The hormone that may signal COVID-19 severity in men

Testosterone is a key hormone for regulating health, especially in men. Low levels of testosterone have been linked with cardiovascular disease and type 2 diabetes.

Testosterone replacement therapy has been shown to improve cognitive function, libido and mood, as well as strengthen bones and muscles and increase energy.

Researchers are continuing to examine the many ways in which testosterone influences men’s health. In fact, one recent exploration discovered a link between low testosterone levels in men and severe cases of COVID-19…

Low testosterone more likely in men with severe COVID-19

This study involved 90 men and 62 women who were hospitalized at Barnes-Jewish Hospital between March 2020 and May 2020 with symptoms of COVID-19 and confirmed cases of the illness.

For the study, researchers took blood samples from the participants and measured levels of several hormones, including testosterone, at days 3, 7, 14 and 28, or for as long as the patients remained hospitalized. A total of 28 men and 14 women remained hospitalized beyond day 14.

The hormones measured included testosterone; IGF-1, a growth hormone; and estradiol, a form of estrogen produced by the body.

The study found that men with severe COVID-19 had testosterone concentrations that were 65 to 85 percent lower than those in men with a milder illness. The difference was independent of other known risk factors for COVID-19 severity such as age, smoking, race, BMI and comorbidities.

Among the 66 men with severe COVID-19, testosterone concentrations were lower at diagnosis and days 3 and 7 compared with the 24 men with milder illness. Estradiol and IGL-1 levels were not linked with COVID-19 severity in men. As for the women, levels of testosterone, estradiol and IGF-1 were similar regardless of COVID-19 severity.

The study also found those men who required artificial ventilation or ICU admission or who died had lower testosterone levels than the men who did not experience these outcomes. Out of the men who had severe COVID-19, 25 of them died from the illness.

Making the low-T connection

“The most important causal factor for low testosterone is likely to be severe illness,” says the study’s first author Dr. Sandeep Dhindsa, an SLUCare endocrinologist and director of Saint Louis University’s Division of Endocrinology, Diabetes and Metabolism.

“In addition, it is possible the men with low testosterone prior to getting COVID are more likely to have low testosterone during the illness as well,” Dhindsa adds. “However, we could not test that hypothesis since we do not have pre-COVID samples on these patients.”

Some factors contributing to low testosterone include aging, obesity and diabetes. In fact, testosterone levels in men decline by 1 to 2 percent each year after age 30.

While the findings indicate low testosterone concentrations could play a role in worse outcomes for men with COVID-19, researchers say that further study is needed.

There are other questions raised by the study that could be explored in future research, such as whether men with low testosterone are more likely to get severely ill when they get COVID-19 or other respiratory illnesses compared to men with normal testosterone levels. Further studies could also address whether testosterone replacement can help in the recovery process after acute COVID-19 illness, as well as investigate the paradox of low testosterone in blood serum but increased sex hormone signaling in men’s immune cells.

How to support testosterone naturally

The best way to support your testosterone levels is through diet and exercise. Losing belly fat has been shown to boost testosterone, as has brief bursts of high-intensity cardiovascular activity. Some foods that support healthy testosterone include oatmeal, beets, pomegranate, watermelon and cruciferous vegetables like broccoli, cauliflower and cabbage.

Studies show a link between vitamin D deficiency and low testosterone, so make sure you’re getting plenty of vitamin D from sunshine, diet or supplements. Also, getting seven to eight hours of sleep every night helps keep your testosterone levels up.

If your testosterone levels are low enough, you may need to talk with your doctor about testosterone replacement therapy. In an earlier issue, we discussed the benefits of testosterone replacement therapy and what it can and can’t do.

Some people expect testosterone replacement therapy to increase muscle mass, boost sex drive and improve mood, but studies indicate these results aren’t guaranteed. And prolonged use of testosterone replacement therapies has been connected with heart issues and a potentially higher risk of prostate cancer. You should definitely discuss with your doctor whether the benefits of testosterone replacement therapy outweigh the risks for you.

Sources:

Low Testosterone Levels in Men Are Linked to More Severe Cases of COVID-19 — Saint Louis University

Association of Circulating Sex Hormones With Inflammation and Disease Severity in Patients With COVID-19 — JAMA Network Open

Is testosterone therapy safe? Take a breath before you take the plunge — Harvard Health Publishing