Treating Low Testosterone with Chinese Medicine (Herbal Medicine, Acupuncture and Moxibustion)

Similar to large numbers of people being told they have low vitamin D in recent years, there appears to be a similar increase in men being told that they have low testosterone.  For better or worse many cultures, ours included, often seem more concerned with finding a way to increase testosterone (i.e. aspects of strength and virility) vs. finding and properly dealing with the causes of the losses of testosterone.  Finding the causes of preservation of testosterone and your own strength is far more important from a Chinese Medicine perspective than simply adding to it which can have negative effects.  This article will explore some of these issues and treatment options from a Chinese Medicine perspective.

In my research for this article I was reading a forum article within a weightlifters discussion group where a man was supplementing with Chinese herbs to increase his overall strength and sexual prowness.  Two observations arose in my mind...  My first observation was the perhaps far too obvious question - would his testosterone be low if he didn’t work out as much, relaxed more, and was less concerned with significant amounts of sexual activity?  A general thinking point with these issues is what are you feeding as an individual and what is truly driving these issues.  Exercise is good, a loving relationship with sexual activity can be a boon to both partners health and psychological well being, but there are issues of proper balance to be taken into account with all activities.

My second observation was of a different matter entirely which highlighted a general lack of knowledge of Chinese Herbal Medicine (CHM) in particular and of the synergistic forces of nature in general.  As the poster wrote about his ‘low T’ formula people starting discussing each ingredient saying you didn’t need that or you needed more of this.  Generally one was needed because it was stronger (i.e. more yang) and not needed because it was weaker (i.e. more yin or harmonizing).  Bodybuilders are a well known group for complex supplementation and are fascinating to observe because of this.  The exact counterpoint to all of this is Buddhist monks who train their minds in meditation by meditating in front of human corpses - a lesson to not be too overly concerned with our perishing physical body and all of its ups and downs.  An aside, but a further point nonetheless...

Now back to my second observation - herbs, foods and our general environment along with our mind, emotions and physical activity levels all have a synergistic effect on our bodies as a system.  In general this means there is no one answer to each individuals issues, but it also means that more is simply not always better.  Within herbal medicine if you are building more yang (warmth, energy, strength), for example, herbal formulas often contain a number of substances to help balance the strength of the herbs to avoid side effects and achieve better results.  In another weightlifters forum discussion one person starting taking some Chinese herbs and broke out with acne all over within a day or two of taking the formula - (i.e. too much heat).  This is an example of herbs not being properly prescribed but also the repercussions of an unbalanced formula overall.

What Is Testosterone and What Does It Do?

Both men and women produce the steroid hormone testosterone (men in the testes and women in the ovaries, with some from the adrenals).  Generally testosterone facilitates muscle development and maintenance of bone (i.e. strength), libido, and fertility (i.e. sperm production).

What Are Symptoms of Low Testosterone (‘Low T’)?

In men low T may lead to low libido, erectile dysfunction, fertility issues, fatigue, hair loss, decreased muscle mass and/or bone density, anxiety, insomnia and other issues.  In women low T may lead to menopausal type symptoms such as hot flashes, insomnia, osteoporosis, decreased muscle strength, irritability, anxiety and low libido.

What Are The Western/Physical Causes of Low Testosterone?

The causes can vary widely which is why proper diagnosis and treatment is key - perhaps more so from a Chinese Medicine perspective.  But anything which injures the testes or ovaries can cause problems such as trauma, cancer treatments (chemo, radiation), the mumps virus in men, genetic issues and removal of the ovaries in women - among other causes including cancers in certain areas of the brain, obesity, hiv/aids, the use of steriods, etc.

What Are Contributing Lifestyle Factors from a Chinese Medicine Perspective?

This is where the crux of the article begins and we can talk about where all of your testosterone is going instead of focusing on simply adding more in (which may still be important).  Common lifestyle/dietary factors for the development of low testosterone are the following:

• Stress - particularly chronic long term stress.  Stress can also be a byproduct of sexual issues, fertility problems, fatigue and psychological issues which may arise creating a cycle of contributing factors.
• Sleep - or lack thereof.  During deep sleep is when functions of restoration happen in the body, when this does not happen our bodies have to work harder to maintain daily functions which will draw from our reserves.
• Alcohol consumption.  While some is probably not detrimental a regular habit of consumption will decrease levels primarily by converting testosterone to estradiol.
• Age - not much you can do about this one per se, but amounts will generally decrease by 1% every year after 45 or so.
• Diabetes (i.e. poor diet and lack of physical movement).
• Lack of exercise, or excessive exercise - one may leave levels low, one may deplete levels.
• Lack of sexual activity, or excessive activity - again one may leave levels low and one may deplete levels.
• Medications such as those for Blood Pressure, SSRI’s for anxiety/depression among others.

What Can Chinese Medicine Offer for Low Testosterone?

The first aspect of treatment is to properly identify the causes as well as possible and determine the Chinese Medicine (CM) diagnostic pattern (see “What Does Acupuncture Treat? for more information).  From that diagnostic pattern proper lifestyle and dietary recommendations can be made to help the internal functions within the body restore and achieve their own balance without excessive direct supplementation which has any number of risks and side effects.

From a CM perspective, the Kidney system is what in charge of the adrenals, sex hormones, vitality, bone development etc. (see “My Kidneys are What?” for a general discussion).  In general this system can either be overstimulated (what we call Kidney Yin deficiency) or truly weak (what we call Kidney Yang deficiency).  As far as low testosterone and other symptoms are concerned they can be the same in both cases but in one it is from the body drawing from its resources too much and from the other it has either already tapped them or there is something more functional happening causing lack of production.

A very general distinction is that with Kidney Yang Deficiency you will have more feelings of cold, stronger signs of true fatigue with a need for more sleep, perhaps a more lowered mood and with Kidney Yin Deficiency you will have more feelings of heat (particularly in the palms and/or feet), fatigue but more in a ‘tired but wired’ way where sleep is still problematic, perhaps with more anxiety or restlessness.

Treatment then will vary depending on the overall diagnosis each person and mixed syndromes are somewhat common requiring consultation with a qualified practitioner.

What Acupressure Points May Be Helpful?

To move on, then, to what you may be able to do for yourself (outside of seeing a practitioner), here are some general points that can be used as self-remedy.

Kidney Yin Deficiency Acupressure Points - KD 6, CV 4, HT 7.

For Kidney Yang Deficiency, Moxibustion can be used on certain points as a home treatment which is more effective than acupressure (See What Is Moxibustion?, for more information).  Points that would be applicable would be - KD 3,  CV 4, CV 6, ST 36, SP 6.

What Herbal Formulas May Be Helpful?

Chinese Herbal Formulas need to be properly prescribed and used in correct dosages to be effective.  The following formulas, however, are used often when the underlying pattern warrants their use.  A breakdown of each formula along with more clinical information can be found by following each formulas link.

Kidney Yin Deficiency (or mixed - more yin signs) formulas:
Liu Wei Di Huang Wan
Zuo Gui Wan

Kidney Yang Deficiency (or mixed - more yang signs) formulas:
Jin Gui Shen Qi Wan
You Gui Wan

There are of course many more options to aid a person with these issues and each case needs to be evaluated individually.  The take home point from this article, however, is to at least bring awareness to where your energy is going not just how to get more.  Work on some of those issues and then see where your measured levels are but also how you feel overall.  Adding more fuel to the fire will rarely lead to a great outcome in the long run...