Prostate hyperplasia (BPH), or simply an enlarged prostate, is a serious problem among men, especially those over age 60. As I’ve pointed out, high testosterone levels are not a precursor to an enlarged prostate or cancer; rather, excessive DHT and estrogen levels formed as metabolites of testosterone are. Conventional medicine uses two classes of drugs to treat BPH, each having a number of serious side effects. These are:
When you're under a lot of stress, your body releases high levels of the stress hormone cortisol. This hormone actually blocks the effects of testosterone,6 presumably because, from a biological standpoint, testosterone-associated behaviors (mating, competing, aggression) may have lowered your chances of survival in an emergency (hence, the "fight or flight" response is dominant, courtesy of cortisol).
My favorite overall tool to manage stress is EFT (Emotional Freedom Technique), which is like acupuncture without the needles. It's a handy, free tool for unloading emotional baggage quickly and painlessly, and so easy that even children can learn it. Other common stress-reduction tools with a high success rate include prayer, meditation, laughter and yoga, for example. Learning relaxation skills, such as deep breathing and positive visualization, which is the "language" of the subconscious.
A: Testosterone products can improve a male's muscle strength and create a more lean body mass. Typically, these effects are not noticed within the first two weeks of therapy, but it is possible that he is more sensitive and responds well to the therapy. Some of the other more common side effects of testosterone patches are headache, depression, rash, changes in libido, acne, male pattern baldness, and increased cholesterol levels. This is not a complete list of the side effects associated with testosterone patches. Megan Uehara, PharmD
My question is in two parts, I am looking for energy and some muscle build but only do push ups and sit ups so not looking for massive results. I am diabetic and I am wanting to get a testosterone booster to have more energy for daily use not so much for help in the bedroom but I would not mind if it helps out. Would I be able to take it not just for a certain product but any testosterone booster? The other question is does it help with any form of muscle growth, again not anything big but some? I would appreciate any advice or information you can give me.
Every ingredient can be harmful when taken in significant quantities (we go more into that below), so we pored over each booster’s ingredient list to make sure that they weren’t serving up an overdose. In particular, we took a close look at magnesium and zinc, which have enough scientific background behind them to offer hard upper limits on how much you can safely consume.
Smith and colleagues (2005) undertook a prospective study on the contribution of stress to coronary heart disease. Their study, which involved 2512 men aged 45 to 59 years, looked at a number of metabolic parameters. They found that an increased cortisol to testosterone ratio was associated with a high risk of coronary artery disease and that this risk was mediated by components of the insulin resistance syndrome. They reported that high cortisol and low testosterone levels are associated with a worsening of insulin resistance and that there is evidence to support the possibility of improving this pattern by treatment with testosterone.
If a man's testosterone looks below the normal range, there is a good chance he could end up on hormone supplements—often indefinitely. "There is a bit of a testosterone trap," Dr. Pallais says. "Men get started on testosterone replacement and they feel better, but then it's hard to come off of it. On treatment, the body stops making testosterone. Men can often feel a big difference when they stop therapy because their body's testosterone production has not yet recovered."
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During the month before my experiment, I was definitely sleep deprived. Some nights I was only getting 4 to 5 hours. Testosterone killer! During my experiment I tried to get 8 to 9 hours of sleep at night as consistently as possible. I had to go to bed earlier, but I was only cutting into time that I would have been using to mindlessly surf the net anyway.
Transdermal preparations of testosterone utilize the fact that the skin readily absorbs steroid hormones. Initial transdermal preparations took the form of scrotal patches with testosterone loaded on to a membranous patch. Absorption from the scrotal skin was particularly good and physiological levels of testosterone with diurnal variation were reliably attained. The scrotal patches are now rarely used because they require regular shaving or clipping of scrotal hair and because they produce rather high levels of dihydrotestosterone compared to testosterone (Behre et al 1999). Subsequently, non-scrotal patches were developed but the absorptive capacity of non-scrotal skin is much lower, so these patches contain additional chemicals which enhance absorption. The non-scrotal skin patches produce physiological testosterone levels without supraphysiological dihydrotestosterone levels. Unfortunately, the patches produce a high rate of local skin reactions often leading to discontinuation (Parker and Armitage 1999). In the last few years, transdermal testosterone gel preparations have become available. These require daily application by patients and produce steady state physiological testosterone levels within a few days in most patients (Swerdloff et al 2000; Steidle et al 2003). The advantages compared with testosterone patches include invisibility, reduced skin irritation and the ability to adjust dosage, but concerns about transfer to women and children on close skin contact necessitate showering after application or coverage with clothes.
Testosterone insufficiency has been associated with HIV infection in men (Dobs et al 1988). Early reports suggested that testosterone therapy may have an ameliorating effect on both depression and decreased energy in HIV infected men, even if testosterone levels were not reduced (Rabkin et al 1999; Grinspoon et al 2000; Rabkin et al 2000). Both depression and fatigue, however, are common features of HIV-positive men and may be associated with factors other than reduced levels of testosterone. The disease itself may induce depression and fatigue may be a consequence of the disease, per se, or of some of the medications used to control HIV.
In 1927, the University of Chicago's Professor of Physiologic Chemistry, Fred C. Koch, established easy access to a large source of bovine testicles — the Chicago stockyards — and recruited students willing to endure the tedious work of extracting their isolates. In that year, Koch and his student, Lemuel McGee, derived 20 mg of a substance from a supply of 40 pounds of bovine testicles that, when administered to castrated roosters, pigs and rats, remasculinized them. The group of Ernst Laqueur at the University of Amsterdam purified testosterone from bovine testicles in a similar manner in 1934, but isolation of the hormone from animal tissues in amounts permitting serious study in humans was not feasible until three European pharmaceutical giants—Schering (Berlin, Germany), Organon (Oss, Netherlands) and Ciba (Basel, Switzerland)—began full-scale steroid research and development programs in the 1930s.
Epidemiological evidence supports a link between testosterone and glucose metabolism. Studies in non-diabetic men have found an inverse correlation of total or free testosterone with glucose and insulin levels (Simon et al 1992; Haffner et al 1994) and studies show lower testosterone levels in patients with the metabolic syndrome (Laaksonen et al 2003; Muller et al 2005; Kupelian et al 2006) or diabetes (Barrett-Connor 1992; Andersson et al 1994; Rhoden et al 2005). A study of patients with type 2 diabetes using measurement of serum free testosterone by the gold standard method of equilibrium dialysis, found a 33% prevalence of biochemical hypogonadism (Dhindsa et al 2004). The Barnsley study demonstrated a high prevalence of clinical and biochemical hypogonadism with 19% having total testosterone levels below 8 nmol/l and a further 25% between 8–12 nmol/l (Kapoor, Aldred et al 2007). There are also a number longitudinal studies linking low serum testosterone levels to the future development of the metabolic syndrome (Laaksonen et al 2004) or type 2 diabetes (Haffner et al 1996; Tibblin et al 1996; Stellato et al 2000; Oh et al 2002; Laaksonen et al 2004), indicating a possible role of hypogonadism in the pathogenesis of type 2 diabetes in men. Alternatively, it has been postulated that obesity may be the common link between low testosterone levels and insulin resistance, diabetes and cardiovascular disease (Phillips et al 2003; Kapoor et al 2005). With regard to this hypothesis, study findings vary as to whether the association of testosterone with diabetes occurs independently of obesity (Haffner et al 1996; Laaksonen et al 2003; Rhoden et al 2005).
“This study establishes testosterone levels at which various physiological functions start to become impaired, which may help provide a rationale for determining which men should be treated with testosterone supplements,” Finkelstein says. “But the biggest surprise was that some of the symptoms routinely attributed to testosterone deficiency are actually partially or almost exclusively caused by the decline in estrogens that is an inseparable result of lower testosterone levels.”
There are valid concerns about the safety of long-term treatment with testosterone particularly with respect to the cardiovascular system and the potential for stimulating prostate cancer development. There are no convincing hard data, however, to support these concerns. If anything, the data strongly suggest that adequate testosterone availability is cardioprotective and coronary risk factors such as diabetes, obesity and the metabolic syndrome are associated with reduced testosterone levels. It is certainly appropriate to avoid giving testosterone to men with prostate or breast cancer but it is not appropriate to accuse testosterone of inducing the development of de novo prostate cancers since evidence for this accusation is lacking (Wang et al 2004; Feneley and Carruthers 2006).
Overall there is evidence that testosterone treatment increases lean body mass and reduces obesity, particularly visceral obesity, in a variety of populations including aging men. With regard to muscle changes, some studies demonstrate improvements in maximal strength but the results are inconsistent and it has not been demonstrated that these changes lead to clinically important improvements in mobility, endurance or quality of life. Studies are needed to clarify this. Changes in abdominal obesity are particularly important as visceral fat is now recognised as predisposing the metabolic syndrome, diabetes and cardiovascular disease.
Testosterone [Figure 1] is the main male sex hormone. It is responsible for male sexuality and is the main hormone-producing the features associated with masculinity such as substantial muscle mass, facial hair, libido, and sperm production. Besides, the hormone has other vital functions as the basic chemical composition of testosterone is steroidal; and steroids are known to have significant physiological, as well as psychological, effects in male individuals, especially adults. Testosterone production is reduced gradually in men starting from the age of 30. Hence, testosterone blood concentrations slowly diminish as age progresses. As a result, men may experience a number of physiological and psychological events, such as a lack of sex-drive, erectile dysfunction, acute depression, fatigue, low energy levels, and insomnia.
On the average, you need to sleep at least 8 hours per night to stay healthy. If you want a night sleep to contribute to the maximum testosterone production, it’s important to make your sleep comfortable. Thus, the bedroom temperature shouldn’t exceed 21°C. In addition, you should ventilate your bedroom thoroughly before sleeping. Furthermore, before going to bed, don’t overload your stomach with fatty foods, as well as don’t drink alcohol and caffeinated beverages. Finally, you have to avoid intense physical activity before bedtime.6
In summary, low testosterone levels are linked to the presence of numerous cardiovascular risk factors. Testosterone treatment acts to improve some of these factors, but effects may vary according to pre- and post-treatment testosterone levels, as well as other factors. There is little data from trials specific to aging males. Appropriately-powered randomized controlled trials, with cardiovascular disease primary endpoints, are needed to clarify the situation, but in the meantime the balance of evidence is that testosterone has either neutral or beneficial effects on the risk of cardiovascular disease in men. It is particularly important to define the effect of testosterone treatment on cardiovascular disease in view of its potential use as an anti-anginal agent.
For people who are worried about low or high testosterone, a doctor may perform a blood test to measure the amount of the hormone in the patient's blood. When doctors find low-T, they may prescribe testosterone therapy, in which the patient takes an artificial version of the hormone. This is available in the following forms: a gel to be applied to the upper arms, shoulders or abdomen daily; a skin patch put on the body or scrotum twice a day; a solution applied to the armpit; injections every two or three weeks; a patch put on the gums twice a day; or implants that last four to six months.
Do low levels of testosterone produce symptoms in middle-aged men? Absolutely. In fact, the classic symptoms were first recognized more than 70 years ago when two American physicians, Carl Heller, MD, and Gordon Myers, MD, showed the effectiveness of testosterone treatment for symptoms of fatigue, depression, irritability, low sex drive, erectile dysfunction, night sweats, and hot flashes in men. Over the years, subsequent studies have found that some—but not all—men with low, age-adjusted testosterone levels exhibit symptoms consistent with andropause. All experience improvement with testosterone therapy.
Exercise boosts testosterone in two important ways. First, specific types of exercise actually cause our body to produce more testosterone. We’ll talk more about those in a bit. Second, exercise helps to increase muscle mass and decrease body fat. As we’ve discussed previously, adipose tissue converts testosterone into estrogen. The less fat we get, the more T we have.
Among my favorite stress management tools is the Emotional Freedom Technique (EFT), a method similar to acupuncture but without the use of needles. EFT is known to eliminate negative behavior and instill a positive mentality. Always bear in mind that your emotional health is strongly linked to your physical health, and you have to pay attention to your negative feelings as much as you do to the foods you eat.
The reasons for considering such therapy become evident from the many associations, indicated above, that reduced testosterone has with a variety of both physiological functions (bone metabolism, muscle mass, cognitive function, libido, erectile function) and pathophysiological states (metabolic syndrome, diabetes mellitus, obesity, insulin resistance, autoimmune disease). Although a definitive long-term, large scale placebo-controlled double-blind study of testosterone therapy in the aging male has not yet been carried out, multiple shorter-term trials have suggested improvement by testosterone with a resultant enhancement of muscle mass, bone density, libido, erectile function, mood, motivation and general sense of well-being.
A: If a health insurance company is providing coverage for a medication, including testosterone replacement therapy, they determine the final cost of the product. Costs will vary from one health insurance plan to another. To determine the costs of the testosterone replacement options, the health insurance plan should be contacted. There are various options for testosterone replacement therapy including gels, injections, patches, and tablets that dissolve under the lip. All of the formulations can be effective and each has advantages and disadvantages. The most appropriate testosterone replacement therapy depends on a variety of factors, including cost, patient preference, and tolerability. Testosterone replacement gels, such as AndroGel and Testim, are very effective and easy to administer. AndroGel and Testim can be easily applied to the skin once daily. However, the gels can be irritating to the skin and AndroGel and Testim are typically quite expensive. Testosterone replacement injections, such as Depo-Testosterone (testosterone cypionate) and Delatestryl (testosterone enanthate), are usually inexpensive. The injections are given only once every one to two weeks. The major disadvantage with injectable testosterone is that testosterone levels may be difficult to control. Levels may be too high after an injection and too low before the following injection. A testosterone replacement patch, such as Androderm, is applied every night and left on for 24 hours. Androderm can be applied to the arm, back or stomach, in an area without too much hair. Androderm can cause irritation of the skin. A testosterone tablet, Striant, is placed under the upper lip against the gums and replaced every 12 hours. Striant molds to the upper gum so that eating and drinking can occur normally. The testosterone tablet can irritate the gums and cause a bitter taste and toothache. People with low testosterone should work with their doctor or healthcare provider to find a safe, effective, and affordable testosterone replacement option for them. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. Derek Dore, PharmD
Many clinical studies have looked at the effect of testosterone treatment on body composition in hypogonadal men or men with borderline low testosterone levels. Some of these studies specifically examine these changes in older men (Tenover 1992; Morley et al 1993; Urban et al 1995; Sih et al 1997; Snyder et al 1999; Kenny et al 2001; Ferrando et al 2002; Steidle et al 2003; Page et al 2005). The data from studies, on patients from all age groups, are consistent in showing an increase in fat free mass and decrease in fat mass or visceral adiposity with testosterone treatment. A recent meta-analysis of 16 randomized controlled trials of testosterone treatment effects on body composition confirms this pattern (Isidori et al 2005). There have been less consistent results with regard to the effects of testosterone treatment of muscle strength. Some studies have shown an increase in muscle strength (Ferrando et al 2002; Page et al 2005) with testosterone whilst others have not (Snyder et al 1999). Within the same trial some muscle group strengths may improve whilst others do not (Ly et al 2001). It is likely that the differences are partly due to the methodological variations in assessing strength, but it also possible that testosterone has different effects on the various muscle groups. The meta-analysis found trends toward significant improvements in dominant knee and hand grip strength only (Isidori et al 2005).
Testosterone levels generally peak during adolescence and early adulthood. As you get older, your testosterone level gradually declines — typically about 1 percent a year after age 30 or 40. It is important to determine in older men if a low testosterone level is simply due to the decline of normal aging or if it is due to a disease (hypogonadism).