Article last updated: January 2020 by Oskar Faarkrog, ISSA Certified Trainer
Hormones and body-composition go hand-in-hand, therefore being skinny-fat means there’s a great chance that some of your hormones are “out of whack”.
The most common issues are low testosterone levels or an underactive thyroid.
Testosterone is the primary male sex hormone and it’s the main muscle building hormone in your body.
Here are the most common symptoms of low testosterone:
- A lot of body-fat around the lower waist, hips and lower chest. (Skinny-fat physique).
- Puffy nipples, man boobs or gynecomastia.
- Feminine bone structures: Narrow shoulders, small wrists, small rib cage and wide hips.
- Passive behaviour, social anxiety, depression.
- Not waking up with morning wood +5 days per week.
- Very difficult time to gain strength and muscle mass on the upper body.
- Very difficult time to lose excess body-fat.
These are essentially many of the symptoms most of my skinny-fat clients deal with, however, they’re also the symptoms of having hormonal imbalances.
Your body-composition is truly a representation of your internal health, therefore it’s crucial that you get your hormone levels checked.
Regardless of whether you’re a teenager, in your 20s or 50+, I highly recommend that you get blood-work done starting from today and later make it part of your yearly health check-up.
Doing hormonal blood-work is a long-term investment in your health because it enables you to take action and thereby correct any problems you have.
And if you’re in good health you can keep the hormonal blood-work for future reference.
It’s equally important to check your hormones when you don’t have any problems because you can use your healthy blood-work as a base-line in the future when you get hormonal problems. (And most of us do sooner or later).
For the average guy, testosterone levels start dropping every single year, starting from around age 30 therefore it’s inevitable that you will eventually have to take action to correct that decrease.
The Biggest Reasons to Why You Have Low Testosterone
The biggest reasons to why people have low testosterone are:
- Lack of long, high quality sleep.
- Lack of sunshine.
- Excess body-fat.
- Diet high in estrogenic foods such as milk products and soy.
- Lack of vitamin D3.
- Boring lifestyle without goals and ambitions.
From the blood work I’ve seen so far in clients and readers, I’ve found that most skinny-fat guys have low testosterone levels so there’s a good chance that you do too.
Guys with low testosterone levels have shorter life-spans, more health problems and a lower quality of life.
Therefore, it makes no sense to accept being in sub-optimal health when you know there are proven testosterone boosting diet, lifestyle and exercise techniques that will enable you to make massive improvements.
It’s like saying that because you got an infection you should just accept it and not take antibiotics.
How to Check for Low Testosterone
Getting your hormones checked is a simple procedure.
The draw your blood at the hospital, analyse it and report the result back to you.
In most major cities, you can order to get all of these hormones measured through a private clinic or hospital and get the results directly to your email inbox within a few days.
The other way is to go to your General Practitioner (GP) and get the tests done for free.
In some countries, for example in Scandinavia, getting these tests done is free as long as you say you have symptoms of low testosterone levels.
If you’re short on time and 300-500 USD isn’t a significant expenditure, I would always recommend is to get it done through a private hospital or clinic. It’s less hassle and much faster.
When you get it done privately, you won’t have to explain to a GP why you want to get your blood work done and wait for a long time to get your results.
Remember, most GPs have the testosterone levels of your grandfather so they won’t be able to relate with you when you’re there to optimise your hormones.
They might even get offended when you question their advice to not bother getting tests done.
Make Sure You Get A Copy of The Results
At age 18 I had a testosterone level of 279 ng/dl. When I got the result, my GP said I was all good because I was in range.
Then I checked my result and compared it to the average levels of men in various age groups. It turns out, my levels were the average of an 84 year old man.
My conclusion after seeing many doctors and specialists is that most of them will not be able to help you with hormonal imbalances because they lack the knowledge to do so.
The only thing your doctor will be good for is to provide you with the ability to get your blood work done and to send you the results.
Remember, the range that doctors operate by are largely based on the blood-work of men who come in to get tested.
How often do you hear about a healthy young man to go to the GP to get his yearly hormonal blood-work done? It almost never happens.
This means your results are being compared to guys with low testosterone levels — not healthy guys with optimal testosterone levels.
Therefore, my advice is that you ALWAYS request a copy of your own blood work so you can look through the results yourself and so you can keep the blood-work for future reference.
The Blood Work You Have to Do
Before you get checked, I want to point out that checking total testosterone alone isn’t enough.
There are several hormones which bind to testosterone, thereby making a big part of your testosterone unusable.
In reality, only a small fraction of total testosterone is free and ready to be used and for males with a healthy endocrine system, roughly 2-3% of total testosterone will be free.
This means that you will want to check both your total testosterone production, but also do blood work for free testosterone levels and for the hormones that bind to testosterone.
Here’s a list of the hormones you need to check:
- Total Testosterone and Free Testosterone: The primary male sex hormone. You will ideally test for both total and free testosterone and if you’re on a tight budget, just do the total testosterone test. Testing for free testosterone isn’t that accurate due to the small amount of free testosterone in your bloodstream, therefore this should never be used as a stand-alone test, but rather to supplement total testosterone and other hormonal blood tests.
- Estradiol (E2): The primary female sex hormone. Estradiol binds to testosterone therefore we want to keep it at the low end of the recommended range. Skinny-fat guys often have high estradiol levels which are displayed through symptoms such as puffy nipples and excess body-fat around the lower waist, hips and lower chest. The main reasons to why people have high estradiol is because of eating estrogenic foods such as soy and milk products and having excess body-fat.
- Sex-Hormone-Binding-Globulin (SHBG): SHBG binds to your testosterone, thereby leaving less free testosterone. The main reasons to why people have high SHGB are high estradiol levels, low magnesium levels, low zinc levels and low Omega-3 levels.
- Vitamin D3: Optimal vitamin D3 levels increase your natural testosterone production, energy levels, strengthen your immune system and strengthen your bones. Even though this is referred to as a vitamin, it is technically a hormone that is absorbed through the skin when you get sunshine. (The food in your diet mostly contains Vitamin D2 which is absorbed and utilised to a much smaller degree by the human body compared to Vitamin D3). For optimal vitamin D3 levels, fair skinned people need about 10-20 minutes of daily sun exposure at noon in a sunny and warm climate (with shorts and a tank top on and without any sunscreen), people with dark skin need 20-40 minutes and black people need 1-2 hours. The issue is that many people can’t get enough sunshine, especially those of you living in Northern countries or those of you who are dark-skinned or black, therefore supplementing with vitamin D3 becomes essential.
In your first test you need to test all of them and then you can narrow down your tests later if needed and focus on the specific issues you have.
How to Check Your Thyroid Function
The second thing I recommend you check is your thyroid function. An under-active thyroid (hypothyroidism) results in a slower metabolism, constipation, fatigue and cold intolerance and the main reasons to why people have an underactive thyroid is a lack of iodine in their diet and low Calorie diets.
I’ve personally found that roughly 20% of skinny-fat guys have early stage hypothyroidism, often as a result of doing low Calorie diets for extended periods of time.
Hormones To Check Thyroid Function:
- Free T3 and Free T4: The two thyroid hormones which are accountable for over 99% of thyroid function.
- Thyroid Stimulating Hormone (TSH): This hormone is used to detect early hypothyroidism. When a decrease in thyroid hormones happens, the pituitary gland responds by producing more TSH (Thyroid Stimulating Hormone). This increase in TSH is your body’s attempt to stimulate thyroid hormone production and thereby keep your T3 and T4 levels normal. The increase can happen months or even years before you get hypothyroidism therefore testing for TSH is a powerful way to prevent hypothyroidism.
6 Things To Remember Before Doing Blood-work:
- Be specific of the lab tests you need to get done. (See the list of hormones to check above).
- Avoid alcohol for 72 hours prior to testing.
- Avoid hard training 48 hours prior to testing.
- Get a good night of sleep.
- Eat as you normally do.
- Take the tests early in the morning.
After You Get Blood Bork Done
After getting the results, a lot of skinny-fat guys get very anxious because the blood work isn’t optimal.
If that’s you, I want you to stay calm because one blood test isn’t conclusive of anything. It’s just an indicator.
First and foremost, blood testing isn’t 100% accurate and factors such as your sleep, training and diet prior to doing the test will affect the result.
This means that you can NEVER start any kind of drug or hormone treatment based on one test. You would need at least 3 separate tests at 3 separate times to even consider it.
Second, hormonal imbalances are mainly evaluated through symptoms (i.e. low sex drive, not being able to lose body-fat, fatigue) because in the end you’re not trying to improve a number but the way you feel on a daily basis.
This means that hormonal levels that are optimal for one guy may not work for another guy.
For example, if a guy used to be a college athlete with testosterone levels of 1200 ng/dl he may not feel his best when these levels drop to 700 ng/dl.
In contrast, a guy who had levels of 200 ng/dl may feel amazing at 700 ng/dl. This is why you can’t look at the numbers alone, but also need to evaluate your symptoms and how these improve.
Third, many of the hormonal imbalances and symptoms you have now will correct themselves once you get lean and after you’ve followed a good training program, diet plan and sleep regimen for 3-6 months.
Therefore, my advice is that you master the basic bodyweight exercises, get lean and put at least 1 year into a solid training, eating and sleeping regimen before you worry about low testosterone levels.
Use the blood work as reference and try to optimise it naturally through training, diet and lifestyle.
I personally used diet, training, sleep and stress management advice to boost my natural testosterone production with 180%.
You can start with these things and then only worry about low testosterone if you still have that issue after +1 year of following my advice.
Be proud but stay hungry,
Oskar Faarkrog, ISSA Certified Trainer