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Prediabetes is associated with an increased risk of testosterone deficiency, independent of obesity and metabolic syndrome.

Prediabetes is a condition in which blood glucose level is higher than normal but does not reach the level for diabetes diagnosis.[1, 2] Studies have shown that people with prediabetes tend to develop type 2 diabetes within 10 years, and are at increased risk for cardiovascular disease.[1]

Among US adults over 18 years, the prevalence of prediabetes has increased from 29.2% in 1999 to 36.2% in 2010.[3] Considering the entire US population in 2010 (approx. 309 million, data from US Cencus), this corresponds to 112 million US adults, or over one third of the US population.

Data from non-diabetic men have revealed an inverse association between insulin resistance and testosterone levels; i.e. a higher degree of insulin resistance is associated with lower testosterone levels.[4-6] This raises the question whether prediabetes, which is a state of increased insulin resistance, is also associated with low testosterone. However, few studies have investigated testosterone levels in men with prediabetes, and the risk of testosterone deficiency in men with prediabetes has not been reported.

Because the prevalence of prediabetes is affecting such a large number of Americans, and is on the rise, it is important to investigate how this condition might affect testosterone levels. Knowing that can help
detect men who are likely to have testosterone deficiency and might be at risk for health derangements caused by low-T.

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Muscles – not just for bodybuilders!

 
For most people, the mere word “muscles” brings to mind huge muscular bodybuilders...
 
The importance of muscle mass, strength, and power for physical performance in exercise and sports is obvious.
 
However, muscles aren’t just for show or athletics. Here I will explain why….
 
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Efficacy and safety of injectable testosterone undecanoate (Aveed or Nebido) for the treatment of hypogonadism

Since its approval in 2004, many clinical studies have been conducted with testosterone undecanoate, the first long-acting injectable form of testosterone.
 
Testosterone undecanoate has been proven to have an excellent safety profile and need only be administered four times annually to produce stable testosterone levels.[1]
 
Long-term studies have validated the clinical efficacy of testosterone undecanoate in maintaining stable therapeutic levels of testosterone and safely conferring the desired benefits of androgen replacement.[1]
 
Here I summarize the results from a comprehensive meta-analysis of all uncontrolled and placebo-controlled randomized clinical trials (RCTs) demonstrating the effect of injectable testosterone undecanoate on multiple clinical outcomes.[2]
 
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Testosterone and Fat Loss - the Evidence

 

It is well documented that obesity may cause hypogonadism, and that hypogonadism may cause obesity [1-4] This has generated debate about what condition comes first; obesity or hypogonadism? And what should be the first point of intervention?
 
In this article I will summarize data from several reviews on the associations of hypogonadism and obesity [1-4], and make the case that these conditions create a self-perpetuating vicious circle. Once a vicious circle has been established, it doesn’t matter where one intervenes; one can either treat the obese condition or treat hypogonadism first. The critical issue is to break the vicious circle as soon as possible before irreversible health damage arises. 
 
Nevertheless, as I will explain here, treating hypogonadism first with testosterone replacement therapy may prove to be a more effective strategy because it to a large extent “automatically” takes care of the excess body fat and metabolic derangements. In addition, treating hypogonadism first also confers psychological benefits that will help obese men become and stay more physically active. 
 
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Red Meat - Good or Bad for Fat Loss?

Consumption of red meat has been associated with fat gain (weight gain) because of its high fat and calorie content. Even though the old idea that “a high fat intake causes body fat gain” has been completely debunked in medical research [1-9], red meat still is a food that's on the forbidden or avoid list in most diet plans. And for some reason, women tend to be especially afraid of eating meat…
 
While there are studies showing an association between meat intake and obesity [10-12], there are also studies not showing this [12-14]. And when digging deeper in the data, many of the studies that did report a significant association with meat intake and fat gain / obesity have several flaws that invalidate their conclusions....
 
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Effects of long-term testosterone treatment on weight loss and waist size in obese men - is TRT the next obesity treatment?

Testosterone, historically believed to be important only for male reproduction and sexuality, has over the past decades transformed from niche hormone to multi-system player.[1] A rapidly accumulating body of research is showing that testosterone is an important metabolic hormone with marked effects on energy metabolism and body composition.[2]
 
In USA, 36% of the adult population are obese (BMI >30), (affecting a similar proportion of men and women) [3], and obesity prevalence is escalating worldwide. According to the McKinsey Global Institute (MGI) report “Overcoming obesity: An initial economic analysis”, obesity is “one of the top three preventable social burdens (along with smoking and violence/war/terrorism) generated by human beings” imposing an estimated annual global direct economic burden amounting to 2 trillion USD.[4] 
 
Obesity treatments with comprehensive lifestyle modification and/or drugs are notorious for their poor long-term efficacy and inability to achieve long-term weight loss maintenance.[5-9] Even with continued lifestyle treatment, significant weight regain occurs.[7, 9, 10] And obesity drugs have side effects which limit their long-term and widespread use. [11, 12] Therefore, new interventions are urgently needed to combat this alarming preventable threat to society. 
 
Here I summarize a recent study that investigated the effects of long-term testosterone treatment – up to 8 years - on weight loss and waist size in 411 testosterone deficient men with obesity classes I-III.[13]
 
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Dr. Pierce's Medical Organization Affiliations

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