Low Testosterone, Adrenal Fatigue and Gut Health

The Link between Inflammation and Low Testosterone and Erectile Dysfunction

EMedicine Health online states that 67% of men age 40 have at least some trouble with erectile dysfunction and that number increases an average 12% for each decade of life afterwards, with men age 79 reporting 90% ED.  In 2007 it was estimated that 18 million men suffered ED in the United states, while in 2020 that number had increased to 33 million. The number of men age 20-40 reporting some incidence of ED is 52%. As you can see, it is a bigger problem than is actually acknowledged.

What are the causes?

A study in 2019 published by Harvard Health indicated that chronic inflammation is actually the primary cause. The study reports that often, ED is the first sign that is reported regarding Low Testosterone, heart disease, Venous Insufficiency or Kidney disease, but is often overlooked. This may be due the way in which it is reported. (8) Many men in their 20’s to 50’s won’t report difficulty obtaining an erection. They won’t even report low sex drive, or premature ejaculation. What they report is a general sense of fatigue. Weight gain. Loss of motivation. Interestingly, blood work is not often done at this stage. In 47% of cases the patient is prescribed an antidepressant like a Selective Serotonin Reuptake Inhibitor (SSRI). 

relations and ED

The study went on to say that medications such as Viagra, Cialis and other vasodilators that were prescribed could actually be more damaging long term. This is because the younger the patient, the higher the risk of further damage to the blood vessels. You see, the Blood Vessels in the Penile tissue are the smallest and have the thinnest walls. If you cause them to “Blow out” before age 50, you have a problem beyond age 50. Not only that, But there are significant risks. Curing the problem might be better than the medication. The medications can have side effects of Stroke, heart attack, loss of hearing and vision. 

Where does Chronic Inflammation start?

In the blog published in January titled What is Leaky Gut and Do I Have It? I go over what happens when the gut is under attack. This attack can be from the environment outside the body, or the things that you place into the GI system.  If you are unsure of the symptoms of Inflammation here are some examples:

How do you know if you have a leaky gut?

  • constipation that is chronic and have difficulty going to the bathroom for a bowel movement 2-3 times a day 
  • bouts of Diarrhea that come on especially after a meal or seem out of the blue
  • If you have joint pain in the mornings
  • Joint stiffness in the mornings
  • Headaches, particularly migraines
  • Hives
  • Itchy dry skin, even with lotion
  • Autoimmune disorders like chronic fatigue, adrenal fatigue, eczema, 
  • Allergies to food and environment
  • Sinusitis, ear infections, Sinus infections
  • Runny nose
  • Acne

How Does inflammation in the Gut and the Rest of the Body Affect Testosterone and ED?

To start, the gut must have the ability to absorb certain nutrients to produce hormone precursors, Neurotransmitters and Hormones themselves. It turns out that Serotonin (80%  of it), which is the feel good neurotransmitter, is produced in the gut. IT is also required to obtain an erection. If you lack serotonin or you are taking serotonin sparing drugs, Like SSRIs, you will likely have a decreased ability to obtain an erection. 

A study published in 2016 (10)  indicates that Obesity and a high fat/high calorie diet are both reported to result in changes to gut bacteria and intestinal wall permeability, leading to the passage of bacterial endotoxin (lipopolysaccharide- LPS) from the gut to the blood system (metabolic endotoxaemia), where it initiates systemic inflammation. Endotoxin is known to reduce testosterone production by the testis, both by direct inhibition of Leydig cell steroidogenic pathways and indirectly by reducing pituitary Luteinizing Hormone drive.

The problem is that the low T promotes a decrease in good gut bacteria and an increase in non-ovarian Oestrogen production (4). This then leads to further inflammation and lower testosterone. And the cycle continues. The Cycle in itself can lead to Heart disease, Spider Veins, Stroke, and ED. 

When you’re ready to talk about correcting the problem, Schedule Here


(1)Blumberg, R., and Powrie, F. (2012). Microbiota, disease, and back to health: a metastable journey. Sci. Transl. Med 4:rv137. doi: 10.1126/scitranslmed.3004184
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(2)Human Microbiome Project Consortium (2012). Structure, function and diversity of the healthy human microbiome. Nature 486, 207–214. doi: 10.1038/nature11234
PubMed Abstract | CrossRef Full Text | Google Scholar
(3)Harada, N. (2018). Role of androgens in energy metabolism affecting on body composition, metabolic syndrome, type 2 diabetes, cardiovascular disease, and longevity: lessons from a meta-analysis and rodent studies. Biosci. Biotechnol. Biochem. 82, 1667–1682. doi: 10.1080/09168451.2018.1490172
PubMed Abstract | CrossRef Full Text | Google Scholar
(4)Flores, R., Shi, J., Fuhrman, B., Xu, X., Veenstra, T. D., Gail, M. H., et al. (2012). Fecal microbial determinants of fecal and systemic estrogens and estrogen metabolites: a cross-sectional study. J. Transl. Med. 10:253. doi: 10.1186/1479-5876-10-253
PubMed Abstract | CrossRef Full Text | Google Scholar
(6)Sooriyamoorthy, T., & Leslie, S. (2021). Erectile Dysfunction. [Updated Aug 12, 2021]. In: StatPearls [Internet]. Retrieved Dec. 8, 2021 from https://pubmed.ncbi.nlm.nih.gov/32965924/
(7) https://www.health.harvard.edu/mens-health/which-drug-for-erectile-dysfunction
(8) https://www.statista.com/statistics/1248479/effects-of-ed-on-relationships-among-us-men/
(9) https://medlineplus.gov/ency/article/004024.htm
(10) Gut Endotoxin Leading to a Decline IN Gonadal function (GELDING) – a novel theory for the development of late onset hypogonadism in obese men
Kelton Tremellen https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4918028/
(11)Dopamine and serotonin: influences on male sexual behavior, Elaine M Hull 1, John W Muschamp, Satoru Sato
(12) https://www.sciencedirect.com/topics/medicine-and-dentistry/estrogen-metabolism



Gut Health and Hormones: Gut Health Part 3

So now that I know leaky gut exists, What else should I know?


Those pesky little signalers in your body that drive every process. They are affected by leaky gut.

In fact, there are now studies that link the diagnosis of PCOS and Leaky gut. (1) They show that women who have leaky gut are more likely to suffer from lack of diversity in the biome, but also that they suffer from the inflammatory processes surrounding leaky gut. The imbalance in the microbiome plus the leaky gut lead to estrogen dominance.  One study even suggests that some of the gut bacteria are pro estrogen forming. Which means that they will break down the cholesterols from the food you eat and use them to produce more estrogen.

But its not just Estrogen. Turns out that poor gut health is a leading cause of LowT as well. Testosterone is also produced in part by nutrients that we ingest and can absorb. (2) When the gut is leaky, it creates inflammatory cascades that decrease function of the gonads. The reduced function decrease Gonadotropin hormone. This hormone triggers production of testosterone. Lack of testosterone has been linked to

  1. Erectile dysfunction
  2. Heart Disease
  3. Stroke
  4. Decreased Muscle Recovery, repair, rebuilding
  5. Gynecomastia
  6. Breast cancer in men

Medication or Supplements?

Well, Lets be honest. When was the last time a pharmaceutical company gave you a drug that cleared up all your problems and created none.

Recently, I have even seen some of the LowT clinics prescribing the use of metformin.  And sure, The research for Obese Males with Type II diabetes shows that (3)

  1. It decreases cholesterol
  2. Decreases obesity
  3. Decreases inflammation
  4. Can improve overall heart health
  5. Changes the gut bacteria ratio


So that same physician that is giving you testosterone is giving you metformin. Then you have to up the testosterone dose, making it more expensive. Long term, the use of metformin also showed in healthy males to cause Erectile Dysfunction. (4) Seems odd that the same guy is writing you a prescription for the two. Sure, 12 weeks of cycling on and 6 months off may help with someone with high cholesterol. But research shows those problems with ED start around 12-18 weeks.

Are you willing to risk morning sex for 6-pack abs? I know which one I’d rather have….

Supplements that boost testosterone, lower blood sugar, cleanse the liver and lower cholesterol: Berberine (taken from the peel of Bergamot oranges), Bergamot and Turmeric. (5)


So which do you want?

When is the last Cure we had in the US?

When is the last time you heard a list of side effects that nearly scared you to death?

Interested in Reducing or Reversing your PCOS or Erectile Dysfunction?

Book a Call



(1) https://www.ncbi.nlm.nih.gov/pubmed/28045919

(2) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4918028/

(3) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7751595/

(4) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5296448/

(5) https://www.sciencedirect.com/science/article/pii/S2213434415300256#:~:text=Thus%2C%20bergamot%20extract%20alone%20or,in%20patients%20with%20cardiometabolic%20disorders.