Testosterone And Heart Health

Posted by Dr. Michael White, Updated on May 4th, 2015
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Testosterone therapy has been a heated issue for years among doctors and researchers, who disagree on how much it impacts heart health in men. A recent study published in the Journal of Clinical Endocrinology & Metabolism followed nearly 800 men over a ten-year period and found that those who had lower-then-average testosterone levels were 40 percent more likely to die from heart disease than those with normal levels. Similarly, a study published in the journal Diabetes Care found that men with low levels of testosterone were four times as likely to develop diabetes compared to those with optimal testosterone levels. These studies suggest that low testosterone may play a significant role in mens increased risk of heart disease.

ThirdAge spoke with Dr. Elizabeth Lyster, a member of Holtorf Medical Group (HMG) in Philadelphia, who treats patients with complex hormonal imbalances, fatigue and low thyroid, including patients with other medical problems. Lyster holds that the majority of HMG patients have hormone levels including testosterone that are lower than average. She argues that testosterone significantly lowers the risk of heart disease, diabetes, and even death.

Q: Why do you believe testosterone is good for heart health? A: Testosterone is directly related to the quality and function of blood vessels in men, which is crucial to cardiovascular health. Vascular damage in men leads to erectile dysfunction, which is an indicator of low testosterone, and also an indicator of poor cardiovascular health. Optimal testosterone (T) levels are associated with lower mortality from all causes in men. Optimal T levels improve cardiovascular health and regulate nitric oxide receptors, which increases dilation of blood vessels similar to how Viagra works, but with fewer side effects. Q: So, it seems like youre saying that testosterone therapy can only do good and no harm. Some have said, however, that hormone therapy can be risky. Is there any potential danger to hormone replacement therapy? A: There really isnt. Unfortunately, there are a lot of myths surrounding this issue. For example, prostate cancer is considered to be a hormone-sensitive cancer, and therefore the treatment often consists of things that block testosterone. Now that might be the case once theres already established prostate cancer. However, there is a more cutting-edge way of thinking about this: As men get older and see their testosterone levels decline, this is actually what sets up their risk for prostate cancer. We dont know exactly why. Its important to detect the declining the testosterone levels as they occur. People are afraid of this, and its really a shame.

Q: Testosterone treatment is not yet a standard treatment for heart-disease patients. Do you think it should be? A: Our healthcare paradigm in the western world is to diagnose and treat illness as it comes up instead of preventative care. For men, there is no question, based on research, that having optimal testosterone levels prevents heart disease. Q: So you believe preventative testosterone therapy would be useful and save many lives as a standard form of treatment. What are chances of standard testosterone therapy occurring in the future? A: I think the tail wags the dog. People are asking for more of this type of care, but I think its coming slowly. In this society, we still want to simply take a pill to fix any problem. But many lives could be saved if preventative testosterone treatment was standard. Q: Who, then, should receive testosterone therapy? How should men figure out whether or not they would benefit from it? A: Ideally, men should be screened starting at age 25. Testosterone levels dont necessarily have to be measured right away, but men should be asked if they are regularly having spontaneous early morning erections, which usually means their T levels are normal. Generally, symptoms of low testosterone include fatigue, irritability, decreased sexual function (libido and erectile function), low mood (including depression), and cognitive dysfunction (brain fog). At any point, if a man does not feel like his normal self and is having some of these symptoms, he should have his T levels checked. Any T level below 300 should be treated.

Q: What is testosterone treatment like? A: There are lots of ways to replace testosterone. It can be administered through the skin with a gel or cream (pharmaceutical or compounded), pellet implants (such as Testopel), or injections. The injections are usually given weekly, while the pellet implants are given about every three months. Q: Weve talked a bit about the importance of testosterone for mens heart health, but lets turn to its potential for women. Testosterone is sometimes used for women who have low sex drives. What is your opinion about this? A: In general, my opinion is very favorable. Its normal for women to have a little bit of testosterone in their system, and when they have the right amount, they feel good, confident, have high sex drives, and they can build an appropriate amount of muscle when they exercise. As of now, there are no FDA approved testosterone treatments for women, which is indicative of the bias in the pharmaceutical industry. Estrogen is good for womens lipid profiles, and testosterone is not, so testosterone treatment in women has to be highly monitored. But the benefits very often outweigh the risks. Q: What are some potential side effects of testosterone therapy, for both sexes?

A: In men, side effects can include testicular shrinkage and lower semen volume, which is easily treated or can be reversed by discontinuing therapy. For women, side effects may include facial hair, acne, and hair loss in women who are prone to male-pattern balding. These effects are pretty rare, and can be reversed by stopping treatment. During therapy, estrogen and DHT levels need to be monitored by a doctor who has experience with testosterone therapy. Q: Would you ever consider prescribing testosterone therapy for yourself or your spouse, or other family members? A: I would never hesitate to have my own spouse use testosterone to feel his best, and if I needed support in the areas of libido, muscle mass or weight management, I would absolutely consider adding low-dose testosterone to my regiment for optimal wellness!

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Testosterone And Heart Health

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