Q: My Dad is 86 years old and is starting to get pretty rickety. He has trouble getting up out of chairs and his legs are weak. I suggested he take some testosterone but he wants nothing to do with it (he’s getting cranky too). I love my father and hate to see him declining this way. Do you have any suggestions for helping him get his strength back? And maybe his good humor too?

A: Low testosterone can be the culprit in both rickety legs and crankiness in older men. An interesting study published in the Journal of Clinical Endocrinology & Metabolism (Leblanc et al, Oct 2011) found that men with the highest testosterone levels had significantly more muscle in their arms and legs than men with the lowest testosterone levels.

The two simplest ways to raise testosterone levels without supplementing it are exercise and avoiding estrogens. The best kind of exercise is weight lifting, but even a daily walk will make a big difference. Any type of natural muscle building will raise testosterone levels. The best way for your Dad to exercise may be at a gym with trainers experienced in working with seniors.

The most common source of estrogen in older men is belly fat. Other possible sources include:

— Body lotions and other personal care products containing phthalates, parabens and other estrogenic chemicals

— Microwaving foods in plastic containers

— Fake fragrances found in scented laundry products, dry cleaned clothes, air fresheners, colognes and hair products

— Pesticides

— Prescription drugs such as heartburn drugs, anti-anxiety drugs (e.g. Valium), some antibiotics, and some heartburn drugs such as digoxin and calcium channel blockers.

Lack of sleep, an issue for older men who get up frequently at night to urinate, can cause a drop in growth hormone (IGF-1), which can also cause a drop in testosterone.

And yes, supplemental testosterone can work wonders to build muscle and improve mood in older men, but it should be used with caution, especially with men who have a lot of belly fat because of conversion to estrogen. The booklet Hormone Balance for Men explains the hows and whys.

Here’s a great article by Dr. John Lee about Men and Testosterone and some information on testing testosterone levels.

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