An Integrative Approach to Testicular Health: Testing, Nutrition, and Supplement Options

The health of our bodies is an intricate balance influenced by various factors, and one area that deserves significant attention is testicular health. Testicles, also known as testes, play a vital role in the male reproductive system by producing hormones like testosterone and generating sperm. Despite their importance, many individuals overlook the significance of maintaining optimal testicular health, often due to a lack of awareness or discomfort discussing the topic. However, understanding the importance of testicular health is crucial for overall well-being and can help support the body's natural functions.

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What Are The Testes Role In The Body?

The testicles, also called “testes,” are the primary reproductive organ in men. There are two of these oval-shaped, smooth, and soft organs that sit within the scrotum; the sac of skin that holds the testes, functioning to protect them and aid in temperature regulation. The testes have two main functions: to produce sperm and testosterone. Production of both sperm and testosterone is dependent upon the Hypothalamic Pituitary Testicular (HPT) axis. When sperm or testosterone is needed, the center of the brain, or hypothalamus, senses this need and begins to release gonadotropin-releasing hormone (GnRH). GnRH then tells the pituitary gland, also located in the brain, that the body needs more sperm or testosterone. In response, the pituitary gland releases luteinizing hormone (LH) and follicle-stimulating hormone (FSH). LH stimulates a specific type of cell in the testes called Leydig cells to make testosterone. FSH stimulates another type of testicular cell, Sertoli cells, to make sperm. The amount of circulating testosterone and the amount of sperm, as well as other hormones and proteins produced by the testes, sends a feedback signal to the hypothalamus, and depending on the amount made and the amount needed, the hypothalamus will either continue to make GnRH or will cease or lower production.

What are the Top Testicular Health Issues Addressed With Integrative Approaches?

The top testicular health issues addressed with integrative approaches include hypogonadism and infertility.

Hypogonadism

Hypogonadism is the term used for low testosterone production. There are two types of hypogonadism: primary and secondary. Issues with the testicular production of testosterone cause primary hypogonadism. Issues with the hypothalamus or pituitary gland cause secondary hypogonadism. Causes of hypogonadism include injury, genetic conditions, undescended testes, obesity, vitamin D deficiency, hypothyroidism, zinc deficiency, gut microbiome dysbiosis, hemochromatosis, chemotherapy radiation, and aging. Symptoms of hypogonadism may include low sperm count, fat gain in the abdomen, reduced libido, erectile dysfunction, problems with orgasms, reduced amount of ejaculate, diminished penile sensations, muscle wasting, and more.

Infertility

Male infertility is responsible for 50% of infertility cases. Male infertility is marked by a decrease in the production of sperm, small cells that have the ability to fertilize a woman’s egg. Hormonal imbalances, genetic diseases, structural blockages, immune problems, excessive alcohol use, smoking, poor diet, high stress, dysbiosis in the gut microbiome, certain drugs and medications, low thyroid functioning, chemical exposures, and high amounts of oxidative stress can contribute to male infertility.

Functional Medicine Labs That Can Help Individualize Approaches for Patients with Testicular Concerns

Functional medicine testing focuses on unearthing the root cause. Functional medicine testing for testicular concerns may include a male hormone panel, thyroid panel, micronutrient panel, comprehensive stool testing, and an oxidative stress panel.

Male Hormone Panel

A male hormone panel, such as the Male Hormonal Health panel by Genova Diagnostics, shows levels of hormones including testosterone, estradiol, dihydrotestosterone (DHT), DHEAS, sex hormone binding globulin (SHBG), and more. It’s important to measure these hormones whenever assessing for testosterone, as they are all involved in testosterone metabolism. DHEA, produced in the adrenal glands, has the ability to convert into testosterone. Testosterone can convert into both estradiol and DHT. SHGB serves as the taxi for testosterone in the body. When testosterone is bound to SHBG, it is unavailable for use. Because of the interconnectedness of these hormones, it's important to measure all of them (like with the panel mentioned by Genova Diagnostics) rather than one singular hormone.

Thyroid Panel

As underactive thyroid is a potential factor in hypogonadism and infertility, a thyroid panel may be helpful for every man with low testosterone. A full thyroid panel includes TSH, T3, and T4 hormones to give a complete assessment of its functioning. Access Medical Laboratories Thyroid Panel has these three markers included.

Micronutrient Panel

Various micronutrients, including vitamin D and zinc, may play a role in hypogonadism. Micronutrients, including CoQ10, vitamin E, carnitine, and vitamin C, have also been shown to affect various attributes of sperm, including sperm count, morphology, and motility. Therefore, a micronutrient test such as SpectraCell's Micronutrient Test may be warranted to check various micronutrients in one test.

Comprehensive Stool Testing

Comprehensive stool testing assesses various markers associated with the digestive system, including the gut microbiome. The gut microbiome is composed of a variety of microbes, including bacteria, viruses, and fungi. These microbes can affect our digestion and absorption, inflammatory and immune reactions, and hormones. Alterations to the gut microbiome have been linked to lower testosterone levels and infertility, and thus, a comprehensive stool test that assesses the gut microbiome, such as GI360 by Doctors Data, may be indicated.

Oxidative Stress Panel

Oxidative stress is a natural byproduct of the body’s biochemical processes and is the damage caused by free radicals. It can also occur due to smoking, poor diet, lifestyle, and environmental factors. This Advanced Oxidative Stress test by Precision Point provides information on how much oxidative stress is present in the body. When not properly neutralized, oxidative stress can increase the risk of various health concerns. It's been shown that oxidative stress can negatively influence and impact the DNA of sperm as well.

Best Nutrition for Testicular Health

One of the most researched diets for fertility is the Mediterranean Diet. The Mediterranean diet consists of fatty fish, olive oil, nuts, seeds, minimally processed whole grains, fresh fruits, and vegetables. Low intake of polyphenols, a type of phytonutrient, can affect the hypothalamic pituitary-gonadal axis; polyphenols are found in foods recommended by the Mediterranean Diet, such as berries, herbs, and spices. Additionally, the Mediterranean diet can support sperm quality, possibly due to the emphasis placed on fruits, vegetables, and fish, which have, in other studies, been shown to support sperm quality and are included in the Mediterranean diet. One of the main foods to avoid on the Mediterranean diet is processed sugar. Processed sugar has been found to alter genes related to the production of testosterone, potentially affecting testosterone levels. Lastly, there is research showing the Mediterranean diet has positive impacts on the gut microbiome and can help reduce oxidative stress, two factors that may influence fertility and the microbiome, which may play a role in hypogonadism.

Top Supplements and Herbs for Patients with Testicular Concerns

There are many supplements and herbs that may help support patients with testicular concerns. Here are the most common:

Vitamin D for Testicular Health

Vitamin D levels have been implicated in both hypogonadism and infertility. For hypogonadism, both low and high vitamin D levels can be associated with hypogonadism, which is why testing prior to supplementation is important. For infertility, low vitamin D seems to affect sperm production and quality.

Dose: Vitamin D dose should be dependent upon vitamin D levels in the blood.

Duration: Duration of vitamin D supplementation will depend on blood levels achieving reference range levels.

Zinc for Testicular Health

Zinc is a mineral required for over 50 enzymes to function correctly. It has been studied for both hypogonadism and infertility in men. For hypogonadism, zinc intake is correlated with optimal levels of testosterone. For cases of infertility that are due to immune dysfunction, zinc may help to reduce the amount of antibodies that affect sperm.

Dose: 50 mg 2x/day

Duration: 1-4 months

Probiotics for Testicular Health

Probiotics are supplements that contain various microbes with the intent to support the gut microbiome. There are studies that show the interconnectedness of testosterone levels and an altered microbiome. Additionally, there is evidence to suggest the microbiome can affect the quality of sperm produced.

Dose: Comprehensive stool testing should be used to determine the dose and type of probiotic needed.

Duration: Duration should be determined based on symptom improvement and testing markers.

Tongkat Ali for Testicular Health

Tongkat ali is an herb with medicinal properties. It has been used for men’s health concerns, including sexual health. There is research showing that Tongkat Ali may help support testosterone levels.

Dose: 100-600 mg/day

Duration: 3 days- 6 months

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Summary

The function of the testes is vital for the health of men. Both hypogonadism and infertility can have testicular origins, and thus focusing and doing testing related to the testes can help address these health concerns. Functional medicine testing provides a wide array of testing options to evaluate the root cause of testicular health conditions. Complementary and integrative approaches can be tailored to the patient depending on lab results with the ultimate goal of supporting overall well-being.