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Can Age-Related Declines in Testosterone Levels be Prevented or Reversed?

It is well-documented that testosterone levels decline with age in men.

After the age of 40 years, total testosterone decreases on average -4 ng/dL ( -0.124 nmol/L) per year [1] or 1.6% per year [2], and bioavailable testosterone by -2 to 3% per year. [2]

In older men (over 60 years of age), the average rate of decrement in total testosterone levels has been found to be 110 ng/dL every decade.[3]

However, the relative contributions of changes in health and lifestyle to that decline have not been adequately evaluated. A notable study was set out to investigate this...

OBJECTIVE:

The objective of this study was to establish the relative importance of aging, health, and lifestyle in contributing to the testosterone decline in aging men.[4]

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Young men might also suffer health consequences of low testosterone levels

The consequences of low testosterone levels (aka low-T) 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...

 Low total testosterone levels are associated with an adverse blood lipid profile, which includes high TG and low HDL, [1, 2] and a decline in total testosterone levels predisposes men to increased risk of cardiovascular disease (CVD) and mortality.[3-7]

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High-Normal Blood Pressure and Cardiovascular Disease

1 in 3 US adults aged 40-59 years has high blood pressure (hypertension); among those over 60 years of age the prevalence is over two-thirds, 67%.[1] High blood pressure is a well known risk factor for cardiovascular disease; the leading cause of death worldwide.[1, 2] As two-thirds of sudden cardiac deaths occur in clinically healthy individuals [2], novel indicators of early recognition of adverse cardiometabolic risk in disease-free adults are clearly needed. It has been demonstrated that healthy disease-free adults with high-normal blood pressure (aka pre-hypertension, defined as 120-139/80-89 mmHg) have an adverse cardiometabolic risk profile.[2]

The prevalence of high-normal blood pressure in disease-free US adults is 36.3%; it is especially common in people with overweight/obesity, enlarged waist lines, and elevated glucose, insulin, hemoglobin A1c (glycated glucose), C-reactive protein (an inflammatory marker), and triglycerides (blood fats).[2]

High-normal blood pressure is an independent risk factor for cardiovascular disease (CVD)...[3-5]

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Blood Cholesterol Testing - don't let the routine standard lipid panel fool you!

 

The mere word “blood cholesterol” strikes horror in many people. We have been indoctrinated since the well-known Framingham Study in the 1980s that the higher the blood cholesterol level, the higher the risk of heart disease.[1-3] However, much has been discovered in medical research since then. 
 
Today there is compelling evidence showing that strict reliance on the traditional cholesterol test – aka the standard lipid panel - that is routinely run in primary care, can falsely indicate that you're fine, even when you aren't. 
 
Here you will find out what to look for when interpreting your cholesterol levels...
 
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The 20-year public health impact and direct cost of testosterone deficiency in U.S. men

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 cost burden imposed by consequences of testosterone deficiency ...[12]

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Watch Your Waist - it may shorten your life!

Your waistline not only makes or breaks your esthetic appearance; if you belly gets too large, it may greatly jeopardize your health and even longevity.

Waist circumference strongly correlates with abdominal obesity and is the most commonly used measure of body fat distribution.[1, 2] Many studies have found enlarged waist circumferences to be associated with all-cause mortality, in most cases independently of general obesity.[3-11]

Abdominal obesity (aka visceral obesity) appears to be more strongly associated with multiple chronic diseases than is gluteo-femoral obesity (fat deposition around the butt and thighs).[1] Increased waist circumference confers a health risk even in normal weight people.[12]

A notable large study investigated the association of waist circumference with mortality using intuitive 2 in (5 cm) increments for men and women, and also evaluated risk within narrow categories of body fatness (BMI). In addition, the study estimated years of life lost due to a large waist circumference.[13]


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Association of IGF-1 (Insulin-Like Growth Factor-1) with Mortality, Cardiovascular Disease, and Cancer

IGF-1 (insulin-like growth factor-1) is a peptide hormone, produced predominantly by the liver in response to pituitary GH (growth hormone).[1] IGF-1 is involved in a wide variety of physiological processes. In adults, IGF-1 has metabolic and anabolic effects, and it mediates many of the effects of GH.[2-4]
 
GH and IGF-1 levels are reduced with normal aging, a phenomenon called somatopause.[5-7] It has been suggested that somatopause is an age-related GH deficiency state.[5] Somatopause has been considered to contribute to physiological deterioration seen with aging, like reduced muscle mass, reduced exercise tolerance, decreased strength, osteoporosis, increased fat mass, elevated cardiovascular risk, impaired quality of life, cognitive/memory decline and reduced immunity.[7-12] These changes are similar to those seen in classic (non-aging related) GH deficiency (GHD).[13, 14]
 
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Testosterone Treatment and Heart Attack Risk - new study shows testosterone treatment can even be beneficial

Testosterone therapy has been in use for more than 70 years for the treatment of testosterone deficiency, historically called hypogonadism.[1]In the past 30 years there has been a growing body of scientific research demonstrating that testosterone deficiency is associated with increased body weight/adiposity/waist circumference, insulin resistance, type 2 diabetes, hypertension, inflammation, atherosclerosis and cardiovascular disease, erectile dysfunction (ED) and increased risk of mortality [2, 3]. In line with the detrimental health outcomes seen with testosterone deficiency, testosterone therapy has been shown to confer beneficial effects on multiple risk factors and risk biomarkers related to these clinical conditions.[4]
 
Despite these well-documented health benefits, testosterone therapy is still controversial, in large part due to a few flawed studies and media outcry about potential elevated heart attack risk with testosterone therapy. On July 2, 2014, a study was published which demonstrated that testosterone therapy is not associated with an increased risk of MI, and that is actually may protect against heart attack....[5]
 
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Cardiovascular Risks and Elevations of Blood DHT Levels Vary by Testosterone Preparation

 

 

 

The cardiovascular effects of testosterone and testosterone therapy are subject to intense investigation in medical research and have recently generated heated discussions among healthcare professionals. 
 
While the main focus has been on testosterone per se, it is important to remember that testosterone is both a hormone in its own right, and a pro-hormone that gets converted to both estradiol and DHT (dihydrotestosterone). Estradiol and DHT exert effects themselves that are different from the effects of testosterone.
 
Therefore, when analyzing the effects of testosterone, especially supplemental testosterone administered as testosterone replacement therapy, it is critical to take into consideration how it affects downstream testosterone metabolites like estradiol and DHT.
 
Here I will present results from a recent systematic review and meta-analysis that specifically investigated how different routes of testosterone therapy administration (i.e different testosterone preparations) affect blood levels of testosterone and espcially DHT , and how this in turn relates to cardiovascular adverse events.[1]
 
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Dietary Guidelines on Fat Intake - has there ever been any evidence to support the low-fat recommendation?

In an effort to slash heart disease, the Dietary Guidelines for Americans [1] have since 1977 been urging people to: 
 
1. Reduce total fat consumption to 30% of total caloric intake.
 
2. Reduce saturated fat consumption to 10% of total energy intake.
 
Government issued dietary guidelines are highly authoritative and regarded by a majority as being backed by solid research. However, as it turns out, this is not the case… 
 
Dietary recommendations regarding intake of total and saturated fat are highly controversial, and the debate is heating up. A recent systematic review and meta-analysis of six studies that were available 1977, when the first version of the Dietary Guidelines for Americans was published, shows: [2]
 
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