Testosterone is an important hormone that is made in the body. It affects a number of organs and is responsible for a variety of physiologic functions in men. Testosterone is responsible for growth of male sexual organs, sperm production, libido (low sexual desire), mood, red blood cell production, body hair growth, and muscle strength.
As we age, testosterone declines in a significant number of males. In studies, low testosterone affects almost 14 million American men over the age of 45, and for every decade of life, the rate of low testosterone increases by 17%.
How is testosterone produced?
Testosterone production is primary controlled by the brain, which sends signals to the testicles to produce testosterone. This pathway is called the hypothalamic–pituitary–testicular axis (HPT axis). Testosterone is found in two different forms in the blood, available and non–available which both together make up total testosterone. Available testosterone can be further divided into two forms; unbound (circulates freely in the blood) and loosely bound (can become free if necessary) which accounts for 2% and 38% of circulating testosterone respectively. Sixty percent of the testosterone is tightly bound to a molecule called sex hormone binding globulin and is not readily available.
What are the causes of low testosterone?
Causes of low testosterone may vary. There is evidence that the cells (leydig cells) which produce testosterone in the testicles may decline as men age. Other causes include decreased hormonal signals from the HPT axis and increases in the binding of free testosterone.
How can testosterone be replaced?
There are ways to increase testosterone production or replace testosterone.
- Resistance Training. Bodybuilders know that very well. The rage they feel inside them after a good workout – that is testosterone feeling. Not aerobic or jugging, we taking about heavy weight lifting. In response to resistance human body produce more testosterone to speed up muscle recovery.
- Supplements. There are lots of opinions on nutritional supplements stimulating testosterone production. The only sure way to find out if a supplement really helps is to take it and do blood test for “Total Testosterone”. If you reached 600-700 ng/dl you are good but not great.
- Testosterone Injections. By far this is my favorite source of testosterone. It’s effective and easy on the liver. Not every one is brave enough to do injections to themselves but once you get over the needle fear – it’s no brainier.
What are the benefits of testosterone therapy?
There are a number of benefits of testosterone treatment in men that have low testosterone and symptoms. Improvement in Sexual Health Testosterone replacement has been shown in a variety of scientific studies to improve sexual desire and improve sexual performance. It has also been shown to improve the effect of PDE5 inhibitors (i.e, Viagra) in men that initially do not respond to this class of medication. Improvement in lean body mass, decreased fat mass, and strength Testosterone has been found to increase lean body mass when compared to placebo (no medication). In separate studies, testosterone has also been shown to decrease total fat mass and percent body fat from baseline when compared to placebo. Also, testosterone was found in a number of studies to improve muscle strength in both the upper and lower body. Bone strength Testosterone has been found to slow the break down of bone. Bone mineral density, which is measured by a DEXA scan (Dual-energy X ray absorptiometry) has shown improvement after testosterone therapy, which may lead to a reduction in bone fractures.
What men should not undergo testosterone therapy?
Patients that should not be placed on testosterone therapy are: Men with prostate cancer (known or suspected) Males with breast cancer Men that are sensitive to certain ingredients in the testosterone therapy Woman Precautions of taking testosterone Males interested in fertility Men with liver damage (oral treatments) Edema (water retention) in patients with cardiac renal or hepatic disease Gynecomastia (breast enlargement) Men with sleep apnea Men with elevated red blood cell count Testosterone may lower good cholesterol (HDL) and elevate the bad cholesterol (LDL) May cause an elevation in PSA.
Are there other forms of hormone replacement?
Dehydroepiandrosterone (DHEA) DHEA is a hormone that is made by the adrenal gland. It has the ability to be converted into a number of hormones including testosterone. Studies that demonstrate positive effects of DHEA show an improvement in the areas of age related memory decline, muscle mass, bone density and sexual function. Also, DHEA deficiency has been associated with diabetes mellitus, Alzheimer disease, some cancers and cardiovascular disease. DHEA is available in many over the counter formulations, but they are not regulated by the FDA and there can be inconsistency of dosage amounts from one tablet to the next.