063 - Low T Is a Red Flag! Not Just a Hormone Problem
In tactical professions, we often hear about testosterone through the lens of performance, muscle, or aging. But what if low T wasn’t just a hormone issue, but a biomarker of systemic dysfunction?
This peer-reviewed article reframes functional hypogonadism not as a standalone condition, but as a clinical red flag, a marker that deeper metabolic and chronic disease processes may be underway.
For tactical athletes, coaches, and rehab professionals, this demands a shift in how we assess, screen, and respond to low testosterone.
What They Found:
This clinical review outlines the pathways of testosterone production and the difference between functional and pathological hypogonadism. Functional hypogonadism refers to low serum testosterone without a structural problem in the hypothalamic-pituitary-testicular (HPT) axis. Instead, it’s driven by reversible lifestyle and metabolic factors, most notably visceral obesity, inflammation, insulin resistance, and chronic disease. Key points:
Visceral fat and insulin resistance suppress testosterone production centrally (via GnRH) and peripherally (via SHBG dynamics).
Low T is reversible with weight loss, improved nutrition, and behavior change.
Measuring testosterone alone is insufficient; SHBG, LH, and prolactin should also be assessed.
Aging alone doesn’t cause a significant T drop unless compounded by poor health or obesity.
Common triggers: opioids, excess alcohol, inactivity, high-carb diets, sleep deprivation, and chronic inflammation.
What This Means:
For tactical professionals, low testosterone isn’t just about energy or libido; it’s a diagnostic signal of cardiometabolic strain. This article reframes low T as an opportunity for early intervention. It’s not just a hormone to replace, it’s a system to investigate. From a readiness standpoint, addressing functional hypogonadism means restoring the internal terrain, reducing disease risk, improving recovery, and supporting long-term performance.
Tactical Implications:
Screen Beyond Testosterone: Evaluate LH, SHBG, prolactin, and metabolic markers when T is low, don't isolate the hormone.
Treat the System, Not the Symptom: Functional hypogonadism is reversible through lifestyle change—don’t jump to exogenous T first.
Use Waist Circumference, Not BMI: Visceral fat is the key risk, not overall size. Focus your assessments accordingly.
Embed Metabolic Education into Your Practice: Teach athletes and operators that low T is often a health performance issue, not a supplement problem.
Questions To Consider:
How often do you screen for underlying metabolic risk when testosterone is low?
Are you using anthropometrics (waist circumference, body comp) or relying too much on BMI?
Do your training programs prioritize sleep, nutrition, and inflammation management alongside strength?
What’s your process for flagging when "low T" is a symptom, not the diagnosis?
Could your tactical pipeline be improved by making functional hormone assessment part of annual readiness checks?
Wittert G. Understanding functional hypogonadism: Serum testosterone as a marker of chronic disease and cardiometabolic risk in men. Endocrinology Today. 2022;11(4):24-30.