Testosterone
and male health
In the journal Annals of Internal Medicine, a new study is reporting that low testosterone in men can mean a shorter life span. This meta-analysis of 11 studies, involved more than 24,000 subjects may be the most definitive done on the subject. The data from this study show that men with low total testosterone concentrations had higher risks for all-cause mortality and that men with testosterone concentrations below 5.3 nmol/L (<153 mg/dL) had an increased risk of cardiovascular death. In addition, the relationship between dihydrotestosterone (DHT) levels, all-cause and CVD mortality is complex (nonlinear) as both low levels of DHT (below 0.59 nmol/L) and high levels of DHT (above 2.45 nmol/L) had a higher risk for all-cause mortality and/or CVD events.
For years, men have been told just the opposite. That male menopause was natural. That the risks of cancer and cardiovascular disease were too great to augment declining testosterone by dabbling in hormone replacement therapy. Within mainstream media, the sly implication is that there must be something wrong with a man who wishes to maintain reproductive health past a certain age.
For those that dare to speak about hormone replacement therapy (HRT) for men, the main-stream media is quick to attack. Below are some typical headlines regarding Robert Kennedy and his openness about using HRT. (BTW testosterone therapy is not the same as “taking steroids”), and shame on the Washington Monthly for suggesting this.
Robert Kennedy’s honest, affirmative answer to the question of whether he is on testosterone therapy (HRT) is refreshing. It speaks to his commitment to good health, his commitment to sharing knowledge with the public, and his transparency in dealing with the press. He was willing to share some very private information about himself that he didn’t have to. BTW- Mr. Kennedy takes his workouts seriously, his physical fitness is very important to him.
To review, testosterone is a vital sex hormone that helps regulate sex drive, bone mass, fat distribution, muscle mass and strength, and the production of both red blood cells and sperm in men. A small amount of circulating testosterone is converted to estradiol, a form of estrogen.
Testosterone in men begins to drop in their late twenties and then drops noticeably in the 40s into the 50s. Many doctors refer to this as “andropause” – in other words, the male equivalent of menopause.
Low testosterone can cause many physical problems. Low testosterone in the aging male is linked to depression and persistent depressive disorders, including fatigue, listlessness, suicidal thoughts, anxiety issues, erectile dysfunction, gonadal hypogonadism, and panic attacks. Testosterone is known as the “happy hormone” for a reason.
Studies in older men have documented that men with lower testosterone levels have a higher prevalence and incidence of cognitive decline and dementia, including Alzheimer’s disease. Furthermore, endocrine disruptors in foods and the environment cause a reduction in sperm counts, the quality of sperm, and can cause benign testicular tumors.
low testosterone concentrations can also be seen in older men, described as an age- and comorbidity-driven functional hypogonadism, and might relate to depressive symptoms exhibiting a wide array of clinical pictures ranging from dysthymia and fatigue over inertia, listlessness to hopelessness and suicidal thoughts. Also, various traits of anxiety, from unfocussed fear to phobic anxiousness and open panic syndromes, are influenced by testosterone.
The psychological symptoms caused by low testosterone in men are similar to what many view as the female stereotype of pre-menopause (depression, anxiety, fatigue, and even hot flashes). Given the propaganda surrounding gender dysphoria, it is not surprising that men experiencing such symptoms might mistake the symptoms associated with low testosterone levels for being the wrong gender. As a decreased libido can be very hard on the male psyche, it is not surprising that some might reach for the label of gender dysphoria and then, to view transitioning. This can be seen as an answer to this serious and, for many, shameful health issue.
So much of identity is linked to gender that it is easy to be embarrassed and ashamed. Testosterone deficiency is not something to be ashamed of. It is a common medical condition, particularly in aging males. It can lead to all sorts of undesired conditions, and it is worth a blood test and a consult with a specialist to determine if one is deficient or not.
Vitamin D deficiency, environmental toxins, and endocrine disruptors are considered some of the leading causes of lowered testosterone levels in the population. Higher levels of glyphosate exposure are also found to be associated with reduced testosterone levels in animal models.
Testosterone deficiency is also becoming an increasing concern in young men. Twenty percent of adolescent and young adult males currently have testosterone deficiency.
Low testosterone has also been linked to the emergence of metabolic syndrome, which affects approximately 25% of the adult population. This link is also related to the formation of male central (abdominal) obesity. Therefore, it is not surprising that low testosterone levels are common in men with type 2 diabetes, and may be associated with insulin resistance.
What is Metabolic syndrome? Metabolic syndrome is a cluster of conditions that together raise your risk of coronary heart disease, diabetes, stroke, and other serious health problems - including an increased risk of cancer. Metabolic syndrome is also referred to as insulin resistance syndrome.
Metabolic syndrome symptoms:
A large waistline
High blood pressure
High blood sugar
High blood triglycerides
Low HDL cholesterol
“We now have several decades of high-quality research showing remarkable longevity and health benefits in men with normal testosterone levels compared with men with low levels,”
Abraham Morgentaler, MD, Harvard Medical School. Author of “Testosterone for Life”
Why and what types of testosterone therapy?
There are four types of hormone treatment delivery options
Oral (synthetic)
Creme (synthetic)
Injectable (synthetic-long acting)
Pellets (bio-identical)
The video below gives a lot of good information on testosterone therapy. The company that produced the video sells bioidentical hormones in pelleted form, so there is that bias. But even still, this video has a ton of great information, and personally, I am a big fan of bioidentical hormone replacement therapies.
The video above also discusses testosterone and the link between cancer and hypertension. Note that specific formulations of testosterone will break down in your body into estrogens - and can cause “man boobs”. So, there is no question that the correct dosing and type of testosterone therapy is critical. That means finding a specialist for an initial consult.
Bioidentical hormones are only approved by the FDA as compounded products. So be prepared, the cost is not cheap. That said, the injectable formulations work well for many, but they do not have some of the benefits of the pelleted forms mentioned in the video above.
Of note, women also produce testosterone and as they age, and the amount in their body also decreases over time. A good bioidentical hormonal replacement therapy (HRT) treatment plan for women will most likely contain estrogen, progesterone, and testosterone. HRT therapy for women should begin before age 60 or within 10 years of menopause.
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