DHEA (dehydroepiandrosterone) is most known for being a pro-hormone which in the body gets converted to testosterone and estrogen. It is a long held view that DHEA exerts all its effects via conversion to testosterone and estrogen. However, recent studies show that DHEA also has several interesting non-hormonal actions…
A few days ago, Jan 29th 2014, a controversial study was published showing that men aged 65 years and older, had a two-fold increase in the risk of heart attack in the 90 days after filling an initial testosterone therapy (TT) prescription, regardless of cardiovascular disease history. Among younger men below 65 years of age with a history of heart disease, the study reported two to three-fold increased risk of MI in the 90 days following an initial TT prescription (and no excess risk was found in younger men without such a history).
This study has stirred up heated discussions and media headlines. Let’s dissect it and look under the hood…
Many studies have highlighted the importance of investigating all major hormones, and correcting deficiencies and imbalances if present.[1-8] Given the known mechanisms of testosterone and GH/IGF-1 in building muscle (and possibly also DHEA in elderly) it is reasonable that age-related low levels of anabolic hormones contribute over time to sarcopenia and frailty.[1, 2, 4, 7, 9, 10]
Thus, multiple small effects in aggregate can lead to adverse loss of muscle and disability. In this scenario, if replacement was to occur, it would require lower doses of multiple anabolic hormones. An added benefit to this approach would be fewer side effects from the use of lower hormone doses . In addition, multiple anabolic hormone replacement might also have beneficial additive and/or synergistic effects.[11-13]
A notable study investigated whether supplementation with testosterone and GH together, in physiological doses, results in greater improvements in body composition and muscle performance in older men, compared to testosterone supplementation alone…
The consequences of low testosterone levels have been primarily investigated in middle-age and older men. However, low-T in young men aged 20-39 years can confer health risks as well…
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Will has previously mentioned DHEA as it relates to hormonal effects and health promotion:
When it comes to health promotion and longevity, DHEA is a supplement which deserves more attention than it is getting.
DHEA levels (the main circulating form of DHEA in the bloodstream is DHEAS) decrease approximately 80% between ages 25 and 75 year.[1, 2] This large decline in DHEA has led to interest in the possibility that aging related DHEA deficiency may play a role in the deterioration in physiological and metabolic functions with aging, and in the development of chronic diseases.
In support of this, it has been reported that DHEA level is negatively correlated with mortality and risk of developing cardiovascular disease (CVD) (i.e. lower DHEA(S) levels are associated with higher mortality and CVD risk).[3-5] More recently it has been found that a steep decline or extreme variability over time in DHEA(S) levels is associated with higher mortality, more so than baseline DHEA(S) levels.
Aging not only reduces DHEA(S) levels, but also results in an increase in arterial stiffness [7, 8], which is an independent predictor of cardiovascular disease (CVD) risk and mortality.[9-11] It has been reported that DHEA levels are inversely associated with arterial stiffness (i.e. lower DHEA levels are associated with increased arterial stiffness. [7, 12, 13] Therefore, it is possible that DHEA replacement could reduce arterial stiffness, and thereby contribute to reduction in CVD and mortality…
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Metabolic Burnout, does it really exist? People claim they suffer this condition, others offer ways to fix it or cure it, but what is it? Can it be tested for? I answer those Qs in this latest vid!
Testosterone deficiency, popularly known as “low T”, has entered the center stage in both the lay and medical communities. However, how is testosterone deficiency (a.k.a. hypogonadism) diagnosed? What is the testosterone level threshold below which you can say you have low T? What are the references ranges for healthy men?
Here you will find out what the medical guidelines say, what critical information they are ignoring, what you should point out to your doctor if he/she doesn’t think you have low T…
Testosterone deficiency in men, aka hypogonadism, is associated with increased total and abdominal fat mass, and reduced muscle mass, which negatively impacts body composition.[1, 2] This contributes to development of risk factors like insulin resistance, chronic inflammation, and atherogenic dyslipidemia (a triad of increased blood levels of small, dense LDL particles and triglycerides, and decreased levels of HDL particles), which increase the risk for cardiovascular disease, metabolic syndrome and diabetes.[1, 3-16]
Previous studies have shown that testosterone replacement therapy ameliorates these risk factors in testosterone deficient (hypogonadal) men; it increases insulin sensitivity [17-20] and HDL (the “good” cholesterol)[9, 10, 20, 21], and reduces waist circumference [9, 20, 22], fasting blood glucose [9, 20] triglycerides (blood fats), LDL (the “bad” cholesterol) [19, 22-24], and several inflammatory markers.[17, 25]
A 2011 meta-analysis concluded that testosterone replacement therapy improves metabolic control, as well as reduces abdominal obesity. Many studies have shown that testosterone replacement therapy in hypogonadal men increases muscle mass and reduces fat mass.[19, 26-32] Further, adding testosterone (50 mg/day for 1 year, administered as a transdermal gel) to a diet and exercise program results in greater therapeutic improvements of glycemic control and reverses the metabolic syndrome.
Testosterone also has direct (non-obesity mediated) beneficial effects on many metabolic and cardiovascular risk factors [12, 33-37], and reduces death risk independently of body fat status. In line with all these effects, low testosterone levels are associated with increased risk of cardiovascular complications , and all-cause and cardiovascular disease death [40-42]. Low testosterone may thus be a predictive marker for men at high risk of cardiovascular disease. In a group of men aged 50-91 who were followed for 20 years, it was found that men whose total testosterone levels were in the lowest quartile (241 ng/dl or lower) were 40% more likely to die than those with higher levels, independent of age, adiposity, lifestyle or presence of cardiovascular risk factors.
Thus, treatment of testosterone deficient men with testosterone has demonstrated considerable health benefits. Despite this, critics state that most of the studies on testosterone replacement therapy were too small. They also argue that the studies were of too short duration (most of them lasting 6-12 months), and that the long-term effects of testosterone on body composition are not known.
Two 5 year long studies were just published that addressed the duration and small study size shortcomings in previous research…