Friday, December 1, 2023

The Testosterone Revolution Mens Health

How To Find Your Testosterone Level

Men’s Health: Erectile Dysfunction and Testosterone

With testosterone, as with life, normal is nuanced. And fraught . To get an accurate reading, you should have at least two tests, since testosterone is constantly in flux. It peaks in the morning, so if youre young and on a typical sleeping schedule, aim to be tested by 10:00 a.m. If youre over 50, it doesnt matter as much.

Be aware that your level can be affected by certain social factors and health habits.In the new book Testosterone: An Unauthorized Biography, scientists Rebecca M. Jordan-Young and Katrina Karkazis point out that T levels even respond to social factors like feedback. For instance, rugby players who watched video of good game plays and got positive feedback had up to a 50 percent increase in T compared with guys who were shown their mistakes and received critical assessments.

Resistance training can also give you a short-term boost in testosterone. Cardio doesnt elevate T levels as much in normal-weight men, says Jesse Mills, M.D., the director of the Mens Clinic at UCLA. But heres the thing: Jordan-Young and Karkazis dug through the research to find that T levels alone dont deserve the credit when it comes to an athletes performance. And cutting sleep short and taking multivitamins with biotin can push testosterone levels down .

Irrational or not, I felt like more of a man. The whole experience was a microcosm of our relationship with T. We act like its destiny, but its just biologyeasily misunderstood and more varied than we think.

Get Your Testosterone Level Tested

Sounds obvious, but as many as a quarter of men receiving T therapy do it blindlythat is, they start a regimen without testing whether they actually have low T. Supplementation wont help if your T levels are normal. In fact, it will turn off your own production, says Brad Anawalt, M.D., chief of medicine at the University of Washington Medical Center. The pituitary recognizes theres plenty of testosterone in the blood and stops producing hormones that stimulate the testicles to make more. To be sure, get a fasting testosterone test from your doc, preferably in the morning, when the hormones levels peak. Repeat the test at least once, with the second a day or more after the first. Two low morning readings indicate testosterone deficiency. Readings can vary from day to day and even hour to hour, and they can be lower if youre sick. So dont test when youre under the weather.

Testosterone therapy side-effect: It could turn off your own production of the hormone.

What Causes Low Testosterone Levels In Men

Testosterone levels gradually drop in men as a natural part of aging. Levels may begin to decline when men are in their thirties, and then a reduction of roughly 1 percent a year starts at age 45, according to research.

Lifestyle factors also have an impact on testosterone production, including exercising too much or not eating a healthy diet. Obesity is strongly linked to lower testosterone levels. Your doctor can order a blood test to find out if your testosterone levels are in the normal range.

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Effect Of Testosterone: It’s Easier To Build Muscle

“Muscles are extremely responsive to testosteroneone of the most reliable things we see is an increase in muscle mass,” says Dr. Morgentaler.

This is because androgen receptors are found in muscle tissue, so testosterone activates them to stimulate growth. Of course, to make the most of this benefit, youll need to be doing your part by strength training as well.

In addition to an increase in lean muscle mass, some men report fat loss as well. While testosterone doesnt directly incite fat loss itself, part of it may be thanks to the uptick in muscle massthe more muscle you have, the higher your basal metabolic rate will be, which means your body will burn more calories at rest.

Jed Kaminetsky, M.D., a clinical assistant professor in the department of urology at NYU Langone Medical Center also notes that this may be partially because testosterone improves overall motivation to get up and sweat it out, so if you’re motivated to put in the work again, you’ll see results.

Related:7 Reasons You’re Not Building As Much Muscle As You Could

The Perils Of Too Much Testosterone

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Having too much naturally-occurring testosterone is not a common problem among men. That may surprise you given what people might consider obvious evidence of testosterone excess: road rage, fighting among fathers at Little League games and sexual promiscuity.

Part of this may be due to the difficulty defining “normal” testosterone levels and “normal” behavior. Blood levels of testosterone vary dramatically over time and even during the course of a day. In addition, what may seem like a symptom of testosterone excess may actually be unrelated to this hormone.

In fact, most of what we know about abnormally high testosterone levels in men comes from athletes who use anabolic steroids, testosterone or related hormones to increase muscle mass and athletic performance.

Problems associated with abnormally high testosterone levels in men include:

  • Low sperm counts, shrinking of the testicles and impotence
  • Heart muscle damage and increased risk of heart attack
  • Prostate enlargement with difficulty urinating
  • Liver disease
  • Fluid retention with swelling of the legs and feet
  • Weight gain, perhaps related in part to increased appetite
  • High blood pressure and cholesterol
  • Insomnia
  • Increased risk of blood clots
  • Stunted growth in adolescents
  • Uncharacteristically aggressive behavior
  • Mood swings, euphoria, irritability, impaired judgment, delusions

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Prostate Health And Cancer

For a long time, it was believed that higher testosterone concentrations increased the risk of prostate cancer or caused rapid cancer growth, while low testosterone concentrations would have a protective outcome. PSA is often used as a marker of prostate health, and several studies have investigated this association and at how TRT affects PSA. Most of these studies found that increased testosterone even over the long term does not affect PSA or its effect to be negligible .

A prostate saturation hypothesis by Morgentaler and Traish may explain these results, that when androgen receptors on the prostate become saturated, the prostate becomes insensitive to further serum testosterone increases, such as with TRT. A placebo-controlled trial study by Marks et al. found an increase in serum testosterone and dihydrotestosterone when men were on IM TRT for 6 months however, when biopsied before and after TRT, there was no change in androgen levels within the prostate tissue. PSA is not the perfect marker for prostate cancer so, several studies have tried to clarify if TRT increases the occurrence of prostate cancer. A plethora studies have not demonstrated testosterone concentrations to be higher in men with prostate cancer compared to those without cancer. Moreover, reports have shown that hypogonadal men with normal PSA levels do not have lower cancer rates than the general healthy population .

Mens Health Month And Driving Research

Mens Health Awareness Month is rooted in a long history of healthcare avoidance more common in males. Men are less likely to adopt preventative health measures and are more likely to engage in risky behaviors and go longer periods between check-ups. These are a few examples of factors contributing to shorter average life spans of males and being more prone to develop conditions like heart disease and cancer.

Mens health is a family issue. By taking steps towards better health, you become an example for future generations engrained in healthier living. Get involved today through the many awareness activities taking place this month, and start your own health journey by:

  • Eating healthier
  • Exercise regularly
  • See your doctor for a check-up

If you have Low T, upcoming research studies here at Clinical Pharmacology of Miami may be an option. Volunteering in clinical trials is a great way to celebrate Mens Health Awareness Month. Participation allows you to learn more about your condition to prioritize your health better while you help advance medicine for future generations. To learn more, call us at 817-2900, or visit our website.

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Testosterone Treatment & Coronary Artery Plaque Volume In Older Men With Low Testosterone

This is an interesting study suggesting that testosterone increases non-calcified plaque. While this study does demonstrate some truth to this statement, there appear to be multiple confounding issues.

Objective: They wanted to see if giving testosterone slows the development or progression of non-calcified coronary artery plaque.

Design, setting, and participants: Double-blinded, placebo-controlled trial at 9 academic medical centers in the United States. The participants were 170 of 788 men aged 65 years or older with an average of 2 serum testosterone levels lower than 275 ng/dL and symptoms suggestive of hypogonadism who were enrolled in the Testosterone Trials between June 24, 2010, and June 9, 2014.

Intervention: Testosterone gel vs placebo for 12 months. Testosterone dose was adjusted to maintain the testosterone level in the normal range for young men

Main outcomes and measures: Noncalcified coronary artery plaque volume, as determined by Coronary CT angiography was the primary outcome. Coronary Artery Calcium Score and Total Coronary Artery Plaque Volume were both secondary outcomes.

Results: 138 completed the study and were available for the primary analysis. At baseline, 70 men had a coronary artery calcification score higher than 300 Agatston units, reflecting severe atherosclerosis.

Primary outcome: There was a significantly greater increase in noncalcified plaque volume from baseline to 12 months in the testosterone group compared to the placebo group .

Things Your Doctor Wants You To Know About Testosterone

Mayo Clinic Minute: How low testosterone can affect men’s health

From the best time of day to work out to what replacement therapy actually means.

Testosteroneyou know it, you love it, you cant get enough of it. It helps you set PRs, keeps muscle on your body, and makes you more virile. At least thats mostly true. Its also true that testosterone, especially low testosterone, is misunderstood.

So we asked an expert for clarity. Dr. Faysal Yafi, M.D., F.R.C.S.C., the Director of Men’s Health and Newport Urology and Chief, Division of Mens Health and Reconstructive Urology at the University of California, Irvine chatted with us about what testosterone is, how to make the most of it, and what to do as we start to ageand it starts to dip. Here are four key takeaways.

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The Truth About Testosterone

Do they really raise your T?

You see the ads everywhere, from Facebook to the online version of your local newspaper. They promise huge increases in testosterone by simply taking an over-the-counter supplement. But do these supplements really work to combat low testosterone, or are they all hype? Men’s Health Nutrition adviser Mike Roussell, Ph.D. gives you the facts, based on his review of all the published scientific research. Watch the video to see what he discovered.

To find out more about what supplements you should take, check out our guide to the Best Multivitamins for Men.

Effect Of Testosterone: Your Energy Levels Can Soar

“It’s very common for men to come in with low T and one of their primary symptoms is fatigue,” says Dr. Morgentaler. “And when we treat them, a lot of men will say that their energy has improved.” Many men also report an improvement in the “brain fog” that can come along with low testosterone, adds Dr. Tamler.

While researchers aren’t exactly sure how exactly testosterone plays a role in energy yet, Dr. Morgentaler says one of the thoughts is that it has an effect on your mitochondria, which produce energy within cells. This case isnt closed on this yet, but the theory is that “testosterone turns them on so they’re more productive in terms of creating the energy that the cells need.”

Dr. Tamler also notes that it may be tied back to androgen receptors as well. “If they don’t get sufficient input, that can cause fatigue,” he says. So bringing testosterone levels back up can help reverse this.

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Everything You Need To Know About Trt

Its commonly accepted that as you grow older, Father Time forces you to slow down and lose strength as body fat collects around your midriff, and you begin to morph into the stereotypical male whos past his prime and has seen better days. Worse, your thinking can become cloudy and your memory may develop gaps as you begin the steady slide of cognitive decline.

Adding to this misery, the aches and pains of rising inflammation start to become more common. The dynamism of your physical prime starts to fade. Eventually, old injuries take center stage as the pain begins to grow. The slow creep of time begins to overtake your body as it seems to betray you. As time marches on, you feel as if you are becoming a shell of the man you once were.

This is a terrifying reality as your sense of physical power gives way to a meeker existence. However, medical science has a way to get at the heart of these symptoms and give men a new lease on life.

Specific Signs And Symptoms Of Low Testosterone

Vigorous Extend

Symptoms for low T vary depending on the cause of the problem and the age when it begins to happen. In younger males, signs may include:

  • Underdeveloped genitalia
  • Lack of secondary sexual characteristics, like a deeper voice and facial hair

In men who are middle-aged or older, symptoms may include:

  • Low energy
  • Inability to get or maintain an erection
  • Low sperm count
  • Loss of muscle and bone strength
  • Fertility problems

Not all men with age-related low testosterone have symptoms or are bothered by them, and the seriousness of the complications can vary widely. Symptoms like fatigue, sleep problems, and depression can also be caused by other factors, such as side effects from medication, mental health issues, and excessive alcohol use.

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Testosterone Replacement Therapy Isnt Steroids

Steroids are illegal to use without a prescription, so a lot of guys associate testosterone replacement therapy with those iconic locker room injections. But theyre not the same thing.

Testosterone replacement means increasing testosterone from low to normal levels, says Dr. Yafi, as you would for people who have low thyroid hormone, or diabetics who have low insulinbring them to normal levels.

In anabolic steroid abuse, people with normal testosterone levels supplement with steroids and bring their testosterone over the top. But if youve got low testosterone, then replacement therapy may actually improve your quality of life, says Dr. Yafi. And a bonus? Testosterone replacement therapy, when done in a clinical, appropriate way is extremely safe.

What Is Normal Testosterone By Age

Testosterone levels are measured through blood tests, and in the UK, measured in nanomoles per litre . For men, a “normal” adult reading falls anywhere upwards of 0.30 nmol/l, with the optimal range above 0.45 nmol/l.

From the age of 30 onwards, your T-levels start to decline at a rate of 1% each year. “Most men still maintain a normal level of testosterone throughout their lives, experience no symptoms, and this is why you see men who can father children well into their eighties,” says Dr Luke Pratsides, lead GP at Numan.

“However, for some men, their testosterone may drop below the lower limit or around the lower limit of the range,” he continues. “This is when they can start experiencing symptoms like diminished sex drive, erectile dysfunction, subfertility, low stamina, muscle atrophy, decreased energy and lower mood.”

The Molecule Of Masculinity

In its molecular form, testosterone is the hormone that forms the foundation of masculinity.

At your physical peak , your testosterone is at its highest level of as much as 1,200 ng/dl . At the age of 35, your testosterone levels begin to drop at a rate of 1% a year.

Also, environmental factors such as exposure to plastics, toxins in the environment, and water pollution can interfere with testosterone production. Anyone with levels of around 350 ng/dl or lower can begin to experience symptoms of low testosterone.

Symptoms of low testosterone can include:

  • Displaying unjustified irritability
  • Have trouble focusing or problem-solving
  • Lack of resilience to stress
  • Difficulty sleeping regular insomnia
  • Lack of energy feeling tired all the time

Making matters worse, these symptoms can go unnoticed as they develop over time. The slow and steady rise of these symptoms can sneak under your radar causing you to settle for a lower quality of life.

But there is a solution for you to consider.

Cancel Out Other Causes

Low Testosterone – Health Matters

If your levels are a little low, dont just blame it on your age. Lately, some doctors have begun to question the idea that testosterone starts dipping by about 1 percent a year around age 35. If that were true, it should happen in all men, and it doesnt, says Ranjith Ramasamy, M.D., director of male reproductive medicine and surgery at the University of Miami Miller School of Medicine. A healthy, fit 40-year-old will have testosterone levels like a 20-year-olds.

More From Men’s Health

Poor health is more likely to cause low T than the other way around. If your levels are right around 300 ng/dL, which is on the cusp of being low, and you have symptoms, look first at other conditions, Dr. Anawalt says. Medications like opioids lower testosterone. So does a condition called male hypogonadism, in which problems with the testicles or the pituitary glandor bothprevent your body from producing enough T. Far more common than either of these: extra pounds. If youre overweight and lose 7 percent of your body weight, testosterone could increase 10 to 15 percent, which would put you squarely in the normal range, Dr. Anawalt says.

If you lose 7 percent of your body weight, your testosterone could climb into the normal range.

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