Training After 40! is a post from: The Final Frontier In Bodybuilding , Fat Loss, Health & Fitness

Testosterone Boosting Supplements : The Facts

It’s In Your Blood: The Facts About Your Blood Work

Got Test?

Boosting Testosterone is a post from: The Final Frontier In Bodybuilding , Fat Loss, Health & Fitness

I wrote an extensive article on sarcopenia  (age related loss of muscle masss)  in 2007 HERE.  As expected, this has become a big area of research and interest. An article just published in the NY Times business section entitled  “Doctors Seek Way to Treat Muscle Loss” covers the commercial interests in this condition. Various comments I don’t agree with, but it’s clear, as I predicted, this would be an area of focus once it was fully appreciated how much $$$ it costs the health care system and how much $$$ can be made from a magic pill to treat it.

Doctors Seek Way to Treat Muscle Loss
By ANDREW POLLACK
Published: August 30, 2010. NY Times

Bears emerge from months of hibernation with their muscles largely intact. Not so for people, who, if bedridden that long, would lose so much muscle they would have trouble standing.

Why muscles wither with age is captivating a growing number of scientists, drug and food companies, let alone aging baby boomers who, despite having spent years sweating in the gym, are confronting the body’s natural loss of muscle tone over time.

Comparisons between age groups underline the muscle disparity: An 80-year-old might have 30 percent less muscle mass than a 20-year-old. And strength declines even more than mass. Weight-lifting records for 60-year-old men are 30 percent lower than for 30-year-olds; for women the drop-off is 50 percent.

With interest high among the aging, the market potential for maintaining and rebuilding muscle mass seems boundless. Drug companies already are trying to develop drugs that can build muscles or forestall their weakening without the notoriety of anabolic steroids. Food giants like Nestlé and Danone are exploring nutritional products with the same objective.

In addition, geriatric specialists, in particular, are now trying to establish the age-related loss of muscles as a medical condition under the name sarcopenia, from the Greek for loss of flesh. Simply put, sarcopenia is to muscle what osteoporosis is to bone.

“In the future, sarcopenia will be known as much as osteoporosis is now,” said Dr. Bruno Vellas, president of the International Association of Gerontology and Geriatrics.

NY Times article Cont: HERE

Preventing Age Related Loss of Muscle Mass is a post from: The Final Frontier In Bodybuilding , Fat Loss, Health & Fitness

“Testosterone boosting” supplements/formulas have become a very popular category in the supplement industry of late. It seems everyone, boy or man, seems to want to “boost” their levels of the hormone that makes men men. Don’t get me wrong, I am a big fan of this hormone, and readers can see that via my other writings on the topic found throughout this web site. Everyone, men and women, can potentially benefit from maintaining optimal levels of this essential hormone.

However, this write up is not going to cover the hormone per se, but to discuss the various over-the-counter (OTC) products/formulas claiming to increase it. As there are literally hundreds, perhaps thousands, of products/formulas on the market at this point, all claiming to “boost” this important hormone, I am going to be talking in generalities about these products vs. a specific ingredient or formula.

A few ingredients in these formulas have been shown – via dubious “research” at best – to have a small impact on T, with the majority of them either having no research behind them or research that found they did nada for T levels.

To summarize this supplement category, the T booster supplements generally contain ingredients that:

• Have no data behind them – or -
• The data they do have is of very poor quality/ and/or taken out of context/not applicable – or -
• The doses used in the formula are far below what a study used to get the effect.

Obviously, the above can (and does!) apply to many products/formulas in the sports nutrition industry, but I find the “T boosters” worse then other categories in that respect.

OK, so lets give some T booster product the benefit of the doubt and say it does have some effects on T. That brings up a few important issues to consider.

Physiological Threshold Concepts

Here’s a simple thought experiment: If you take a small amount of testosterone, say 25mg per week of T- propionate•, will your testosterone levels go up slightly for a short time? Yes. Will your muscle mass increase and or your strength increase? Nope. Anyone who has ever taken any T – or knows the first thing about the topic – knows  there’s a threshold dose at which one actually experiences changes in body composition and or strength.

The point being, it’s one thing to show formula/ingredient X has had some small impact on serum testosterone (and most have not…), quite another to show that change actually had any effects on body composition or other end points people using such products generally care about, such as increases in strength and muscle mass.

As with any hormone, there’s a physiological threshold that has to be met before it actually impacts muscle mass, strength, etc.

Anyone who has ever used T in the form of cypionate or enanthate (both long acting esters of T) knows that changes in body composition generally start at around 200mg per week at the least, with more being the norm.

The above assumes a person with “normal” testosterone levels vs. HRT/TRT therapy for those who are found to be medically low in T.••

So, with all that, do you really think that T booster supplement you are using – which already tends to lack any solid data to begin with – is really going to be the equivalent of  200mg per week of testosterone Cypionate? If so, I got a bridge in Brooklyn to sell ya’…Hell, the sound of exotic sports cars can raise T levels. Do you think listening to the sound of a Maserati, Lamborghini and Ferrari before you hit the gym will result in more muscle mass? Me neither….Which brings us to the next section in expectation of the obvious question: how does one know if the T booster he’s using is having any effects on the production of T?•••

Do you put air in your tires without checking the pressure?

Do you put air in your tires without actually checking to see if you need any air or what the air pressure actually is before you add additional air to the tires? I know I don’t, but that’s exactly what you’re doing (assuming said T booster actually has any effects on T…) by using such a product without actually knowing what your T levels were when you started. Altering your T levels is not a minor undertaking, nor should it be done casually, and it can have long term effects, both positive and negative. As I indicated – and we will get more into depth on the topic shortly – I have no faith these products are actually impacting T either at all, or enough to actually cause any changes in body composition (e.g., increases in LBM and or decreases in BF) or strength anyway; but having no idea where you are starting from and if the product is doing anything, is just about as dumb as it gets.

I was going to say something more polite and PC like “it’s not logical” but screw that, it’s just stupid, not to mention a big waste of money in the long run.

If you want to go the Bro Logic/Bro Science/hopeful thinking/placebo-driven route, it’s your money, I guess. I know, I know, you’re that one person who is immune to placebo effects…

Interesting side note – and something I will blog about in the near future, is the fact that placebos are getting stronger! It’s vexing the pharmaceutical industry as we speak, in fact.

A very quick word on Non-T mediated Effects.

This article is looking at two specific issues as it relates to the T booster products:

• The impact on T levels specifically
• That people are using them in an attempt to alter body composition and or increase strength

I am not looking at other potential uses, such as for libido and such, which may happen by what’s called “non-T mediated” effects. Meaning, they have an effect, but not via testosterone per se. For example, Horny goat weed contains biologically active compounds that may have Viagra-like effects  that act via PDE 5 inhibition.  There are other active compounds found in various herbs and such that show some promise in the areas of libido and others, but they are often not doing their “thing” via testosterone, and even if they are, that does not mean the effects it’s having on testosterone – be it to lower SHBGs, increase free T, or what have you – is adequate to impact body composition and or strength. And, as mentioned previously, many of these compounds are very dose specific, which may or may not exist in that dose in the product/formula in question. Finally, no place is the placebo effect stronger then is the area of libido, but we won’t go there…

An Open Offer….

I have made this offer via email (after being contacted by various manufacturers of some T boosting product usually asking why I’m being so hard on this category of supplements), and on various forums and such, but will put it out there for all to see:

To any seller/manufacturer of a “T Booster” type product/formula. If you wish to have the product tested to see if it truly does increase T levels, I will be all too happy to have it tested for you. Be it, a true double-blind placebo crossover trial, which could also test whether or not the product in question will alter body composition (in response to resistance training of course), or as a simple open label study.••••

For those who don’t know, the open label study is the weakest study design, which means its validity may be questioned. However, done correctly, it can at least give some decent info and it’s the least expensive study to do by far. In this case, it would simply be used to test for the effects on T levels, vs. any effects on the more important issue of changes in body composition and or strength.

I would simply send say 20 men, all of whom are approximately the  same age, with approximately the same amount of time in the gym, and other variables of importance, and have their T levels tested before, during (mid way) and after using the product. Obviously, they would all be told not to alter their diet, training programs, or supplement intakes during the study period, which would be decided by myself and the company funding it.

The costs would simply be 3 blood draws 3 times X 20 men (as an example, but there may be more or less people in the study), my costs, and the cost of the product. I would personally tabulate the lab tests results, etc, and write it up. Not perfect, but a lot better then what most companies currently offer as “proof” their T-booster has any effects on T.

If there is a statistically significant effect on T,••••• I will of course eat my words that such formulas – or at least the formula tested – don’t generally do jack for T (much less body comp and/or strength, which would not be addressed by such an open label type study…), will post the results everywhere and anywhere I can (which is a lot of dang places!), and of course the company can use the results for their own marketing with my blessings. I will not, of course, withdraw my major point: even if said product actually does increase T, this result does not imply a change in body composition and/or strength unless that too (a much more complex and expensive undertaking to do correctly) is examined.

Of course, if the results show the product does nothing for T levels – or whatever else gets tested for  – I will post that too…

That’s my open offer – call it a challenge if you like – to those manufacturers/sellers/proponents making some outlandish claims about T-boosting products.

I won’t be holding my breath waiting for anyone to take me up on the offer.

Finally, if you want to get your own T levels checked – whether you be using such a product or not -  ask your doctor or simply do it with the Life Extension Foundation who will do it by mail using a local lab for the blood draw.

Wanna know what supplements  actually have solid science behind then? What’s been shown to be worthless? What’s worth your hard earned money for supplements? This site has tons of free info, and my ebooks – BBR and FLR -  cover the topic in great depth.

Notes:

• = A fast acting ester of T

•• = Typical replacement dose for TRT/HRT is 100mg weekly of Cyp/enanth with doses adjusted up or down depending on blood work and other factors. There are also other methods: patches, gels, etc.

••• = There’s  also additional issues that need to be addressed, such the total T/free T ratio, SHBGs, estrogen increases/decreases, possible impact on the HPTA, and other possible changes that are beyond the scope of this here  write up and would be potentially specific to the ingredient/product/formula in question.

•••• = if you have such a study already done, and it has been published in a peer reviewed legit journal, by all means, send me a copy and I will be happy to read it, and if it passes the smell test, happy to recommend it!

••••• = Of course other things of importance can also be tested for, such as changes in free T/total T, E2, etc, but that will increase the costs.

You want the truth??!!

The Facts On Testosterone Boosting Supplements is a post from: The Final Frontier In Bodybuilding , Fat Loss, Health & Fitness

Review By Will Brink and Elissa Lowe

If you’d rather not plow through a long review, we’ll give you the short version up front: if you’re a man, the Alpha Male Challenge is a must-read… whether you’re a couch potato who hasn’t exercised in years or the proud owner of a six-pack.

It’s also worth a read if you’re a woman: there’s useful info here for both sexes. And – let’s face it – you’re in a position to inspire and encourage the men in your life: husbands, boyfriends, family, friends and colleagues alike.

Yes, the Alpha Male Challenge is that good – and as professional fitness writers, we’ve seen what the market has to offer. It’s rare to find a book as comprehensive as this one is.

What’s so great about it? Alpha Male Challenge is nothing less than a roadmap for achieving physical AND mental/emotional excellence in a modern world. It’s “the ultimate man-ual for guys” who want to boost their confidence, courage and resilience, along with their health and fitness.

Needless to state, it’s sorely needed. It’s no secret that American men are at a crossroads. As “Challenge” authors James Villepigue and Rick Collins observe:

“Although American life is more ‘comfortable” than it was in generations past, many men are fatter, sicker, more stressed, and less rested than ever before.”

Too true! Studies show that testosterone levels are plummeting, and – as a group – men are losing their manliness and becoming androgynous, flabby and weak. But – despite the approval of the New York Times – it’s NOT “Hip to be Round.” “Beta” isn’t better…for our men, or the women who love them.

The 10-week program outlined by Villepigue and Collins melds the masculine ideal of the past with the realities of the present: knuckledraggers need not apply. Thus, it’s no surprise that it involves reshaping attitudes as well as bodies. As the authors put it,

“When you really think about it, shouldn’t every man’s goal be not only to look more heroic, but also to be more heroic?”

The Alpha Male Challenge is designed to transform men inside and out, so drills incorporating the “Four C’s” – commitment, confidence, courage and conscience – are as much a part of the program as the training and nutrition plans.

True to its name, the Challenge is challenging – but never dull…the authors have created a program that’s tightly constructed, yet flexible. For example, specific types and amounts of cardiovascular exercise are mandated, but there’s a wide selection of activities to choose from, ranging from the practical (i.e., parking a few minutes away from work and walking the rest of the way), to the fun (frisbee, basketball, boxing, etc.). Likewise, The Paleo diet-inspired food plan requires discipline, but not privation. Villepigue and Collins drew on their knowledge of bodybuilding nutrition to create a healthy, balanced high-protein/high-fiber/moderate carb eating plan that can be customized for maximum fat loss as well as muscle gain. Their “Alpha Fuel Solution” even incorporates a weekly “feast meal,” where you can reward yourself for your hard work by eating “like a mere ‘mortal man’” (if you wish).

The strength training routines lie at the heart of the book – and for good reason. As the authors note:

“…physicality is nonetheless one universal measure by which human males are judged. Size and strength have helped separate the leaders from the followers since we were nomadic hunter-gatherers traversing the ancient grasslands.”

The “Alpha Wave Training” is focused on three basic goals: building lean body mass and muscular endurance, maximizing strength, and boosting explosive power. As the name implies, there are three phases, or “waves.” The workouts for each wave consist of ten exercises: six address the primary goal (60%), with two movements each (20%) for the others. The reason for this ratio is simple:

“Over the course of the 10 weeks of your Challenge, this ratio has the incredible effect of helping you get the most out of the present Wave’s primary training target, while maintaining the results you’ve already earned and laying the foundation for the work yet to come.”

Each workout is different, to constantly challenge your muscles and keep things interesting, and let’s face it, keeping things interesting is often half the battle to sticking to a program The rest intervals between exercises are also strictly controlled, to maximize muscle growth and minimize time spent in the gym.

Although the workouts vary, progress is simple to track… beyond keeping tabs on your weight and (shrinking) pants size, you’ll use the “MaleScale™” – a “before-after” rating system – to measure your success. The MaleScale provides a personal metric – or “Alpha Factor” – that’s based on “Alpha Attitude,” physical measurements and athletic performance. There is no “right” score: your goal is to improve on your own, baseline Alpha Factor, not measure up to someone else’s.

All this is just the tip of the iceberg: in addition to the above, the book features concise explanations, detailed exercise instructions, recipes, sample meal plans… and one hell of a lot of inspiration. It contains everything you need to succeed.

If that’s not enough, however, there’s a bonus: the authors provide extensive online support through their and website: . The site features a forum, articles, blog and automated MaleScale. Like the book, the site is a collaborative effort, with contributions by other professionals in addition to the authors themselves.

As far as we’re concerned, “The Alpha Male Challenge” is THE program for any man looking to fulfill his potential for physical AND emotional growth in an often confusing modern world, where what it means to be a “man” is often unclear. As co-author Rick Collins told us:

“James and I put our blood, sweat and tears into this project, and we hope it shows.”

Believe us, it does.

Amazon has this book for sale HERE if interested.

Book Review: Alpha Male Challenge is a post from: The Final Frontier In Bodybuilding , Fat Loss, Health & Fitness

As hormone replacement therapy (HRT) has become much more common place, and there is a growing understanding that keeping men in the “healthy” range for testosterone (T) has various benefits, I wanted to briefly address the issue. For those who need a refresher on the basics of blood work, see my article “It’s In Your Blood”

To review the general issues of low T in men, according to one recent review by a Dr. Shabsigh and colleagues:

“Hypogonadism (low testosterone) is associated with central obesity; insulin resistance; low levels of high-density lipoprotein (HDL); high cholesterol levels; and high levels of low-density lipoprotein (LDL), triglycerides, fibrinogen, and plasminogen activator-1. Some observational studies show a correlation between low testosterone and cardiovascular disease (CVD), and others show no correlation. Interventional studies do not reveal a direct long-term relation between testosterone therapy and CVD. Short-term data suggest cardiovascular benefits of testosterone.”•

The above review also leaves out other known effects of low T, such as loss of libido, depression, loss of muscle mass and decreases performance, as well as other issues best avoided.

Most studies find clear health benefits for men with hypogonadism treated with HRT. However, some fears of long term side effects such as cardio vascular disease (CVD) and prostate cancer have been raised. These fears appear to be unfounded, with benefits to the cardio vascular system for men low in T.

So what of the risks of CVD or prostate cancer with HRT?

The jury is still out, but most data does not find an association between HRT and CVD or prostate cancer. For example, a retrospective analysis by researchers at Beth Israel Deaconess Medical Center published in The New England Journal of Medicine found no causal relationship between testosterone replacement and prostate cancer or heart disease risk. According to Dr. Abraham Morgentaler:

“We reviewed decades of research and found no compelling evidence that testosterone replacement therapy increases the incidence of prostate cancer or cardiovascular disease.”••

This review of 72 studies puts to rest-at least for me- that there is any risk of testosterone replacement therapy, at least where it concerns CVD or prostate cancer. Not everyone would agree with that opinion however and anyone considering HRT should get full blood workup done and talk with their doctor about it.

But what about healthy men with normal testosterone levels taking additional testosterone? That’s a little less clear at this time. Studies are conflicting whether or not adding additional testosterone to men with normal levels presents an increased risk. However, a study published in The New England Journal of Medicine (NEJM) – considered one of the most prestigious medical and scientific journals in the world – found healthy men given 600mg per week of testosterone enanthate did not suffer any side effects, negative changes in lipid profiles, and did not see a rise in prostate-specific antigens, or increased aggression. •••

But what if the person has already had a heart attack? Interestingly, one study suggests testosterone therapy may actually help after a heart attack, but it’s preliminary research done on animals. ••••

This is just a sample of the many studies published on the topic. Finally, what about the very high doses used by high level bodybuilders and other athletes? That’s petty much an unknown at this time. As with many hormones, below a certain levels, health issues arise and above a certain level, the same thing happens, though the health issues may or may not be the same. For example, very high levels or very low levels of T may present an increased risk for cardiovascular disease (CVD) but far more is known about too little vs. too much when it comes to testosterone and CVD or prostate issues, etc. At the very high doses used by some athletes it would not surprise me if there was an increased risk of CVD but data is scarce here. So what’s the take home?

• For men with low testosterone, studies are quite clear the benefit of HRT outweigh the risks by a long shot.

• In men with normal testosterone who take moderate doses (defined here as 600mg per week or less), there appears to be little risk, at least in the short term. Other side effects, such as acne, hair loss (if genetically susceptible) and others are still possible however and should not be ignored

• In bodybuilders and other athletes taking very high doses, say above 1000mg per week or more, the risks are unclear and not recommended without very close medical supervision, especially if other risk factors are involved, such as a family history of CVD, etc.

That pretty much sums up my thoughts on the issue.

Cites:

• Cardiovascular issues in hypogonadism and testosterone therapy.Am J Cardiol. 2005 Dec 26;96(12B):67M-72M.

••http://www.sciencedaily.com/releases…0129072631.htm

••• “The Effects Of Supraphysiologic Doses Of Testosterone On Muscle Size And Strength In Normal Men (vol.336, July, 96).

•••• Cardiovasc Res. 2003 Feb;57(2):370-8.

Effect of testosterone on post-myocardial infarction remodeling and function. Cardiovasc Res. 2003 Feb;57(2):370-8

Got Test? is a post from: The Final Frontier In Bodybuilding , Fat Loss, Health & Fitness

Is a loss of strength, mobility, and functionality an inevitable part of aging? No, it’s not. It’s a consequence of disuse, suboptimal hormone levels, dietary and nutrient considerations and other variables, all of which are compounded by aging. One of the greatest threats to an aging adult’s ability to stay healthy and functional is the steady loss of lean body mass – muscle and bone in particular.

The medical term for the loss of muscle is sarcopenia, and it’s starting to get the recognition it deserves by the medical and scientific community. For decades, that community has focused on the loss of bone mass (osteoporosis), but paid little attention to the loss of muscle mass commonly seen in aging populations. Sarcopenia is a serious healthcare and social problem that affects millions of aging adults. This is no exaggeration. As one researcher recently stated:

“Even before significant muscle wasting becomes apparent, ageing is associated with a slowing of movement and a gradual decline in muscle strength, factors that increase the risk of injury from sudden falls and the reliance of the frail elderly on assistance in accomplishing even basic tasks of independent living. Sarcopenia is recognized as one of the major public health problems now facing industrialized nations, and its effects are expected to place increasing demands on public healthcare systems worldwide” (Lynch, 2004)

Sarcopenia and osteoporosis are directly related conditions, one often following the other. Muscles generate the mechanical stress required to keep our bones healthy; when muscle activity is reduced it exacerbates the osteoporosis problem and a vicious circle is established, which accelerates the decline in health and functionality.

What defines sarcopenia from a clinical perspective? Sarcopenia is defined as the age-related loss of muscle mass, strength and functionality. Sarcopenia generally appears after age 40 and accelerates after the age of approximately 75. Although sarcopenia is mostly seen in physically inactive individuals, it is also commonly found in individuals who remain physically active throughout their lives. Thus, it’s clear that although physical activity is essential, physical inactivity is not the only contributing factor. Just as with osteoporosis, sarcopenia is a multifactorial process that may involve decreased hormone levels (in particular, GH, IGF-1, MGF, and testosterone), a lack of adequate protein and calories in the diet, oxidative stress, inflammatory processes, chronic, low level, diet-induced metabolic acidosis, as well as a loss of motor nerve cells.

A loss of muscle mass also has far ranging effects beyond the obvious loss of strength and functionality. Muscle is a metabolic reservoir. In times of emergency it produces the proteins and metabolites required for survival after a traumatic event. In practical terms, frail elderly people with decreased muscle mass often do not survive major surgeries or traumatic accidents, as they lack the metabolic reserves to supply their immune systems and other systems critical for recovery.
There is no single cause of sarcopenia, as there is no single cause for many human afflictions. To prevent and/or treat it, a multi-faceted approach must be taken, which involve hormonal factors, dietary factors, supplemental nutrients, and exercise.

Dietary considerations

The major dietary considerations that increase the risk of sarcopenia are: a lack of adequate protein, inadequate calorie intake, and low level, chronic, metabolic acidosis.

Although it’s generally believed the “average” American gets more protein then they require, the diets of older adults are often deficient. Compounding that are possible reductions in digestion and absorption of protein, with several studies concluding protein requirements for older adults are higher than for their younger counterparts (Young, 1990; Campbell et al., 1994; Campbell et al., 1996). These studies indicate that most older adults don’t get enough high quality protein to support and preserve their lean body mass.

There is an important caveat on increasing protein, which brings us to the topic of low level, diet-induced, metabolic acidosis. Typical Western diets are high in animal proteins and cereal grains, and low in fruits and vegetables. It’s been shown that such diets cause a low grade metabolic acidosis, which contributes to the decline in muscle and bone mass found in aging adults (Frassetto et al., 2001). One study found that by adding a buffering agent (potassium bicarbonate) to the diet of post-menopausal women the muscle wasting effects of a “normal” diet were prevented (Frassetto et al., 1997). The researchers concluded the use of the buffering agent was “… potentially sufficient to both prevent continuing age-related loss of muscle mass and restore previously accrued deficits.”

The take home lesson from this study is that – although older adults require adequate intakes of high quality proteins to maintain their muscle mass (as well as bone mass), it should come from a variety of sources and be accompanied by an increase in fruits and vegetables as well as a reduction of cereal grain-based foods. The use of supplemental buffering agents such as potassium bicarbonate, although effective, does not replace fruits and vegetables for obvious reasons, but may be incorporated into a supplement regimen.

Hormonal considerations

As most are aware, with aging comes a general decline in many hormones, in particular, anabolic hormones such as Growth Hormone (GH), DHEA, and testosterone. In addition, researchers are looking at Insulin-like Growth factor one (IGF-1) and Mechano Growth factor (MGF) which are essential players in the hormonal milieu responsible for maintaining muscle mass as well as bone mass. Without adequate levels of these hormones, it’s essentially impossible to maintain lean body mass, regardless of diet or exercise.

It’s been shown, for example, that circulating GH declines dramatically with age. In old age, GH levels are only one-third of that in our teenage years. In addition, aging adults have a blunted GH response to exercise as well as reduced output of MGF (Hameed et al., 2003), which explains why older adults have a much more difficult time building muscle compared to their younger counterparts. However, when older adults are given GH, and then exposed to resistance exercise, their MGF response is markedly improved, as is their muscle mass (Hameed et al., 2004).

Another hormone essential for maintaining lean body mass is testosterone. Testosterone, especially when given to men low in this essential hormone, has a wide range of positive effects. One review looking at the use of testosterone in older men (Gruenewald et al., 2003) concluded:

“In healthy older men with low-normal to mildly decreased testosterone levels, testosterone supplementation increased lean body mass and decreased fat mass. Upper and lower body strength, functional performance, sexual functioning, and mood were improved or unchanged with testosterone replacement”

Contrary to popular belief, women also need testosterone! Although women produce less testosterone, it’s as essential to the health and well being of women as it is for men.

The above is a highly generalized summary and only the tip of the proverbial iceberg regarding various hormonal influences on sarcopenia. A full discussion on the role of hormones in sarcopenia is well beyond the scope of this article. Needless to state, yearly blood work after the age of 40 is essential to track your hormone levels, and if needed, to treat deficiencies via Hormone Replacement Therapy (HRT). Private organizations like the Life Extension Foundation offer comprehensive hormone testing packages, or your doctor can order the tests. However, HRT is not for everyone and may be contraindicated in some cases. Regular monitoring is required, so it’s essential to consult with a medical professional versed in the use of HRT, such as an endocrinologist.

Nutrient considerations:

There are several supplemental nutrients that should be especially helpful for combating sarcopenia, both directly and indirectly. Supplements that have shown promise for combating sarcopenia are creatine, vitamin D, whey protein, acetyl-L-carnitine, glutamine, and buffering agents such as potassium bicarbonate.

Creatine

The muscle atrophy found in older adults comes predominantly from a loss of fast twitch (FT) type II fibers which are recruited during high-intensity, anaerobic movements (e.g., weight lifting, sprinting, etc.). Interestingly, these are exactly the fibers creatine has the most profound effects on. Various studies find creatine given to older adults increases strength and lean body mass (Chrusch et al., 2001; Gotshalk et al., 2002; Brose et al., 2003). One group concluded:

“Creatine supplementation may be a useful therapeutic strategy for older adults to attenuate loss in muscle strength and performance of functional living tasks.”

Vitamin D

It’s well established that vitamin D plays an essential role in bone health. However, recent studies suggest it’s also essential for maintaining muscle mass in aging populations. In muscle, vitamin D is essential for preserving type II muscle fibers, which, as mentioned above, are the very muscle fibers that atrophy most in aging people. Adequate vitamin D intakes could help reduce the rates of both osteoporosis and sarcopenia found in aging people (Montero-Odasso et al., 2005) leading the author of one recent review on the topic of vitamin D’s effects on bone and muscle to conclude:

“In both cases (muscle and bone tissue) vitamin D plays an important role since the low levels of this vitamin seen in senior people may be associated to a deficit in bone formation and muscle function”
and

“We expect that these new considerations about the importance of vitamin D in the elderly will stimulate an innovative approach to the problem of falls and fractures which constitutes a significant burden to public health budgets worldwide.”

Whey protein

As previously mentioned, many older adults fail to get enough high quality protein in their diets. Whey has an exceptionally high biological value (BV), with anti-cancer and immune enhancing properties among its many uses. As a rule, higher biological value proteins are superior for maintaining muscle mass compared to lower quality proteins, which may be of particular importance to older individuals. Finally, data suggests “fast” digesting proteins such as whey may be superior to other proteins for preserving lean body mass in older individuals (Dangin et al., 2002).

Additional Nutrients of interest

There are several additional nutrients worth considering when developing a comprehensive supplement regimen designed to prevent and or treat sarcopenia. In no particular order, they are: fish oils (EPA/DHA), acetyl-l-carnitine, glutamine, and buffering agents such as potassium bicarbonate. There is good scientific reason to believe they would be beneficial for combating sarcopenia, but data specific to sarcopenia is lacking. For example, EPA/DHA has been found to preserve muscle mass (e.g. is anti-catabolic) under a wide range of physiological conditions. The anti-inflammatory effects of fish oils would also lead one to believe they should be of value in the prevention or treatment of sarcopenia. In general, fish oils have so many health benefits, it makes sense to recommend them here.

Acetyl-l-carnitine also offers many health benefits to aging people, and data suggests it should be useful in combating this condition. More research specific to sarcopenia is needed however.

Glutamine is another nutrient that should be useful in an overall plan to combat sarcopenia. Finally, data does suggest strongly that bicarbonate and citrate buffering agents containing minerals such as potassium, magnesium, and calcium can reverse the metabolic acidosis caused by unbalanced western diets. However, I hesitate to recommend this particular strategy as it does not address the root cause, which is the diet itself. Much greater health benefits will result from improving the diet over simply adding in this supplement. In addition, there are potential problems that could result from excessive intake of buffer salts, such as hyperkalemia and formation of kidney stones.

Exercise Considerations

Exercise is the lynchpin to the previous sections. Without it, none of the above will be an effective method of preventing/treating sarcopenia. Exercise is the essential stimulus for systemwide release of various hormones such as GH, as well as local growth factors in tissue, such as MGF. Exercise is the stimulus that increases protein and bone synthesis, and exerts other effects that combat the loss of essential muscle and bone as we age. Exercise optimizes the effects of HRT, diet and supplements, so if you think you can sit on the couch and follow the above recommendations…think again.

Although any exercise is generally better then no exercise, all forms of exercise are not created equal. You will note, for example, many of the studies listed at the end of this article have titles like: “GH and resistance exercise” or “creatine effects combined with resistance exercise” and so on. Aerobic exercise is great for the cardiovascular system and helps keep body fat low, but when scientists or athletes want to increase lean mass, resistance training is always the method. Aerobics does not build muscle and is only mildly effective at preserving the lean body mass you already have. Thus, some form of resistance training (via weights, machines, bands, etc.) is essential for preserving or increasing muscle mass. The CDC report on resistance exercise for older adults summarizes it as:

“In addition to building muscles, strength training can promote mobility, improve health-related fitness, and strengthen bones.”

Combined with HRT (if indicated), dietary modifications, and the supplements listed above, dramatic improvements in lean body mass can be achieved at virtually any age, with improvements in strength, functionality into advanced age, and improvements in overall health and general well being.

Conclusion

Hopefully, the reader will appreciate that I have attempted to cover a huge amount of territory with this topic. Each sub-section (nutrition, hormones, etc.) could easily be its own article if not its own book. This means each section is a general overview vs. anything close to an exhaustive discussion. Below is guide to web sites that offer additional information regarding the topics covered in this article and should (hopefully!) help fill in any gaps.

To summarize, to prevent or treat sarcopenia:

• Get adequate high quality proteins from a variety of sources as well as adequate calories. Avoid excessive animal protein and cereal grain intakes while increasing the intake of fruits and vegetables.

• Get regular blood work on all major hormones after the age of 40 and discuss with a medical professional if HRT is indicated.

• Add supplements such as: creatine, vitamin D, whey protein, acetyl-l-carnitine, glutamine, and buffering agents such as potassium bicarbonate.

• Exercise regularly – with an emphasis on resistance training -  a minimum of 3 times per week.

I’m going to conclude this article the way most people would start it, with the good news and the bad news. The bad news is, millions of people will suffer from a mostly avoidable loss of functionality and will become weak and frail as they age from a severe loss of muscle mass. The good news is that you don’t have to be one of those people. One thing is very clear: it’s far easier, cheaper, and more effective to prevent sarcopenia – or at least greatly slow its progression – than it is to treat it later in life. Studies have found, however, that it’s never too late to start – so don’t be discouraged if you are starting your sarcopenia fighting program later in life. People following my programs for either weight loss or weight gain (in the form of muscle…) will be following the proper guidelines for avoiding sarcopenia.

Additional information:

Info on diet induced metabolic acidosis, recommended foods and more info on the topic in general, see Dr. Berardi’s web site:

http://www.johnberardi.com/articles/nutrition/bases.htm

Discussion on the importance of regular blood work:
It’s in your blood!

CDC guide to resistance training for older adults:
http://www.cdc.gov/nccdphp/dnpa/physical/growing_stronger/spotlight.htm
References:

Brose A, Parise G, Tarnopolsky MA. Creatine supplementation enhances isometric strength and body composition improvements following strength exercise training in older adults. J Gerontol A Biol Sci Med Sci. 2003 Jan;58(1):11-9.
Campbell WW, et al. Protein requirements of elderly people. Eur J Clin Nutr 1996 Feb;50 Suppl 1:S180-3; discussion S183-5.
Campbell WW, et al. Increased protein requirements in elderly people: new data and retrospective reassessments Am J Clin Nutr 1994 Oct;60(4):501-9.

Chrusch MJ, Chilibeck PD, Chad KE, Davison KS, Burke DG. Creatine supplementation combined with resistance training in older men. Med Sci Sports Exerc. 2001 Dec;33(12):2111-7.

Dangin M, Boirie Y, Guillet C, Beaufrere B. Influence of the protein digestion rate on protein turnover in young and elderly subjects. J Nutr. 2002 Oct;132(10):3228S-33S.

Frassetto L, et al. Potassium bicarbonate reduces urinary nitrogen excretion in postmenopausal women. J Clin Endocrinol Metab. 1997 Jan;82(1):254-9.

Frassetto L, et al., Diet, evolution and aging–the pathophysiologic effects of the post-agricultural inversion of the potassium-to-sodium and base-to-chloride ratios in the human diet. Eur J Nutr. 2001 Oct;40(5):200-13.

Gotshalk LA, Volek JS, Staron RS, Denegar CR, Hagerman FC, Kraemer WJ. Creatine supplementation improves muscular performance in older men. Med Sci Sports Exerc. 2002 Mar;34(3):537-43.

Gruenewald DA, Matsumoto AM. Testosterone supplementation therapy for older men: potential benefits and risks. J Am Geriatr Soc. 2003 Jan;51(1):101-15; discussion 115.

Hameed M, et al.. Expression of IGF-I splice variants in young and old human skeletal muscle after high resistance exercise. J Physiol 547: 247–254, 2003

Hameed M, et al. The effect of recombinant human growth hormone and resistance training on IGF-I mRNA expression in the muscles of elderly men. J Physiol 555: 231–240, 2004

Lynch GS. Emerging drugs for sarcopenia: age-related muscle. wasting. Expert Opin Emerg Drugs. 2004 Nov;9(2):345-61.
Montero-Odasso M, Duque G. Vitamin D in the aging musculoskeletal system: an authentic strength preserving hormone. Mol Aspects Med. 2005 Jun;26(3):203-19.

Young VR. Amino acids and proteins in relation to the nutrition of elderly people. Age Ageing 1990 Jul;19(4):S10-24.
Additional references of interest:
Anawalt BD, Merriam GR. Neuroendocrine aging in men. Andropause and somatopause. Endocrinol Metab Clin North Am. 2001 Sep;30(3):647-69.

Gruenewald DA, Matsumoto AM. Testosterone supplementation therapy for older men: potential benefits and risks. J Am Geriatr Soc. 2003 Jan;51(1):101-15; discussion 115.

Herbst KL, Bhasin S. Testosterone action on skeletal muscle. Curr Opin Clin Nutr Metab Care. 2004 May;7(3):271-7.

Iannuzzi-Sucich M, Prestwood KM, Kenny AM.
Prevalence of sarcopenia and predictors of skeletal muscle mass in healthy, older men and women. J Gerontol A Biol Sci Med Sci. 2002 Dec;57(12):M772-7.

Morley JE. GRECC, VA. Testosterone replacement in older men and women. J Gend Specif Med. 2001;4(2):49-53.
Tenover JS. Androgen replacement therapy to reverse and/or prevent age-associated sarcopenia in men.
Baillieres Clin Endocrinol Metab. 1998 Oct;12(3):419-25.

Vermeulen A, Goemaere S, Kaufman JM.
Testosterone, body composition and aging. J Endocrinol Invest. 1999;22(5 Suppl):110-6.

Wittert GA, Chapman IM, Haren MT, Mackintosh S,Coates P, Morley JE. Oral testosterone supplementation increases muscle and decreases fat mass in healthy elderly males with low-normal gonadal status. J Gerontol A Biol Sci Med Sci. 2003 Jul;58(7):618-25.

Sarcopenia, the undiagnosed epidemic is a post from: The Final Frontier In Bodybuilding , Fat Loss, Health & Fitness

Let’s face it, bodybuilding is a visual endeavor and sport. No one wants to have a great body without a full head of hair to match. So, it should have come as no surprise to me that I received so much mail after I wrote my first article on the topic in 1997 in MMI (issue 179). “Hair today gone tomorrow” was published in MMI and later on the BrinkZone.com web site. It was clear to me that I hit a nerve with readers as I received more email and snail mail then I had expected, especially considering the fact it was an article that had nothing to do with building muscle! Why did I write it? From the last article,

“I thought a new article for those people who are really bumming that their hair is falling out, want to make sure their hair does not start falling out, or are just real paranoid about their hair falling out, was in order. If you fit any one of the above descriptions-which most people do- than this is the article for you! So why do I care so much about hair loss? My mother’s father was bald, my father is mighty thin up top, my hair started to thin a while back -you do the math!”

I have received countless emails and letters over the years asking me to update the article. Here, finally, is the updated version which will integrate info from the last article and the newer recommendations. People who have not read the first article can view that HERE

Readers of this article may be confused by some of my comments if they are not familiar with the last one, so I recommend you read the first article. Go ahead, I can wait!

What causes male pattern baldness (MPB)? From 1997:

“So what makes your hair fall out? Well for a long time scientists thought that DHT was the sole cause of hair loss, but this does not appear to be the case. As most of you already know, androgens such as testosterone (natural and otherwise) can convert to DHT by the previously mentioned enzyme 5AR. People who have high levels of the enzyme 5AR have higher levels of DHT and are prone to losing their hair.

Men with a congenital deficiency in 5AR show no receding of the hair line. This knowledge of the relationship of DHT to hair loss kicked off the big race to find things that shut down the 5AR enzyme and thus reduce the amount of DHT. Simple enough right? Well I have said it a thousand times before and I will now say it a thousand and one times: two plus two rarely makes four in the human body and this is the case again regarding the relationship of DHT to hair loss.”
“People and researchers who used 5AR inhibitors such as Proscar and Saw Palmetto found it helped with the hair loss but in no way shut it down or regrew much of the hair that was lost. What appears to be the ultimate cause of hair loss for most people is an auto immune response where the body actually attacks the hair follicle like some kind of foreign invader thus causing an inflammatory response.

By yet unknown mechanisms, DHT causes a change in the follicle signaling the immune system to attack the follicle and your hair starts falling out (If you take a close look, you can actually see a red line of inflammation on the scalp of some people losing their hair). How do we know this? It was discovered that the hair follicles of people losing their hair look very similar under a microscope to people who experience organ rejection after surgery. And, it has been found that the immune system suppressing drug which is used to stop the organ rejection (Cyclosporine) grows hair like crazy because it shuts down the immune response in the body.

A cure you say?

NO! If you take some Cyclosporine and you grow hair it will be because you have no immune system and you will get very sick and possibly die. I shit you not-don’t mess with this stuff. Anyway, though DHT is clearly important in the cause of hair loss, it is not the final cause and a new race has been started to address the inflammatory response which ultimately causes you hair to fall out.

Clearly, you have to attack hair loss from both the DHT and inflammatory response, and that’s what most of this article is about….sort of. There are also other factors related to hair growth and hair loss such as nutrition, SODases, Nitric Oxide (NO) and others, but DHT and the immune response are the two biggies.”
2005 comments:

Interestingly, almost a decade later, our understanding of the cause of MPB has changed little. Androgens (e.g., DHT) and a poorly understood immune response, that has interactions with SODases, NO, and other factors, creates the environment for MPB.

1997 treatment options versus 2005:

In the previous article, I covered copper binding peptides, Nizerol shampoo, Proscar, Minoxidil, and a very promising mystery drug called RU 58841. What follows in this section are comments on each of them from 1997 followed by my thoughts now after almost a decade of experience with them:

Copper binding peptides: back when I wrote the first article a drug called Iamin had just been approved by the FDA for wound healing. Another drug similar to Iamin is Tricomin. Both Iamin and Tricomin were invented and subsequently patented by Dr. Loren Pickart. As I stated in the 1997 article about these compounds,

“These drugs are copper based compounds that have certain peptides added to them. When put on the skin they have profound anti inflammatory properties and increase the rate at which skin heals dramatically (hence Iamin700s approval for wound healing). As I mentioned earlier, chronic inflammation at the site of the hair follicle appears to be a major link in the chain of what makes hair fall out.”

2005 thoughts: Unfortunately these products did not turn out to be nearly as effective for MPB as I had hoped. Feedback was lackluster at best. I believe they still have some use in multi ingredient formulas that may add some small additional benefit, but the general advice is they are minimally effective for MPB alone.

Nizoral Shampoo 1997:

“Nizoral is an anti fungal shampoo and the active ingredient is a plant derivative called Ketoconazol and is produced by Janssen Pharmaceuticals. How and why Nizoral works on hair loss in not very well understood. It might work by blocking the DHT at the follicle and/or working by reducing the amount of inflammation at the hair follicle.”

2005 comments:

Nizoral turned out to be a big disappointment. It was very popular when I wrote the article, but has dropped out of use by most people. It can now be had without a prescription in 1% strength, but it’s a moot issue at this point as Nizoral is ineffective for treating MPB in my opinion. There was one small study (Pierard-Franchimont C, et al. Dermatology. Ketoconazole shampoo: effect of long-term use in androgenic alopecia. 1998;196(4):474-7 )that appeared to find Nizoral about as effective as Minoxidil, so people can use Nizoral if they want I suppose, but feedback and experience says it’s of no use.

Proscar 1997:

“…Proscar is a very specific inhibitor of the enzyme (5AR) that converts androgens into DHT. Its official use is for prostate enlargement which is also related to DHT levels (among other things). It was felt originally that Proscar would not be effective for hair loss because it only inhibits the enzyme found in the prostate and not in the hair follicle.

Well again, nothing is cut and dry in the human body, and Proscar has been found to reduce the amount of DHT in circulation which reduces the amount of DHT the follicle has to deal with and thus less hair is lost. Several recent studies have shown Proscar is effective for hair loss and can help regrow some hair on some people, but as I said before, the use of 5AR inhibitors only deals with a part of the problem and are generally not very effective when used as the only treatment.”

2005 comments:

At the time I wrote the above, Proscar (finasteride) came in 5mg pills and was approved for benign prostatic hyperplasia (BPH) only. Because studies found 1mg almost as effective as 5mg for lowring DHT, I recommended people split the 5mg tabs into 4, which gave you 1.25mg. Of course the producer of finasteride (Merck) saw the marketing potential for treating MPB, and finasteride was packed in 1mg pills and sold as Propecia.

There is of course no difference between Proscar and Propecia except the dose, so people in the know still buy Proscar and divide it into 4 pieces to save money. I would still recommend Finasteride for MPB, but it is far from the miracle drug for MPB people hoped it would be when it came out. Side effects such as gyno, reductions in libido, and others also appears to be higher in the real world then the studies claimed. Finally, finasteride does appear to work topically (contrary to what Merck claims) which will greatly reduce systemic side effects. However, topical is generally less effective then oral treatment.

Minoxidil 1997:

“…Minoxidil did not turn out to be the hair growth stimulant we all hoped it would be and if it had not recently gone OTC I would not even have included it in this list. However, being minoxidil can now be purchased without a prescription and is about half the price of what it used to cost, I think it is a useful addition to a person’s regimen. For hair growth, minoxidil has pretty much been a bust, but for reducing hair loss, I have found it is definitely better than nothing.”

2005 comments:

The only thing that has changed since I wrote the above is that Minoxidil comes in a stronger version for men (5% vs. 2%) and can be found as a generic, saving money for the user. I think Minoxidil makes a good carrier for other compounds you may want to use topically, such a Finasteride, etc.

1997 comments on RU 58841:

“RU 58841: This is the mother of all topical anti androgens. RU58841 is made by the Roussel Corporation of France. This stuff shuts down DHT at the hair follicle like nothing else. One of the major problems has been that anti androgens such as Spironolactone and Flutamide taken orally might be good for hair loss, but they cause all sorts of problems related to having low androgens in your body, such as loss of muscle, increased fat, loss of sex drive, gyno, etc.

When these same anti androgens have been used topically (put directly on the scalp) they do not cause the negative systemic side effects, but they did not seem to do much of anything for hair loss or growth either. Therefore, a topically active anti androgen without systemic effects would be highly desirable. RU58841 is a topical anti androgen that shuts down DHT at the follicle without any systemic side effects in the body!”

2005 comments:

If there has ever been a drug that appeared to be close to a cure for MPB with no side effects, this was it. So what happened to it? That too is a bit of a mystery, but the general consensus is that the company never developed it for market for financial reasons after other drugs for MPB faired not nearly as well in the market place as was expected. It’s a real shame. After the article came out, I knew several enterprising people with enough money to have batches made up for their personal use, and they all said it was the best thing they had used topically.

Additional possible treatments
Avodart:

Recently, a dual inhibitor of both enzyme types (5ar-1 and 5ar-2) that convert testosterone to DHT has been approved for BPH. It’s called Avodart (dutasteride)and is made by GlaxoSmithKline. Finasteride was shown to reduce DHT by up to approximately 70+% or so, where as Avodart reduced DHT by 90-96% depending on dose (0.5mg – 2.5mg). So, this drug would appear more effective for treating MPB, and Glaxo’s data found 2.5mg of Avodart grew 1.5 times more hair compared to 5mg Finasteride over a 6 month period with approximately similar side effects as Finasteride.

Real world feedback is that it is indeed superior to Finasteride for MPB, but side effects are more common. Several doctors I know who prescribed it for MPB told me many men stopped using it due to side effects, so the claim that it has a similar incidence of side effects to Finasteride may not be true. However, it may be worth using topically mixed into some vehicle such as Minoxidil or some custom blend. There are many of them found on the internet in fact, and feedback is generally good. As stated, topical is never as effective as oral, but the side effects are minimized.

Flutamide and Spironolactone

Flutamide is not really a new drug, but an old drug being used for MPB. It’s a powerful anti -androgen used with men with prostate cancer. I consider the side effects for healthy men FAR too great to be used orally, though some men have gone that route. I think they’re crazy. However, topical versions are fairly common on the ?net and this may be viable alternative – albeit a less effective alternative -to oral administration. Pretty much everything I have said about Flutamide goes for Spironolactone. Gyno, reductions in sex drive, etc, is common in men taking it orally, but topical formulations exist and appear to be moderately effective, especially when combined with other compounds.

Best overall multi ingredient topical formula:

There are hundreds, perhaps thousands, of topical formulas on the market. I have not viewed them all nor used them all. Keeping that in mind, my recommended all-in-one topical formula I recommend is Proxiphen produced by a Dr. Proctor out of Texas. Dr. Proctor is probably one of the foremost experts on MPB and one of the good guys in an otherwise shady industry. I have spoken to him many times and he knows his sh*%. Proxiphen contains minoxidil, as well as the prescription agents phenytoin and spironolactone, SODs, copper peptides, TEMPO, PBN…over a dozen active ingredients in all. Another plus is that Dr. proctor never sits on his success with Proxiphen in that he is constantly adding new compounds to the formula if he feels they show promise for MPB.

Because it contains prescription agents, Proxiphen can only be dispensed on a physician700s diagnosis of hair loss. This is not as big a deal as you may think, but you will have to see your doctor to get an official diagnoses of MPB. You do not have to travel to TX to get it, but your Doc will have to communicate with Dr Proctor for you to obtain Proxiphen. Dr, proctor does produce non prescription products that may also be worth a try, but none of them will be as effective as his prescription based product. Dr. proctor can be contacted at 800-926-1752 or 713-960-1616. Web site: www.drproctor.com

Low Level Laser Therapy (LLLT)

99% of the time, something that looks like a scam and smells like a scam, is a scam. There is that 1% of the time when what looks rather scam-ish at first actually may work as claimed. Such may be the case with LLLT. Makers of LLLT devices have claimed for years they grew hair but there was no hard data to support it, and what the mechanism was was never really explained. Thus, I was very skeptical say the least.

I have had to alter that opinion however as a study published in the International Journal of Cosmetic Surgery and Aesthetic Dermatology ( Vol. 5, Number 2, 2003.) found LLLT may actually work as claimed. The study found increased hair counts and improved tensile strength in 28 men and 7 women who used the LaserMax Hair Comb  for 6 months. The results were impressive and no side effects were reported as one would expect. I have also spoken to the director of one clinic that does many hair transplants and they find greatly increased healing rates post op using the laser comb. So, my opinion of this gizmo is guardedly positive and it may be worth incorporating into your hair loss prevention plan.

If All Else Fails!:

Ok, so you have tried most of the above, don’t want to try the above, or don’t have enough hair left on top of your head for the above to really make a difference, and you want information on transplants. As you know, when transplants first came out, they were pretty crude and looked pretty damn bad. Things have changed for the better in the last few years with some truly impressive results.

So, the good news is there are procedures that now look totally natural. Bad news, none are going to give you the hairline you had before you started losing your hair. You have to have realistic expectations here to begin with.

Ok, after a great deal of research I am of the opinion that the laser method is superior to other methods. There is a great deal of confusion out there regarding the laser method propagated by people using outdated information or fear of competition. People who put down the laser method claim all sorts of things that are simply not true today with the right laser being used by an experienced medical professional.

Before we get to that, a little background. Lasers are finding new applications in the medical and cosmetic field almost every day such, such as their use in surgery and the use of lasers in skin rejuvenation and resurfacing. It700s been slower in the field of hair transplantation using lasers. The reason for this is simple, the first generation of lasers used for hair transplants were non-pulsating CO2 lasers which caused damage to the local blood supply (dry hole) and poor hair growth resulted.

Keep in mind, blood supply to the transplanted follicle is essential for any growth to take place. Without adequate blood supply, the transplanted follicle simply dies. These older lasers caused thermal damage to the area (burned the area due to excessive heat from the laser), which of course is not what you want. This is the main criticism of the laser approach.

However, newer generation pulsating CO2 lasers showed a vast improvement in maintaining blood supply resulting in improved graft growth and survival of the transplanted hair. Later improvements added the Super Pulse laser which is a big improvement over older lasers that caused extensive thermal damage. Another type of laser that is used is the Erbium laser.

Both lasers appear to have their strengths and I have seen excellent results with either. The right laser in the hands of a doctor who has experience with this method does not hinder blood supply at all, and excellent graft growth follows after the hair follicle is transplanted. The laser greatly reduces actual surgery time and trauma to the area, so post op pain is reduced and recuperation time is also reduced.

Some other reasons the laser method is superior to having someone cut holes in your head with a scalpel or needle punch: every time a laser hole is made, bald tissue is actually being removed. This reduces the total amount of bald area present. This advantage is not seen when using a scalpel blade or needle to prepare recipient sites. Lasers also decrease the incidence of what is called “postoperative epidermal inclusion cysts.” These are ugly little bumps that often show up in the area of the transplanted hair, and they look like sh*$ to be honest.

There are yet more advantages to the use of the laser versus the “cold steal” methods (e.g., scalpel, needle punch, etc.) that I don700t have the space or need to cover. It’s the only method I have personally seen where I simply could not tell that work had been done on the person’s head until I saw the before pictures!

The clinic with probably the most experience with laser transplants is the Hair and Scalp laser Clinic in Clearwater Florida. The clinical director is John Satino and the doc doing the work is Dr. Markou. They can be reached at 1-800-883-4247 or 1-727-572-9344. Web site is www.hairscalplaserclinic.com

Now, if you can find someone in your area using the laser method who has real experience with it and can give you referrals to speak to regarding their work, by all means use them, but not many people are currently using the laser method for transplants. On a final note, I don’t want people to think there can’t be satisfactory results with some of the more traditional scalpel and needle punch methods, but in my opinion none of them are superior, or more natural looking, than the results achieved with the laser in the hands of an experienced medical professional.

Conclusion.

Ok, please don’t bombard me with questions about the latest greatest cure for hair loss you read about or are using. The above is about the only treatments I have any faith in. The longer I have been researching the topic the more I realize how few of the products out there actually work and what a vexing problem MPB is to solve. However, the information in this article is about as good as you are going to find in your attempt to not end up looking like the guy in the Gold’s Gym logo!

Hair Today Gone Tomorrow: The Sequel! is a post from: The Final Frontier In Bodybuilding , Fat Loss, Health & Fitness