In functional medicine, we strive to address the underlying cause(s) of illness, not merely to provide symptomatic relief. So when someone visits my office with symptoms of low T — low libido, erectile dysfunction, fatigue or hot flashes, muscle weakness, weight-loss resistance, and so on — I don’t just treat the low T. Instead, I ask what’s causing it, and the answer to that question is often metabolic syndrome.

I then ask what’s causing the metabolic syndrome, and I work with my patient to identify and address the root causes of that condition. After successfully addressing the metabolic syndrome, we can then reassess hormone levels and seek other ways to restore healthy levels, if necessary.

I refer to this approach as “baking the cake.”

What Is Metabolic Syndrome?

Metabolic syndrome is a cluster of biochemical and physiological abnormalities that place a person at a higher risk of developing cardiovascular disease (CVD) and type 2 diabetes. While there are several definitions and different sets of criteria for diagnosing metabolic syndrome, the easiest set of criteria used to diagnose metabolic syndrome is the one proposed by the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III), which is a program managed by the National Heart, Lung and Blood Institute. According to the NCEP ATP III, you’re likely to have metabolic syndrome if you meet three of the following five criteria:

  • You’re a man with a waist circumference over 40 inches
  • You’re a women waist circumference over 35 inches
  • Your blood pressure is over 130/85 mmHg
  • You have a fasting triglyceride (TG) level over 150 mg/dl
  • Your fasting high-density lipoprotein (HDL, “good cholesterol”) is less than 40mg/dl (men) or 50 mg/dl (women) and your fasting blood sugar is over 100 mg/dl

Given these criteria, 30 to 35 percent of all Americans are estimated to have metabolic syndrome. Take that in, because the implications are tremendous. It means that one third of our population (possibly including you) is a ticking time bomb. It means that even if you are taking medication for your high cholesterol and blood pressure, you may still have the underlying mechanisms in your body that will lead to a higher risk of heart disease and diabetes and predispose you to certain cancers, even though your lab results show that your blood pressure and cholesterol are acceptable.

Exploring the Metabolic Syndrome–Low T Connection

So, what does metabolic syndrome have to do with testosterone? A rarely mentioned symptom of metabolic syndrome is a sharp decline in hormone levels for both men and women. This can happen at any age, and it certainly happens to most of us as we get older.

The double edge sword is that a decline in testosterone worsens the metabolic syndrome, causing chaos in the endocrine system — the collection of glands that produce hormones to regulate metabolism, growth and development, tissue function, sexual function, reproduction, sleep, mood, and so on.

Without adequate testosterone levels, sugar (glucose) levels are difficult to balance, sleep suffers, pain ensues, and depression or anxiety can set in, not to mention the total lack of libido for both men and women.

Baking the Cake

Many people with symptoms of low T visit a hormone clinic and start taking hormone supplements. Now, while there may be some value to that approach, too often the metabolic syndrome is ignored, testosterone levels continue to decline, and higher doses are required. Eventually, the honeymoon is over and symptoms return regardless of the dose.

A more effective approach, by far, is to “bake the cake.” With this approach, we address the metabolic syndrome first through changes to diet and lifestyle and by adjusting nutrients in order to restore your body’s natural ability to produce testosterone. This alone may enable your body to produce enough testosterone to achieve healthy function and make you feel much better.

If at that point testosterone is still required, it will feel more like icing on the cake. The good feeling that is provided by optimizing testosterone levels will be more consistent, and you’ll gain the true benefits of protecting yourself from heart disease, diabetes, and certain cancers.

Disclaimer: The information in this blog post is provided for general informational purposes only, and may not reflect current medical thinking or practices. No information contained in this post should be construed as medical advice from Dr. Matt Lewis, D.C., DACBN, CFMP®, nor is this post intended to be a substitute for medical counsel on any subject matter. No reader of this post should act or refrain from acting on the basis of any information included in, or accessible through, this post without seeking the appropriate medical advice on the particular facts and circumstances at issue from a licensed medical professional in the recipient’s state, country or other appropriate licensing jurisdiction.

About the Author: Dr. Matt Lewis, D.C., DACBN, CFMP®, specializes in diagnosing and treating the underlying causes of the symptoms related to chronic and unexplained illness through nutrition, lifestyle, chiropractic, and other natural approaches to whole-health healing in Tampa, Florida. He earned his B.S. in Biology from Shenandoah University, his Doctorate in Chiropractic from Life University, his Diplomate status in Clinical Nutrition from the American Clinical Board of Nutrition, his CFMP® from Functional Medicine University, and his certification as a Digestive Health Specialist (DHS) through the Food Enzyme Institute. Dr. Lewis’ passion for health and wellness stems from his own personal experience. With a family history of autoimmune conditions and diabetes, and his own lab tests showing his genetic susceptibility to Hashimoto’s thyroiditis (autoimmune thyroid), he has learned how to restore his own health and vigor to prevent the onset of these and other illnesses and live an incredibly active life. Through this process, he acquired a deeper understanding of health and wellness, which he now offers his patients in Tampa.