Ageless Forever Anti-Aging News Blog

Testosterone - Men

Is hypogonadism, aka "andropause", the male version of menopause?

Many men who reach middle-age start to experience symptoms that resemble those of menopause; reduced libido, lack of energy, weight gain, fatigue, depression and osteoporosis, to name a few.[1-5]
 
Therefore these conditions are frequently seen as being equivalent, and hypogonadism (which sometimes get the prefix "late onset") has therefore been called "andropause", "male climacteric", "male menopause" or "MANopause.[6, 7] 
 
However, this is very misleading. In this article I will contrast and comment on the differences between hypogonadism, also known as testosterone deficiency, and menopause.[8]
 
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Testosterone Deficiency - Prevalence and Treatment Rates

Testosterone deficiency, also known as hypogonadism, is gaining recognition among both clinicians and the general population. This article summarizes the findings from a review on the prevalence of testosterone deficiency, as well as the proportion of hypogonadal men who are receiving testosterone treatment.[1]
 
While testosterone prescribing has increased lately, as you will find out here, the prevalence of testosterone deficiency far exceeds the prescribing rate; i.e. majority of men with low-T are still not being treated with testosterone therapy.
 
You may be surprised to find out that testosterone deficiency is still not well-understood by general practitioners and cardiologists, and that these key clinicians lack knowledge on its deleterious cardiovascular effects. Therefore, even man needs to take control of his own health and don't let any ignorant or old-school doctor deny you a prescription that you may need...
 
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Testing for testosterone deficiency - things to know about the blood draw

The first step (aside from identifying symptoms) in diagnosing testosterone deficiency, aka low-T, is to do a blood test.

Here I cover some important practical things to know about a blood draw for testosterone analysis...

 

 

 

 

 

 

 

 

 

 

 

 


 

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Adverse health effects of testosterone deficiency in men

 
Testosterone deficiency, also known as hypogonadism, is a state with sub-optimal circulating levels of testosterone concomitant with clinical signs and symptoms attributed to low physiological testosterone levels.[1-3] 
 
Sexual dysfunction is the most commonly recognized symptom of testosterone deficiency. However, testosterone also plays a broader role in men's health. A growing body of evidence has established associations between low testosterone levels and multiple risk factors and diseases including the metabolic syndrome, obesity, type-2 diabetes, sarcopenia, frailty, mobility limitations, osteoporosis, cognitive impairment, depression, cardiovascular disease, and reduced longevity.[3-12]
 
This summary gives an overview of the detrimental impact of testosterone deficiency on a wide range of health outcomes.[13]
 
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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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Multiple beneficial effects of testosterone replacement therapy in men with testosterone deficiency

Alleged concerns regarding risk of cardiovascular disease with testosterone replacement therapy (TRT) have been promulgated recently. However, a large and growing number of intervention studies show to the contrary that TRT reduces cardiovascular risk factors and confers multiple beneficial health effects. Thus, fears promoted by some recent flawed studies need to be critically re-evaluated. 
 
This article gives an overview of studies that have investigated health effects and safety of TRT.[1] As outlined here, the position that testosterone deficiency (TD) should be regarded as a risk factor for cardiovascular disease is supported by a rapidly expanding body of evidence.[2-4]
 
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How Is Testosterone Deficiency "Low-T" Diagnosed? - Things you need to know before going to your doctor

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...
 
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Testosterone and Prostate Cancer - Bye Androgen Hypothesis, Welcome Saturation Model

 

A long-held belief is that testosterone stimulates development of prostate cancer and/or accelerates its growth. This fear is the most common reason for doctors' reluctance to prescribe testosterone replacement therapy, even in hypogonadal men [1, 2] , which unnecessarily deprives many hypogonadal men of clinical benefits.
 
This summary gives an overview of an in-depth review of current literature regarding the relationship of testosterone levels and prostate cancer, and the effect of testosterone replacement therapy on prostate cancer progression and recurrence.[3] Key studies which have refuted the old belief that testosterone has harmful effects on the prostate are presented, along the new testosterone-prostate paradigm known as the saturation model.
 
Surprisingly, new research provocatively suggests that it is not high testosterone levels that are problematic for prostate cancer, but to the contrary that it is low serum T that is associated with worrisome cancer features and outcomes...and new experimental research has uncovered mechanisms that explain how low testosterone levels may be detrimental for prostate health, and support the new view that testosterone therapy actually may have beneficial effects with regard to prostate cancer...
 
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The Androgen Study Group - Cutting Through Misleading Headlines and Exposing the Truth about Testosterone Therapy and Health

Recently several flawed studies, implicating that testosterone replacement therapy increases risk for heart attack and death, created large media headlines. This despite a large body of research evidence showing the contrary, ie. that testosterone replacement therapy decreases risk for heart disease and that higher testosterone levels are associated with reduced death rates. No wonder there is confusion and unnecessary concern and among healthcare providers and their patients.
 
In response to this, The Androgen Study Group was formed. The Androgen Study Group is a multidisciplinary group of androgen researchers and clinicians who are dedicated to education and accurate reporting on the science of testosterone deficiency in men and its treatment. With the media attention that testosterone therapy is attracting it is critical that clinical trials are properly conducted and analyzed, and that results are presented in a way that is not misleading. The mission of the Androgen Study Group is to ensure that the results of research on testosterone deficiency and its treatment is presented accurately and fairly in the medical literature as well as in public media.
 
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Low free testosterone levels and loss of muscle mass

 

Hypogonadism, aka testosterone deficiency or low-T, is primarily diagnosed by low total testosterone levels. However, more and more research is showing that free testosterone, which is the active fraction of total circulating testosterone, is independently associated with important health outcomes.

 

Levels of free testosterone decline more steeply than total testosterone as menage.[1-7 In many cases, total testosterone levels can be relatively high, but free testosterone low. Therefore it is important to assess both total and free testosterone levels in order to get a clear picture of the androgen status.

A recent study specifically assessed if baseline testosterone (total and free) levels predict muscle loss in middle-aged and elderly Japanese men over a 10 year period.[8]

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Dr. Pierce's Medical Organization Affiliations

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