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High cortisol also suppresses LH and FSH pulsatility, directly reducing gonadal hormone output in both men and women. Sustained cortisol demand can reduce progesterone, testosterone, and DHEA production. Cortisol and sex hormones share the same steroid biosynthesis pathway and compete for pregnenolone as a common precursor. More severe or long-standing patterns may require 12 to 24 months of comprehensive support. Rhodiola and eleuthero support blunted cortisol patterns.
Thyroid health is essential for maintaining hormonal balance, as it regulates metabolism, energy levels, weight, and cardiometabolic health, as well as directly influencing hormone levels. Improving gut health through diet, probiotics, or other interventions may positively affect men's hormone balance and overall well-being. Body composition analysis helps assess muscle mass, which is closely tied to testosterone levels. Testosterone plays a role in preserving muscle mass; naturally declining testosterone levels can lead to changes in body composition, including reduced muscle mass and increased body fat. Understanding one’s cardiometabolic health status and adopting healthy diet and lifestyle habits can support heart health and may preserve sexual function. Men’s hormone health is closely linked to cardiovascular and metabolic health. Therapies to directly address testosterone levels may also be considered.
Elevated cortisol promotes insulin resistance, central adiposity, immune suppression, and accelerated hippocampal atrophy. Cortisol dysregulation carries systemic consequences that extend far beyond the stress response system. Cortisol dysregulation is frequently the central hormonal disturbance linking chronic fatigue, anxiety, weight gain, poor sleep, immune dysfunction, and metabolic instability into a coherent clinical picture.
By addressing hormones and their root causes through functional medicine, men can look and feel their best at every age. Men’s hormone health is about far more than testosterone. In general, optimal testosterone levels in men should be between 300-1,000 ng/dl—although individual levels are highly variable. It’s important to note that testosterone replacement therapy is not without risk and hormone therapy should always be monitored by a qualified medical provider. At its core, the functional medicine approach aims to identify and treat the underlying cause of low testosterone. Testosterone therapy is recommended for conditions you’re born with, such as Klinefelter syndrome, as well as low T levels due to acquired conditions, like an injury or cancer treatment. Normal testosterone levels are considered anywhere between 300 and 1,000 ng/dl.
Gut dysfunction can significantly impair hormone metabolism and absorption — this step was non-negotiable. This patient wasn’t just dealing with low testosterone. His fasting blood sugar was elevated at 100, flagging early blood sugar dysregulation. This was a patient with multiple overlapping systems in need of support. This was not a straightforward "low T, give testosterone" case. He had a significant family history of CVD (his father had a myocardial infarction, his paternal grandfather died of one at 68) and high blood pressure and cholesterol ran throughout the family. He wasn’t just looking for a quick fix, he was looking for long-term hormone optimization done right.
At The Lamkin Clinic, cortisol evaluation always includes a diurnal assessment, not a single AM value. The diurnal curve should be retested every 3 to 6 months during active treatment to guide protocol adjustments. Mild to moderate dysregulation with consistent lifestyle changes typically shows meaningful improvement within 3 to 6 months. Licorice root extends cortisol half-life and may help low-cortisol states. Phosphatidylserine and ashwagandha reduce elevated cortisol.
Men with unexplained hormone imbalances or those seeking a personalized approach to hormone optimization may consider genetic testing. Adrenal testing typically includes cortisol levels (which may include the cortisol awakening response) and DHEA measurements via saliva or urine samples. While the adrenal glands contribute a smaller portion of testosterone production compared to the testes, they are still vital for overall hormone balance.

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