A long-held belief is that testosterone causes prostate cancer or accelerates its growth. This so called “androgen hypothesis” arose from a small study in the 1940s. Medical students and doctors have been taught ever since that high testosterone levels promote the development of prostate cancer, that low testosterone is protective, and that the administration of testosterone to a man with existing prostate cancer is like ‘‘pouring gasoline on a fire.’’ This fear is also the most common reason for doctor’s reluctance to prescribing testosterone replacement therapy, even in hypogonadal men.[2, 3]
A common Q I get is “Should I get my T levels checked Will?” When should you get your level checked? When you’re feeling tired, or lack libido or extra sore from workouts? After age 40? My answer may surprise you….
“Skinny Fat” is a term that is applied to those people who are thin yet have a high bodyfat level. Fashion models are often very thin, but have a surprisingly high bodyfat level for example. Skinny Fat types are both at higher risk for various conditions (sarcopenia, osteoporosis. etc) and also tend to look terrible naked… BTW, my Fat Loss Revealed program is a sure fired way to avoid being Skinny Fat.
March 6th 2014 FDA approved Aveed for treatment of male hypogonadism, aka testosterone deficiency.1 Aveed is a long-acting form of injectable testosterone called testosterone undecanoate. In Europe, testosterone undecanoate (under the name Nebido) has a long successful TRT track record for treatment of testosterone deficiency and its consequences (especially obesity, the metabolic syndrome and diabetes).2-16
In contrast to shorter acting forms of testosterone (e.g. cypionate), testosterone undecanoate only needs to be injected every 6 to 12 weeks, and thereby offers practical benefits to patients. (Comment: for Nebido (1000 mg per 4 ml), the initial interval is 6 weeks, followed by intervals of 10-14 weeks; for Aveed (750 mg per 3 ml), the initial interval is 4 weeks, followed by 10-week intervals).
Five days after the FDA approval a notable and impressive 6-year long TRT study was published, confirming the health benefits of TRT that have previously been found in shorter term studies…44
Recent evidence strongly suggests that testosterone deficiency is a predisposing factor for various chronic illnesses, including cardiovascular disease, diabetes and osteoporosis.1-3 Testosterone deficiency has also been implicated as a modifiable disease risk factor for various chronic diseases in otherwise well patients.4-7
Cardiovascular disease, diabetes and osteoporosis-related fractures consume a significant portion of the $2.3 trillion in annual U.S. health expenditures. The economic impact of diabetes is estimated at $503 billion, $152 billion for cardiovascular disease, and $6 billion for osteoporosis-related fractures.8-10
Thus, the total burden of these diseases is over $660 billion, representing approximately 29% of all U.S. health care expenditures in 2008. Since testosterone deficiency is a potentially modifiable risk factor for these and other medical conditions, it may be responsible for substantial financial and quality-of-life burden on the U.S. health care system.11
A study was conducted to specifically quantify the U.S. health care (or should I say sick care) cost burden imposed by consequences of testosterone deficiency …12
In part 1 I covered issues related to the effect of TRT (Testosterone Replacement Therapy) on male fertility. Here I will outline options for men to increase endogenous testosterone production by non-TRT means, and ways to speed up spermatogenesis for those who chose to go the TRT route…
The prevalence of testosterone deficiency (aka hypogonadism or Late Onset Hypogonadism), defined as total testosterone (TT) at or below 300 ng/dl is close to 40% in men aged 45 years and older presenting to primary care offices in the US.1 Year 2006 is was estimated that more than 13.8 million men over 45 years of age visiting a primary care doctor in the United States have symptomatic androgen deficiency.1
A large international web survey using the Aging Males’ Symptoms (AMS) questionnaire showed the prevalence of symptomatic testosterone deficiency to be 80% in men aged 16–89 (mean 52 years).2 It is notable that in the survey 40% of respondent were at younger ages when ‘Late Onset Hypogonadism’ is generally not believed to be occurring.2 The surprisingly high prevalence of raised scores indicative of testosterone deficiency in the younger age groups may be due to the increasing prevalence of conditions in these age groups known to reduce testosterone levels, such as obesity 3-7 and chronic work stress. 8-10 Stress-induced cortisol elevation, by increasing SHBG, lowers the free active fraction of testosterone and thereby reduces its action.11
This large and rising prevalence of testosterone deficiency is gaining recognition among doctors and patients alike. However, while testosterone replacement therapy (TRT) confers great benefits to men with sup-optimal testosterone levels, it also comes with some side-effects which are especially relevant for men who wish to have a family…Many testosterone users and even clinicians 12 are unaware that testosterone supplementation suppresses the hypothalamic-pituitary-gonadal (HPG) axis and may result in infertility…
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…