Did you know that testosterone
deficiency predisposes men to heart disease, depression and a
host of other ailments associated with normal aging?
The problem is that most doctors
are ignorant of the fact that cells throughout the body
require testosterone to properly function. Insufficient
testosterone causes males to lose strength, virility,
cognitive function and their youthful health. The long-term
consequence of testosterone deficiency is possible death from
a wide range of diseases.
Testosterone remains a
misunderstood hormone to all but the most dedicated health
enthusiasts. The general public is afraid of testosterone
because some young athletes have abused it. Others think it
causes prostate cancer. Scientific studies, on the other hand,
clearly show that lack of testosterone is an underlying
culprit behind many age-related disorders.
Today's physicians practice
medicine as if low testosterone has no impact on an aging
man's health. For example, if a male patient is depressed,
anti-depressant drugs are prescribed that often fail to
correct the underlying problem. Anti-depressant drugs have
many unpleasant side effects including impotence, which can
make a man feel even more depressed. Published studies
document that testosterone replacement is an effective
anti-depressant in many men.
Men who complain of impotence
are routinely prescribed ViagraŽ, a drug with both unpleasant
and potentially lethal side effects. Testosterone can be far
more effective than Viagra because it stimulates sexual
receptor sites in the genitalia and the brain1
(where it enhances desire).
When testosterone levels are
low, the body tries to compensate by making more cholesterol,
a precursor to adrenal testosterone production. Many men
prescribed statin drugs can obtain the same
cholesterol-lowering effect by restoring their testosterone
level to a more youthful range.2
The most profound effect that
testosterone has in the body may be its ability to prevent
atherosclerosis and heart attack. A series of new studies
reveal that testosterone is a critical missing link that
cardiologists are failing to account for in treating those
with coronary artery disease and congestive heart failure.3
This article discusses the beneficial functions of
testosterone and describes methods for safely restoring levels
to healthy ranges.
In youth, testosterone levels
are at their peak. Vitality, assertiveness, and libido all
thrive in their hormone-induced glory. As we age, however, the
endogenous level of this essential androgen begins to drop
drastically. By the time a man is 30 years old, he will have
already started down the path of testosterone deficiency,
losing as much as 2% every year for the rest of his life.4
This means that by the time he reaches 60 years of age, he
will be functioning with about 60% less testosterone than he
had in his twenties.
It is now estimated that as many
as 40 million men in the U.S. suffer from inadequate levels of
testosterone-and most of them don't even know it.5
They only know that they are depressed, or that their sex
drive is not what it used to be. But a lowered sex drive is
not the biggest problem associated with testosterone
deficiency.
Recent research has revealed
that testosterone, long thought to be a causative factor in
heart disease, actually prevents many forms of this killer.6
In fact, at youthful levels testosterone can keep diseases
such as atherosclerosis at bay almost indefinitely.7
With this
revelation comes a whole new problem: How do you re-establish
youthful levels of testosterone?
Testosterone:
What is it?
Historically speaking,
testosterone has been the subject of much speculation and
scrutiny. Long before scientists knew what testosterone was or
where it came from, ancient cultures were carving statues
depicting testicles as the symbols of fertility and virility.
As of 1400 AD, the Chinese were regularly processing urine
from young men and mixing it with ground bull testicles to
produce an extract used for treating impotence, prostate
enlargement and infertility.8
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Figure 1.
Metabolic Pathways Involved with Testosterone.
Testosterone is synthesized from cholesterol by means
of a number of enzymatic reactions. The immediate
precursors of testosterone are androstenedione and
DHEA-Sulfate (DHEA-S). Both testosterone and
androstenedione can undergo metabolic conversion to
estrogens (estradiol and estrone) via the aromatase
enzyme. |
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Today, we have a much greater
understanding of the production and purpose of testosterone.
We now know, for example, that testosterone is the major
androgen hormone produced in males; that it is created
predominantly by the Leydig cells in the testes in response to
the release of luteinizing hormone (LH) by the pituitary
gland. We also know that it is carried by the bloodstream and
binds to specific target cells where it exerts
tissue-dependent effects, such as masculinization, anabolism
(tissue building) and sexual arousal. Testosterone is a major
growth hormone that stimulates the production of red blood
cells within the bone marrow.9
Testosterone also inhibits cells called osteoclasts that
enhance bone breakdown. When testosterone deficiency occurs,
as with aging and in other conditions, a lack of inhibition of
these very same cells stimulates bone loss that leads
ultimately to osteoporosis.10
But despite our seemingly vast
knowledge on the subject, much of the value of testosterone
has yet to be elucidated. Researchers are just now discovering
that not only does testosterone affect us sexually, but that
it is also responsible for numerous biological actions
including protein synthesis, oxygen uptake, cholesterol
regulation and immune surveillance.11
Of these new discoveries, one of
the most controversial-and potentially life saving-is
testosterone's beneficial effect on the cardiovascular system.
The myth of
testosterone
Diseases of the heart and blood
vessels have become a nationwide epidemic, killing more than
half a million men in the U.S. every year.12
While it's commonly known that the chances of developing heart
disease grows proportionally with age, the fact that the
increased risk may be tied to the progressive reduction of
available testosterone has not yet been universally accepted
by conventional medicine.
Owing to early studies that
showed men to be twice as likely to die from coronary heart
disease than women, it has long been believed that
physiologically high levels of testosterone has a deleterious
effect on the cardiovascular system. This theory has further
been supported by cases of sudden cardiac death and other
cardiovascular disorders that have been induced by the abuse
of anabolic steroid drugs such as methyltestosterone.13
Another complication was that for many years, endocrinologists
failed to believe that testosterone levels dropped in relation
to age. Older patients with heart disease were tested and
their testosterone levels found to be within the youthful
range. Unfortunately, scientists were looking for the wrong
type of testosterone measuring the total amount of
testosterone rather than focusing on the free testosterone.
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THE
DANGERS OF
ANABOLIC STEROIDS
Most of
the hesitation to use natural testosterone
supplements or creams to prevent cardiovascular
disease stems from the popular misconception that
all testosterone is the same. It isn't.
Whereas
most studies on natural testosterone have shown
positive physiological effects, anabolic steroid
drugs are another matter entirely. While synthetic
testosterone steroids may resemble the natural
testosterone molecule, they are in fact chemically
different and do not provide the same healthful
benefits. On the contrary, anabolic steroids such as
methyltestosterone have numerous serious side
effects that actually lay the foundation for heart
attack and stroke-such as increased LDL
cholesterol*and blood clotting-the very problems
that natural testosterone combat.**
* Zitzmann M, et al.
Contraceptive steroids influence the hemostatic
activation state in healthy men. J Androl 2002
Jul-Aug;23(4):503-11.
**
Mottram DR, et al. Anabolic steroids. Baillieres
Best Pract Res Clin Endocrinol Metab 2000
Mar;14(1):55-69. |
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We now know that much of an
aging man's testosterone is "tied up" or bound to a protein
called sex hormone-binding globulin (SHBG). Once bound to SHBG,
testosterone is no longer available for use by the rest of the
body, becoming in effect biologically inert. As a result, the
typical male has only a small amount of bio-available or
"free" testosterone accessible-roughly about four percent of
the total testosterone. Furthermore, research has shown that
this free testosterone becomes increasingly bound with age,
leaving available levels of testosterone low while total
levels appear normal.14
But despite having to overcome
the hurdles of medical dogma that erroneously devalued
testosterone for decades, researchers have finally established
an indisputable link between its youthful levels and a healthy
cardiovascular system.
To lay the groundwork for our
examination of these cardiovascular benefits, we'll begin with
a brief discussion of the cardiac disease most often induced
by low levels of testosterone: atherosclerosis.
The foundation
of heart disease
Atherosclerosis is the most
common form of cardiovascular disease. It is the accumulation
of fatty plaque deposits in the arteries, resulting in
stenosis-a narrowing of the arterial diameter, which restricts
blood flow to vital organs.15
Depending on the location of the
stenosis, atherosclerosis can manifest itself in several
different ways. Should the blockage occur in one or more of
the arteries that supply the heart, coronary artery disease
(CAD) results. The most common clinical manifestation of CAD
is angina pectoris (chest pain). This occurs when the oxygen
needs of the heart muscle are inadequate. In essence, the
heart muscle is crying out for more oxygen. Angina, therefore,
is symptomatic of narrowed coronary arteries and their
inability to allow proper blood flow to suit the heart's need
during physical exertion or emotional stress. If blockage of
coronary flow is complete, it will result in a heart attack
(myocardial infarction or MI).16
If the blockage appears in the
arteries supplying the brain, the result is called a
cerebrovascular accident or stroke.17
Restricted blood flow to the legs-known as
claudication-interferes with the ability to walk, resulting in
pain and disability due to a lack of oxygen caused by the
impaired blood flow. When such stenosis becomes severe,
infection and gangrene may follow, often leading to amputation
of the afflicted limb.18
To treat these disorders, common
medical practice relies on various techniques such as
angioplasty and coronary artery bypass grafts.19
Angina is most often treated with medication such as
nitroglycerin which rapidly dilates the coronary arteries
allowing more blood to flow to the malnourished heart.20
The effects of nitroglycerin do not last long.
Although these procedures are
often effective at temporarily keeping the disease manageable,
preventing atherosclerosis in the first place is by far the
best solution. To do this, you need testosterone.