The Truth About Low T: Customized Testosterone Therapy

Testosterone is on the decline in American men making low testosterone a growing epidemic. As we mentioned in an earlier post, The Truth About Low T: Men, Middle-Age, and More, low testosterone has many causes and results from a combination of issues. From 1987 to 2004, Americans saw a 15% decline in serum testosterone. We can expect to see even lower tissue levels, as determined by salivary testing. So, the problem is likely much worse.

Two recent articles confirm the metabolic and health benefits of testosterone therapy in men with low testosterone.

The first study, published online from the Journal of Clinical Endocrinology and Metabolism, reviewed 820 studies and found that “low endogenous testosterone levels are associated with increased risk of all-cause and CVD death.” The results of this study substantiates previously documented publications.

The second study, published in the Journal of Clinical Endocrinology and Metabolism, was reported in the Newmax article Low Testosterone Does Not Shorten Life.  However, when you actually read the article, there is very little evidence to support the headline. The study states that “low testosterone is linked to diabetes via a bi-directional relationship with visceral fat, muscle, and possibly bone. There is consistent evidence from randomized trials that testosterone therapy alters body composition.”

The conclusion that diabetes in men should be treated with dietary management and exercise as the foundation, is correct. However, testosterone support in men identified to have low testosterone is also appropriate. Testosterone therapy in diabetics is just one piece of the puzzle. Low testosterone is found to be common in type II diabetes and  obesity. A one-size-fits-all approach is never appropriate in medicine.

Testosterone support in men with documented low T does provide many metabolic and health benefits. Unfortunately, it is not as simple as it appears in the “Is It Low T?” commercial with the man dancing with his shadow. Customized testing will determine your exact hormone levels and from these results, we can create an individualized therapy plan for you. Our individual pathways to health and wellness are unique and should be treated that way.

Now that you know the truth about the metabolic and health benefits of customized testosterone therapy, what will you do about it? If you have symptoms and need answers or more information, call our office at 318-255-3223.

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We have provided links to these studies and more on the Seasons Diigo bookmarking service.

 

From the Doctor’s Desk: Health and Wellness Defined

Definitions.

Health can best be defined as the absence of disease.  Wellness is best defined as the existence of positive health.  So health and wellness can be best defined as the absence of disease in the presence of positive health.

Why the focus on health and wellness these days? I think modern medicine gets a failing grade. Obesity is epidemic in the American culture today. One of my patients knew that her weight was not healthy. However, her previous physician told her that she should learn to live with her new heavier weight and maybe the weight would level out. That statement haunted her and led her to find a physician who offered her more hope and solutions.

Health and wellness cannot be achieved through a traditional, allopathic (Western modern medicine) medical approach. Why? Western modern medicine (we’ll call it traditional for our purposes) uses a disease-focused model utilizing pharmaceuticals. Pharmaceuticals block biochemical reactions, produce mitochondrial toxins, and deplete important nutrients. There is no positive health there.

In fact, the 4^th – 6^th leading cause of death is from prescription drugs (Mol Aspects Med. 2005 Aug-Oct;26(4-5):363-78). In contrast, functional medicine is a health and wellness model utilizing natural substances found in the body to enhance cellular processes. A health and wellness model looks to work with the body, to facilitate metabolic reactions and optimize physiologic function (The principles of metabolic therapy for heart disease. Heart, Lung and Circulation 2003; 12:S55-S62).

In some ways, the two are complementary; but in many ways, the two are not. I am not advocating a boycott of traditional medicine. In fact, I still practice some traditional medicine when disease exists.

The key is this — does disease exist or not?  If disease doesn’t exist, and health and wellness or health restoration is your goal, then a functional or integrative approach is the way to go to facilitate and optimize physiologic function.

So, what is a functional medicine approach?  To help define functional medicine, let’s look at a few examples.

The traditional medicine approach.

Metformin or Glucophage is a well-recognized drug used to treat diabetes.  Metformin works to improve insulin sensitivity and thus facilitate glucose uptake inside the cells.  Type II Diabetes is marked by very poor insulin sensitivity and thus blood sugar rises.  Traditional medicine prescribes Metformin to provide a 13% improvement in insulin sensitivity.

Remember, pharmaceuticals block biochemical reactions.  Metformin reduces folic acid and vitamin B12 and can elevate homocysteine. Elevated homocysteine levels increase blood clot risk (this is one of the ways that birth control pills increase blood clot risk).  Diabetics and those with insulin resistance are already at an increased risk of blood clots. Can you see how the treatment is piling on in this situation?

The functional medicine approach.

Let’s contrast that with a functional medicine approach. Vitamin D deficiency is rampant today. Vitamin D deficiency has been implicated in heart failure, myocardial dysfunction, sudden cardiac death, and is required for normal insulin release and glucose control.  Remember the 13% for metformin? Higher vitamin D levels resulted in a 60% improvement in insulin sensitivity (Chiu K., et al., “hypovitaminosis D is associated with insulin resistance and beta cell dysfunction,” Amer Jour Clin Nutr  2004).

Remember, functional medicine works with and facilitates the body’s functions. Vitamin D does not block any biochemical reactions, nor does it interfere with any. Thus, there is no negative effect comparable to Metformin. Now, too much of a good thing can be a problem. Too much Vitamin D can elevate calcium. Because of this, Vitamin D should be prescribed under the watchful eye of a physician.

Why do I do what I do?

Amazing results — as naturally as possible. This is why I practice functional medicine. This is why I created Seasons. A health and wellness model, through functional medicine, works with the body to enhance and optimize physiologic function.  Health and health restoration can only be achieved by working with the body. Let’s get out of the way and let the body heal itself.

My Doctor Said I Have Polycystic Ovary Syndrome

Each week, I wonder what I should write about on the SeasonsWC blog. Then, I listen to my patients, and they tell me what they want to know. (Funny thing listening to your patients). This week, at least three women had questions about their diagnosis of polycystic ovary syndrome. Some time ago an ultrasound revealed that they had multiple ovarian cysts, and they were given birth control pills to control their symptoms. That was all they knew.

“So I learned I have cysts on my ovaries,” they said. “But what does that mean?”

Doctors call it polycistic ovary syndrome. To make things even more confusing, we’ll often just call it PCOS or PCO. (It’s fewer syllables.)

PCO is a hormonal syndrome. A syndrome is a group of symptoms that collectively indicate a disease or other abnormal condition–and PCO is an abnormal condition, not a disease. Of course, abnormal conditions can lead to disease. But an abnormal condition can also be restored to a healthy condition, whereas disease cannot.

PCO is the most common hormone problem in women today, effecting 5% of reproductive aged women. It causes androgen excess, another fancy medical term that means a woman’s body is producing too many male hormones. This means women may have facial hair, hair loss, low voice, acne… Androgen excess in women has been recognized by doctors since Hippocrates. You may have heard of the Hippocratic Oath. Hippocrates discovered a lot of things, including facial hair in women.

To be more specific, PCO is characterized by

• High androgen levels (think testosterone)
• High insulin levels and insulin resistance
• Irregular cycles (due to anovulation)
• Multiple ovarian cysts

It doesn’t really sound so bad–just facial hair, acne, deep raspy voice, and irregular cycles. Obviously, those symptoms are a very big deal for many women. In fact, they are the primary complaints of women with PCO. But they aren’t the biggest problems. PCO is associated with some pretty serious diseases and health problems:

• Obesity (50% of women with PCO)
• Type II diabetes (10% of women with PCO)
• Infertility
• Cardiovascular disease (hypertension, abnormal cholesterol, atherosclerosis)
• Psychopathology (anxiety, depression, bipolar, eating disorders)
• Cancer (breast, uterine…)
• Metabolic syndrome

Worst of all, polycystic ovary syndrome, if untreated, leads to poor health and early death. But don’t worry! We know how to treat PCO, and I’ll talk about that in my next post.