Testosterone Replacement Therapy and Insulin Resistance
Insulin resistance is, “when cells in your muscles, fat, and liver don’t respond well to insulin and can’t use glucose from your blood for energy.” Insulin resistance is a precursor for prediabetes and type 2 diabetes. When insulin resistance goes on for too long, the pancreas, which creates insulin, still does so, but the body struggles to make use of the insulin.
The relationship between low testosterone and insulin resistance is more complex than simple cause and effect. In fact, it’s unlikely that low testosterone directly causes insulin resistance—rather, it’s more likely that the causes of low testosterone are also potential causes or symptoms of insulin resistance, and that by treating those causes through testosterone replacement therapy, insulin resistance may therefore be reduced or alleviated.
Treating the Symptoms of Low Testosterone May Treat Insulin Resistance
One of the major symptoms and/or risk factors for low testosterone is obesity. We know that obesity is the leading risk factor for type 2 diabetes, the ultimate outcome of prolonged insulin resistance. We also know that obesity is closely associated with low testosterone—obesity actually causes low testosterone levels.
One of the reasons for this is that fat acts as an estrogen-producing organ. The more fat a man has on his body, the lower his testosterone levels are likely to be and the more likely he is to be obese and to have insulin resistance, prediabetes, or diabetes.
So what is the solution? Certainly losing weight can help, but when testosterone levels are low, it becomes hard to build muscle—losing weight is therefore more difficult because resistance exercise is one of the best ways to build muscle and burn fat.
Treating the root cause may be difficult. If the reason for the obesity is an eating disorder, it may be difficult, if not impossible, to treat the obesity issue, and in turn, the low testosterone levels being caused by the obesity (or, if not caused, exacerbated).
If low testosterone is the culprit and obesity is a symptom, then treating the low testosterone may help not only with insulin resistance, but with obesity itself. If weight is lost and endogenous testosterone levels (the amount of testosterone your body can naturally produce) rise, then insulin resistance may be treated, and prediabetes or type 2 diabetes may even be cured.
To treat these symptoms, the root cause must be determined. It starts with a testosterone test to see what your testosterone levels are and if they’re behind your symptoms.