Richard Laliberte

Sounds obvious, but as many as a quarter of men receiving T therapy do it blindly-that is, they start a regimen without testing whether they actually have low T. Supplementation wont help if your T levels are normal. In fact, it will turn off your own production, says Brad Anawalt, M.D., chief of medicine at the University of Washington Medical Center. The pituitary recognizes theres plenty of testosterone in the blood and stops producing hormones that stimulate the testicles to make more. To be sure, get a fasting testosterone test from your doc, preferably in the morning, when the hormones levels peak. Repeat the test at least once, with the second a day or more after the first. Two low morning readings indicate testosterone deficiency. Readings can vary from day to day and even hour to hour, and they can be lower if youre sick. So dont test when youre under the weather.

Testosterone therapy side-effect: It could turn off your own production of the hormone.

Cancel Out Other Causes

If your levels are a little low, dont just blame it on your age. Lately, some doctors have begun to question the idea that testosterone starts dipping by about 1 percent a year around age 35. If that were true, it should happen in all men, and it doesnt, says Ranjith Ramasamy, M.D., director of male reproductive medicine and surgery at the University of Miami Miller School of Medicine. A healthy, fit 40-year-old will have testosterone levels like a 20-year-olds.

Poor health is more likely to cause low T than the other way around. If your levels are right around 300 ng/dL, which is on the cusp of being low, and you have symptoms, look first at other conditions, Dr. Anawalt says. Medications like opioids lower testosterone. So does a condition called male hypogonadism, in which problems with the testicles or the pituitary gland-or both-prevent your body from producing enough T. Far more common than either of these: extra pounds. If youre overweight and lose 7 percent of your body weight, testosterone could increase 10 to 15 percent, which would put you squarely in the normal range, Dr. Anawalt says.

If you lose 7 percent of your body weight, your testosterone could climb into the normal range.

Weigh the Risks

You dont want testosterone therapy if you do want kids: In healthy men, it can make the pituitary shut down sperm production. Possible side effects of T therapy also include an increased risk of sleep apnea, blood clots, and prostate cancer.

Then Pull the Trigger

Your doc still may write you an Rx. In men with verifiably deficient levels-generally below 300 ng/dL-and low-T symptoms (fatigue, decreased sex drive), replacement can ratchet up desire, sexual activity, physical function, and vitality. But not this weekend: It takes three to six months for supplemental testosterone to have an effect.

Either were in a low-T epidemic or an epidemic of falling for persuasive ads. Testosterone- replacement prescriptions have soared-they quadrupled in guys aged 18 to 45 between 2003 and 2013-as ads for the therapy have become widespread. So if youre tired or losing muscle, have ED, cant concentrate, feel irritable, or just never feel all that great, could T therapy really help? How to find out:

What Testosterone Replacement Really Does to Your Sex Life

Thats most scary for the 35 percent of American men categorized as obese-guys who have a body-mass index (BMI) of 30-plus. Its also a concern for the 38 percent of guys classified as overweight, whose BMI is in the 25 to 29.9 range.

But even men sporting modest paunches are at risk. Yup, Dad Bods, Skinny Fat dudes, Beer Belly Light guys-maybe even you. Recent Mayo Clinic research shows that men who are in the normal range (with a BMI of 18.5 to 24.9) but have fat in their midsection are up to four times as likely as leaner men to have metabolic disorders. Why some people predominantly carry fat in visceral deposits isnt fully understood, says Paul Cohen, M.D., Ph.D., an assistant professor and head of the Laboratory of Molecular Metabolism at Rockefeller University in New York. There clearly are genetic and hormonal influences.

While researchers learn more about how fat harms you, theyre also finding new ways to fight it. And it may not take much to reduce your health risks, according to a new, albeit small, study in Obesity. When people who had a normal BMI but excess body fat lost 5 percent of body weight, they saw major benefits: visceral fat down 11 percent, total fat down 9 percent, liver fat down 50 percent, and insulin sensitivity up 26 percent. If you weigh 200 pounds, losing 5 percent means shedding just 10 pounds. These four tips make it a little easier. Get after it!

Muscle is the opposite of fat, says Mayo Clinic cardiologist Francisco Lopez-Jimenez, M.D. All over your body, muscle is metabolically active in ways that counteract visceral fat-extracting glucose from your blood, helping your liver process fatty acids, and reducing inflammation. Dr. Lopez-Jimenez and his colleagues have found that people with big guts often lack lower-body muscle mass, and the correlation is stronger as people age. It stands to reason: Strong muscles add bulk to your legs and butt-your biggest muscle groups-providing a better balance of muscle to fat in your body and powering a healthier metabolism.

If you have to choose one type of exercise, strength training may be best for specifically trimming your gut. In a Harvard study, men who did 20 minutes of daily weight training had less of an increase in age-related abdominal fat than men who spent the same amount of time doing aerobic activities. Emphasize exercises that challenge your whole body: squats, deadlifts, pullups. However, the same study found cardio had a greater impact on overall weight. Dr. Lopez-Jimenez suggests a mix of both, but combine them the right way by alternating cardio and weight training on different days. Men who do that may burn more visceral fat than they would by stacking workouts on top of each other in the same session.

Belly flab may be due as much to what happens in your head as in your gut. Losing visceral fat is difficult because your body defends fat like a castle on a very round hill, through the processing of hormones in brain circuits that control appetite. Thats because in evolutionary/survival terms, fat is good. It seems to be your bodys inherent system for stockpiling food, and it served mankind well when actual, edible stores were meager. Your ancestors who could sock away the most fat from the least food and release its energy in the most frugal, thrifty way possible had a genetic advantage. Your prepare-for-the-worst body isnt in sync with the indulge-every-whim bounty of food markets and restaurants-or the lack of exertion that comes from neither hunting nor gathering.

Over the years, your body matches energy intake and output with about 99 percent accuracy, says Michael Schwartz, M.D., codirector of the Diabetes Institute at the University of Washington. But even a finely tuned system cant compensate for gradual gains from endless calorie bombardment. As a rough estimate, most obese people dont gain more than five pounds of fat a year, but that adds up over ten years, says Dr. Schwartz.

Evidence suggests that keeping calorie consumption confined to an earlier window means less weight gain than eating more later in the day. One new study tested the 16:8 diet-16 hours of fasting and 8 of eating. Researchers instructed 23 obese participants to eat any food in any amount between 10:00 a.m. and 6:00 p.m., but stick to water and calorie-free drinks at other times. After 12 weeks, volunteers ate about 300 fewer calories a day than a control group and lost about 3 percent of their body weight-enough to cause a discernible drop in visceral fat compared with the control. No participants leaving the study complained about the diet, so its likely that volunteers found it fairly easy to stick with. Researchers say thats critical for improving metabolic health in a sustainable way.

<h3>3. Nurture your inner rain forest</h3>

One of the most important parts of your metabolism is your microbiome-the ecosystem of gut bacteria that break down food and produce chemicals that may prevent obesity, likely by reducing inflammation. A healthy microbiome should be like a rain forest. A big-belly microbiome is kind of barren. The key difference is biodiversity. Obese people have fewer species of microbes in their gut, says Dan Knights, Ph.D., an associate professor at the University of Minnesotas Biotechnology Institute. These microbes are like a factory producing thousands of compounds, good and bad. You want to provide food for the microbes making good compounds.

To restore your inner Amazon, eat food closer to nature. Most Americans are living in a fiber desert, Knights says. Every plant has its own set of fibers, with different chemical structures and different microbes that break them down. Aim for about 30 grams per day. Fiber-rich foods like fruits, vegetables, legumes, and whole grains are linked to a rise in short-chain fatty acids, which may reduce your risk of inflammation and metabolic problems. In one study, each ten-gram increase in daily fiber intake was associated with a 3.7 percent drop in visceral fat. Supplementing can help: Add two tablespoons of psyllium husks to your cereal or salad. Knights snacks on <a href="https://www.nugonutrition.com/products/fiber/" link="null" target="_blank"> NuGo dLish </a> bars, which deliver 12 grams of fiber from diverse sources.

<h3>4. Change the nature of your fat</h3>

Not all body fat is harmful. Visceral fat is white fat-a type associated with an unhealthy metabolism. But another kind-brown fat-burns calories and helps the body generate heat. We dont have a lot of brown fat and lose it as we get older, says Dr. Cohen. Preliminary research also suggests that as you gain girth, you may actively switch healthy brown fat to unhealthy white fat.

If brown fat can turn white, can white fat turn brown? Its a hot area of research. Investigators have found a third type of fat called beige fat that can be activated so it has fat-burning power. Beige fat tends to be embedded in subcutaneous fat, which may be why subcutaneous fat is relatively benign and may even be protective, Dr. Cohen says. Our dream is to find a pharmacological target-five to ten years away-that would turn unhealthy white fat to healthy brown fat. You may already have a natural way to make beige fat brown. New research suggests you can turn on the beige-fat furnace by notching your homes thermostat down to 66 or below for ten hours a day. Cold temps activate beige fat to keep you warm.

Belly fat is such an important (and dangerous) factor for your overall health that its now discussed as an organ. The visceral fat that makes up a spare tire or, worse, a beer belly-and that surrounds your liver, stomach, and intestines-isnt flabbily inert. It appears to be biologically active, pumping out hormones and other substances, and it may even increase your risk of metabolic problems like cardiovascular disease and type 2 diabetes, and maybe even cancer.

The Top 4 Ways to Lose Belly Fat for Good

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Richard Laliberte

Articles written by the author

What Testosterone Replacement Really Does to Your Sex Life

The Top 4 Ways to Lose Belly Fat for Good