When it comes to making a decision of whether or not to start using testosterone replacement, it is important you arm yourself with medical facts based on peer reviewed published literature. More and more evidence supports the safety and health benefits of using testosterone replacement to treat the symptoms of andropause (fatigue, reduced sex drive, erectile dysfunction, increased body fat, decreased lean body mass). In doing so many patients are not aware that they reduce their risks of dying from all causes by 25-50% (Journal of American Heart Association, 2013). I see hundreds of men in my practice who meet the criteria for metabolic syndrome which is consists of increased abdominal waist circumference, low HDL, high triglycerides, abnormal blood sugars and high blood pressure. Having metabolic syndrome increases a mans risk of dying two-fold, of having a heart attack or stroke three-fold and developing diabetes five fold. Testosterone replacement therapy helps reduce all components of metabolic syndrome and the most important aspect of treating these patients. I see reversal of symptoms in men with metabolic syndrome every day and would like to share my experience and the facts with you.
- Why is testosterone so effective at reducing blood sugar and risks of developing diabetes?
The simple answer is because testosterone burns fat an builds lean body mass like nothing else we have seen in medicine. The average male that I see in my practice will gain anywhere from 8-20 pounds of lean muscle and lose 6-20 pounds of body fat within the first two months of starting testosterone. This reduction in body fat and increase in lean muscle increases the patients basal metabolic rate (the number of calories their body burns each day) and increases the secretion of adiponectin from fat cells. Adiponectin plays a key role in a cells ability to respond to insulin which makes the process of regulating blood sugar more efficient. Just today, I had an 8 week follow up with a 44 year old male with type two diabetes whose HgBA1C (marker for blood sugar control over the last 3 months) went from 10.9 to 8.9 which is huge in the world of diabetic care. The only change he made was injecting 0.4ml of testosterone cypionate and propionate (160/40mg/ml) combination 2x per week. He reported an increase in energy, sex drive, strength of erections and overall well being. His body fat went from 29% to 23% in just 8 weeks which is remarkable.
2. Is having low or suboptimal testosterone harmful?
Patients often ask what the risks are of using testosterone replacement and I go through the three or four typical side effects we see in men who use testosterone. However, it is really important you understand the flip side of the coin which is the risks of having a low testosterone. There are 50 years of studies that show that men who have suboptimal testosterone have increased risk of diabetes, heart attack, stroke, cancer, dementia and osteoporosis. So there are severe consequences of NOT treating men with testosterone. In addition, I think you also have to consider the improvement in quality of life. I can not tell you how many men (and women) I treat with testosterone replacement that tell me how their quality of life has improved. I hear things like “my sex life with my wife has never been better and we are closer now we have been in years.” Or “I am now getting home from work, have energy to play with my kids and will then go and work out whereas before I came home and crashed on the couch.” Or “I am so much more focused at work and my productivity has increased exponentially.” I literally hear these stories every day and it gives me so much joy to treat men with symptoms of andropause with testosterone.
3. When should I start using testosterone replacement therapy?
The medical literature is clear that if you have any of the symptoms of andropause or metabolic syndrome that using testosterone will reduce body fat, reduce blood sugar, reduce waist circumference, improve HDL and lower blood pressure as a result. In my practice I have men a young as 30 on testosterone replacement and they do fantastic. However, each case and patient is unique and in addition to using testosterone replacement we customize nutrition, exercise and functional medicine programs to maximize results. If you are not sure if you would qualify the first step is to have all your hormone levels checked by a physician who specializes in functional medicine and integrative endocrinology.
The reality is that 20-25% of the worlds population has metabolic syndrome and a two-fold increase risk of death, three-fold increased risk of having a heart attack or stroke and a five-fold increased risk of developing diabetes. Until recently, doctors did not focus on testosterone replacement in their treatment approach to men with metabolic syndrome and pre-diabetes. However, the medical literature is clear that using testosterone improves all the parameters of metabolic syndrome in addition to improving a patients overall quality of life (increased sex drive, improved erections, weight loss, improved fitness). If you would like to be evaluated for metabolic syndrome and see if you would benefit from testosterone replacement therapy feel free to contact one of our professional patient coordinators and have your labs done today.
Dr. Sean Breen is board certified in Anti-Aging, Functional and Regenerative Medicine and has a bioidentical hormone replacement practice in Irvine, CA