When the coronavirus crisis started, one or two patients contacted me, concerned that having high testosterone levels would put them at greater risk from the disease.
Their concerns made sense to a degree. More men than women were becoming severely unwell due to Coronavirus, so one of their main differences (sex hormones such as testosterone) must be to blame? In fact, the media had already started jumping on this along with some scientists who were ready to vilify the male hormone.
Despite some evidence that testosterone ‘suppresses’ the immune response to vaccines in trials, I wasn’t convinced.
The extent of immune response doesn’t necessarily mean that you are more likely to survive an infection.
Interestingly, this has been supported by new research on Coronavirus sufferers which shows that those with coronavirus and low testosterone are more likely to become unwell and die from contracting coronavirus than men with normal or high testosterone levels.
Higher testosterone suppresses the production of cytokines, which are a reaction to infection. These do help to fight infection, but in some cases (such as coronaviruses COVID-19, SERS and MERS) they can cause a Cytokine Storm, which results in the immune system causing more harm than good, in fact it is one of the main reasons for death.
Ali Daneshkhah, a postdoctoral research fellow at Northwestern University explains more about the effect of a cytokine storm:
‘This is what seems to kill a majority of COVID-19 patients, not the destruction of the lungs by the virus itself. It is the complications from the misdirected fire from the immune system.’
This new study demonstrates that men with high oestrogen and low testosterone levels tend die and become severely ill more frequently than the population. This may be linked to why obese individuals are more likely to die from coronavirus infection.
Obesity causes an increase in oestrogen levels as these men have higher levels of the enzyme aromatase. Aromatase converts testosterone into oestrogen, thereby reducing testosterone levels and replacing them with high oestrogen levels.
High oestrogen levels produce a negative feedback loop in the pituitary gland which further suppresses production of LH (luteinising hormone). Luteinising hormone is the hormone which signals to the testicles to produce testosterone.
We often see that obese men have low testosterone levels combined with high oestrogen. The higher oestrogen rises, the lower the output of LH and therefore the lower a man’s testosterone production.
Correlation does not equal causation
Currently, we can’t jump to too many conclusions from this research.
Correlation does not equal causation – that is, just because men who suffered more from Coronavirus had low testosterone levels, does not mean that the low testosterone caused them to do worse. It could be that men with coronavirus who suffered more began to produce less testosterone.
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