Testosterone

Testosterone isn't just for sex any more. Yes, it does increase libido in men and women. Remember that  any hormone, whether it is Testosterone, DHEA, Human Growth Hormone( HGH), Estrogen, Human Chorionic Gonadotropin (hcG), Estradiol, Estrone, Estriol, Progesterone, etc.  has literally hundreds of mechanisms of action (things they do). Testosterone also converts fat to muscle (we are losing a pound  a year with aging), improves memory, improves sleep quality, increases bone density, and improves heart function.

Actually, there are more receptors on your heart for Testosterone, than anywhere else you may have imagined them to be. In Europe, Testosterone is a first line heart medication. The heart is a muscle. You have Testosterone receptors from your brain to your toes.

So, how does one know if there is a deficiency or insufficiency of Testosterone. The following laboratory studies are necessary:

• CBC, Chem Profile, Lipid Profile with VAP, Homocysteine, hsCRP (Looking for anemia, heart function, inflammatory status)
• DHEA-S (Dehydroepiandosterone Sulfate) (THE most abundant hormone, receptors on every cell of your body)
• Vitamin C (If low, Testosterone converts to Estrogen)
• 5-DHT (Dihydrotestosterone) (Testosterone can convert into 5-DHT))
• Estradiol, Estrone (Testosterone can convert into Estrogen)
• HgbA1C (Indicates what your blood sugar has averaged over three months)
• hcG (Human Chorionic Gonadotropin) (helps reprime your hypothalmus to produce Testosterone, and lose weight)
• HGH (Human Growth Hormone, also known as IGF-1 or Somatocedin C)
• FSH, LH (Indicator of Hypothalamus (Brain) Receptor function)
• Fasting Insulin (Receptors for Insulin become resistant with aging)
• Progesterone (If low, Testosterone converts to Estrogen)
• Prolactin (If high, major cause of erectile dysfunction )
• PSA (Prostate test)
• RBC Zinc (If low, Testosterone converts to Estrogen)
• SHBG -Sex Hormone Binding Globulin (If high, binds your Testosterone)
• Free Testosterone (Testosterone which is available for use)
• TSH, T3, T4, Free T3, Free T4, TBG, reverse T3, Antithyroperoxidase Abs, Antithyroglobulin Abs (Indicates status of Thyroid)

Yes men,  we need  your estrogen levels.  More specifically, estradiol and estrone. Most of my male patients have higher estrogen levels than my women patients. Why would men have more Estrogen? That is a good question. And that is why you need to be monitored when you take Testosterone.

Have you noticed that aging men have breasts? Have you noticed that aging men have abdomens that resemble pregnancy?  Have you noticed that no matter what they do, they are not able to get that V look. Have you noticed that your waist is bigger than your hips (which is one definition of obesity for men)?  Have you noticed that aging men look puffy, like aging women? Of course, eating the standard American diet (SAD) does not help our cause.

What is actually happening biochemically is that the aging male's Testosterone is converting into Estrogen. Testosterone converts into Estrogen because of the following reasons:

• Abdominal obesity contains inflammatory hormones that convert Testosterone to Estrogen
• Decreased Zinc (which is a major result of a refined white flour, white sugar diet) converts Testosterone to Estrogen
• Decreased Vitamin C (you do not need mega doses) coverts Testosterone to Estrogen
• Insufficient Omega 3 Fatty Acids (see The Good Fats section of website) converts Testosterone to Estrogen
• Increasing Aromatase and 5 Alpha Reductase enzymes convert Testosterone to Estrogen (prescription available)
• Increased alcohol comsumption converts Testosterone to Estrogen
• Liver dysfunction secondary to diet, environment, golfing, alcohol, medications, surgeries, etc. converts T to E
• Progesterone deficiency converts Testosterone to Estrogen

Some Benefits of Bioidentical Testosterone Replacement are:

• enhanced libido
• conversion of fat to muscle
• improved oxygenation
•  blood sugar control
• maintainence of immune system
• maintainence of  concentration
• improved mood
• partial protection against SDAT (Senile Dementia Alzheimer's Type)
• decreased CVD (Cardiovascular Disease)
• lowered glucose
• decreased Insulin requirements
• decreased Triglycerides
• increased Insulin Receptor activity

After all these lists, I think a story is in order. The Hertoghe Family is a family of four generations of European Endocrinologists. Great Grandpapa, Grandpapa, Father, and now Son and Daughter - are Endocrinologists. In the 1910s, Great Grandpapa extracted bull testicles and implanted them in an aging male to determine the life enhancing properties of Testosterone. It worked. Unlike women, men produce 90-95% of their Testosterone in their Leydig Cells. Women don't have Leydig Cells.

Dr. Hertoghe, the son, hosts medical seminars all over the world. Finally, the book on Hormone Replacement which is amazingly broad in scope has been translated to English. I have had the honor of training with Dr. Hertoghe, reading the French, and now the English version of hormonal replacement in the aging male and female. On the first day, we spent twelve hours discussing just the Thyroid. The Europeans replace all of the hormones in low physiologic doses, not big pharmacologic doses. Also, whenever possible,  replacement is accomplished with bioidentical compounded hormones.

Now, let's say you have a deficiency or insufficiency. Testosterone may be obtained via your local pharmacy as the scrotal patch, or gel to be applied to your chest (a lot, and it's messy). If you are working with an Integrative Medicine  Physician (MD or DO), they may prescribe compounded gels (more concentrated, requiring very little), or periodic injections into your buttocks. Gels and injections bypass the necessity for liver detoxification. Compounded hormones are made by pharmacists that specialize in compounding. Compounded pharmacists make bioidentical hormones in individualized doses,and in various forms: creams, gels, troches, injectibles, etc.

Of special note is that we are NOT discussing the anabolic bad boy Testosterone that weight lifters and bigorexic men use. Men who use the wrong kind of Testosterone may develop LVH (Left Ventricular Hypertrophy), eventually leading to Congestive Heart Failure and consequent inability to pump blood from the heart to the remainder of the body, resulting in death. Other symptoms of synthetic overdosing of Testosterone are sterility, erectile dsyfunction, testicular atrophy, liver enzyme elevation, and red man syndrome.

A note about the woman in your life. Women produce one tenth the amount of Testosterone as men until their mid thirties when their adrenal production falls dramatically. In women, Testosterone is produced in the ovaries and adrenal glands. Since women produce a tiny amount of Testosterone, women may leave their consultation with a low dose prescription. Husbands have been known to send me flowers. Please know I  prefer plants as they live. Men have told me I returned their wife to them. That meant more to me than all the plants in the universe.