While the golden years can bring wisdom and satisfaction for a life well lived, they can also result in the transformation of a healthy and vigorous male into a frail senior citizen. But can this decline be slowed, or even reversed, by the use of a male hormone that increases strength and endurance? Moreover, can we trick the body into thinking it is younger than it actually is without paying a human price? This edition of Health-Watch takes a manly look at these questions.
What is testosterone and what does it do?
Testosterone, also known as the macho hormone, is an anabolic steroid. “Anabolic” means to build up; testosterone builds tissue -especially muscle tissue -by increasing protein formation within cells.
Testosterone is produced by the testicles and affects many parts of the body and brain. It is responsible for the development and functioning of the male sex organs, masculine characteristics like facial hair, and a host of additional bodily functions. These include sex drive, the health of the prostate, and aggression and assertiveness. It modulates sperm production, as well as mood, energy level, and muscle bulk and strength.
In addition, testosterone builds bone, and is therefore important for the prevention of osteoporosis. Men who suffer hip fractures, for instance, may have low testosterone.
Normal levels of testosterone are based on age. A level below 300 nanograms per decilitre of blood can be considered subnormal in young adults.
Tell me about testosterone decline.
Testosterone levels change over the course of a man’s lifetime. Hormone production typically begins to decline after age 40 as a normal part of what has been described as andropause, the male equivalent of menopause. While most men experience a drop in testosterone levels, some may experience symptoms bothersome enough to report to a physician. A small percentage of men will suffer a steep decline in hormone levels relative to their age group, which, if occurring in conjunction with bothersome symptoms, leads to a little-known condition known as late-onset hypogonadism.
What are the effects of low testosterone?
Now that you know what testosterone does, it won’t surprise you that deficiency can affect men in different ways, some of which resemble how menopause can affect women. For instance, it can have serious implications in terms of reduced libido; loss of muscle that, in turn, can lead to reduced mobility; erectile dysfunction; and mood and sleep disturbances. All of these can greatly reduce one’s quality of life.
Late-onset hypogonadism is not an easy diagnosis to establish, as some men will show low testosterone levels without symptoms, and some men with symptoms may have low-ish but still normal-range blood levels of testosterone.
The study: Basaria S, Coviello AD, Travison TG et al. Adverse events associated with testosterone administration. N Engl J Med 2010;363: 109-22.
Tell me about this study.
Researchers based out of Boston University looked at whether or not testosterone could safely reverse the ravages of time in men over 65 years of age. Since studies
have already suggested that testosterone can increase strength, endurance and muscle mass in senior citizens who are in good health, these scientists wanted to know how it might work in men who were already less mobile and weakened as a result of old age.
This study recruited men who had low levels of blood testosterone and demonstrated difficulty walking more than two blocks or climbing stairs. Half of the patients were randomly assigned to receive a testosterone skin gel, applied daily at a dose that brought their blood testosterone level toward the normal range. The control patients received a placebo gel that was indistinguishable from the one containing the potent male hormone designed to be absorbed through the skin. The study then followed all the subjects for months and measured their ability to lift or push weights using both chest and arm muscles, as well as their legs.
So what happened?
Being particularly cautious about not allowing harm to come to study subjects, and well before the planned number of patients had been recruited, the safety board monitoring the progress of the study halted recruitment and study procedures once they noticed a slight increase in the number of heart attacks occurring in the testosterone gel group -events that were not occurring as often in the control group. By that point, there appeared to be a clear trend toward increased strength and endurance in the testosterone group, though not in a definitive way.
Should the study have been stopped early?
Good question. Safe and ethical research is of paramount importance in this day and age, and in that regard the decision to stop the study was correct. On the other hand, the suggestion of a slight increase in risk for subjects receiving the testosterone may have been simply the result of bad luck; and had a few more months elapsed, the cardiac risk might have evened out and the benefits of testosterone might have become more evident. Many of the men recruited into the study suffered from high blood pressure and diabetes, and by chance, there were more of these in the testosterone arm, potentially accounting for the increased risk seen in patients using the real McCoy.
What’s the bottom line?
If you and your physician are convinced that you suffer from late-onset hypogonadism and you are otherwise at low cardiovascular risk, testosterone gel may still be considered a reasonable treatment option, as long as you understand the risks associated with boosting your mojo.
The material provided in HealthWatch is designed for general educational purposes only and does not pertain to individual cases. It should not replace necessary medical consultations with your own doctor or medical professional.
Reprinted from The Gazette www.montrealgazette.com
Low Testosterone Advice 