Testosterone Therapy

By Abraham Kryger, MD, DMD (May 27, 2017)


While many men and yours truly have always been strongly interested in slowing aging and longevity, modern medicine, for the most part, has been slow to deliver any effective products. Bones, skin and hair still become more brittle every day as hormone levels drop with time, older men go gray, lose muscle mass, and gain more fat around their bellies. Overall energy and libido continue to decline at a relatively fast pace after age 50 for all of us. While average life expectancies have increased, up to 78 for men, and more people are living longer, we are not necessarily living better.

Some anti-aging researchers have claimed that natural testosterone supplement therapy can effectively "slow the hands of time". They theorize that by enabling the body to restore its hormone dependent tissues to more youthful levels, without the well-known negative side effects, skin delivery testosterone offers significant advantages over injectables. With fewer side effects than the synthetic esters of testosterone, efficient delivery through skin absorption is superior to oral delivery for several reasons, but particularly because oral and injectable testosterone delivery can cause serious liver damage.

Some physicians believe that Andropause, the so-called male equivalent of female menopause, really exists. The American government took a look at this question in late 2009. They recruited men over the age of 65 to determine whether low testosterone (T) lead to certain aging associated diseases. The specific aims of this study were to test the theory that transdermal testosterone treatment, using Androgel 1% gel, in elderly men with low serum testosterone, improved certain conditions. These men all had symptoms plus objectively measured abnormalities in at least one of five areas related to low testosterone: physical or sexual function, vitality, cognition, and anemia. The trials would determine if more favorable changes occur in those with a placebo treatment. (1)

So what did the researchers discovered thus far? To begin with, let’s see what they were looking at: “As men get older, they experience many conditions, often together, that eventually result in the inability to perform many activities of daily living, an increased propensity to fall, and decreased independence. These conditions include decreased mobility, disability and low vitality.” These are changes that take place in many aging men and some women that result directly from the study purpose.

Furthermore, “Elderly men also experience increased anemia, metabolic syndrome, decreased sexual function and memory impairment. These conditions likely have multiple causes, but one cause that could contribute to all of them was a low serum testosterone concentration. When young hypogonadal men are treated with testosterone, they experience improvements in sexual function, muscle mass and strength, bone mineral density and a sense of well-being. However, the benefits of testosterone therapy in older men with age-related decline in testosterone concentration are not known and were the subject of this investigation.” (2)

Which diseases could be affected in Andropause? Although the threshold for treatment seems to vary greatly and the guidelines change for different age groups, nonetheless there are multiple conditions associated with low T. According to Dr. B.B. Yeap and his colleagues at the University of Western Australia, total testosterone remains stable while free T drops in men over 70. (3)

Testosterone replacement therapy (TRT) guidelines were first introduced back in 1996 by the AACE (American Association of Clinical Endocrinologists). Along with its prior use as a treatment for sexual dysfunction, anemia and osteoporosis, new applications were mentioned in this pamphlet. Testosterone levels were also found to be very low in HIV, AIDS or cancer wasting syndrome. In addition low T is linked to the following conditions: (5)

Diabetes 30-50%
Obesity 40-60%
Chronic Opioid use 40%
Metabolic Syndrome 50%
Chronic Kidney Disease 40-50%
Anemia 20-30%
HIV 40-75%
Erectile Dysfunction 30-40%
Low Libido- 60%
Cardiovascular and Respiratory Disease 15-25%

Andropause, retitled as Androgen Deficiency in Aging Males (ADAM) has the potential to become the new name of a future age- related testosterone deficiency condition.

Today male hormone replacement therapy has become more widespread in other countries like Australia and Europe rather than in America, and there is still some reluctance on the part of most primary care physicians to diagnose or treat it. A recent online physician survey estimates that ninety percent of physicians are not aware of the Andropause diagnosis nor do they feel comfortable with the treatment of hypogonadism or “low T”.

New T products were emerging on an annual basis, but although they were made for males, some are basically only strong enough for females. Yes, females too sometimes need TRT as they age, but there is no product available. About 3 percent is the highest potency transdermal testosterone product available. Perhaps the major problem with rubbing T gels all over your skin is the transference issue.

To hear their stories and to help you understand how testosterone works in the male body, read, "Listen To Your Hormones, A Doctor’s Guide to Sex, Love and Long Life."  Paperback and audiobook (MP3 CD) versions of this book are available here in our online health store.

Thank you for your interest.

- Abraham Kryger, MD, DMD, CEO Testocreme® Inc.

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