Low Testosterone And Metabolic Syndrome

Jan 04, 2023
Low Testosterone And Metabolic Syndrome
What is metabolic syndrome? Metabolic syndrome is five conditions that are believed to be interlinked and can lead to heart disease, diabetes, stroke, and other severe and often long-term illnesses. Typically to be diagnosed with Metabolic syndrome,...

What is metabolic syndrome?

Metabolic syndrome is five conditions that are believed to be interlinked and can lead to heart disease, diabetes, stroke, and other severe and often long-term illnesses. Typically to be diagnosed with Metabolic syndrome, you must have three or more of the following conditions:

  • High blood glucose

  • Low levels of HDL

  • High levels of triglycerides in the blood

  • Large waist circumference or “apple-shaped” body

  • High blood pressure

Each of these is a risk factor for heart disease, but when you combine them in a group of three or more, you significantly raise your cardiovascular risk factors. This can also result in the following:

  • Diabetes

  • Stroke

  • atherosclerosis (fatty buildup in artery walls)

Some of the underlying conditions which can contribute to metabolic syndrome:

  • Being overweight or obese

  • Being insulin resistant

  • Not getting sufficient physical activity

  • Being predisposed because of genetic factors as well as advanced age.

Let’s look at the conditions mentioned above:

 High Blood Glucose

Hyperglycemia is the medical term for high blood glucose and is commonly referred to as high blood sugar. This happens when either the body has too little insulin, or the body can’t use the insulin properly. Insulin is a hormone the body produces to regulate blood sugar in the bloodstream.

Suppose this condition persists for an extended period. In that case, it can lead to diabetes and is associated with an increased risk of:

  • Heart attack

  • Stroke

  • Kidney disease

  • Blindness

  • Nerve damage

  • Amputation of the feet or legs

  • Dental disease

Are low serum testosterone levels and type 2 diabetes related?

Research has shown a correlation between men with type 2 diabetes and hypogonadism (low testosterone levels). One explanation could be the fact that overweight males with type II diabetes have an increased amount of aromatase enzyme, which is an enzyme that is found to be in abundance in fat cells and, in turn, is responsible for the conversion of testosterone to estradiol. By increasing a male’s testosterone level, we see an increase in insulin sensitivity.

Insulin sensitivity is the body's ability to respond to insulin. Insulin helps convert glucose into energy, so if the sensitivity is low, then it means that the body isn’t responding correctly to the insulin and, therefore, not converting glucose into energy. This excess glucose is then converted into fat and contributes to obesity, which can then lead to metabolic syndrome. 


Cholesterol, in simplest terms, is a fatty wax-type substance produced in the liver and comes from the food you eat. It is estimated that approximately 20% of the Cholesterol in your bloodstream comes from the food you eat, whereas the body makes the other 80%. Cholesterol is found in all cells in the body and the blood.

Cholesterol by itself can’t be transported by itself in the bloodstream. The body bundles these particles up with proteins which can be mixed with blood. These “lipoproteins” move cholesterol and other fats through the body. The two types of these that get mentioned the most are:

Low-Density Lipoproteins (LDL)

They are often described as “bad” cholesterol. LDL makes up most of your body’s cholesterol. High Levels of LDL cholesterol raise your risk for heart disease and stroke.

High-Density Lipoprotein (HDL)

is often described as the “good” cholesterol. HDL absorbs cholesterol in the blood and carries it back to the liver. The liver then flushes it from the body. High HDL cholesterol levels can lower your heart disease and stroke risk.

LDL becomes increasingly crucial as too much LDL cholesterol builds up on the walls of your blood vessels. This buildup is called “plague” and can cause health problems like heart disease and stroke.

Another component is triglycerides.

Triglycerides are fat in our blood that your body uses for energy. When you eat, your body converts any calories it doesn’t use right away into triglycerides. If you have a high level of triglycerides with low HDL (the good cholesterol) or high LDL (the bad cholesterol), you are potentially at a higher risk of heart disease or stroke.

This is also likely to contribute to being overweight or obese. Cholesterol is an essential substance used to make cell membranes and many hormones, including Endogenous sex hormones.

Endogenous sex hormones

Endogenous sex hormones are hormones that the body produces naturally. They are responsible for sexual development, reproductive health, and gender-related characteristics. The primary sex hormones in humans are testosterone and estrogen.


Testosterone is a hormone produced naturally by the body, primarily in men. It is responsible for various bodily functions, including developing male characteristics such as muscle mass, facial hair, and a deep voice. It also affects sex drive, sperm production, bone density, and red blood cell count.

What can cause low testosterone levels?

Various factors, including aging, obesity, lack of physical activity, medical conditions such as diabetes or kidney disease, and stress, can cause low testosterone levels. Some genetic disorders can also affect testosterone production—androgen treatment which is the intentional suppression of male hormones for unrelated health reasons.

Free testosterone levels vs. bound testosterone levels

Free testosterone levels refer to the amount of unbound, active testosterone in the bloodstream.

Bound testosterone refers to the amount of testosterone bound to proteins and cannot provide a direct effect on the body. This form of testosterone makes up the majority of circulating testosterone in men and women, but unlike free testosterone, it does not have any active effects on the body.

What is the sex hormone binding globulin test?

The sex hormone binding globulin (SHBG) test measures the amount of SHBG in the blood. This protein binds to testosterone and other hormones, making them inactive and preventing them from affecting different body tissues. Low levels of SHBG can lead to higher levels of active hormones, while high levels can result in lower amounts.

What is calculated free testosterone?

Free testosterone is calculated by measuring the amount of unbound, active testosterone in the bloodstream. This is usually done through a simple blood test which measures total testosterone levels and then further calculates free testosterone levels using a mathematical equation to measure the ratio of bound to free-floating hormones in the bloodstream. The results from this calculation estimate how much hormone is available for cellular use and can be used as an indicator of overall health and well-being.

Concerns for aging men

Middle-aged men are particularly at risk of developing low testosterone levels. Declining testosterone levels in aging men can lead to various adverse health outcomes, including:

- Decreased sex drive

- Erectile dysfunction

- Reduced muscle mass and strength

- Increased body fat

- Low energy levels/fatigue

- Mood changes, such as depression or irritability

- Memory loss or difficulty concentrating

- Loss of body hair

- Hot flashes

- Difficulty sleeping


Affects the reproductive tract, the urinary tract, the heart and blood vessels, bones, breast, skin, hair, mucous membranes, pelvic muscles, and the brain. It also influences metabolism and is essential for normal sexual development. Estrogen helps to maintain healthy bones by helping the body absorb calcium, and it can help protect against heart disease.

What happens when estrogen levels are too high or too low?

Too much or too little estrogen in the body can lead to various health problems. High estrogen levels can lead to abnormal menstrual bleeding and an increased risk of certain forms of cancer, including breast and endometrial cancer.

Low levels of estrogen can lead to a decrease in bone density, an increase in cholesterol levels, and other health issues such as hot flashes, night sweats, fatigue, mood swings, and vaginal dryness.

What is an estradiol test?

The estradiol test measures the levels of a hormone in the blood. Estradiol is one of the main types of estrogen hormones, and it plays a vital role in sexual development, fertility, bone health, and other functions.

Low testosterone and cardiovascular risk factors

Some scientific evidence suggests that testosterone deficiency leads to cardiovascular disease, and there is ample evidence that as testosterone levels rise, cholesterol levels fall. So, the drop in our LDL and HLD levels makes sense.

Apple Shaped Mid-section

Apple Shaped Mid-section

Apple shaped body

Obese people (as determined by the body mass index) with metabolic syndrome have a visceral (apple-shaped) fat distribution and have higher risk factors for macrovascular disease. This fat is particularly troubling as it is directly associated with the fat that builds up around abdominal organs and is linked to diabetes, heart disease, and other metabolic abnormalities than fat that lies under the skin. Blood tests typically show higher blood sugar and triglyceride levels in people with belly bulges.

 Body mass index (BMI)

The Body Mass Index (BMI) is an important metric used to determine an individual's level of obesity. BMI is calculated using an individual's height and weight values and measures the person's total body mass. It is a valuable tool for healthcare professionals to use when determining if someone is at risk for being overweight or obese and monitoring an individual's weight status over time.

High blood pressure

High blood pressure or hypertension is generally defined as blood pressure above 140/90 and is considered severe if the pressure is above 180/120. High blood pressure usually develops over time. It is often associated with an unhealthy lifestyle, poor dietary choices, and a lack of regular physical activity. Certain health conditions, such as diabetes and being obese, can also increase the risk of developing high blood pressure.

How is this related to low testosterone?

When we begin to compare not only the interconnection between the five conditions present in Metabolic syndrome as well as the other underlying factors, but we also start to see a strong correlation between them and some of the symptoms of having low testosterone, such as:

  • Heart disease and atherosclerosis

  • Osteoporosis

  • fat deposits

  • Insulin resistance

  • High LDL, Low LDL, High triglycerides

 There is much research to be done to conclusively link the cause and effect of low testosterone on every facet of metabolic syndrome. Still, testosterone has been shown to lower cholesterol, increase lean muscle mass and help protect against heart disease.

Testosterone Therapy may help with metabolic syndrome.

Testosterone Replacement Therapy (TRT) is a treatment that aims to provide people with low endogenous testosterone levels the ability to restore their hormone balance naturally. It has been used to treat various conditions, including metabolic syndrome.

Evidence suggests that Testosterone therapy can help reduce blood pressure and improve overall cholesterol levels by reducing both LDL (bad cholesterol) and triglyceride levels. TRT has also been found to positively affect insulin resistance, helping the body to regulate blood sugar levels better. In addition, TRT may help reduce fat deposition in the abdominal area, ultimately improving cardiovascular health. Finally, TRT can help improve bone density and muscle mass, aiding in weight loss and physical fitness.

The Massachusetts Male Aging Study

A long-term research project focused on aging men's health. The MMAS has been running since 1986, including around 1,700 participants from different socioeconomic backgrounds. The study is conducted by the Harvard T.H. Chan School of Public Health and funded by the National Institute of Health. The MMAS has shown that, among other things, testosterone therapy can help improve the symptoms of metabolic syndrome in older men and potentially prevent or delay the development of related diseases. This study further demonstrated that low T levels in a nonobese population were found to predict the later onset of the metabolic syndrome, particularly among men with a BMI < 25 kg/m 2

Common low testosterone treatments

• Testosterone Replacement Therapy (TRT): TRT uses synthetic testosterone to treat men with low levels. It can be applied as a topical gel, injected, or implanted under the skin in pellet form.

• Natural Supplements: Herbal supplements such as ginseng and Tribulus Terrestris are known to help increase testosterone levels naturally.

• Diet and Exercise: Eating healthy foods, exercising regularly, getting adequate sleep, and reducing stress may help raise testosterone levels. It’s important to note that diet and exercise alone won’t necessarily restore normal testosterone levels; however, they should be part of any treatment plan.

Testosterone Replacement Therapy

While Testosterone replacement is not a miracle cure for metabolic syndrome, There is convincing evidence that low testosterone is an independent risk factor. Testosterone replacement can positively affect the health of those with low testosterone levels.

If you are experiencing any symptoms associated with metabolic syndrome and have been diagnosed with low testosterone, then Testosterone replacement should be considered as an option. Your doctor will be able to evaluate your symptoms and advise you on the best course of action. With the help of Testosterone replacement, many men have been able to restore balance to their hormones and enjoy better overall health.


Metabolic Syndrome is an umbrella term for several conditions often seen together, including obesity, high blood pressure, insulin resistance, and low testosterone levels. Low testosterone can seriously affect overall health and well-being, so it’s essential to recognize the signs of low testosterone early and seek treatment if necessary. Testosterone Replacement Therapy (TRT) may help reduce risk factors associated with Metabolic Syndrome, such as cholesterol levels, and fat deposits in the abdominal area.

Titan Wellness Center

Titan Wellness Center


Q. What is Metabolic Syndrome?

A. Metabolic syndrome is a group of conditions that increase the risk of heart disease, stroke, and other health problems such as diabetes and obesity. It includes high blood pressure, excess fat around the waist, elevated cholesterol levels, and high blood sugar levels.

Q. What are the causes of Low Testosterone?

A. Low testosterone can be caused by various factors, including aging, lifestyle choices (diet, exercise, etc.), genetics, and medical conditions such as hypogonadism or testicular injury or infection.

Q. Is there a link between metabolic syndrome and low testosterone?

A. Yes, there is a link between metabolic syndrome and low testosterone. Low testosterone has been associated with a higher risk of developing heart disease, diabetes, obesity, osteoporosis, and other health issues.

Q. How can Testosterone Replacement Therapy help?

A. Testosterone replacement therapy (TRT) is a treatment that aims to restore hormone balance naturally in men who have low levels of testosterone. TRT has been found to reduce cholesterol levels, improve insulin resistance and reduce fat deposition in the abdominal area - all of which are beneficial for those suffering from metabolic syndrome. In addition, TRT may also help improve bone density and muscle mass, aiding in weight loss and physical fitness.

Q. Can Metabolic Syndrome be reversed?

A. Although Metabolic Syndrome cannot be cured completely, it can be managed through lifestyle changes such as maintaining a healthy diet and exercising regularly. In addition, Testosterone Replacement Therapy may help to reduce the risk of further health complications associated with metabolic syndrome.

Q. What should I do if I think I have low testosterone?

A. If you think you may have low testosterone levels, it is crucial to speak to your doctor, who will perform a blood test to determine whether or not this is the case. They will then let me know the best course based on your circumstances.

TRT may be recommended in some cases to restore balance and improve overall health and well-being. At Titan Wellness, we specialize in this area and provide a comprehensive hormone replacement strategy tailored to your needs. We are here to help you get back to living your most optimized life. Please feel free to contact us for more information. We look forward to hearing from you soon!

Q. Is testosterone involved in increasing insulin resistance?

Yes, low testosterone has been associated with an increased risk of insulin resistance. Testosterone replacement therapy (TRT) may help to reduce cholesterol levels and improve insulin sensitivity, thereby reducing the risk of metabolic syndrome. Additionally, TRT may help to increase muscle mass and improve bone health.

Q. what is subnormal plasma testosterone?

Subnormal plasma testosterone is a medical condition in which the level of testosterone, the male sex hormone produced by the testes, falls below the amount typically considered to be expected. This condition is also known as hypogonadism or low testosterone.