a story about me.

I, about 10 years ago, I was in Cabo, my wife and I, with another couple who we'd known for a very long time. And one of the fellow that I was there with, a guy named John, great guy, I saw that he was doing testosterone. And he said, yeah, I'm going over to the drug store to pick up a bunch of testosterone because it's so cheap here and I don't need a prescription. I said, oh, cool. So I went with him and I said, so, you know, how, how does this affect you? And he said, look, you know, I've been a general contractor.

I work on cars. I'm constantly busy. And the last five to 10 years, I don't want to get out of my bed or off of my recliner unless I have my testosterone. And if I have my testosterone, I feel just like I did 20 years ago. I thought, oh, that sounds good. So I did some. I tried it, some cream. And after a few days, indeed, I felt about 20 years younger. I got my energy back. I got my enthusiasm back and even more than I realized that it was already lacking. Right. But it really made a huge difference.

So I go to my doctor who's a very nice guy, a bright guy, and he agreed to test me for my testosterone.

Free Testosterone, Estrogen, and SHBG 6:29

Sent me to LabCorp. And their bottom of their range is 264. And if you go to any male specialist, they'll usually say, oh my God, that's really low. But LabCorp's 264. So guess what? I came in at 264. And so because of that, he wouldn't give me testosterone, which is kind of silly because if I tested a day earlier or a day later or under some different circumstances, it could have varied by 10 to 20 points because testosterone is not a stationary hormone. No hormones are. They change from day to day and throughout the month.

And so that was a real eye-opener for me because I couldn't get my testosterone. So no big deal, you know, fast forward a while. And so the bottom line is if your testosterone is normal or high and you're having symptoms of low testosterone, we need to know a great deal more. a great deal more about other hormones. So we do free testosterone testing. It's very important because it's telling us how much Testosterone is free, as the name implies, unbound and bioavailable. Like, is it actually available for us to utilize it to make us feel better?

Now, if the testosterone total is higher normal, but the free testosterone is low, this can actually be very dangerous for several reasons. One of them is that testosterone in excess will convert to estrogen. And that's one of the reasons that testosterone creams can be dangerous because when you take the cream, your testosterone peaks and then it plummets. You take it again and it peaks and you have too much and then it plummets. And with every peak, It can be converting to estrogen and overestrogenizing you.

And this can lead to the infamous, unintentional man boobs. Not a pretty sight. So it's important to test free testosterone whenever you test testosterone. We should also run a test for estrogen. When I'm checking out men particularly, if they're in some way taking an estrogen, I mean a testosterone supplement, we're always going to test their estrogen to see if there's an over conversion factor. So this is very important. We also test Maybe the most important test for this is sex hormone binding globulin.

And it does just what it says.

Stress, Fertility, and Hormone Interactions 9:13

It binds your sex hormones, testosterone, progesterone, estrogen, et cetera. And sex hormone binding globulin increases with stress. It goes up with stress. and it binds your testosterone, and it binds estrogen in women. And it's really an attempt by nature to slow down your metabolism. We don't want people getting pregnant if there's a war going on or a famine. So it's a built-in safety valve, I would say, to keep us from damaging ourselves. Now I've done a great deal of fertility work. I mean, a lot of fertility work.

And mostly women are coming to me after they've seen many other providers. They may have seen other acupuncturists, a functional medical doctor. They may have done some reproductive procedures, et cetera. And so the patients that come to me almost always have what's called unexplained infertility. And I'll tell you that in 90% of those cases, the problem is stress. Now, to prove this, we have multiple tests for hormones that all go up with stress. Reverse T3 is a test or a hormone that can be tested for that goes up under stress and it binds into the T3 receptor sites.

Again, T3 is the energizer bunny. It's what gives you most of your energy. And so it binds into those receptor sites so you can't use your T3. We test sex hormone binding globulin because again, it goes up with stress and it will bind your hormones so you can't really use them. We'll test for cortisol. Cortisol dampens T4, which is the storage form of thyroid, to T3, which is the active form of thyroid. So if your cortisol is too high, it's very, very difficult because you're not going to have a lot of energy.

Now, my main point is this testosterone levels are critical for men and for women and the way treatment testosterone treatments are approached can sometimes create very dangerous physical issues. I'm not saying it's bad. I'm saying you have to be very, very careful if you're going to do testosterone supplementation directly.

Testosterone Treatment Cautions and Next Steps 11:39

Now, whether you use pellets, which would be my favorite method, or creams, or oral, which is my least favorite method, you can have some very serious problems. Now in my next episode, I'm going to talk to you about something really important. I'm going to talk to you about the 10 or so most effective herbal and supplement ways to increase the benefits of testosterone. Now it's really important. I read hundreds literally of research articles a month and abstracts and look into all these issues. But when you experience something for yourself, it actually makes a big difference.

So I read the textbooks, I read the studies, but I'm going to share with you how in the beginning of 2024, the first four months actually of 2024, I doubled my effective testosterone levels. I doubled my strength, literally doubled every exercise except one. And that took a couple more months, but I doubled my strength and I had a significant increase in muscle size and muscle tone. And I'm going to share with you. the five or six things that I used that made that difference, but then I'll go into some of the other things that can also be effective.

And maybe more importantly, I'm going to point out the things that you see in a lot of supplements that really there's very little, if any, validation for their ability to increase testosterone levels. So anyway, until we meet again, I want you to be happy, real clarity and balance can begin. Visit AlamedaAcupuncture.com. That's AlamedaAcupuncture.com to learn more, explore our supplements, or book a call. We'd love to hear from you.