GLP-1 and Testosterone Replacement Therapy: A Dynamic Weight Loss and Muscle-Building Duo
GLP-1 agonists are popular and effective weight loss drugs that include brands like Ozempic and Wegovy as well as the specially compounded forms that we provide at TRT Miami.
As the latest scientific research demonstrates and as we’ll explore here, GLP-1 agonists pair well with testosterone replacement therapy (TRT) for men with hormone imbalances to achieve healthy weight loss while retaining muscle and high energy levels.
So, if you want to both maximize your male vitality and shed stubborn excess body fat at the same time in the most cost-effective manner possible, compounded GLP-1 medications combined with exogenous testosterone is the way to go.
Let’s explore how and why testosterone replacement therapy can support men’s weight loss.
The link between low testosterone and excess body fat
Testosterone is men’s male sex hormone, called an androgen.
In addition to supporting reproductive health (healthy sperm counts, strong erections, etc.) and maintaining muscle mass, testosterone also regulates body composition (the ratio of muscle mass to fat).
Unfortunately, men’s testosterone levels have declined precipitously across all age groups over recent decades, so that the average 40-year-old has less testosterone than his father did at the same age and even less than is grandfather at the same age.
Yale School of Medicine (emphasis added):
“From 1999 to 2016, testosterone levels have declined in adolescent and young adult men (AYA)… After controlling for confounders—including year of study, age, race, BMI, comorbidity status, alcohol and smoking use, and level of physical activity—total testosterone was lower among men in the later (2011-2016) versus earlier (1999-2000) cycles.”
The Journal of Clinical Endocrinology and Metabolism speculates that there are many culprits for this generational testosterone loss, including poor lifestyle (lack of exercise, nutrition-deficient diets, etc.) as well as environmental pollutants that disturb the delicate human endocrine system (hormone system).
(If you are unsure of your testosterone levels, particularly if you are a man over 40, we can provide a simple and affordable blood test to assess both total testosterone and free testosterone levels.)
The result of the low T epidemic is that low testosterone drives the accumulation of visceral fat — the worst kind of body fat that we’ll discuss more coming up. In turn, higher body fat further degrades testosterone production in a downward health spiral.
In fact, nearly half of all men battling metabolic dysfunction in the form of obesity or diabetes also suffer from low testosterone (called “hypogonadism” in clinical literature): “Up to 40% of men with obesity and/or type 2 diabetes have co-existing hypogonadism, which is associated with an adverse metabolic phenotype,” reports The Journal of Clinical Endocrinology and Metabolism.
Taking all of the above data into account, any strategy for long-term weight loss should consider the benefits of metabolism-enhancing testosterone levels in men.
GLP-1 weight loss drugs raise testosterone levels in men through multiple potential mechanisms
Even in the absence of any identifiable dysfunction of the male reproductive system causing low testosterone (called “primary hypogonadism”), studies show that high sugar intake alone can tank testosterone levels in otherwise healthy men.
Reproductive Biology and Endocrinology (emphasis added):
“After adjusting for co-variates (age, race, family income, serum cotinine, BMI, heavy drinking, and physical activity), excessive consumption of SSBs [sugar-sweetened beverages]… was significantly associated with low testosterone levels…
The main findings of the present study are consistent… in terms of the influence of SSBs on male reproductive health…
The effects of SSB consumption on testosterone levels in adult males must be considered if primary and secondary hypogonadism have been ruled out as a source of low testosterone and related symptoms.”
Since we know that high sugar intake via diet and the resulting blood sugar spikes impair testosterone production, it follows that preventing those blood sugar spikes would improve testosterone levels.
That’s exactly what we have found.
As research suggests, the blood sugar-limiting and weight loss effects of GLP-1 drugs improve testosterone levels in obese men.
But the benefits of GLP-1 for healthy testosterone levels don’t stop there. I
In addition to the beneficial impacts of weight loss and enhanced blood glucose management on the male hormone system, the decrease in oxidative stress in the testes through direct action of the drugs on the GLP-1 receptors located throughout the male reproductive system also boost T counts.
Via Andrology (emphasis added):
“Insulin resistance and type 2 diabetes, treatment modalities for obesity and type 2 diabetes could result into improvement of testosterone levels…
Studies with GLP1-R analogues show beneficial effects on both body weight and testosterone levels in men with low testosterone levels and obesity with or without type 2 diabetes. Overall, it is expected that the weight-lowering effect is the main contributor for improvement of low testosterone levels in the treatment with antidiabetic drugs. Nevertheless, the current available data suggest that the rise in testosterone levels due to treatment with GLP1-RA is higher than what could be expected for the amount of weight loss. This might be explained by acting on the testicular GLP1-R and/or by the decrease of the antioxidants in the testes.”
How testosterone replacement therapy (TRT) augments weight loss with GLP-1 therapy
We’ve discussed how GLP-1 drugs can improve testosterone levels in men.
Now, let’s explore the other side of the coin: how testosterone enhances weight loss in concert with GLP-1 agonists.
Testosterone shreds visceral fat (‘belly fat’)
The clinical evidence is clear: testosterone, the male sex hormone, decimates excess body fat — particularly that stubborn, resistant type of body fat around the abdomen called “visceral fat.”
In laymen’s terms, we often call visceral fat a “beer gut” or “belly fat.”
Visceral fat is particularly insidious for long-term health, as it puts men at much greater risk of cancer, stroke, diabetes, and other common chronic health conditions.
Worse still, visceral fat is often the most difficult type of fat to shed. Hence the term in popular culture you might be familiar with: “skinny fat”— characterized by low body fat distribution across the legs, arms, and chest, but with high visceral fat deposits in the belly and hips.
https://youtu.be/GqN–zcMrmQ?si=05E3Gc2IWv6FJMze
Fortunately, testosterone replacement therapy is a visceral fat killer.
“Concentrations of… total and free testosterone, were negatively correlated with waist/hip circumference ratio and visceral fat area,” medical journal Metabolism found in a study of two dozen men between the ages of 25-50. Additionally, in the same study, higher testosterone was found to correlate with lower blood glucose levels.
Testosterone therapy powers weight loss in obese men and boosts lean muscle mass
“Testosterone therapy in obese men with testosterone deficiency offers a well tolerated and effective therapy and produces sustained and significant weight loss,” per research published in Current Opinion in Endocrinology, Diabetes and Obesity. “Testosterone therapy increases [lean body mass], reduces fat mass and produces sustained and significant weight loss, reduction in waist circumference and BMI… Testosterone therapy in obese men with testosterone deficiency is a unique and effective therapeutic approach to management of obesity.”
Testosterone counters potential muscle loss associated with GLP-1 agonists
One of the potential side effects of GLP-1 weight loss drugs, which we aim to avoid for obvious reasons, is loss of lean muscle mass.
According to Diabetes, Obesity and Metabolism, “with greater weight loss there is concern about potential side effects on muscle quantity (mass) [resulting from GLP-1 use].”
By some estimates, lean muscle loss accounts on average for somewhere between 15-40% of the total weight lost during GLP-1 therapy — the rest being fat.
It goes without saying that the male weight loss patients we treat are interested in burning fat without sacrificing muscle mass.
Given that concern, testosterone therapy for men with insufficient testosterone levels is an excellent adjunct therapy to avoid the potential muscle loss that can accompany the use of GLP-1 medications.
Particularly among men with poor blood sugar management resulting from metabolic dysfunction — which often contributes to, and goes hand-in-hand with, overweight/obesity — muscle loss is a major health concern that needs to be addressed in combination with weight management.
Per another study from the medical journal Andrology, men with metabolic dysfunction benefit greatly from testosterone replacement therapy in terms of maintaining lean muscle mass.
Therefore, given what we have discussed previously about the muscle-preserving benefits of testosterone, GLP-1 patients, especially older men, are ideal candidates for TRT.
To learn more about the androgen-enhancing therapies we offer at our leading anti-aging clinic, TRT Miami, visit our contact page and we’ll get started on your journey to restored health and vitality today.
