Risks of Testosterone Replacement Therapy in Men
Testosterone is a hormone that is produced in both the testicles and ovaries. Testosterone levels are significantly higher in males and increase substantially during puberty before it begins to dip around age 30. In addition, the adrenal glands produce (DHEA) dehydroepiandrosterone, which the body then converts into testosterone and estrogen. Testosterone is the main androgen (steroid hormone) that regulates the development of male characteristics. Anabolic steroids typically refer to synthetic testosterone which is administered by injection, gel, or patches.
Testosterone does play an important role in the male libido, sperm count, bone and muscle mass, and the way men store fat in the body.
Low testosterone levels can lead to:
- decreased libido
- erectile dysfunction
- decreased energy
- weight gain
- mood instability
- decreased body hair
- osteoporosis (thin/weak bones)
- decreased muscle mass
Amidst all of the advertisements for low testosterone or “Low T” and the promotion of testosterone supplements or drugs, overuse of these products can become a real problem. Misuse of synthetic and other testosterone-enhancing supplements or drugs may lead to long-term dangerous health problems. Some bodybuilders and athletes have been known to abuse synthetic testosterone by taking it in very high doses to enhance their physical appearance and expand their performance. Some clinics are also pushing and “selling” testosterone therapy to patient’s rather than finding a root cause of the person’s condition.
Studies of men who truly meet the diagnosing criteria for needing testosterone replacement therapy are estimated at:
– 0.1% of men in their 40s
– 0.6% in their 50s
– and 3.2 in their 60s
– and only 5.1% of men in their 70s
High levels and long-term use of testosterone can lead to:
- heart attack
- heart failure
- liver problems
- kidney problems
- male infertility
- increased risk of prostate cancer
- breast tenderness
- increased risk of male breast cancer
- sleep disturbances
- high red blood cell count
- reduced infertility in men 45 and younger
Therefore it is important to take stock of your own health before turning to testosterone therapy. Consider other reasons you may be experiencing fatigue, low sex drive, depression or any of the other symptoms associated with low testosterone. Do you exercise regularly and eat a well-balanced diet? Is your sex life being affected? Can you rule out relationship or psychological issues? If erectile dysfunction is an issue, recognize that cardiovascular disease can have a direct impact on erectile dysfunction. The decision to start testosterone therapy should be individually evaluated for potential benefits versus the risks that may be involved. Additionally, studies indicate the importance of having a complete blood count (CBC) baseline draw prior to starting testosterone as well as continued monitoring throughout testosterone treatment and know what to look for if anything were to go wrong. Here at Alta Mountain, we believe more than a CBC should be done to correctly monitor the effects of testosterone supplementation. A CBC, metabolic, thyroid panel, cholesterol panel, sex hormone panel, inflammation panel, and iron levels all need to be taken into account when monitoring health to avoid any other health consequences.
Although testosterone was first used as a clinical drug in 1937 little is still known about the medical relevance levels of testosterone deficiency. This is due in part to normal testosterone production in adult men varies so extensively, making it difficult to determine correct dosing for each individual and whether or not they even need to boost their testosterone levels. One study discovered the symptoms most often attributed to testosterone deficiency are actually caused almost exclusively to the deterioration in estrogens induced by low testosterone levels.
Frequently, men are advised that they need to have testosterone supplements or injections to lower their risk of a cardiovascular event. Why are they telling people this? Because of studies that have indicated that men with higher testosterone levels have the lower risks of stroke, heart attack or a cardiovascular event. But does this solve the problem for these patients? Not necessarily. If you look further into those studies, you find the men with the highest testosterone levels have healthy lifestyles that allow for higher testosterone levels. So, is it the lifestyle or the high testosterone that gives them the cardiovascular protection? In my medical opinion it’s the lifestyle.
C-reactive protein, pro-inflammatory cytokines, TNF-alpha and macrophage inflammatory protein 1 are all chronic systemic inflammatory markers to determine inflammation in the body. When inflammation is high then testosterone is low. The higher the inflammation the lower the testosterone. Which presents the question. Is it the low testosterone that creates high inflammation or the high inflammation that reduces the testosterone? If high testosterone lowers inflammation, then you would think this would be a great treatment. However, in many cases I have found this not to be true. In my lab findings with patients, I find that patients being treated with testosterone are having a number of inflammatory issues occurring and getting worse over time that are not being addressed. These inflammation markers are either being amplified by the treatment or have been overlooked by the treating physician so inflammation has continued to build up in the body.
There are four main causes that turn off the production of testosterone
This first is cortisol, the stress hormone that is released by either physical, mental or emotional stress. This hormone “steals” the necessary hormones to produce DHEA, testosterone, and other hormones.
Then second is insulin. As a man treads toward insulin resistance his testosterone decreases. The higher the insulin the lower the testosterone. The worst part is this becomes a “negative feedback loop,” where one continues to cause the other. When insulin is high, testosterone is reduced and that reduced state induces a decrease in insulin sensitivity so the body is now less sensitive to glucose and in turn raises insulin more which further reduces testosterone and the cycle continues and may ultimately turn into stage two diabetes.
Now the third has a lot to do with the first two causes. This is excess adipose tissue. Adipose tissue is very pro-inflammatory and increases inflammation in the body, which as previously discussed lowers testosterone. Adipose stimulates aromatase complex which increases estrogen. Estrogen reduces the production of testosterone. Estrogen and cortisol have a strong link, when stress is high and cortisol is released then adipose is created in the body. Couple this with poor eating habits due to stress and you now have an increase in insulin that turns on the negative feedback loop.
The fourth cause is mitochondrial dysfunction. Mitochondria are little powerhouses found in the cells in our bodies, their job, long story short, is to make energy in the form of ATP. Well, when these little guys aren’t happy then neither are you. Some of the first mitochondria that get disrupted are found in the Leydig cells which are the cells responsible for testosterone production. What makes these guys mad? Poor nutrition, high oxidative stress from smoking, drugs, poor sleeping habits, vegetable oils, chemical cleaners, pesticides, diets high in sugar, processed foods and alcohol.
Ways to naturally increase testosterone levels
- lower inflammation in the body
- exercise regularly include weight bearing exercise
- get regular 7+ hours of good quality sleep
- eat whole organic foods and grass-fed meats
- supplement with whole food sources of zinc, magnesium and Vitamin D
- support the adrenal glands
- avoid meats that contain antibiotics and hormones
- avoid plastics with BPA
- avoid reheating foods in the microwave in plastic
- avoid alcohol
- reduce stress
I am not opposed to people getting testosterone creams or injections to raise their testosterone levels, if it’s needed. However, I believe a large number of individuals being treated for “low T” have the ability and should naturally raise their own testosterone and not rely on medications to do this. Take in to account that long-term use of testosterone injections, gel or patches can cause a severe reduction in the body being able to produce testosterone on its own.
If you have “low T” you need to determine the cause and make lifestyle changes. If supplements are needed then I always recommend WHOLE FOOD SUPPLEMENTS not synthetics. A synthetic vitamin will create a change in the body but will NEVER NOURISH IT and a major contributor to most of our conditions today as Americans is malnutrition.
If you are interested in meeting with Dr. Nathan Eldredge about your concerns with testosterone then contact us today at Alta Mountain Chiropractic: 801-523-2582. We are happy to order labs, set up consultations and get you started on the right track to improve your health and happiness.