Ageless Forever Anti-Aging News Blog

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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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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Testosterone, Mortality and Longevity

Population studies show that men with low or low-normal testosterone levels are at an increased risk of mortality compared to those with higher levels, and that cardiovascular disease accounts for the greater proportion of deaths in men with low testosterone.[1] 
 
Here I summarize a medical review paper which addressed the following two questions: [1]
 
1.  Is testosterone deficiency directly involved in the pathogenesis of these conditions or is it merely a biomarker of ill health and the severity of underlying disease processes?
 
2.  Does testosterone replacement therapy retard disease progression and ultimately enhance the clinical prognosis and survival?
 
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Testosterone Therapy and Cardiovascular Risk - Advances and Controversies

One of the most debated issues related to testosterone therapy is its effects on cardiovascular risk and clinical events, like for example heart attack.
 
January 27th, 2015 a comprehensive medical review paper was published, addressing the controversial topic of testosterone therapy and cardiovascular risk.[65] It was written by the Androgen Study Group academicians and published in Mayo Clinic Proceedings.
 
Here I summarizes key conclusions from this milestone medical review.
 
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Health Consequences of Subclinical Testosterone Deficiency - riskier than previously thought

 
In discussions about diagnosis and health consequences of hypogonadism, aka testosterone deficiency, the prime focus is given to testosterone levels and signs/symptoms.[1-3] However, emerging research has identified a less clinically evident gonadal dysfunction called “subclinical” hypogonadism (or “compensated” hypogonadism).[4, 5]
 
Subclinical hypogonadism is characterized by normal testosterone levels in the presence of elevated LH level. As testosterone levels are not markedly reduced in subclinical hypogonadism, intuitively one may think it does not confer negative health consequences.
 
However, a recent study by Corona et al., which specifically was conducted to investigate the potential health ramifications of subclinical hypogonadism, shows that it should not be neglected. Surprisingly, subclinical hypogonadism is associated with an almost 10-fold increased risk of cardiovascular mortality, which is comparable to that for overt hypogonadism! [6]
 
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Video Summary of Testosterone Replacement Therapy and Cardiovascular Risk

One of the most controversial and debated issue related to testosterone replacement therapy is its effects on cardiovascular risk and related clinical outcomes.
 
In the February 2015 issue of Mayo Clinic Proceedings a comprehensive medical review paper, written by Dr. Abraham Morgentaler and his coauthors of the Androgen Study Group – www.AndrogenStudyGroup.org - was published.[1]
 
The aim of the review was to analyze all available studies on testosterone replacement therapy and cardiovascular effects, and to clarify the grossly misleading conclusions from two recent studies that caused a tremendous media scare.
 
In this 8 minute video, Dr. Morgentaler presents the key results from this comprehensive analysis…
 
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Testosterone Treatment and Hormonophobia – Cardiovascular risk, the Media, and the Authorities

 
One of the most controversial and debated issue related to testosterone replacement therapy is its effects on cardiovascular risk and related clinical outcomes.
 
In this video presentation, Dr. Morgentaler clarifies misperceptions of testosterone replacement therapy and cardiovascular disease risk, which have created unwarranted concerns and distorted public discussion of testosterone replacement therapy as a medical treatment.
 
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Risk of Blood Clots in Men Receiving Testosterone Therapy?

Venous thromboembolism is a blood clot that forms in a vein deep inside a part of the body; it mainly affects the large veins in the lower leg and thigh. 
 
Blood clot formation (venous thromboembolism) has been suggested to be one main risk with testosterone replacement therapy. In 2014, both the US Food and Drug Administration (FDA) [1] and Health Canada [2] implemented a requirement for manufacturers to add a warning about the potential risks of venous thromboembolism and deep vein thrombosis to the label of all testosterone products.
 
However, until recently there were no comparative studies examining an association between testosterone replacement therapy and venous thromboembolism. Here we report the results of a recent case-control study - published July 20th 2015 - that specifically examined the risk of venous thromboembolism associated with testosterone therapy in middle-aged and older men.[3]
 
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Long-term testosterone treatment with different testosterone preparations - provocative results on diagnosis and adherence

Due to lack of consistent clear-cut guidelines for diagnosis and treatment of testosterone deficiency, there is a lot of confusion among both health professionals and suffering men. The multiple different testosterone preparations available further add to the complexity of testosterone treatment.

This article presents the intriguing results from a notable study that analyzed effects of testosterone therapy with seven different testosterone preparations in symptomatic men who had previously been denied treatment because of “normal” baseline testosterone levels.[1]
 
The results are quite provocative and highlight several important practical issues relating to diagnosis and treatment of hypogonadism…
 
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Dr. Pierce's Medical Organization Affiliations

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