Busting the Myths About Testosterone Replacement Therapy

Not so shockingly, Men are less likely than women to visit a healthcare provider when they’re not feeling 100%. And often they wait until a medical issue has become serious before they do anything about it. Some of this tendency may be because men are less likely to ask for help in general (hence their often-joked-about difficulty with asking for directions). And some of it may be because, like most adults of working age these days, men often feel that they’re too busy to look out for number 1.

When it comes to hormonal issues, we have come across a whole new reason why men sometimes hesitate to get the help they need – misinformation about negative side effects of hormone replacement therapy. With the rise in chronic conditions and disease, we at YM strongly believe that men need to be more proactive about their health. This November for Men’s Health Month, we’re going to help you put any fears you have about T Therapy to rest.

This information doesn’t replace the need to see your doctor – in fact, we hope that it will encourage more men to take their health seriously and visit their healthcare practitioners.

Low Testosterone Is One Of The Most Common Health Concerns For Men

Many signs of “low T” develop slowly over time. As a result, men often ascribe their symptoms to simply growing older. However, a reduction in testosterone levels doesn’t have to be a normal consequence of aging. Although your hormone levels do begin to drop as early as your 30’s for a variety of reasons, there are a number of steps you can take to help protect them.

What Are The Symptoms Of Low Testosterone?

How can you tell if you have low testosterone levels? Only your healthcare practitioner can make a definitive diagnosis, but the following signs could indicate it’s time to schedule an appointment.

Lagging libido
Unexplained fatigue
Depression
Irritability
Increased body fat
Male breast tissue growth
Loss of muscle tone

Natural Ways To Protect Your Testosterone Levels

1. Sleep

Missing a few hours can quickly cause your levels of testosterone to drop. Try to maintain a consistent sleep schedule, and practise good “sleep hygiene” by ensuring your bedroom is dark and switching off any electronics for one hour before bedtime.

2. Exercise

Working out is one of the more direct ways to give your testosterone levels a boost- there’s a reason many men feel “pumped up” after a workout. Weights are the most effective activity for raising testosterone levels, and recent studies found high-intensity interval training HIIT workouts productive in this regard.

3. Eat a balanced diet

Include plenty of good quality protein, unrefined carbohydrates, and healthy fats.

4. Keep stress levels in check.

When you’re stressed, your levels of the hormone cortisol rise. And when cortisol rises, testosterone drops. So avoid chronic, long-term stress. And if you’re feeling overwhelmed, schedule some mini-breaks for yourself. Calling a time out on a hectic schedule to meditate or simply go for a short walk can pay off in the long run.

5. Watch your vitamin D levels

Spending time in the sun, or taking vitamin D supplements during the winter, can give your body a key component needed to raise your testosterone levels if they are low.

6. Avoid estrogen-mimicking materials

Many compounds found in daily life can affect your hormones because they mimic estrogen in your body. In particular, avoid materials made with BPA, parabens, and phthalates. That means not using things like plastic water bottles, air fresheners, and scented grooming products.

Consider Bioidentical Testosterone Replacement Therapy (TRT)

If you are experiencing the uncomfortable symptoms listed above, consider coming in to discuss whether TRT is the right choice for you. When you meet with us, we’ll take a blood sample and analyze it to determine what your hormonal baseline should be, what you’re lacking, and the best way to move forward. Then we will design a personalized health regimen that’s all about increased energy, mood, and looking and feeling younger, healthier and optimal.

Wait – Should You Be Concerned About Bioidentical Testosterone Replacement Therapy?

If you have been reading mixed information about TRT, you’re not alone. That’s why in October 2015, a group of respected experts in endocrinology, diabetology, internal medicine and science research from around the world, including Harvard Medical School and Johns Hopkins University School of Medicine, got together to discuss Testosterone Deficiency.

All of the experts volunteered their time as they debated the top considerations and treatment issues surrounding Testosterone Replacement Therapy based on the best available scientific evidence, and drafted the following resolutions.

Expert Resolutions On Low T Following The 2015 Conference

Low testosterone should be taken seriously
Low T symptoms benefit from treatment
Testosterone Deficiency is a global public health concern
Testosterone replacement is an evidence-based therapy
Even mild cases can benefit
Men of any age can benefit
T Therapy does not increase heart risk
T Therapy does not increase Prostate Cancer risk
T Therapy shows promise in certain chronic conditions such as Diabetes

Now, I know that for many of the men who are hesitant to come in and discuss testing and treatment for low testosterone, there are a couple of issues they are most concerned about. So let’s dig a little deeper into two key areas: Does TRT actually affect your risk of heart disease or prostate issues?

The History OF The T Therapy Controversy

Testosterone Therapy has been in use since the 1940s, however, until the turn of the century, it was exclusively prescribed for men with severe testosterone insufficiency such as after treatment for pituitary cancer. The primary concern in the early days was that it may be associated with an increased risk of prostate cancer.

The Rise of T Supplements In Sports

In the past 20 years, the use of Testosterone supplements has grown and it has become controversially associated with illicit athletic performance enhancement and its use as an anabolic steroid in bodybuilding.

The Media Effect

Negative media stories peaked in 2013 when a retrospective study was published in a top medical journal reporting increased cardiovascular risks. A second retrospective data analysis in 2014 reported an increase in nonfatal myocardial infarction (heart attack) rates following a T prescription compared with the rate before the prescription.

Following the negative press, Health Canada and the FDA added warnings to T products in 2014 stating that there was a risk of cardiovascular issues. The FDA also limited the prescription of Testosterone products to men with identified underlying Testosterone issues, and rejected the concept of age-related testosterone decline. In contrast, the European Medicines Agency (EMA) reviewed the same evidence but decided not to add any warnings to T products in Europe.

Studies Lose Credibility

While the damage had already been done to the reputation of TRT, subsequent analysis showed that neither of the 2013/14 studies provided credible evidence of an increased risk to the heart.

The first study underwent 2 official corrections: one for misreporting its results, which actually showed an approximately 50% lower rate of adverse cardiovascular events in men who received a T prescription compared with untreated men, and the second for large data errors, including that nearly 10% of its all-male database was comprised of women.

The second study had no control group, so it is unknown whether cardiovascular events (nonfatal heart attacks in that study) differed between treated and untreated men with testosterone deficiency.

Does Bioidentical TRT Cause Heart issues?

Looking at the origins of this question, we know that two observational studies received intense media attention after reporting increased cardiovascular risks, however both studies had major flaws. One misreported results, the other had no control group. The 2015 conference highlighted the following facts:

Subsequent research tells us that low testosterone levels are associated with increased atherosclerosis, coronary artery disease, obesity, diabetes, and mortality.
Several randomized controlled studies in men with known heart disease (angina, heart failure) showed better blood flow and exercise capacity in those supplemented with testosterone versus the placebo group.
The largest meta-analysis showed no increased risk with T therapy, in fact, reduced risk was noted in men with metabolic conditions such as diabetes.
There is no evidence of an increased risk of blood clots (aka thrombosis, including an increased risk of stroke) with T therapy.

Does Bioidentical Testosterone Replacement Therapy Cause Prostate Cancer?

Medically, the greatest concern for the first 70 years of TRT was the fear that it may cause prostate cancer. The 2015 conference addressed this concern and these were their findings:

Upon reviewing all available evidence they found that the evidence does not support the theory that T therapy is associated with an increased risk of prostate cancer.
Androgen (male hormone) levels in the general (non-supplemented) public are not associated with any increased risk of prostate cancer nor aggressive disease.
Study participants taking Testosterone therapy had no greater risk of prostate cancer than the placebo groups
Aggressive/high-grade prostate cancer is in fact associated with low serum testosterone levels.
Early data suggests that there is no increased risk of recurrence or progression of prostate cancer in men who have been previously treated for prostate cancer when taking TRT.

If you’d like to learn more about TRT in order to determine if it’s a good choice for you, give us a call to book your free consultation at one of our three Florida clinic locations in Ocala, The Villages (Fruitland Park) and Daytona. The exciting advances in health optimization and regenerative medicine make BHRT an excellent option for many people dealing with the effects of changing hormones.

Come in and get optimized!

Larry Siegel, NP – YM

Larry Siegel is an ARNP and certified SottoPelle practitioner who offers his services at several clinics in the greater Ocala, Daytona Beach, and Villages area of Florida. He founded YM in 2016 in order to create a clinic that offered only the highest quality of ongoing care and anti-aging therapies (including bioidentical hormone replacement, and more) outside the rigid standards of traditional medicine.

References

Fundamental Concepts Regarding Testosterone Deficiency and Treatment: International Expert Consensus Resolutions – https://www.ncbi.nlm.nih.gov/pubmed/27313122

Baillargeon J, Urban RJ, Ottenbacher KJ, Pierson KS, Goodwin JS. Trends in androgen prescribing in the United States, 2001 to 2011 [published correction appears in JAMA Intern Med. 2013;173(15):1477]. JAMA Intern Med. 2013; 173(15):1465-1466.

Morgentaler A, Miner MM, Caliber M, Guay AT, Khera M, Traish AM. Testosterone therapy and cardiovascular risk: advances and controversies. Mayo Clin Proc. 2015;90(2): 224-251.