Why men are seeing an epidemic of low testosterone

This dream woman of a personal trainer told me I could eat bacon, beef jerky, hot wings, beer, and oysters. She also said I would do well to avoid tofu, something I have had an aversion to ever since my hippie ex-wife used to feed it to me on a daily basis.

I usually don't like talking to health and fitness professionals, because they always tell me to stop doing something I love, or to start doing something I don't. But I appreciated talking to Ali Gilbert, the Director of Performance at CLAY Health Club + Spa in Greenwich, Connecticut, because she told me I could still have beer and bacon and get my workout on the golf course, so long as I walk and don't drive the little cart.

To be honest, the beer and bacon rule does have a caveat. "I don't take stuff away from people," said Ali, who was also just recently honored by Golf Digest magazine in their "50 Best Golf Fitness Professionals" list. "I'm not putting them on a diet . I try to teach them how to live their life, but live a healthy lifestyle. That includes all the foods they love, but in moderation – and having an understanding of what they're eating, and when."

Ali is something of a Renaissance woman when it comes to fitness, sports and nutrition . She is a partner at Greenwich DX Sports Labs; and at CLAY, she is the performance and golf fitness specialist. As Director of Performance, she instills a training philosophy and culture among all the trainers at CLAY. She is a golf performance expert, provides specialized personal training, is in charge of nutrition coaching and I love her approach.

She says that a lot of her clients are high-powered CEOs who constantly go out to business dinners. "I tell them, if you're going to drink alcohol, drink alcohol, or have starch. But don't have both." Ali tells me that alcohol is metabolized and will be used first for energy, and anything you eat with it is "thrown onto the back burner and is more likely to be stored as fat, so you're better off pairing alcohol with protein and vegetables." I was disappointed that my beer and tortilla chips are out of the question, but the good news is, I can still have a beer with hot wings.

The epidemic of low testosterone

Ali often gives talks about men's health and hormone optimization, and speaks prolifically about a silent epidemic of low testosterone. We hear about this issue, and think it's only something that affects a few of us as we get older, but in fact, this epidemic has hit men of all ages and it's time to understand it better and start taking action. General practitioners are often not on board with early testing, and surprisingly, there is no standard patient care model for optimizing hormones in men or women. It's essential to understand what it is, how it affects you, and what the consequences might be.

Ali calls testosterone the "winning hormone" – it's what makes you a man. "If your doctor questions why you want your levels tested, first, I would say to find a new doctor. But secondly, say because you want to know if you're functioning properly as a man." One of the biggest problems is when a younger man goes to the doctor feeling lethargic, and is misdiagnosed with depression . Low testosterone creates a feeling of lethargy. "The symptoms are very close to depression ," says Ali. "A lot of men who feel this will go to their doctor, and the doctor won't even check the hormone levels, he'll just write a prescription for an antidepressant."

The risks of low testosterone go beyond lethargy – low testosterone levels also mean you are at higher risk for a heart attack, and that estrogen levels are more likely to be higher, which is also a health risk. "Overall well-being, ability to maintain erections, ability to recover from workouts, all of that is affected. A lot of guys feel that, and they don't know why. They start to feel it in their thirties, and they think they're depressed."

The antidepressants don't work in that case, but Ali tells me what does. "From a fitness perspective, there are different ways you can train to increase hormone levels, specifically, testosterone and growth hormone. There are also different ways you can eat, certain foods to avoid, and certain foods to have," she said. Bloodwork is highly encouraged before embarking on a fitness regimen, and she notes that she has seen several men in their fifties who have never had their testosterone levels checked. "It's an uphill battle with a lot of general practitioners who don't test for it, they don't know enough about it, or they don't see it as necessary with someone in their twenties or thirties. I think it's highly necessary."

Ali says one food to avoid is soy, because it contains phytoestrogens – and also to make sure to eat enough healthy fats. She encourages golfers to bring a snack on the course. She recommends a nice, manly snack like beef jerky, which besides containing salt which is good for avoiding dehydration, it also has the requisite protein and fat that helps avoid the crashes that might normally occur if you fill up on sugary snacks.

Ali also speaks to the importance of supplements. "Most guys are deficient in Omega-3, as well as zinc and magnesium, Vitamin B6 and Vitamin D. Those are directly related to testosterone levels in men." Zinc (which is contained in my favorite seafood – oysters) blocks the enzyme which converts testosterone to estrogen.

Why are so many men suffering from low testosterone levels?

Low testosterone is more prevalent today than it was in our grandfathers' time. "Your grandfather didn't have the same issues men today are having," said Ali, who notes that the percentage of American men's testosterone dropped an incredible 17 percent over the past few decades. The question is, why? "A lot has to do with the environment," said Ali. "We live in a very estrogen-saturated environment with toxic chemicals in everything. Our food quality, the water source too – women take birth control, use the restroom and it gets excreted through urine, and then you have all those hormones and estrogen going through the water system."
In addition to the environmental factors, Ali also credits societal factors for the decline in testosterone. It's no surprise that the low testosterone epidemic corresponds to the obesity epidemic. The American Heart Association notes that one in three adults in the U.S. is obese, and another third are overweight – marking a serious health risk of high blood pressure, diabetes, heart disease and stroke – and low testosterone.

"The more obese somebody is, the more sedentary they are. The more body fat you carry, the more estrogen receptors you have, and the more estrogen your body has," said Ali. "That's a health risk. A man's fat storage pattern is becoming more like that of a female. I always say in my talks, we're turning boys into girls, and girls into women a lot quicker. If you look at the adult male who's overweight, they have the hip fat and the belly fat that is consistent with most women."

The normal range in males for testosterone is about 250 to 1100 ng/dL, with an average of 450 ng/dL. There's a big educational curve, and Ali encourages all of her clients of all ages to get their testosterone tested. "Start in your twenties, and you can trendline it and see where you are."

Low testosterone is becoming a very serious problem for men of all ages, but it's not getting the press and attention it deserves. In an increasingly toxic environment, and a culture which embraces unhealthy diet , it will only continue to grow unless major changes are made and awareness becomes a priority.