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  • Writer's pictureMonica Bell

Low Testosterone and COVID Risk

Now that we are approaching our third year of living with COVID many mysteries remain but also the more we are learning. One of the pressing questions is why do some people get COVID and others don’t and some people get sicker and require hospitalization.

We know that risk factors such as age and co-morbid medical conditions play a large role in the severity of illness and subsequent hospitalization. But we are also discovering that hormone levels are critical to our understanding of who contracts COVID and who gets sick. For example, in one study women who received prescriptions for hormone replacement therapy with estrogen within 6 months of a COVID-19 diagnosis had reduced mortality.

Another study found that females that older females who were taking or had taken hormone therapy were less likely to have COVID infection than age-matched females who had never taken hormone therapy.

But what about men? Much has been made of the fact that men have higher mortality rates than women due to COVID ( and that varies by state). There is speculation that men engage in more high-risk behaviors, and then of course there is the estrogen argument. But a recent study reveals a fascinating look at the role low testosterone plays in hospitalization.


Studies on Low Testosterone and Hospitalization for COVID

The Journal of the American Medical Association (JAMA) published the study on September 2, 2022, and these are some of the assumptions and other findings prior to the study:

  • Other studies have shown that testosterone concentrations during hospitalization are lower in men with severe COVID-19 than in men with a milder disease course.

  • Because acute illness can lower testosterone concentrations, it was not clear whether testosterone concentrations in men with severe illness were subnormal even prior to contracting COVID.

  • Men with chronically low testosterone concentrations have decreased muscle mass and less strength, both of which contribute to reduced lung capacity and ventilator dependence.


Most Recent Study on Low Testosterone and COVID

This study searched the electronic health records of 2 major health systems in St Louis, SSM and BJC HealthCare, to identify patients who met the following criteria: men, older than 18 years of age, history of COVID-19 infection, and had at least 1 measurement of testosterone concentration. The study period was between January 1, 2017, and December 31, 2021, and 820 patients met the inclusion criteria.

A summary of the results:

  • Hospitalization rates increased if the patient’s testosterone concentration was lower than 200 ng/dL

  • Men with low testosterone were 2.4 times more likely than men with normal testosterone to be hospitalized if they contracted COVID.

  • This increased risk was independent of other factors that increase the risk of hospitalization for COVID, such as advanced age, co-morbid conditions, and immunosuppression.

  • The data suggest that low testosterone in men is a risk factor for hospitalization for COVID. And since we know that men with low testosterone have less muscle mass and reduced lung capacity, this makes sense.


Other Factors Related to Testosterone

  • Testosterone therapy was associated with reduced hospitalizations for respiratory conditions among men with chronic obstructive pulmonary disease.

  • Men with low testosterone are in a generalized inflammatory state compared with men with normal testosterone. Testosterone therapy reduces inflammatory mediators.

  • Other studies have confirmed that men with more severe COVID had lower testosterone than men with a milder course.


What Now?

The short answer, have your testosterone levels checked. At Optimal Hormone Health, we will complete a series of labs to determine the best testosterone replacement therapy for you. And the fantastic news? In addition to the possibility of added protection from COVID with restored testosterone levels, you may also benefit from:

  • Increased libido and improvement in erectile dysfunction

  • Boosted energy levels

  • Improved strength and muscle and bone mass

  • Better sleep

  • Improved mood

  • Decreased cardiovascular risk

  • Enhanced memory and concentration


The Pieces of the Health Puzzle

Staying healthy in a rapidly changing world of infectious diseases is challenging. But the foundations of good health don’t change and form an armor of protection against many chronic medical problems. Exercise, a plant-based diet, good stress management, and hormonal balance will give you the protection you need before, during, or after an illness. And besides, you will feel and look better every day.

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