PEAK male Institute
07.06.2023 - 5 min read
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When you hear ‘testosterone,’ the first thing that comes to mind is virility, given that it’s the male sex hormone. But there’s more to testosterone than that –a lot more –and what you don’t know can hurt you –literally.
Testosterone is a hormone found in all humans (and some animals), although the male body produces it in much greater amounts than does the female’s.
Testosterone levels in younger men are high and drop precipitously with the natural aging process, creating a multitude of health problems. Cells throughout a man’s body are laden with receptor sites that are activated by testosterone, including muscle, bone, vascular, or nerve tissue. Testosterone is of inestimable importance, providing critical command signals to those receptor cells. As the hormone’s levels diminish with age, various processes begin to degenerate, affecting mood, cognitive functions, and worse, including heart attacks and strokes, excess abdominal fat, loss of insulin sensitivity leading to diabetes, and atherosclerosis.
Despite the fact that published studies have confirmed testosterone’s benefits, particularly the relationship between testosterone blood levels and cardiovascular events such as heart attack and stroke, (1) conventional medicine still questions the value of testosterone replacement in maturing men, which has resulted in needless heart attacks and stroke.
Researchers identified 2,416 men (aged 69-81 years) who were not on any kind of testosterone-related treatment. These men were subjected to a battery of blood tests that included total testosterone and estradiol (estrogen). The first observation was that men with increasing levels of testosterone had a decreased incidence of diabetes, hypertension, and body fat mass. Those with low testosterone were twice as likely to have a history of cardiovascular disease. It was also noted that men with the highest testosterone levels were the most physically active.
Flawed research has played a large role in medical error and the obvious mistakes made by doctors who design clinical trials. (2) For example, it has been well established that aging men are at risk of having excess activity of an enzyme called aromatase. As a result, too much testosterone is converted to estrogen, with disastrous results. (3) Aging men tend to develop dangerously high levels of estrogen and dangerously inadequate testosterone, though many aging men suffer both low testosterone and estrogen. (4) Elevated estrogen can sharply increase heart attack risk by promoting platelet aggregation and coagulation in coronary arteries and increases inflammation, which can cause unstable plaque to rupture and occlude a coronary artery, causing a sudden heart attack. A study was conducted to test whether strength and mobility would be improved in men (average age 74) if a huge dose of testosterone cream were applied to this group, who demonstrated a high prevalence of obesity, hypertension, diabetes, and elevated LDL, and who also had limited mobility and many of whom had known cardiovascular disease. All of these men had very low total testosterone levels (mean 243 ng/dL) at baseline, but the doctors never checked their estrogen levels. Early results showed it to be effective in improving muscle strength, but the study was discontinued as too many cardiovascular events occurred. The authors admitted that the testosterone cream may have converted to estrogen and caused these cardiac problems. Had proper baselines been developed, the outcomes might have been vastly different –and medical care improved.
But one of the shortcomings of Western medicine is that doctors are not generally trained to think holistically –to consider that in the body, everything is connected.
Healthy testosterone levels also protect against heart attacks. While higher blood levels of HDL (High Density Lipoprotein, or the ‘good cholesterol) protect against atherosclerosis and subsequent heart attack, few understand the critical role testosterone plays.(5)HDL removes cholesterol from the arterial wall and returns it to the liver for safe disposal via reverse cholesterol transport. Testosterone enhances this process, demonstrating that it is one of the hormone’s unique and lifesaving anti-atherosclerotic effects.
Since both HDL and testosterone levels often drop precipitously as men age, the combination of both low HDL and testosterone virtually guarantees a payday of tens of billions of dollars for pharmaceutical behemoths due to enormous ‘need’ for vascular stents and drugs as palliatives. Yet despite the aggressive and widespread use of statins and other advances in cardiac medicine, heart attacks and strokes are still among the leading causes of death, globally.
It should now be apparent that the benefits of testosterone supplementation have been underrated, as well as the farce being perpetrated by the medical establishment –in conjunction with the research community and pharmaceutical industry –that questions the value of the hormone.
And there’s more, such as testosterone and the risk of stroke. One way to evaluate one’s risk for a stroke is to undergo an ultrasound test to measure carotid artery thickness. When excess occlusion is detected, a risky surgical procedure (carotid endarterectomy) is performed to restore blood flow tothe brain.
Yet a study by the American Heart Association in April 2004 using ultrasounds to measure the carotid thickness in 195 independently living elderly men in 1996 and again in 2000 found that men with low testosterone had a 3.57 times greater progression of thickening than those with higher testosterone levels. The doctors concluded that “Low free testosterone levels were related to intima-media thickening of the common carotid artery in elderly men independently of cardiovascular risk factors. (6)
Low estrogen levels can also have a lethal impact on this group. 99% of men today have no idea what their blood estrogen levels are, which helps to explain the epidemic of age-related disease that is bankrupting this nation's medical system and increasing the chances of death.
Studies have shown (7) that men with even slightly elevated estrogen levels doubled their risk of stroke and have a far higher incidences of coronary artery disease. Men who present with benign prostate enlargement or prostate cancer also tend to have a higher blood estrogen level (often in combination with low free testosterone blood levels). (8)
On the other hand, men with insufficient estrogen are predisposed to osteoporosis and bone fracture.
Most importantly, measuring estrogen levels in men, since the hormone is associated with women, is often ignored by the medical community, despite the potentially lethal consequences.
Establishing an estradiol (estrogen)/testosterone balance is of critical importance. Low estradiol and testosterone predict mortality in aging men. In fact, in a study of 3,014 men aged 69-80 years, serum levels of testosterone and estradiol were measured during a mean follow-up of 4.5 years. Men with low testosterone had 65% greater all-cause mortality, while men with low estradiol suffered 54% more deaths. Those men low in estradiol and testosterone were almost twice as likely to die – a 96% increase in mortality – compared to men with the two hormones in the optimal ranges. Men produce estrogen naturally through an enzyme called aromatase that transforms testosterone into estradiol. Some aging men tend to have too much aromatase activity, which causes their testosterone to convert to excess estradiol, resulting in a depletion of essential testosterone and unsafe levels of estradiol. Some lack aromatase and suffer an estrogen deficit or produce so little endogenous testosterone that there is not enough to convert into estrogen, which causes low levels of both free testosterone and estradiol.
But the human body is a marvel, and no matter what the underlying cause, aging men can easily achieve optimal free testosterone and estradiol serum levels. Free testosterone, the hormone in its unbound form, is available to cell receptor sites throughout the body. Measuring free testosterone blood levels is the most accurate way of assessing testosterone status in aging men. Aromatase can be suppressed with absorbable forms of the flavonoid chrysin, which is naturally occurring in honey and certain plants, and/or lignans, which are naturally occurring in flax and sesame seeds, as well as soybeans, tofu, and cruciferous vegetables such as broccoli or cabbage. Low-cost generic aromatase-inhibiting drugs are also available, as are topical testosterone creams.
Heart disease, osteoporosis, and muscle wasting Heart disease, osteoporosis, and muscle wasting are all strongly linked to testosterone deficiency/hormone imbalance, as are chronic inflammatory and neurodegenerative disorders. All of which may be avoidable as men age, with the proper treatment and information. It’s time to give testosterone the respect and attention that it deserves. Virility is one consideration, but it’s critical that both aging men and the medical community recognize that there’s much more to the testosterone than being that little pill you might pop when, say, you’re going to see Alice.
The first step is to have your blood work done and the results evaluated by a healthcare professional experienced in TRT or HRT supportive therapy. If you are experiencing any of the symptoms mentioned here, call Peak Male Institute at (941) 203-8944 and schedule a consultation with one of our clinicians experienced in either Testosterone Replacement Therapy (TRT), Hormone Replacement Therapy (HRT) and or SEND US A NOTE, or better yet Find us on Google Maps and make an appointment.
1. Ohlsson C, Barrett-Connor E, Bhasin S, et al. High serum testosterone is associated with reduced risk of cardiovascular events in elderly men. J Am Coll Cardiol. 2011 Oct 11;58(16):1674-81.
2. Boutron, I., Dutton, S., Ravaud, P., and D. G. Altman. 2010. Reporting and interpretation of randomized controlled trials with statistically nonsignificant results for primary outcomes. JAMA. 303(20): 2058-64.
3. Cohen PG. Obesity in men: the hypogonadal-estrogen receptor relationship and its effect on glucose homeostasis. Med Hypotheses. 2008 70(2):358-60
4. Tivesten A, Vandenput L, Labrie F, et al. Low serum testosterone and estradiol predict mortality in elderly men. J Clin Endocrinol Metab. 2009 Jul;94(7):2482-8.
5. Langer C, Gansz B, Goepfert C, et al.
6. Muller M, van den Beld AW, Bots ML, Grobbee DE, Lamberts SW, vander Schouw YT. Endogenous sex hormones and progression of carotid atherosclerosis in elderly men. Circulation. 2004 May 4;109(17):2074-9
7. Barud W, Palusinski R, Beltowski J, et al. Relation between markers of inflammation and estradiol (the major female sex hormone) in older men. Med Sci Monit. 2010 Dec; 16(12):CR593-7
8. Krieg M, Nass R, Tunn S. Effect of aging on endogenous level of 5 alpha- dihydrotestosterone, testosterone, estradiol, and estrone in epithelium and stroma of normal and hyperplastic human prostate.