In an article from the July 2021 Journal of Urology (206:97), Drs Zhang et al explore the relationship between diet and testosterone.
Testosterone is a male sex hormone responsible for a number of functions in the human body including maintenance of muscle mass, sex drive, bone health as well as a variety of other functions including memory. It is secreted by the Leydig cells within the testicles. Testosterone deficiency is typically due either to diminished testicular function or diminished stimulation of the testicles by the pituitary.
This paper focused on the observation that testosterone deficiency can be related to increase levels of pro-inflammatory cytokines. Cytokines are proteins secreted by cells involved in the immune response and can cause proliferation, mobilization and survival of immune cells.
Pro-inflammatory foods include foods that are high in total fat and refined carbohydrates. The study looked at a series of men who both completed a dietary history and had hormone evaluation. Results were available for over 4000 patients with an overall prevalence of testosterone deficiency of over 25 %. Mean total testosterone was lower among men with the most proinflammatory diet compared to the least inflammatory diet. The increase in risk of lower testosterone was 29% between the two groups and the relationship held even when examining only men with obesity as obesity itself was also shown to be a risk factor for testosterone deficiency.
The authors then speculated that a pro-inflammatory diet could potentially elevate levels of cytokynes: IL-1, IL-6, IL-17, and TNF which are markers than can impair testosterone secretion by activating inflammation and reactive oxygen species production by interstitial macrophages located next to Leydig cells. The Authors conclude that a more anti-inflammatory diet could be a feasible method to increase T levels.
In my practice I have counseled patients on weight loss as well as exercise and getting adequate sleep in order to promote better general health. Obesity is well known to impact both testosterone levels as well as fertility and healthy weight loss can often improve both.