Dr. Michelle Weiner
Lifestyle Medicine


When Estrogen & Testosterone Get Out Of Whack, Here's What To Do

I've written before about how many men are experiencing both low testosterone levels (low T) and increased estrogen levels. This combination of hormone imbalances can result in a man packing on the belly fat—and even developing breast tissue! It can also result in decreased mental ability and energy levels, depression, and issues with sexual function like loss of libido and erectile dysfunction. Low testosterone is also a risk factor for heart disease, obesity, metabolic syndrome, diabetes, osteoporosis, and other health issues.

The good news is that men can do something about low testosterone and high estrogen, returning these hormones to healthy levels. In fact, there is a ton of ways that men can rebalance their hormones through healthy lifestyle change. Here's where to start:

Always maintain a healthy weight.

Being overweight is a huge contributor to sex hormone imbalance; in particular, body mass index (BMI) is correlated to lower levels of total testosterone. Obese men—and men with metabolic syndrome or type 2 diabetes—have lower total and free testosterone as well as low sex hormone-binding globulin (SHBG). Why is this? Well, extra abdominal fat (also known as visceral fat) is estrogen's favorite place to hide. Visceral fat is also known to contain inflammatory factors, which contribute to a greater risk of cardiovascular disease and erectile dysfunction. Conversely, men having low testosterone and/or lower levels of SHBG have a greater risk of developing metabolic syndrome and type 2 diabetes. In short: Unhealthy weight gain and abdominal fat need to go!

Adopt a ketogenic diet.

To best address weight gain, hormone imbalances, and low testosterone concerns, I recommend a ketogenic diet with a focus on alkaline foods. This is my own long-term health program and includes four components:

1. Maintaining a net alkaline pH in your body (and measuring that!)

2. Eating a keto diet (and measuring ketones!).

3. Incorporating intermittent fasting into your diet.

4. Living an overall alkaline-friendly lifestyle, including more exercise, quality sleep, reduced stress, positivity, and more.

These lifestyle changes can help balance hormones and aid your body in the detoxification process, support lean muscle mass and healthy bones, and turn you into a fat-burning machine (Remember, all of that fat storage is where all the excess estrogen is likely hiding!). It can also optimize blood sugar and insulin levels, lead to more energy, an improved mood, and healthier libido, and help suppress appetite by normalizing leptin and ghrelin hormones—which control hunger signals. This is all due to a ketogenic diet's ability to switch your body to using fat as its fuel source instead of glucose.

Focus on healthy fats.

So what do you eat on a keto-alkaline diet? The diet I recommend to my patients consists of 20 percent healthy protein, 56 to 70 percent healthy fats (like omega-3 fatty acids), and 5 to 8 percent healthy carbs. People are always a bit shocked about the percentage of fats, but they can be healthy for you in so many ways. There is even research that supports the thinking that when men decreased their healthy fat intake, serum concentrations of testosterone and free testosterone also decreased.

Learn to control stress.

The bottom line here is that when cortisol (your stress hormone) is elevated, testosterone’s effects are reduced. And this makes a lot of sense. Why would a body in "fight-or-flight" be channeling energy to maintain a healthy libido?

Experiment with intermittent fasting.

As you decrease the amount of sugar you consume and increase the amount of healthy fats in your diet, it's also great to adhere to some level of intermittent fasting. For most of my patients, this means leaving a 13- to 15-hour window between dinner and breakfast. This creates a need for the body to find energy reserves beyond stored glucose, as the body can store reserves for only about 24 hours. Intermittent fasting will allow you to drop your glucose storage levels way down, and your body will burn more fat. 

Exercise is important. But do the right kind!

High-intensity interval training (HIIT), or burst training, is the best exercise for hormone balance and metabolism, as it has been found to boost testosterone levels and burn fat. HIIT is when you exercise strenuously in short bursts, with periods of less intense exercise in between. Strength training is also important in supporting a natural increase in testosterone. Go with more weight and lower reps, and focus on working a wide range of the larger muscle groups (think hamstrings, back, chest, shoulders, quadriceps).

written by- by Anna Cabeca, D.O. August 6, 2017 for www.mindgreenbody.com