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Ageless Forever Anti-Aging News Blog

How well informed are general practitioners and cardiologists about testosterone deficiency and its consequences?

A rapidly growing body of medical research is showing that testosterone deficiency (aka hypogonadism and low-T) is strongly associated with a wide range of detrimental health outcomes [1, 2], and that testosterone replacement therapy improves those health parameters that are negatively affected by testosterone deficiency.[2, 3]
 
Therefore, leading testosterone scientists now view testosterone deficiency as a cardiovascular risk factor that contributes to the development of cardiovascular disease.[4-7]
 
As general practitioners and cardiologists primarily care for these patients with cardiovascular disease, a survey study was conducted to assess their knowledge, beliefs and clinical practice with respect to testosterone deficiency and cardiovascular health.[8]
 
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Estrogen elevations in response to Testosterone Therapy – to treat or not?

 

During testosterone therapy, total and free estradiol (the main form of estrogen) levels increase dose-dependently in both young (aged 19-35 year old) and 52 older (aged 59-75 year old) men, and more so in older men compared to younger men.[1]
 
The potential clinical consequences of higher estradiol levels and higher estradiol-to-testosterone ratios in older men remains poorly understood, and the optimal management of high-normal or elevated estrogens is controversial among clinicians.[2]
 
Interestingly, in some patients, an initial elevation in estradiol is followed by decreased estradiol after prolonged testosterone therapy.[3, 4] This may be due to reduced body fat mass or decreased testosterone levels over time with fixed dose treatments. 
 
Here you will get advice on how to best approach estrogen management while on testosterone therapy…
 
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DHEA supplementation – specific health benefits for menopausal women

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In a previous article "DHEA – why it is especially important for menopausal women" I explained why DHEA is especially important for women than men, and even more so for peri- and postmenopausal women. In this article, I will cover specific health benefits of DHEA supplementation for menopausal women.
 
There are indications that women with lower DHEA levels are at higher risk for cardiovascular disease and mortality.[1, 2] In postmenopausal women, lower DHEA(S) levels are linked to higher cardiovascular mortality and all-cause mortality [3] and lower DHEA(S) levels are also associated with a 41% greater risk of stroke, regardless of other risk factors.[4] These observations are supported by experiments showing that treatment with DHEA reduces experimental atherosclerosis [5-7], improves blood vessel (endothelial) function [8-11], and has anti-inflammatory [12-15] and anti-oxidative effects.[8, 12, 16, 17] Notably, some of the anti-atherosclerotic effects of DHEA are mediated by DHEA on its own, and not via its conversion to estrogen.[18]
 
Because DHEA is the major source of estrogen and testosterone in post-menopausal women, this begs the question if not all post-menopausal women should supplement with DHEA? Several studies show that DHEA supplementation confers significant health benefits beyond mere relief of menopausal symptoms. Notable are its beneficial effects on the bone, vagina, skin and prevention of breast cancer.
 
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Testosterone Boosting Medications and Cardiovascular Risk - a systematic review and meta-analysis

Accumulating evidence shows beneficial effect of testosterone therapy on a wide range of health outcomes, including inflammation, insulin sensitivity, muscle mass, body fat mass, lipid profiles,  endothelial, bone mineral density, energy and vitality, mood, sexual function and overall quality of life. [1-9]
 
Despite this, concerns have been raised that testosterone therapy could have detrimental effects on cardiovascular disease.
 
In this article I summarize results from a comprehensive systematic review and meta-analysis, the largest to date, of all placebo-controlled randomized clinical trials (RCTs) on the effect of testosterone therapy on cardiovascular-related outcomes.[10] 
 
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Omega-3 fat intake for prevention of skin aging

Photoaging is the process of aging of the skin due primarily to regular and long-term exposure to ultra-violet radiation. The long-chain omega-3 fatty acids (EPA and DHA) have been implicated in modulating inflammatory processes associated with the skin, and supplementation with 3 g EPA+DHA for 6 months has been shown to reduce both UVB-erythemal sensitivity (i.e. sun induced skin reddening) [1], sunburn and sun induced itchy rash.[2]
 
A recently published study in Journal of Dermatological Science [3] investigated the associations between daily omega-3 fat intake and the severity of skin photoaging...
 
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Primary Prevention as an Anti-Aging Strategy - the importance of starting down the right path

 
Risk factors and chronic diseases typically get most attention among middle-age and older folks. And rightly so, since that's when the manifestations of chronic diseases start to show up, and when people get reminded about their chronological age.
 
An integral component of anti-aging (aka successful aging or healthy aging) is the freedom of physical disabilities and debilitating chronic diseases.[1-3] While it is true that it is never too late to become health conscious and reap the benefits of a healthy lifestyle [4, 5], the fact remains that the sooner we start the better off we will be as we get older.[6, 7] If you are in your 20s, 30s or early 40s, read on….
 
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What is Preventive Medicine and Primary Prevention?

"An ounce of prevention - A pound of cure for an ailing health care system" [1]
 
Over the past decade, interest in anti-aging treatments and interventions aimed at promoting health, vitality and youthfulness over the life course into old age, has risen exponentially. The popularity and rise of anti-aging interventions has been fueled by the aging baby-boomer generation and the great dissatisfaction surrounding the current medical system in the US and many other Western nations. 
 
Are you frustrated with today's big-pharma dictated assembly line medicine with doctors who only spend 7 minutes per visit with their patients? Are you against the routine "have a symptom - take a pill" traditional medical system mantra that is so pervasive in modern medicine? Then preventive medicine, which is a unique medical specialty recognized by the American Board of Medical Specialties (ABMS), and primary prevention is for you…
 
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Incidence of Prostate Cancer after Testosterone Therapy for up to 17 years

One of the major concerns among doctors and patients with testosterone therapy is its allegedly negative effect on the prostate.[1] However, according to the current ISA, ISSAM, EAU, EAA, ASA clinical guidelines, there is no conclusive evidence that testosterone therapy increases the risk of prostate cancer or benign prostatic hyperplasia.[2]
 
The guidelines also state that there is also no evidence that testosterone treatment will convert subclinical prostate cancer to clinically detectable prostate cancer.[2]
 
Despite this, many men are being denied testosterone therapy because of undue fears that it would cause harm to the prostate. Here I summarize the results from a study that investigated incidence of prostate cancer with testosterone therapy for up to 17 years.[3]
 
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Adherence to testosterone therapy - short term treatment is not sufficient for achievement of maximal benefits

 

Testosterone therapy confers a wide range of health benefits for hypogonadal men, including improvements in body composition (reduction in body fat, increase in muscle mass), lipid profile cardiovascular function, insulin sensitivity/glucose metabolism, bone mineral density, inflammatory parameters, quality of life and longevity.[1] 
 
Despite this, there is a high discontinuation rate with testosterone therapy.[2, 3]
 
 
In this article I summarize results from two studies that investigated adherence to testosterone therapy and treatment patterns.[2, 3]
 
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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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