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Written by Dr. Welsh, Article reviewed and edited by Dr. Fine M.D..
Published on 26 August 2014

Serotonin Hormone Guide

What is Serotonin?

Serotonin is an important hormone that regulates a wide variety of functions in the body, and is most notable for its effects upon mood and well-being. Serotonin is found in a number of areas of the body, including the brain, central nervous system, platelets and digestive system. Serotonin is synthesized by the body from a hormone known as tryptophan, which most people recognize as the hormone in turkey and many other foods that makes us sleepy. Maintaining Serotonin balance is a vitally important aspect of promoting both the health of the brain and the health of the body.

Effects of Serotonin both Psychological and Physiological

Perhaps contrary to popular belief, the vast majority of serotonin that is produced by the body is secreted into the digestive system, in order to promote motility in the intestinal track. Around ninety percent of the serotonin released by the body serves this purpose.

When Serotonin is released by the digestive system, it acts upon the intestines and drains out into the blood stream over time. Platelets actually have the ability to absorb this Serotonin, and use it for their own purposes. Platelets are cells in the blood stream that don't have nuclei which are primarily used as a clotting mechanism. When the platelets begin to form a blood clot, they emit their stored serotonin, which shrinks blood vessels in the surrounding area in order to control blood flow and help stop circulatory leakage.

Serotonin also promotes cellular metabolism in certain types of tissue, and it is hypothesized that the hormone helps speed up healing in the case of injury.

Neurological Effects of Serotonin

Aside from the digestive system, the second most active area for Serotonin production is the central nervous system, where the hormone impacts physiological activity in a variety of ways. Serotonin impacts a number of regulatory systems in the brain, including sleep, appetite, and mood.

Serotonin also has some influences on learning, memory, and other cognitive abilities. There are a number of antidepressant medications that function by altering the way that the body responds to Serotonin, including Selective Serotonin Reuptake Inhibitors (SSRIs).

Serotonin in Nature

Serotonin is not only found in humans and animals, but also in plants and fungi. Serotonin actually has the ability to promote a pain response under some circumstances, and the hormone often coats the barbs of plants and is often a component of venom in insects. In fact, when Serotonin is administered via injection, it can sometimes cause pain to the patient, as if they were bitten or stung.

Serotonin and Digestive Health

There are also instances where Serotonin is produced by organisms within the digestive system. For example, there are amoeba which can replicate in the stomach and intestines, which release Serotonin, speeding up the digestive tract, which leads to diarrhea. Also, Serotonin is present in many fruits and seeds, which causes the digestive system to pass seeds more effectively.

Serotonin Produced by All Complex Animals

Serotonin is an important neural hormone and is produced by all animals with bilateral symmetry. Dependent upon the complexity of the organism, Serotonin serves an increasingly larger role in the nervous system. In simple animals like invertebrates, Serotonin primarily helps the organism to recognize the abundance of food in a particular area.

In more evolved animals, like vertebrates and arthropods, Serotonin not only evaluates food resources, but also plays a role in social interactions, including dominance and submission. Because reproduction and the viability of young depend on food availability, Serotonin contributes to the production of sex hormones and the motivation to breed. Serotonin also has a powerful impact on growth and mood.

Serotonin, Depression, and Obsessive Compulsive Disorder

Serotonin plays a complex role in maintaining healthy emotional balance in human beings. People that don't produce enough Serotonin are both more likely to suffer from depression and more likely to suffer from compulsive thoughts. Related to the mechanisms of Serotonin, people that don't produce enough Serotonin are more likely to engage in risky activities, including promiscuous sex and self-harm.

There is some clinical evidence that Depression inhibits the brain's ability to produce new neurons in the brain, which suppresses activity in certain parts of the brain, in particular, those related to mood stability and well-being. It is believed that SSRIs have the ability to restore Serotonin Levels in the brain, encouraging the rejuvenation of brain cells, which helps the mind recover from depression and generally improve quality of life from a psychological perspective.

It is unclear, however, whether Serotonin Deficiency leads to depression or if it is perhaps the other way around. Of course, depending on the particulars of the patient, either or both of these issues could be at play. In patients that experience chronic depression and OCD from an early age, the cause would primarily be neurological, whereas in patients that experience depression later in life, the cause is much more likely to be the result of circumstances in their lives.

How Do SSRIs Treat Psychological Disorders such as Depression and OCD?

One of the most common treatments for both OCD and Depression is the prescription of a Selective Serotonin Reuptake Inhibitor. These medications increase the activity of Serotonin in the brain by slowing down the rate at which neurons reabsorb Serotonin after releasing the hormone. The way that our body uses Serotonin is rather simple. A neuron receives a signal to release Serotonin, and it does so, releasing it a very short distance to the next neuron, where it remains active in the space between the neurons, exerting its function.

In many patients with OCD and Depression, Serotonin is released, but it may not be released in sufficient quantities, or it may not stay active for the appropriate amount of time before it is absorbed. SSRIs can treat both of these issues by increasing the Serotonin activity in the brain.

Functions of Serotonin in Humans

Serotonin and Appetite

Many animals use Serotonin as a mechanism to convince the animals to stay in the presence of food, but in humans, Serotonin is used as an appetite inhibitor. When you smell food, this causes your brain to release Dopamine, which is why you suddenly get more hungry when you smell an appetizing meal. Serotonin, on the other hand, is released when you actually eat the food, which suppresses the release of Dopamine by the brain.

There are receptors on cells in the brain that produce Dopamine, known as 5-HT2C. These points absorb Serotonin and subsequently cause the cells to cease the production of Dopamine. In fact, there are drugs and neurological disorders which cause these receptors to deactivate, which prevents the brain from recognizing when its full, which leads to overeating. Many people that feel uncontrollable urges to eat are born without a full array of these receptors.

Serotonin and Diet

As we mentioned earlier, Serotonin is synthesized by the human body from tryptophan. Interestingly enough, simply eating food with tryptophan as an ingredient, such as turkey, does not have a subsequent effect upon Serotonin Levels. On the other hand, eating pure tryptophan does lead to an increase in Serotonin Levels.

There is a reason for this. tryptophan can cross the barrier from the blood stream to the brain, but only under certain circumstances. Tryptophan only crosses the barrier when it is isolated from other proteins that are present in food. This encourages the body to only allow tryptophan produced by its own peripheral organs to pass into the system easily, although this can be bypassed by taking pure tryptophan.

There are studies that present evidence that a high-carb low-protein diet can result in an elevation in Serotonin levels, and it does so by promoting the release of Insulin. The issue with this, however, is that if this process is sustained for a long period of time, it may lead to conditions such as Type-2 Diabetes, obesity, and increasing resistance to insulin which ultimately suppress Serotonin production.

People with more muscle actually have more Serotonin than their leaner counterparts. This is because the muscles use all amino acids except tryptophan, which, because the brain absorbs more Tryptophan when there are lower concentrations of other amino acids, increases Serotonin production.

Serotonin and the Digestive System

When we eat, food passes through the digestive system. As food passes into the intestines, it encourages the release of Serotonin by what are known as enterochromaffin cells. This encourages motility because it stimulates the contraction of the intestines. There are veins which connect to the intestines, and platelets pass this area, absorbing unused Serotonin.

Serotonin is also one of the mechanisms which cause diarrhea. If the body recognizes an irritant or potential danger in the digestive system, production of Serotonin in the digestive system increases dramatically in order to pass the offending substance(s) out of the body more quickly.

If the digestive system creates more Serotonin than the platelets can transport, this increases the concentrations of free Serotonin in the blood stream. Free Serotonin then circulates through the body and encourages nausea and vomiting. There are drugs designed to block this response, and they are generally used in order to suppress vomiting and nausea which are often symptoms of chemotherapy and radiation.

Serotonin and Social Interaction

In many animal species, one's access to food is dependent upon competition. If an animal does not display enough aggression, it may not get as much food to eat. Based upon this inter-relationship between social hierarchy and food availability, Serotonin became involved in social interaction from an evolutionary perspective.

In many animals, Serotonin encourages the animal to engage with its social peers as an alpha. On the other hand, Serotonin impacts the fight-or-flight response dependent upon the social rank of the animal. In aeta-subordinate animals, Serotonin suppresses the urge to flee, whereas in alpha animals, Serotonin encourages flight, based upon a different distribution of Serotonin receptors.

When Serotonin is used by the brain, it is usually absorbed by neurons designed to transport Serotonin. Research has shown that much of the pathology related to anxiety in humans is related to how Serotonin is distributed after it has been absorbed by these transporters.

Serotonin and Aging

There are many ways that Serotonin impacts the aging process, as well as the cognitive capabilities of the brain. In many more primitive animal species, as Serotonin levels rise, it improves certain forms of memory. Serotonin levels falls as the creature ages, which inhibits these processes, but by blocking the re-uptake of Serotonin, it is possible to bolster cognitive memory capability in spite of aging.

In human beings as well as mammals, Serotonin levels do not rise with age in the same way, but they do start to fall as people reach the late stages of the life span, which does impact cognitive capacity.

Serotonin and Bone Mineral Density

Research has shown that in human beings, Serotonin concentrations in the blood stream play a role in controlling and regulating bone mineral density. In rodent subjects, individuals that have their ability to produce Serotonin turned off in the brain but not in the digestive system experience Osteopenia. On the other hand, those that have high levels in the brain, but do not have high levels in the digestive system have elevated bone mineral density.

Human research has not been as in depth, but there is strong evidence that individuals with elevated Serotonin levels in the blood are more likely to experience Osteopenia and Osteoporosis later in life. In the future, regulating Serotonin may be a way to treat patients with health conditions related to bone metabolism.

Serotonin and Human Development

In many animals, Serotonin plays a central role in encouraging normal growth and development into adulthood. Proper Serotonin levels during childhood and adolescence ensure that the body focuses the prime amount of resources into the developing child. If there is not enough food available, or there are other similar situations which can impact health and viability during development, Serotonin levels drop, which causes the child to develop more slowly.

Serotonin also promotes the production of HGH and its related growth factors, especially IGF-1. This is one of the mechanisms which helps encourage growth during puberty, and it also increases healing capacity in the case of injury.

Serotonin and the Cardiovascular System

As we mentioned earlier, Serotonin is released by the digestive system and eventually absorbed by the platelets in the cardiovascular system. When there is damage in the arteries or veins, Serotonin encourages the healing process as it is released from the platelets after they have formed a blood clot. This released Serotonin also emits signals to the immediate area to restrict blood flow, which helps to stem bleeding.

How Does the Human Body Make Serotonin?

There are two mechanisms by which human beings and other mammalian species produce Serotonin, both of which rely on the conversion of Tryptophan into Serotonin. One form of Tryptophan known as TPH1 is converted into Serotonin by the digestive system (the enterochromaffin cells) and the pineal gland, while a second form, TPH2 is converted into Serotonin by circulatory structures attached to the digestive system (the myenteric plexis) and neurons in the brain stem (the raphe nuclei)

In lab mice, TPH1 is shown to be vitally important to heart health, and without the ability to produce TPH1, the subjects have significant issues with heart strength and circulation and have significantly increased mortality.

On the other hand, mice without the ability to produce TPH2 are fine while they are in utero, but they don't grow at the same rate as their peers after birth causing them to be much more likely to die before they have been weaned from the mother. If they survive past five weeks, they end up as healthy as their normal peers, but have significant social issues related to aggression.

How Does Serotonin Deficiency Impact Infant Health?

In the case of human beings, there is some evidence that SIDS may be the result of a malfunction in the way that the infant body processes Serotonin. In animal research, when mice were programmed to produce less Serotonin than normal, it directly led to many issues related to Sudden Infant Death Syndrome, including cardiovascular insufficiency, which increased infant mortality rates. This is because Serotonin produced by the raphe nuclei play a role in breathing as well as heartbeat.

Serotonin Depletion and Mood Disorders

Serotonin is linked to a variety of disorders associated with mood. Serotonin Deficiency is strongly linked to both Depression and Obsessive-Compulsive Disorder. Interestingly enough, Serotonin Deficiency is also a temporary condition that occurs when someone falls for another, emotionally, and is associated with OCD tendencies that occur in the early parts of many relationships.

Serotonin and Alcohol

Moderate consumption of alcohol leads directly to a state of Serotonin Depletion resulting from a reduction in the concentration of tryptophan in the blood stream. This is one of the reasons that people that drink alcohol are more likely to engage in impulsive activities, including sex, because Serotonin has a modulating effect upon both self-control and libido.

Serotonin and Your Health

As you can see, Serotonin is one of the most physiologically complex hormones produced by the human body, and affects change in a wide variety of ways. Healthy Serotonin balance is a vital part of sustaining health and wellness, both psychological and physical.


Serotonin Wiki:


Serotonin WebMD:



Written by Dr. Welsh, Article reviewed and edited by Dr. Fine M.D..
Published on 19 August 2014

Melatonin Hormone Guide

What Is Melatonin?

Melatonin is a hormone that is released by the pineal gland which encourages sleep and helps to preserve the natural human circadian rhythm. Melatonin is also produced by animals and many plants.

Human beings are naturally designed to be awake during daylight and to become sleepy once the sun goes down. That is because we are diurnal creatures. Although the average person sleeps eight hours per night, we have just begun to really understand why we sleep, and the processes behind it, in recent years.

Although we have been keenly aware of the connection between light/dark and the sleep cycle, we are only now becoming aware of the mechanisms which promote this cycle, and melatonin is one of the keys to this cycle.

It used to be believed that Mmlatonin was the primary mechanism which controlled the circadian rhythm, but today it is clear that melatonin is a tool that the body uses to change the body's physiological patterns to induce sleep, as controlled by the central nervous system.

How Do Light and Dark Promote Patterns of Wakefulness?

Our brains actually process the presence or absence of light through the eyes in order to send information to the brain regarding the sleep cycle. The eyes absorb light, and this information passes from the eyes to the hypothalamus. The hypothalamus has a particular region known as the suprachiasmic nucleus which reacts to sunlight and other factors in order to either promote a state of wakefulness or sleepiness by manipulating body temperature, hormone release, and other factors which promote a normal sleep cycle.

Think of the suprachiasmic nucleus as a clock. Under normal circumstances, human beings usually wake up around the same time each day, and the appearance of sunlight plays a central role in establishing that set pattern. For example, when the suprachiasmic nucleus senses sunlight, it responds by promoting the secretion of cortisol and increasing ambient body temperature. In addition to this, the suprachiasmic nucleus also suppresses the release of melatonin, a hormone which encourages the body to go into a sleep state. Once the sun goes down, the body stops suppressing melatonin release, which encourages sleepiness.

Melatonin is often taken as a supplement in order to help promote sleep. This can be effective for many patients, but should only be used for a brief period of time, because long-term use can affect the body's hormone patterns.

Of course, anyone that experiences significant issues with sleep should talk to a professional in order to get the appropriate treatment, but for mild or temporary sleeplessness, melatonin is often a fine option.

Where Does the Body Make Melatonin?

Melatonin is produced by the pineal gland, which is about the size of a bean and is situated in the central portion of the brain. Under normal circumstances, the pineal gland does not produce Melatonin during the day, but as the sun goes down and the suprachiasmic nucleus no longer receives sufficient light signal, this causes the body to start producing Melatonin.

After the pineal gland produces melatonin, it immediately begins to circulate through the blood stream. For people with normal sleeping patterns, this generally happens at about nine o'clock at night. This is why, a couple of hours after the sun falls down, you naturally enter a state of sleepiness, which inhibits your alertness and causes you to seek out a comfortable place to rest.

Once the body starts to release melatonin, it will continue to do so until sunlight, when melatonin levels will drop, encouraging wakefulness, until around nine o'clock in the morning, when the pineal gland completely deactivates and melatonin production halts. During the day, the body produces almost no melatonin.

Of course, time is not the only factor with regard to melatonin, light is also important. If it is the appropriate time, but the body still senses bright light associated with daytime, then the pineal gland will be activated but will not produce melatonin. In many cases, light produced indoors, especially white light with a lot of blue waves, will be interpreted by the brain as sunlight. This is why it's important to turn off computers and televisions about an hour before bed in order to promote a healthy sleep cycle.

Melatonin is processed by the liver, and is filtered quickly. Ninety percent of Melatonin is processed by the liver the first time it passes through the organ.

How Much Melatonin Does the Body Release at Night?

Dependent on a wide variety of factors, different people produce different levels of melatonin. There does appear to be a strong correlation between age and melatonin production, where children produce the greatest concentrations of melatonin, and older adults produce less over time. This is both why children tend to sleep longer and deeper, and why adults tend to sleep for shorter periods of time. Older adults that have issues sleeping produce less melatonin than their peers on average.

How Much Melatonin Should I Take To Sleep?

Melatonin is a common supplement, and is actually the only hormone in America that can be obtained without a prescription. Because melatonin is present in many animal and plant-based foods, it is considered a nutrient, rather than a hormone, and is not regulated under the same rules as pharmaceutical drugs and other Bio-Identical Hormones. Supplements do not require FDA-Approval, and are not subject to regulations which are as strict as those intended for medications.

For this reason, it is important to source melatonin responsibly. An issue with many over-the-counter melatonin products is that they often provide much more melatonin than the body naturally has the capability to producein some cases twenty times more than the pineal gland secretes to promote sleep!

A few noted side-effects of melatonin supplementation are depression, fatigue, and vivid dreaming.

There has been quite a bit of animal research conducted with regard to melatonin, and there is evidence that melatonin affects blood pressure, and long-term or heavy use can potentially affect fertility. Because of the potential impact of melatonin upon blood pressure, those that are at high risk of cardiovascular disease, heart disease, stroke, kidney disease, or hypertension should always talk to their doctor before using melatonin. Melatonin may also exacerbate sleep apnea.

The best way to use melatonin is to use it to establish a healthy and natural circadian rhythm. This means that it should be taken an hour or so before you are ready to go to bed, so that you can get comfortable and fall naturally to sleep. Also, it is important to take a physiologically natural dose of melatonin in order to prevent side-effects and help your body stay in a normal rhythm.

It is important to note that our knowledge of melatonin (as is true with many other hormones), is incomplete, and more potential treatments or more effective usage protocols may be adopted in the future.

Is Melatonin Dangerous?

Although there are potential concerns regarding melatonin's effect upon mood and cardiovascular health, there has never been a case of melatonin overdose, and there is no evidence that Melatonin overdose produces any toxic effects.

Melatonin Research

Many people have taken melatonin and report that it does indeed help them sleep. It is unclear if melatonin is better than placebo at inducing sleep however. Some studies have shown that Melatonin is no more effective than sugar pill, but there is evidence that melatonin produces other benefits.

For example, melatonin does have the ability to help patients realign their circadian rhythm to a normal schedule. Continuing study needs to be performed, however, to compare the benefits of melatonin to sunlight exposure in promoting healthy sleep patterns. Even so, Melatonin can be very useful for individuals that are exposed to bright light, such as the light of a computer screen, after sundown.

Melatonin has been shown to be highly effective at restoring sleep patterns and promoting sleep both for individuals that work odd hours, and for people suffering from jet lag.

Melatonin does not seem to have an impact on average length of sleep, but it does appear to help patients sleep more soundly, and fall asleep more quickly. Patients that have trouble getting themselves in bed at night may find melatonin very effective. The jury is still out, however, as there are some studies that show otherwise.

The biggest benefit of Melatonin is that it can alter an individuals circadian rhythm, helping them to reset the clock when their bodies are out of sync with their lives. Supplemental melatonin provides this benefit for around six hours.

Individuals should not take Melatonin in the hours just after they have woken up, because it can lead to fatigue and cognitive disruption when taken during a period when the body has just had a large amount of sleep.

Melatonin for Insomnia

The body of research regarding Melatonin and Insomnia is small, and there have been mixed results. In one particular study of men and women over the age of fifty, melatonin appeared to improve both sleep quality and the time that it took to fall asleep. Other studies have shared the result of improved sleep onset, but melatonin did not help insomnia patients maintain energy levels in the daytime, and did not help patients stay asleep through the entire night.

Before more conclusive evidence can be drawn, more elaborate research will need to be performed in order to assess the effectiveness of melatonin as an insomnia treatment. Also, there are no set guidelines for how much melatonin to take to treat various conditions.

Melatonin and Jet Lag

Jet lag is a condition that occurs when an individual changes time zones rapidly, causing their normal sleep schedule, as governed by day-night cycles, to be disrupted. The more time zones that an individual travels, the more time that it will take to recover. As a result, people feel fatigued when they would normally be rested, and they also become hungry at off-times.

There are a number of things that can make jet lag worse. For example, many people don't sleep well on planes. Also, caffeine and alcohol can further alter sleep cycle. The circadian rhythm is important, and when individuals with set rhythms become disrupted, it can completely change their ability to go about their day.

A recent survey of people that regularly travel on business showed that around 50% of these individuals routinely have jet lag as a result of long-distance flights. As a result of this jet lag, they claimed that their productivity and performance were directly impacted. For reasons that are unclear, women were more affected by jet lag than their male peers.

Perhaps because melatonin is available as a cheap over-the-counter supplement, there has not been extensive study regarding its benefits with regard to jet lag. However, studies conducted thus far have shown that melatonin is highly effective at mitigating or completely preventing jet lag. Traveling forward in time or traveling 5+ time zones in a trip were correlated with the greatest degree of benefit.

Melatonin and Delayed Sleep Phase Syndrome

There are other conditions which impact circadian rhythm as well. For example, Delayed Sleep Phase Syndrome is a condition in which patients have major issues falling asleep at normal times, sometimes unable to sleep before sunrise.

This condition affects people of all ages, but is most common among teens. Research shows that melatonin can be an effective method to treat this condition and promote healthy sleep, but for many patients, simply exposing oneself to bright light when one wishes to be awake is equally beneficial.

Melatonin and Libido

In animals, melatonin plays a role in sex drive. Melatonin has the ability to suppress both Follicle-Stimulating Hormone and Luteinizing Hormone, which are important for the maintenance of libido as well as the production of sperm. The way that a species responds to melatonin depends on whether they are sexually active during the day or at night.

Animals that mate at night breed better while melatonin levels are high and daytime breeders mate most effectively when melatonin levels are low. Taking melatonin can negatively affect fertility in some individuals, but there is also evidence that it can promote fertility and libido in others. More research needs to be done to more accurately show how melatonin affects human fertility and libido.

Melatonin and Leptin

Leptin is one of the hormones that controls our hunger. High levels of Leptin produce the sensation of satiety. Leptin levels are affected by melatonin in a complex way. Melatonin interacts with Leptin and Insulin, helping to reduce hunger during sleep. If Melatonin and Leptin interact outside of the presence of Insulin, this causes Leptin levels to decline, however.

Melatonin and the Immune System

In addition to sleep, sex drive, and hunger, melatonin also has an impact on the function of the immune system. The research is limited in this regard, but melatonin does seem to have antiinflammatory properties. Researchers are attempting to discover if melatonin can be used as a way to mitigate inflammation. It is believed that Melatonin promotes the synthesis of cytokines which limit inflammation. In the near future, melatonin may be an important part of fighting both viruses and bacterial infections, and it also may benefit many people with cancer.

Melatonin and Dreaming

In some cases, people that take melatonin supplements report intense dreams. Studies have shown that a 50 milligram dose of Melatonin appears to increase the number of dreams because it lengthens the period of time that an individual spends in REM-Sleep, the period where dreams are most common.

Melatonin and Autism

Melatonin is useful for patients with Aspergers and Autism, because it helps them sleep longer and deeper.

Melatonin and Aging

There is some evidence that suggests that melatonin may be a useful anti-aging tool. It has long been known that children produce higher levels of melatonin later in the night, and older individuals reach peak melatonin much earlier. It is hypothesized that this is one of the reasons why younger and older individuals often have such different sleeping habits. It is also hypothesized that this is why adults don't sleep as long, and why they are more prone to sleep dysfunction.

Animal research studies have also shown that exposure to exogenous melatonin changes the expression of thirteen separate genes in geriatric mice, reverting their expression to those associated with youth. The antioxidant properties in melatonin also may have a neuroprotective effect, which promotes neurological health deeper in to the lifespan, while also reducing inflammation. Both of these aspects have a significant impact on longevity.

Melatonin and Diabetes

Diabetes and Melatonin Levels appear to be correlated. Individuals that produce less melatonin than their peers appear to be more likely to develop Type-Two Diabetes. This could be because people that produce enough melatonin have greater issues controlling insulin, and also because less melatonin means that the body doesn't rest as well, which has a tremendous impact on hormone health.

Melatonin and ADHD Treatment

Research has shown that patients taking medications such as Adderall for ADHD find it easier to sleep at night if they take melatonin before bed. Preliminary studies have shown that this benefit of melatonin does not decrease over the course of three months of treatment.


Is There a Connection Between Melatonin and Fertility?


Melatonin and Sleep


Wikipedia: Melatonin



Written by Dr. Welsh, Article reviewed and edited by Dr. Fine M.D..
Published on 19 August 2014

Andropause FAQ

What is Andropause?

Andropause is a medical state that is a natural result of aging, in which symptoms of aging manifest resulting from a decline in Testosterone Production and other male hormones such as dehydroepiandrosterone, also referred to as DHEA.

Andropause is a universal factor of the male condition, although each male will physiologically react to the condition in their own way, and some men will display symptoms much earlier than others.

How Fast do Testosterone Levels Decline Over Time?

From the age of puberty to around the late twenties, males are flush with Testosterone, which contributes to optimal health and wellness. Around the late twenties or early thirties, however, these levels start to drop, at a rate of around 1%-2% per year. This decline is slow and without symptoms at first, but as the decline becomes more severe, the changes start to become apparent.

How Can I Qualify for Andropause Treatment?

In order to be prescribed Testosterone Treatment for Andropause, or other effective treatments, you must undergo clinical evaluation. Many men have Low Testosterone without displaying symptoms. In order to qualify for Low-T treatment, you must not only have clinically low levels of Testosterone, but you must also display symptoms of the condition.

There are many conditions which may prevent you from qualifying for treatment, including prostate cancer and severe sleep apnea.

What Blood Tests Are Necessary In Order to Diagnose Andropause?

Although your doctor may order a variety of tests in order to fully assess your overall health and hormone balance, for Age-Related Low-T, the most important test is the Free Testosterone Test. Free Testosterone is also referred to as Bioavailable Testosterone, and refers to the amount of Testosterone that is available for use by the body, and not currently being used.

With a saliva or blood sample, it is possible to take a snapshot of your current Free Testosterone Levels.

What is Total Testosterone?

Total Testosterone refers to all Testosterone that is circulating through your blood stream. This includes both Free (Bioavailable) Testosterone and bound Testosterone.

Why Is the Total Testosterone Test Insufficient for the Diagnosis of Andropause?

The vast majority of patients with Symptomatic Andropause have clinically normal Total Testosterone Levels, meaning that if Total Testosterone alone is evaluated, most patients with Andropause will appear to have normal Testosterone Levels, because the wrong factor is being measured. Recent research has shown that among men with Andropause, only 13% show depressed Total Testosterone Levels, whereas nearly three out of four of those patients had Low Free Testosterone Levels.

Because many physicians only measure Total Testosterone when evaluating Andropause, symptoms of Testosterone Deficiency are often diagnosed mistakenly as resultant from chronic fatigue, stress, depression, and other factors. Many of the treatments for these conditions actually have a depressant effect upon Testosterone, which could actually exacerbate symptoms in the long run.

By Fifty, What Percentage of Men Have Abnormally Low Free Testosterone Levels?

Among men over fifty, it is approximated that roughly half of men have Free Testosterone Concentrations that would be considered clinically low for men between the ages of thirty and forty.

What Are Other Names for Andropause?

Andropause is often referred to by a number of different names. For the sake of simplicity, it is often referred to in the media as Low-T, although Low-T is a broader term which simply refers to any physiological state in which Testosterone Levels are inadequate to meet the needs of the body. Another informal term for Andropause is Manopause, used to further emphasis the physiological connection between Menopause and Andropause.

Andropause is also sometimes referred to as Age-Related Testosterone Deficiency, which is a more adequate representation of the condition, because Andropause is an age-dependent chronic condition. Other similar names include Partial Androgen Deficiency in Aging Males, Androgen Deficiency of the Aging Male, and Symptomatic Late Onset Hypogonadism.

Because Andropause has not been fully accepted as a medical condition by the World Health Organization or the Food and Drug Administration, there is not a codified set of terms related to the condition, although there is a large amount of on-going study, and the condition is widely recognized by medical professionals and medical research institutes both nation- and worldwide.

What Causes Andropause?

Andropause is caused by a combination of hereditary factors and lifestyle choices, also known as Internal and External Causes. Internal causes are genetic.

Before Andropause occurs, the body enters a state of Hypogonadotrophic hypogonadism. During this period, the body produces less Testosterone than is produced by younger, healthier men. Hypogonadotrophic hypogonadism is a state in which the brain does not respond adequately to signals that Testosterone Levels are insufficient to promote the optimal health of the human body. Hypogonadotrophic hypogonadism generally takes place around the age of forty.

Testosterone production will continue to decline over time, eventually to a point at which the pituitary and the hypothalamus respond by producing elevated concentrations of Gonadotropin-Releasing Hormone and Luteinizing Hormone in an effort to rebound declining Testosterone. This is effective for a brief period of time, but the body eventually reverts to a state of decline once again.

This is the period at which Andropause takes place. Hypogonadotrophic hypogonadism refers to the early state at which GnRH and LH Levels are low in combination with Testosterone. Andropause refers to the period at which Testosterone Production remains inhibited in spite of increased LH and GnRH levels.

This hormonal change is absolutely normal, in that it is a natural progression of male hormone balance, which bears some similarities to menopause, hence the name. One significant way that Andropause and Menopause differ is that there is more variation as to when men begin to experience their change. Women will reach menopause at some point between the early 40s and late 50s, whereas some men will begin to experience symptoms before or even after that period.

What Are Lifestyle Factors Which Encourage Symptoms of Andropause?

Although the human body has a baseline of Testosterone Production dependent on age and genetics, this production can be affected by lifestyle choices which further suppress Testosterone Levels in the body. The following are some factors which can inhibit the body's natural ability to release Testosterone:

  • Inadequate Sleep

  • Poor Diet

  • Sedentary Lifestyle

  • Medications

  • Overindulgence of Alcohol

  • Stress

  • Illness

What Are the Symptoms of Andropause?

Andropause is a complex condition which affects male health in a wide variety of ways. The following are some symptoms associated with Age-Related Testosterone Deficiency:

  • Insomnia

  • Head and Back Aches

  • Reduced Sex Drive

  • Depression

  • Mood Instability

  • Hot Flashes

  • Hypersensitivity

  • Irritability

  • Social Withdrawal

  • Anger

  • Unhealthy Changes in Body Composition

  • Fatigue

  • Loss of Bone Mineral Density

What Are Some Effective Andropause Treatments Available?

Men with Andropause can benefit significantly from Hormone Replacement Therapy. There are a number of options available to Andropause patients, including:

  • Testosterone Patches

  • Testosterone Creams

  • Testosterone Gels

  • Injectable Testosterone (Testosterone Enanthate, Testosterone Cypionate, etc.)

  • Testosterone Pellet Therapy

  • Clomiphene Citrate

What is the Difference Between Andropause and Primary Testosterone Deficiency?

Most men suffering from symptoms related to Andropause have perfectly functioning testes, but do not receive sufficient signaling from the hypothalamus to produce enough Testosterone to meet the needs of the body.

Andropause is a form of secondary hypogonadism related to age. The older that men get, the less efficient that their bodies are at producing Testosterone. Primary Testosterone Deficiency is Low-T that is the result of a direct malfunction of the testes which prevents the body from being able to produce Testosterone at normal levels.

Both of these forms of Testosterone Deficiency can be treated with Bioidentical Testosterone Therapy, but there are more off-label options available to patients that suffer from Andropause and other forms of Secondary Hypogonadism, such as Clomiphene Citrate.

Testosterone production is actually the result of a cascade of signals that begins at the hypothalamus. The hypothalamus releases a hormone known as gonadotropin-releasing hormone (GnRH), which circulates to the pituitary, stimulating the production of Follicle-Stimulating Hormone and Luteinizing Hormone, which both contribute heavily to the healthy function of the male reproductive system. Luteinizing Hormone stimulates the production of Testosterone and other male sex hormones, while Follicle-Stimulating Hormone promotes the healthy production of sperm.

What Are Some Health Risks Associated with Andropause?

Andropause is correlated with a number of health conditions which can severely impact health and wellness, including:

  • Diabetes

  • Hypertension

  • Obesity

  • Chronic Fatigue

  • Heart Attack

  • Stroke

There is even evidence that Andropause leads to an increased risk of Alzheimer's and other neurological disorders.

What is the Goal of Andropause Treatment?

The ultimate goal of Andropause Treatment is not to flood the body with Testosterone, but simply to restore Testosterone Levels in the body to normal, physiological levels. In general, Testosterone Replacement Therapy Treatments aim to restore Testosterone Concentrations to what would be considered mid-normal for a man in his twenties.

In restoring Testosterone Levels to these physiologically normal levels, it is possible to significantly mitigate the symptoms of Andropause, helping men live healthier lives.

What Are the Benefits of Andropause Treatment?

  • Higher Quality of Life

  • Fewer Mood Swings

  • Reduced Irritability and Anxiety

  • Preserved Bone Mineral Density

  • More Energy

  • Enhanced Muscle Health

  • Increased Metabolism

  • Improved Capacity to Burn Fat

  • Increased Libido

There is preliminary evidence that shows that Testosterone Treatment also improves cardiovascular health, but more research is needed.

Does Andropause Treatment Cause Cancer?

There is no evidence that Testosterone Therapy for Andropause causes cancer, but the treatment can exacerbate existing forms of cancer, including breast and prostate cancer, and should not be prescribed to individuals that have or are at high risk of these or other forms of cancer.

How Can I Treat Infertility Related to Andropause?

Unfortunately, Testosterone alone is not capable of restoring fertility. This is because Bioidentical Testosterone actually suppresses the ability of the testes to produce Testosterone and sperm for the duration of therapy. This is temporary, and testosterone production will return after therapy has been suspended, but for patients interested in having children, Testosterone Treatment alone will not be sufficient.

Testosterone can, however, be combined with Human Chorionic Gonadotropin (HCG) in order to simultaneously increase Testosterone Concentrations in the body while simultaneously preserving fertility and the normal function of the Testes. In the male body, HCG acts as a functional analogue of Luteinizing Hormone, both preserving the body's ability to make some of its own Testosterone while also preserving the fertility of the patient.

Clomiphene citrate (brand name: Clomid) is sometimes prescribed to men with Testosterone Deficiency/Andropause that are interested in Testosterone Restoration which also preserves fertility. Clomiphene increases Testosterone and Sperm Production by inhibiting negative feedback mechanisms which can limit the healthy production of Testosterone.

Is It Possible to Use Erectile Dysfunction Medications During Andropause Treatment?

Yes, but you may not have to in the long run. Andropause is one of the main causes of Erectile Dysfunction as men grow older, and many men with Age-Related Testosterone Deficiency report that as a result of Testosterone Replacement Therapy, they no longer rely as heavily on Erectile Dysfunction Medications. Many patients even report that they no longer need to use such medications.

There is research that shows that taking Erectile Dysfunction medications with Testosterone Therapy has the ability to resolve ED issues in 95% of patients.

What Are the Potential Side-Effects of Testosterone Therapy for Andropause?

As with any form of medical treatment, there are risks associated with Testosterone Restoration. The following are some of the risks associated with Andropause Treatment:

  • Oily Skin, increased prevalence of acne

  • Male-Pattern Baldness

  • Headaches

  • Prolonged/Frequent Erections

  • Gynecomastia (increased breast tissue can be treated with estrogen-blockers such as Arimadex)

  • Increased Red Blood Cell Count (can be treated via blood donation)

  • Accidental long term overdose can lead to Heart Disease

All patients that take Testosterone will experience the following symptoms resulting from therapy:

  • Reduced Fertility

  • Testicular Shrinkage

These symptoms are temporary, and will slowly return to a normal state after treatment has ended. Combining Testosterone with HCG can prevent these symptoms, as can Low-T Treatment with clomiphene citrate.

How Can I Mitigate the Effects of Andropause Through Lifestyle?

What Should I Avoid the Onset of Andropause Symptoms?

Stop Smoking and Using Tobacco Andropause has a negative impact on cardiovascular health, and smoking only exacerbates the risk of cardiovascular complications. Also, smoking reduces normal erectile function because nicotine encourages vasoconstriction, which reduces the ability of the body to rush blood flow to the potential erection.

Don't Abuse Alcohol Alcohol promotes the body's production of estrogen, which depresses testosterone production. Also, alcohol reduces zinc levels in the body, which reduces the ability of the body to adequately control estrogen production.

What Should I Do to Delay the Onset and Severity of Andropause Symptoms?

Lose Weight Adipose body fat has the natural ability to promote elevated estrogen levels which suppress testosterone production in men. By losing weight, it is possible to promote a healthier testosterone balance.

Eat Healthier Your body also needs a well-rounded diet rich in nutrients in order to promote optimal hormone balance and mitigate the effects of Andropause. Although the body needs some fat, diets that are high in fat will expose the body to more estrogen. Also, organic foods can help improve Testosterone levels, because many common pesticides have estrogenic qualities. Finally, a diet rich in cruciferous vegetables such as cauliflower and broccoli promotes healthy testosterone balance as a result of naturally occurring antioxidant compounds such as indole-3-carbinol.

Make a Concerted Effort to Improve Sleeping Habits The body produces Testosterone primarily at night. By taking the steps to make sure that you get all the sleep your body needs, you protect your body's natural ability to produce Testosterone.

Take Zinc Supplements Zinc is a very important nutrient which promotes the body's ability to produce its own Testosterone while also inhibiting the body's ability to produce estrogen and other aromatase compounds which suppress Testosterone production.

Manage Stress More Effectively In order to promote healthy Testosterone Production, it is important to control one's stress. Stress increases the production of cortisol, which is another cholesterol-based hormone. The body has a limited amount of these resources, and if you have too much stress, your body will divert resources from Testosterone production to Cortisol production.

What is the Average Dosage for Testosterone Restoration for Andropause?

When men are in their twenties, they generally produce between four and seven milligrams of Testosterone. Because not all Testosterone is absorbed during topical Testosterone Therapy, the initial dosage is generally between ten and twenty milligrams each day in order to bring Free Testosterone Production back to normal.

Because of potential issues related to elevated Testosterone Levels, it is prudent to start with a small dose in order to provide benefits with the lowest risk of side effects. Generally, patients will stay on this starter dose for around three or four months, then come back for further evaluation. Their dose will remain the same or be adjusted based on further testing as well as an evaluation of the effectiveness of treatment.


Andropause: The Male Menopause


Frequently Asked Questions about Andropause (Male Menopause) and Testosterone Replacement Therapy


Wikipedia: Andropause


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If your doctor only prescribes testosterone by itself, you will probably have a rough ride. The tendency is for you to feel great the first couple months, while you increase testosterone levels, followed by a slow deterioration, once your estrogen creeps up.

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