Natural Treatment For High Testosterone

Natural Treatment For High Testosterone

Jennifer* came to my office looking for some help losing weight. (*This patient’s name and some details were changed for anonymity) She was frustrated because she was doing many things right, but the pounds just weren’t coming off. She needed some assistance figuring out what was at the source of her problem.

During my medical interview, she told me was about to get married and wanted to have kids with her soon-to-be husband. I could sense there were a lot of emotions bound up in this statement, so I gently encouraged her to say more. She said her menses had been irregular, and she’d been on birth control for many years. The medication helped manage her menses, but she was concerned because she had just come off it and again she was having irregularity – she was afraid she might never get pregnant.

Jennifer had a stressful career and had been at it a few years, so she was working her way up the ranks. Long hours at the office meant she was exercising less, eating more take-out food, and drinking alcohol to calm down after a long day. She also admitted that she was occasionally smoking cigarettes, to help with her stress. I had started to form a good picture of her overall health and lifestyle, but I had some more questions for her.

She sat on my exam table, and I started my examination on her scalp. I asked if she had noticed any changes in her hair, or hair loss. She showed me a spot on the back of her head she wanted me to look at, and sure enough, the hair was thinning in the classic “bald spot” area that’s usually seen with men. Though she was wearing makeup, I could see what looked like acne around her jaw. I asked her plainly if she ever grew hairs on her chin, “Yes, thick dark ones! I always pluck them! How’d you know?”

I told her that I had a good idea what was going on with her. She had many of the classic symptoms of a woman with high testosterone, a finding associated with a condition called PCOS (polycystic ovarian syndrome). With her weight gain, I suspected her thyroid gland may have been under-functioning too, a condition called hypothyroidism. We ordered some lab testing to confirm our suspicions and in a week she came back in to discuss the results, and what we could do.

When her labs came back her testosterone was quite high. Two other hormones, insulin and DHEA-Sulfate also tested high and her vitamin D was low. She was surprised to find her full thyroid panel was normal. I explained to her the tests had confirmed my suspicions of polycystic ovarian syndrome and that her testosterone levels were causing many of her symptoms, but that her low vitamin D and high insulin were driving her testosterone up.

We started a comprehensive natural medical treatment plan, including lifestyle changes, dietary advice, and a few supplements. Within two months her menses were normal and she was losing the weight she had initially come in to be treated. Another few months went by, and she called the office to let me know she would probably be heavier the next time I saw her. “Why’s that?” I asked foolishly. “Doctor, I’m 5 weeks pregnant! I want to make sure everything on my treatment plan is safe for the baby.” At that point, we had taken her off anything that didn’t have known safety during pregnancy.

Jennifer’s case is a great example of a typical presentation of a woman with high testosterone. Below I’ll describe some of the causes, and natural treatments of high testosterone in women. As with any medical condition, it’s best to see a licensed health care professional for diagnosis and treatment – I’ve seen a few cases where patients self-diagnosed and treated that actually made things worse.

Symptoms of High Testosterone in Women:

Most females with high testosterone will have a combination of two or more of the following:

● Difficulty losing weight or weight gain. Testosterone can increase your muscle mass, which can make it difficult to lose weight.
● Menstrual irregularities or no menstruation. High testosterone can oppose the effects of female sex hormones, estrogens, and progesterone.
● Mood changes. Testosterone can affect the emotional centers of your brain, making you more prone to anger, irritability, and loss of libido.
● Hair loss on the scalp, especially when seen in “male pattern” baldness areas.
● Hair growth (typically thick/dark) in “androgen-dependent areas” – upper lip, chin, chest, abdomen, back, and buttocks.
● Acne, especially near the jawline.
● Deepening of voice.
● Loss of breast tissue, clitoral enlargement.

Labs Helpful in Diagnosis of High Testosterone:

Some or all of the following labs can be run to help understand if you have, and what is causing high testosterone.

● Total/Free Testosterone – It’s helpful to measure both of these, as the “free testosterone” is what is available to your body. You could have a normal testosterone, but high “free testosterone”. A very high level could be a sign of a tumor that is making testosterone.
● DHEA-S – This is another hormone in your body, made in your adrenal glands, with actions similar to testosterone. DHEA can also be converted into testosterone by your body, so high levels make it more likely you’ll make more testosterone.
● Vitamin D -Think of Vitamin D as not just a vitamin, but actually a hormone. It’s in the same family of hormones as cortisol, DHEA, testosterone, and estrogen. Low levels of Vitamin D are tied to insulin resistance in women with PCOS. Most labs will cut off the lower level at 30, but in a patient who is symptomatic I supplement their levels until they are between 50-80, because not everyone’s vitamin D receptor works as efficiently.
● Insulin – High levels of insulin can cause the ovaries to make more testosterone than normal. It may also be a sign of insulin resistance.
● Hemoglobin A1c (HbA1c) – This is a measure of your blood glucose levels over a 3 month period. If this is elevated it can suggest insulin resistance.
● Human Chorionic Gonadotropin (hCG) – This test is usually done if pregnancy is possible, and may be run as a precaution whenever a woman comes to the doctor reporting irregularity or not having menses.
● Prolactin – If this hormone is high it can cause hair growth, changes in menses, and a condition called galactorrhea (excessive or inappropriate milk production).
● Follicle-Stimulating Hormone (FSH) – These hormones from your brain, can influence ovulation, estrogen, and testosterone production. They can be helpful in looking at the whole picture of what’s going on with your hormones.
● Thyroid-Stimulating Hormone (TSH) – Some thyroid problems can mimic or add to the symptoms of high testosterone.
● 17-Hydroxyprogesterone – this test is rarely done, but can be run if your doctor suspects you have a condition called non-classic congenital adrenal hyperplasia.

Natural Treatments for High Testosterone in Women:

Lifestyle Factors:

● Exercise – Numerous studies and my experience with patients show that exercise is probably the most effective treatment for insulin resistance. Since insulin resistance is the cause of high testosterone production in nearly all cases, it makes sense to start with this as a foundation. Typically 150 minutes per week of moderate exercise is the “dose” where we start to see effects, some patients need a bit more. What’s “moderate exercise?” If you can sing while doing it, that’s light exercise. If your lifestyle hasn’t been so active, start gently – injuries can set you way back.
● Avoid Cigarettes and Alcohol – Like exercise, this is good general health advice. Also, studies have shown cigarette smoking and alcohol can make the symptoms from high testosterone worse.
● Reduce Sugars and Refined Carbohydrates – Sugars and the insulin response that follows create the conditions for your body to make too much testosterone. Reducing these will help dampen the effect, and help you to lose weight – which is incredibly effective in reducing high testosterone in women with polycystic ovarian syndrome.
● Eat a (Healthy) Vegetarian Diet – Eating vegetarian just describes what you’re not eating, and I’ve seen many patients actually eat an unhealthy vegetarian diet. A healthy vegetarian diet will be high in vegetables, fruits, and whole grains. The increased fiber of eating mostly plant-based foods helps in 3 ways:
○ It slows the release of sugars from the diet into the bloodstream, making your blood sugar more stable.
○ It feeds good bacteria in your digestive tract, which in turn help your overall health.
○ It acts like a sponge and helps to absorb hormones your body is trying to get rid of through the bile (from the liver), so you don’t reabsorb them into your bloodstream.

Foods/Supplements:

● Fish Oil (DHA/EPA) – Several studies have shown that doses between 3000-6000mg per day of fish oil can reduce both insulin resistance and testosterone levels in women with PCOS. Eating coldwater fish is another option. Salmon, herring, mackerel, sardines, anchovies, halibut, trout and tuna are good examples of food sources high in omega-3 fatty acids.
● Soy – Foods made from soy have some estrogen-like activity, and may be helpful for women with high testosterone. Because of this effect soy foods should be eaten in moderation, so you don’t overdo it with this effect.
● Beans – Foods in the legume category are high in fiber (see vegetarian diet above), and inositol (see below).
● Nuts – Nuts are a great source of mono, and poly-unsaturated fatty acids (MUFA/PUFA). These can help lower testosterone, insulin, and cholesterol. They can also increase something called “sex hormone binding globulin” (SHBG), which “soaks up” testosterone in the blood and makes it less active, by lowering free testosterone.
● Ground Flax Seed – Flaxseed contains lignans which have estrogen-like activity. Typically this is dosed at 30 g per day, which can be tough for many patients – I usually tell them to start at 10 g and work their way up. Ground flax can be added to salads, smoothies, yogurt, and cereals.
● Vitamin D3 – As I mentioned in the lab section, low vitamin D levels are associated with insulin resistance. Typically I supplement patients until their labs are in Ithe 50-80 range.
● Myo-Inositol (Inositol) – Studies have shown supplementing 2 g twice a day lowers both insulin resistance and testosterone levels. They have also shown women with PCOS who continue this treatment through pregnancy have a lower risk of developing gestational diabetes. Myo-inositol is a little different from D-chiro-inositol, which is another supplement you may see which has similar actions – I usually use the “myo” version in my practice.
● N-Acetyl-Cysteine (NAC) – In uncontrolled studies (lower quality of evidence), 600-1000mg of NAC three times a day reduced insulin resistance, testosterone levels and symptoms of high testosterone in women with PCOS.

While the symptoms of high testosterone can be frustrating, there are many natural options to lower it. In my experience natural interventions are both safe and effective, though employing more than one treatment is usually needed to get the best results. Initially I see patients every 4-6 weeks while we’re finding which treatments are most effective, then follow up with labs once to twice year to monitor for optimal responses.

Categories: Women's Health

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