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Male Panels

Four hormones make up the Male Panel: testosterone, estradiol, DHEA-S and cortisol. Interactions between these hormones are fundamental to health and, as a consequence, imbalances may negatively impact health. Progesterone levels are generally not useful in men, although if men are exposed to progesterone cream through skin to skin transfer from a partner, there can be significant accumulation and testosterone deficiency symptoms may ensue.

 

Testosterone

  • Production of testosterone is stimulated by luteinizing hormone (LH).
  • Low testosterone levels may be a result of decreased hormone production or due to increased conversion of testosterone to estradiol via the aromatase enzyme.

 

Estradiol

  • The brain regulates LH output via estradiol levels. If estradiol is high, LH shuts down and testosterone production declines.
  • Excess estradiol can compete with testosterone at gene response sites, and thus interfere with the message testosterone is trying to deliver.

 

Testosterone/Estradiol Ratio

  • Our laboratory data shows that the ratio of testosterone to estradiol for a 20 year old man is between 20 and 40. A decrease in the T/E2 ratio is associated with an increased risk of cardiovascular disease.
  • The aromatase enzyme that converts testosterone to estradiol is found in adipose fat cells. Men with central adiposity or high cortisol levels may have more aromatase activity and therefore convert more testosterone to estradiol.

 

Cortisol

  • Cortisol and testosterone deliver opposing messages to many of the same genes. Consequently, when cortisol levels are high, men with normal testosterone levels may have symptoms of testosterone deficiency because the elevated cortisol interferes with the testosterone message. This results in a functional deficiency; where the system has normal levels of testosterone, but functions as if there is not enough.
  • High cortisol can induce aromatase, which speeds the conversion of testosterone to estradiol, resulting in elevated estradiol levels.
  • Excess cortisol is catabolic for bone and also opposes the action of testosterone, which is anabolic for bone. Thus, significant bone loss may occur with elevated cortisol levels.
  • Over time, high cortisol levels may exhaust the adrenal glands and result in decreased cortisol output.

 

DHEA-S

  • DHEA is stored in the blood mainly in its sulphate form, DHEA-S.
  • Cortisol and DHEA have opposite effects on immune function and insulin regulation.
  • High cortisol levels mean more DHEA must be released to balance effects of cortisol therefore, chronically elevated cortisol can result in a deficiency of DHEA.
  • The ratio of cortisol to DHEA-S increases with age, mostly because of declining DHEA levels. ZRT Laboratory data shows the ratio at age 20 is 0.6, age 45 is 1.0, age 60 is 1.5, and age 75 is 2.3.
  • Low DHEA-S levels may be associated with hypothyroidism, depression, and chronic fatigue.