Effect of Weight Loss on T Levels and Erectile Function
Gain T and Improve Erectile Function With This One Crazy Hack (Weight Loss)
Jeff Tang
July 18, 2023
Hard times create strong men, strong men create good times, good times create weak men, and weak men create hard times.
Hola, in this edition I include the best highlights from the paper, A Perspective on Middle-Aged and Older Men With Functional Hypogonadism: Focus on Holistic Management. The paper is authored by Dr. Mathis Grossmann, professor at the University of Melbourne, Austin Health, Australia, and Dr. Alvin M. Matsumuto, professor emeritus at the University of Washington School of Medicine.
The paper primarily focuses on Obesity, Weight Loss and Testosterone, but does also cover a little about Diabetes, Sleep Apnea, and Osteoporosis, as well as a bit about therapies like TRT. You can see the full set of my highlights here.
Table of Contents
Community
Effect of Weight Loss on T Levels and Erectile Function
Weight Loss and Obesity
Diabetes
Sleep Apnea and CPAP
Data
Editor’s Note
3 High T Links
Community
Decided to postpone the SF T Party to mid or late August. Want to really focus on NYC while I am here. I’ll be hosting an ice bath this Saturday in Brooklyn at the coliving space I’m staying at. Open to all genders and sexes. Reply if you want to join and I’ll add you to a group chat.
Effect of Weight Loss on T Levels and Erectile Function
Weight Loss and Obesity
This infographic tells it at all. As body weight % lost goes up, total testosterone increases. 2 nmol/L is approximately 58 ng/dL, 4 nmol/L is 116 ng/dL
Raw data: study names, sample size N, ages, weight loss intervention, weight loss % of total, and Total T rise.
Obesity is the strongest risk factor associated with low testosterone levels middle-aged and older men.
overweight (BMI, 25 to 30 kg/m2) was associated with a 2.3 nmol/L (66 ng/dL) reduction and obesity with a 5.1 nmol/L (147 ng/dL) reduction in total testosterone and, respectively, a 17.6 pmol/L (5.1 pg/mL) and 53.7 pmol/L (15.5 pg/mL) reduction in free testosterone
A 4 to 5 kg⁄m2 increase in body mass index (BMI) or an incident chronic disease such as type 2 diabetes is associated with declines in testosterone levels equivalent to 10 years of aging
In a meta-analysis, diet-associated weight loss (mean 9.8%) increased testosterone by 2.9 nmol/L (84 ng/dL) and surgical weight loss (32%) by 8.7 nmol/L (251 ng/dL)
Weight loss > 15% was associated with more marked increases in total testosterone [+5.7 nmol/L (+164 ng/dL)], LH (+2.2 IU/L), and free testosterone [+52 pmol/L (+52 pg/mL)].
15% weight loss increased the mean International Index of Erectile Function (IIEF) score by 3.10.
In older diabetic men, weight loss (9.9%) increased the IIEF score by 1.3 relative to controls.
Bariatric surgery studies have reported large improvements in sexual function and sexual quality of life. In a 2-year prospective controlled study of gastric bypass surgery in 64 men (age 49 years; BMI, 46 kg/m2), 30% weight loss increased testosterone by 10.8 nmol/L (311 ng/dL) and reduced sexual dissatisfaction by 7.5 on a 20-scale questionnaire
Mechanisms other than the testosterone increase, including psychosocial factors and body image, may play a role in improved sexual function after bariatric surgery
Knowledge that obesity may be contributing to sexual symptoms and low testosterone levels could provide the motivation to lose weight in some patients.
In obese men, exercise decreased body weight by 5.9 kg and improved erectile function (2.6 increase in IIEF-5 score) ([31]). Given multiple health benefits, exercise, similar to weight loss, should be encouraged routinely.
Interestingly, sildenafil (viagra) alone increased testosterone by 30%
In a rigorous RCT of 140 middle-aged men (mean age, 55 years) with sexual dysfunction and testosterone < 11.4 nmol/L (329 ng/dL), erectile function was initially optimized with sildenafil in all men, leading to a large, clinically meaningful improvement in erectile function (+7.7 on the IIEF erectile function domain)
this increase is also consistent with evidence that resumption of sexual activity by itself can increase testosterone by 30%
erectile dysfunction is an early marker of cardiovascular risk
Diabetes
Up to 50% of men with type 2 diabetes have low testosterone.
A 4 to 5 kg⁄m2 increase in body mass index (BMI) or an incident chronic disease such as type 2 diabetes is associated with declines in testosterone levels equivalent to 10 years of aging
A longitudinal study in 265 men with a baseline hemoglobin A1c of 7.6% reported an inverse relationship between changes in glycemic control and testosterone levels. In those whose glycemic control improved over time, testosterone increased, whereas in those whose control worsened, testosterone decreased
Sleep Apnea and CPAP
continuous positive airway pressure (CPAP), the first-line treatment of obstructive sleep apnoea (OSA), improves erectile dysfunction, fatigue, as well as quality of life
in a recent meta-analysis including 232 men, CPAP had no consistent effect on testosterone level
In a RCT of 67 men with OSA not treated with CPAP, testosterone treatment did not improve quality of life, neurocognitive function, or sexual function, except for a modest increase in sexual desire
Conclusion
1 in 3 adults are obese and 2 in 5 adults are overweight in America. Obesity is increasing in every country around the world.
Average weight is now overweight. Average T is low T. Average mental health is depression and anxiety. Don’t be average.
We’ve setup a society and world where the average person is sick, physically and mentally. Eating healthy is hard and expensive. Eating unhealthy is cheap and convenient.
Don’t accept the way the world is. It wasn’t always like this. It doesn’t need to be like this.
Don’t be average.
Stay High T Friends,
Jeff “Big T” Tang
3 High T Links
Op-ed, Christine Emba: Men are lost. Here’s a map out of the wilderness.
Tweet @georgehristov7, : It is slowly dawning on me that the single thing a lot of incredibly intelligent people could do to vastly improve their lives and impact on the world is to have more courage
Why are we in such a deep courage deficit? What is going on hereBlog: The Rise of the Shaman Bro (and his eventual demise)
How was today's newsletter? |