TUESDAY, Sept. 24 (HealthDay News) — Men with low testosterone may have a slightly increased risk of developing or dying from heart disease, according to a new review.
Researchers analyzed studies that looked at testosterone levels and cardiovascular disease and were published between 1970 and 2013. Testosterone is a male sex hormone involved in sex drive, sperm production and bone health. Over time, low testosterone may contribute to an increase in body fat and a loss of muscle bulk and body hair.
The review, which will be published in the Journal of Clinical Endocrinology & Metabolism, showed increasing evidence suggesting a connection between low testosterone levels and heart disease.
The review, however, did not establish a cause-and-effect relationship between low testosterone in men and heart disease risk.
Among other findings were the following:
“When we reviewed the existing research into testosterone and cardiovascular disease, a growing body of evidence suggested a modest connection between the two,” study lead author Dr. Johannes Ruige, of Ghent University Hospital in Belgium, said in a journal news release. “A specific [disease process] did not come forward, but perhaps less frequently investigated events may play a role, such as thrombosis, where a blood clot develops in the circulatory system, or arrhythmia, where there is a problem with the heart beat or rate.”
“Based on current findings, though, we cannot rule out that low testosterone and heart disease both result from poor overall health,” he added.
Additional research is needed to confirm the relationship between the two conditions.
“Gaps still remain in our understanding of low testosterone and cardiovascular disease,” Ruige said. “Ultimately, the goal is to more accurately assess the impact testosterone substitution therapy may have on the heart health of men who qualify for the treatment.”
Ruige said a growing number of older and middle-aged men are being prescribed testosterone-replacement therapy, but there is debate about whether the practice is too widespread.
The Urology Care Foundation has more about low testosterone.
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Hypogonadal men receiving testosterone therapy may experience significant and sustained weight loss, researchers reported online in Clinical Obesity.
In a study, men lost an average of 10.5% of their baseline body weight after five years of treatment. Over the same period, their mean body mass index (BMI) fell from 31.6 to 29.4 kg/m2.
The study involved 261 men with a mean age of 59.5 years who presented to a single urologist complaining of erectile dysfunction. They also had a range of common comorbidities, including benign prostatic hyperplasia/lower urinary tract symptoms (57%), hypertension (45%), dyslipidemia (33%), and type 2 diabetes (31%).
All subjects received parenteral testosterone undecanoate 1,000 mg at baseline, again six weeks later, and then every 12 weeks for up to five years.
The two investigators, Aksam Yassin, MD, of the Segeberger Kliniken, Norderstedt, Germany, and Gheorghe Doros, PhD, of the Boston University School of Public Health, found that the men’s average testosterone levels rose from 7.72 nmol/L at baseline to 16.2 nmol/L within the first year of therapy, and plateaued at 18-19 nmol/L
At the start of treatment, 162 men (62%) had a BMI of 30 kg/m2 or higher and 88 (34%) had a BMI of 25-25.9 kg/m2. In addition, 179 (69%) had a waist circumference (WC) greater than 102 cm and 74 (28%) had a WC of 94-101.9 cm.
The men experienced a mean weight loss of 11.1 kg or 10.5% of their initial weight, and the loss occurred linearly over five years. Results showed that 14% of patients lost 20 kg more, 31% lost 15 kg or more, 51% lost 10 kg or more, and 80% lost 5 kg or more. Four percent gained weight.
Concomitantly, WC declined in 97.5% of men. The mean reduction was 9.4 cm and occurred in a linear fashion during the study period. In addition, 84% had a WC decrease of 5 cm or more, 48% had at least a 10 cm drop, and 15% had at least a 15 cm reduction. WC increased in 2% of the men.
Furthermore, subjects’ mean BMI dropped from 31.7 kg/m2 at baseline to 30.6 kg/m2 after one year, 29.9 kg/m2 at two years, 29.5 kg/m2 at three years, and 29.4 kg/m2 at both four and five years.
The men who were obese at the start of the study period experienced the greatest reductions in body weight, waist circumference and BMI.
“We may have found at least a partial solution for obese hypogonadal men,” said Farid Saad, MD, of Global Medical Affairs-Andrology at Bayer Pharma, Berlin, which funded the study. “While one would usually prefer a controlled study, here we have very robust data in an unselected group of patients who did not even have the intention to lose weight.”
People are always searching for ways to make themselves look and feel rejuvenated. Low testosterone treatment may be the newest thing in male vitality. Physicians all across the country are starting to implement options liketestosterone replacement therapy (TRT) for men with “low-t.”
Testosterone replacement therapy isn’t a recent practice. The first recorded discovery was in 1849 by Arnold Berthauld, according to the Urological Sciences Research Foundation. Berthauld concluded that when roosters were castrated, they stopped fighting the other animals and their comb fell back. When their testes were replanted, they reverted back to their normal behavior.
“The testes act upon the blood, and the blood acts upon the whole organism,” he famously said.
Commonly known as the male sex hormone, testosterone is secreted by the testicles, which are responsible for the development of the male sex organs in childhood and sperm in adulthood. A decrease in the production of testosterone could lead to failure of the testicles, decrease in libido, changes in sleep patterns, and physical or emotional changes.
Prescribing Testosterone to Men with Low T Levels
In 1988, Dr. Abraham Morgentaler started prescribing testosterone to men with low levels of the hormone.
“There was only a small cadre of about a dozen physicians around the country who were interested in treating men for what came to be known as ‘andropause,’ or ‘male menopause.’ As a urologist, I was particularly concerned that testosterone treatment would cause rapid growth of undetected prostate cancers,” he told Medical Daily.
Dr. Morgentaler, a urologist at Harvard Medical School, the founder of Men’s Health Boston, and author of Why Men Fake It: The Totally Unexpected Truth About Men and Sex, believes that while TRT might not be the elixir to solve every male issue, it does help with many symptoms, such as decreased sexual performance and mood.
Hypogonadism, or low serum testosterone, affects around 39 percent of men over the age of 45. As men get older, their natural levels of testosterone decrease. According to the American Urological Foundation, the incidence of low testosterone increases from about 20 percent of men over 60, to 30 percent of men over 70, and 50 percent of men over the age of 80.
According to the American Diabetes Association, 70 percent of men with lowtestosterone reported cases of erectile dysfunction and a low sex drive. “They also cite that low testosterone is a common condition that often goes undiagnosed because itssymptoms are similar to other conditions. If you have type 2 diabetes, you are twice as likely to suffer from low testosterone as a man without diabetes.”
Benefits of Testosterone Replacement Therapy (TRT)
Dr. Ted Mimlitz, CEO and Co-founder of Men’s’ Medical Institute as well as the Medical Director of Maternity Services at DePaul University, believes thattestosterone replacement therapy (TRT) should be a more widely practiced lowtestosterone treatment option for men.
“Testosterone replacement therapy should be more widely practiced because it works,” Dr. Mimlitz told Medical Daily. “Once a man hits the age of 30, his testosteronelevels begin to decrease each year by one or two percent.”
Many of his patients have seen an increase in their energy, mood and concentration. “Increasing a man’s testosterone levels has been shown to prevent heart disease, hypertension, osteoporosis and mortal diabetes,” said Dr Mimlitz.
Most men aren’t aware of their declining testosterone because it happens slowly over many years.
The simple blood test to determine your testosterone can be done by your primary care doctor or an endocrinologist. Normal results vary. Factors such as age and other health related issues come into play, but on average the levels should be around 300-1000.
Increasing TRT Availability for Men with Low T
Dr. Gino Tutera, founder and creator of SottoPelle Hormone Pellet Replacement Therapy in Arizona, believes that many patients are led to believe that their decreased libido, increased weight gain, and constant tiredness are simply a result of old age.
“By utilizing testosterone hormone replacement therapy, the aging process is significantly altered by minimizing weight gain and providing an increase in energy and libido,” Dr. Tutera told Medical Daily.
Now, many medical centers across the country are opening up with the intent of helping men regain some of their vitality with TRT. Dr Tutera’s clinic offers hormone pellet therapy, which he says provides a steady dosage of natural hormones straight into the blood stream.
Dr. Ken G. Knott of Youth Enhancement Systems also has a clinic specializing in natural hormone therapy in Atlanta, GA. He believes that a big part of the reason why other physicians aren’t prescribing low testosterone treatment options for men, like TRT, is because “there is a fundamental lack of training on testing for testosterone,testosterone replacement therapy — doctors are not properly trained in medical school concerning testosterone,” Dr Knott told Medical Daily.
The common misconception is that many doctors fear that a TRT regimen will lead to an increase in prostate cancer, congestive heart failure and other illness. Those are “false claims,” said Dr. Knott.
“My patients have found that hormone pellet therapy leads to enhancement of libido plus an increased sexual drive; increase in lean body mass and a decrease in body fat; increase in muscle weight, size and strength,” added Dr. Tutera.
“They become more productive at work, more engaged and attentive at home, and more active socially. Simply put, they are acting 15-20 years younger,” said Dr. Mimlitz.
Hayes, FJ. Testosterone-Fountain of Youth or Drug of Abuse?. The Journal of Clinical Endocrinology & Metabolism. 2000.
Topiwala S. Testosterone. MedlinePlus. 2012.