Low Testosterone

There is a lot of attention on testosterone these days. There are lots of Low T clinics popping up all over the place.

The issue is that low testosterone is a major health problem for both men and women. Testosterone has numerous benefits in the body. Ensuring optimal levels benefits health and performance.

Andropause is another name for Low Testosterone.

So, what are the symptoms of low testosterone and what conditions increase when testosterone is low?

Symptoms of low testosterone:

Increased heart attacks and strokes
decreased memory & intelligence
Increased dementia & alzheimer’s
Loss of drive & competitive edge
Stiffness & pain in muscles and joints
Falling levels of fitness
Decreased effectiveness of workouts
Sarcopenia
Osteoporosis
Anemia
Increased cancer
Fatigue, tiredness
Depression, mood changes, hopelessness
Irritability
Dysphoria
Reduced libido & potency: decreased desire & fantasies, decreased morning erections, decreased erectile tension, longer recovery times between orgasms, decreased intensity of orgasms

Testosterone levels tend to decline with age. However…

“We age because our hormones decline,

Our hormones don’t decline because we age.”
– Ron Rothenburg, MD

We also see:

Increased risk of diabetes & metabolic syndrome
Increased inflammation
Increased risk of cancer

Studies show that higher levels of testosterone are associated with lower mortality.

A 10 year prospective study with 11,606 men between the ages of 40 and 79 years validated this. In fact, they concluded that low testosterone predicts cardiovascular disease.[1] It should be noted that these were natural testosterone levels not levels in patients receiving testosterone replacement therapy.

In this study, men with a testosterone level above 564 (compared to 350) had a 41% lower chance of dying for any reason. Also, the risk of dying decreased 14% for every 173 point increase in testosterone. So, a testosterone level of 1000 compared to 300 had a 57% decreased risk of death.

But what about those patients who are receiving testosterone replacement therapy (TRT)? Does it lower their risk too?

A study of 1031 male veterans over the age of 40 years with a total serum testosterone level of < 250. 398 of these patients began testosterone replacement therapy. After 4 years of therapy, the mortality in the treated group was 10.3% while in the untreated group it was 20.7%. This was very statistically significant with a P of <0.0001. This means that there was less than a 0.1% chance that these findings were due to chance.[2]

Also of note in this study, prostate cancer in the testosterone replacement therapy group was 1.6% whereas it was 2.0% in the untreated group.

Higher levels of testosterone improve cognitive function

Lower testosterone levels are associated with lower cognitive function and testosterone replacement therapy improves this function.[3,4]

Testosterone Replacement Therapy (TRT) prevents the production of beta amyloid precursor proteins in men which are increased in Alzheimer’s Disease.[5,6]

In a study by Tan, 36 newly diagnosed Alzheimer’s patients had their serum testosterone levels measured. 10 of these 36 patients had a testosterone of <240. 5 of the 10 received testosterone replacement therapy (TRT) and 5 were given a placebo. The placebo group gradually deteriorated but the TRT group improved over 1 year.[7]

In patients with low testosterone, testosterone replacement therapy (TRT) is effective in improving mood when psych drugs don’t work.[8]

Testosterone Replacement Therapy increases nocturnal and spontaneous erections and improves mood.[9]

High free Testosterone levels were associated with better performance on tests of memory, executive function, and spatial ability and with a reduced risk for Alzheimer’s Disease as well as improved cerebral blood flow.[10]

Low testosterone in associated with Cardiovascular Disease Risk

The lower the testosterone and free testosterone the more likely there was CAD. Testosterone improves exercise induced ST depression. Testosterone dilates coronary arteries. Low testosterone is associated with dyslipidemia. Higher levels of endogenous testosterone are associated with a decreased risk of cardiovascular death.

Low-dose supplemental testosterone treatment in men with chronic stable angina reduces exercise-induced myocardial ischemia.[15]

Short-term administration of testosterone induces a beneficial effect on exercise-induced myocardial ischemia in men with coronary artery disease.[16]

Short-term intracoronary administration of testosterone, at physiological concentrations, induces coronary artery dilatation and increases coronary blood flow in men with established coronary artery disease.[17]

In men with CHF, 12 weeks of treatment with testosterone was safe, well tolerated, and led to significant improvements in physical capacity and symptoms.[18]

Testosterone replacement therapy improves lipid profiles and reduces inflammatory cytokines.[19]

There is an independent inverse association between levels of testosterone and aortic atherosclerosis in men.[20]

Total and free testosterone levels in men less than 45 years of age with coronary artery disease were significantly lower than those of controls. Free testosterone levels less than 17.3 pg/mL had a 3.3 times increased risk of premature coronary artery disease.[21]

There is an inverse relationship between testosterone levels and blood pressure.[22]