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"Male Hormone Modulation Therapy"
The Life Extension Foundation
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| A Hormonal Attack on Aging |
| Controversy and The Life Extension
Foundation have long been considered synonymous by both supporters and
critics. In terms of complexity and instant effect, the protocol you are
about to read surpasses any life extension program ever discussed in these
pages. |
| The age- reversal premise we are espousing
is the subject of three new books written by highly respected medical doctors.
These books provide a persuasive compilation of research findings and clinical
experience to document the safety and efficacy of using this approach to
treat aging. The books fail, however, to lay out an aggressive therapeutic
plan of action. In this protocol, The Foundation provides a novel step-
by- step program to enable members to immediately take advantage of this
new information. |
| In writing this protocol, the Life
Extension Foundation reviewed several thousand published scientific studies
to validate safety and anti- aging efficacy. We also received input from
experts who have personally followed this system for several years. |
| Foundation members are getting impatient.
They don't want to see their bodies ravaged by aging if a documented therapy
is available that can control or reverse this devastating process. In this
case, proven therapies exist and many are FDA-approved. |
| Implementing this protocol requires
diligent medical testing, but the potential for significant age-reversal
is compelling. |
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| Male Hormones and Aging |
| As men age past year 40, hormonal
changes occur that perceptibly inhibit physical, sexual, and cognitive
function. The outward appearance of a typical middle-age male shows increased
abdominal fat and shrinkage of muscle mass, a hallmark effect of hormone
imbalance. A loss of feeling of well-being, sometimes manifesting as depression,
is a common psychological complication of hormone imbalance. (94-97,271) |
| Until recently, these changes were
attributed to "growing old," and men were expected to accept the fact that
their body was entering into a long degenerative process that would someday
result in death. |
| A remarkable amount of data has been
compiled that indicates that many of the diseases that middle- aged men
begin experiencing, including depression, abdominal weight gain, prostate
and heart disease are directly related to hormone imbalances that are correctable
with currently available drug and nutrient therapies. To the patient's
detriment, conventional doctors are increasingly prescribing drugs to treat
depression, elevated cholesterol, angina and a host of other diseases that
may be caused by an underlying hormone imbalance. |
|
If
doctors checked their male patient's blood levels of estrogen, testosterone,
thyroid, and DHEA (instead of prescribing drugs to treat symptoms), they
might be surprised to learn that many problems could be eliminated by adjusting
hormone levels to fit the profile of a healthy 21-year- old.
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| Few physicians know what hormone blood
tests to order for men, nor do they have the experience to properly adjust
hormones to reverse the degenerative changes that begin in mid-life. This
protocol will provide the patient and physician with the information necessary
to safely modulate hormone levels for the purpose of preventing and treating
many of the common diseases associated with growing older. |
|
| Too Much Estrogen |
| The most significant hormone imbalance
in aging men is a decrease in free testosterone while estrogen levels remain
the same or precipitously increase. Through a variety of mechanisms, as
men grow older, they suffer from the dual effects of having too little
testosterone and excess estrogen. The result is a testosterone/estrogen
imbalance that directly causes many of the debilitating health problems
associated with normal aging. (1-12,28) |
| One cause of hormone imbalance in
men is that their testosterone is increasingly converted to estrogen. One
report showed that estrogen levels of the average 54-year-old man is higher
than those of the average 59-year-old women. (1,5,13-18,48) |
| The reason that testosterone replacement
therapy by itself does not work for many men is that exogenously administered
testosterone may convert (aromatize) into even more estrogen, thus potentially
worsening the hormone imbalance problem in aging males, i.e., too much
estrogen and not enough free testosterone. While there are studies showing
that testosterone replacement therapy does not increase estrogen beyond
normal reference ranges, we are going to show later how the standard laboratory
reference ranges do not adequately address the issue of estrogen overload.
(4,8,9,17,22-25,27,29-32) |
| Estrogen is a necessary hormone for
men, but too much causes a wide range of health problems. The most dangerous
acute effect of excess estrogen and too little testosterone is an increased
risk of heart attack or stroke. (39-43, 261-270) High levels of estrogen
have been implicated as a cause of benign prostatic hypertrophy (BPH) (35-
44,46,47) and one mechanism by which nettle extract works is to block the
binding of growth-stimulating estrogen to prostate cells .(42-44,48,49,50) |
| When there is too little testosterone
present, estrogen attaches to testosterone cell receptor sites throughout
the body and creates many problems in aging men. In youth, low amounts
of estrogen are used to turn off the powerful cell-stimulating effects
of testosterone. As estrogen levels increase with age, testosterone cell
stimulation may be locked in the "off" position, thus reducing sexual arousal
and sensation and causing the common loss of libido so common in aging
men. (94,99,259) |
| High serum levels of estrogen also
trick the brain into thinking that enough testosterone is being produced,
thereby slowing down the natural production of testosterone. This happens
when estrogen saturates testosterone receptors in the hypothalamus region
of the brain. The saturated hypothalamus then stops sending out a hormone
to the pituitary gland to stimulate secretion of luteinizing hormone, which
the gonads require to produce testosterone. High estrogen can thus shut
down the normal testicular production of testosterone. (1,54,271-276,277) |
| One further complication of excess
estrogen is that it increases the body's production of sex hormone- binding
globulin (SHBG). (280) SHBG binds free testosterone in the blood and makes
it unavailable to cell receptor sites. (51-52,55,56) |
| Based on the multiple deleterious
effects of excess estrogen in men, aggressive actions should be taken to
reduce estrogen to a safe range if a blood test reveals elevated levels.
We will discuss the appropriate blood tests and steps that can be taken
to lower estrogen levels later in this protocol. |
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| The Critical Importance of Free
Testosterone |
Testosterone is much more than a sex
hormone. There are testosterone receptor sites in cells throughout the
body, most notably in the brain and heart. (60, 180) Youthful protein synthesis
for maintaining muscle mass and bone formation requires testosterone. (59,61-
74, 87- 90,261- 264,287) Testosterone improves oxygen uptake throughout
the body, helps control blood sugar, (68,75- 78- 80) regulate cholesterol,
(67,69,81) and maintain immune surveillance. (82,83) The body requires
testosterone to maintain youthful cardiac output and neurological function.
(58, 65) Testosterone is a critical hormone in the maintenance of healthy
bone density, (59, 66,67,84-86) muscle mass, (65-67,87-90,287) and red
blood cell production. (6 7,69,92,93,98)
Of critical concern to psychiatrists
are studies showing that men suffering from depression have lower levels
of testosterone than control subjects. (94-98) For some men, elevating
free testosterone levels could prove to be an effective anti-depressant
therapy. There is a basis for free testosterone levels being measured in
men suffering from depression and replacement therapy initiated if free
testosterone levels are low normal or below normal. |
| One of the most misunderstood hormones
is testosterone. Body builders tarnished the reputation of testosterone
by putting large amounts of synthetic testosterone drugs into their young
bodies. Synthetic testosterone abuse can produce detrimental effects, but
this has nothing to do with the benefits a man over age 40 can enjoy by
properly restoring his natural testosterone to a youthful level. |
| Conventional doctors have not recommended
testosterone replacement therapy because of an erroneous concern that testosterone
causes prostate cancer. As we will later show, fear of prostate cancer
is not a scientific reason to avoid testosterone modulation therapy. |
| Another concern skeptical doctors
have about prescribing testosterone replacement therapy is that some poorly
conducted studies showed it to be ineffective in the long-term treatment
of aging. These studies indicate anti-aging benefits when testosterone
is given, but the effects often wear off. What doctors fail to appreciate
is that exogenously administered testosterone can convert to estrogen in
the body. The higher estrogen levels may negate the benefits of the exogenously
administered testosterone. The solution to the estrogen- overload problem
is to block the conversion of testosterone to estrogen in the body. Numerous
studies show that maintaining youthful levels of free testosterone can
enable the aging man to restore strength, stamina, cognition, heart function,
sexuality and their outlook on life, i.e., alleviate depression.(261-270) |
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| Why Testosterone Levels Decline |
| Testosterone production begins in
the brain. When the hypothalamus detects a deficiency of testosterone in
the blood, it secretes a hormone called gonadotrophin-releasing hormone
to the pituitary gland. This prompts the pituitary to secrete luteinizing
hormone (LH) which then prompts the Leydig cells in the testes to produce
testosterone. |
| In some men, the testes lose their
ability to produce testosterone, no matter how much LH is being produced.
This type of testosterone deficiency is diagnosed when blood tests show
high levels of LH and low levels of testosterone. In other words, the pituitary
gland is telling the testes (by secreting LH ) to produce testosterone,
but the testes have lost their functional ability, so the pituitary gland
vainly continues to secrete LH because there is not enough testosterone
in the blood to provide a feedback mechanism that would tell the pituitary
to shut down. In other cases, the hypothalamus or pituitary gland fail
to produce sufficient amounts of LH, thus preventing a healthy pair of
testes from secreting testosterone. Blood testing can determine if sufficient
amounts of LH are being secreted by the pituitary gland and help determine
the proper therapeutic approach. |
| If serum (blood) testosterone levels
are very low, it is important to diagnose the cause, but no matter what
the underlying problem, therapies exist today to safely restore testosterone
to youthful levels in any man (who does not already have prostate cancer). |
| As indicated earlier in this article,
a major problem aging men face is not low production of testosterone, but
excessive conversion of testosterone to estrogen. Again, specific therapies
will be discussed later about how to suppress excess estrogen and boost
free testosterone back to youthful physiologic levels. |
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| The Effects of Testosterone on
Libido |
| Sexual stimulation and erection begin
in the brain when neuronal testosterone-receptor sites are prompted to
ignite a cascade of biochemical events that involve testosterone- receptor
sites in the nerves, blood vessels, and muscles. Free testosterone promotes
sexual desire and then facilitates performance, sensation, and the ultimate
degree of fulfillment. |
| Without adequate levels of free testosterone,
the quality of a man's sex life is impacted and the genitals atrophy. When
free testosterone is restored, positive changes in structure and function
of the sex organs can be expected. (It should be noted that sexual dysfunction
can be caused by other factors unrelated to hormone balance such as arteriosclerotic
blockage of the penile arteries.) |
| The genital/pelvic region is packed
with testosterone receptors that are ultra-sensitive to free testosterone-
induced sexual stimulation. Clinical studies using testosterone injections,
creams, or patches have often failed to provide a long-lasting libido enhancing
effect in aging men. (98) We now know why. The testosterone can be converted
to estrogen. The estrogen is then taken up by testosterone receptor sites
in cells throughout the body. When an estrogen molecule occupies a testosterone
receptor site on a cell membrane, this blocks the ability of serum testosterone
to induce a healthy hormonal signal. It does not matter how much serum
free testosterone is available if excess estrogen is competing for the
same cellular receptor sites. |
| Estrogen can also increase the production
of sex hormone- binding globulin (SHBG), which binds the active free testosterone
into a non- active "bound testosterone". Bound testosterone is not able
to be picked up by testosterone receptors on cell membranes. For testosterone
to produce long- lasting libido enhancing effects, it must be kept in the
"free" form (not bound to SHBG) in the bloodstream. It is also necessary
to suppress excess estrogen as this hormone can compete for testosterone
receptor sites in the sex-centers of the brain and the genitals. |
| Restoring youthful hormone balance
can have a significant impact on male sexuality (99-102) |
|
| Testosterone and the Heart |
| Normal aging results in the gradual
weakening of the heart, even in the absence of significant coronary artery
disease. If nothing else kills the elderly, at some point their heart just
stops beating. |
| Testosterone is a muscle-building
hormone and there are many testosterone-receptor sites in the heart. (57)
The weakening of the heart muscle can sometimes be attributed to testosterone
deficiency. (103- 108) Testosterone is not only responsible for maintaining
heart muscle protein synthesis, but it is a promoter of coronary artery
dilation (109-113) and helps to maintain healthy cholesterol levels. (81,114) |
| There is an ever-increasing number
of studies indicating an association between high testosterone and low
cardiovascular disease rates in men. (81) In the majority of patients,
symptoms and EKG measurements improve when low testosterone levels are
corrected. One study showed that blood flow to the heart improved 68.8%
in those receiving testosterone therapy. (9) In China, doctors are successfully
treating angina with testosterone therapy. (9,115,116) |
| The following list represents the
effects of low testosterone on cardiovascular disease: |
Cholesterol, fibrinogen, triglycerides,
and insulin levels increase (30-33)
Coronary artery elasticity diminishes
Blood pressure rises
Human growth hormone (HGH) declines (weakening
heart muscle)
Abdominal fat increases (increasing heart
attack risk)
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| Those with cardiovascular disease
should have their blood tested for free testosterone and estrogen. Some
men (with full cooperation from their physician) may be able to stop taking
expensive drugs to stimulate cardiac output, lower cholesterol, and keep
blood pressure under control if they correct a testosterone deficit and/or
a testosterone/estrogen imbalance. |
Despite numerous studies substantiating
the beneficial effects of testosterone therapy in treating heart disease,
conventional cardiologists continue to overlook the important role this
hormone plays in keeping their cardiac patients alive.
(9,30,31,77,93,111-113,115,116,261-270) |
| Many doctors will tell you that testosterone
causes prostate disease. The published scientific literature indicates
otherwise. |
| As readers of Life Extension Magazine
learned in late 1997, estrogen has been identified as a primary culprit
in the development of BPH. (117-119) Estrogen has been shown to bind to
SHBG in the prostate gland and cause the proliferation of epithelial cells
in the prostate. (124, 182-184) This is corroborated by the fact that as
men develop benign prostate enlargement, their levels of free testosterone
are plummeting while their estrogen levels remain the same or are rising.
As previously discussed, aging men tend to convert their testosterone into
estrogen. The published evidence shows that serum levels of testosterone
are not a risk factor for developing benign prostate disease. (8,36,41,117-137) |
| The major concern that has kept men
from restoring their testosterone to youthful levels is fear of prostate
cancer. The theory is that since most prostate cancer cell lines need testosterone
to proliferate, it is better to not replace the testosterone that is lost
with aging. The problem with this theory is that most men who contract
prostate cancer have low levels of testosterone and the majority of published
studies show that serum testosterone levels do not affect one's risk for
contracting prostate cancer. |
| Since the perception is so strong
that any augmentation of testosterone can increase the risk of prostate
cancer, we did a MEDLINE search on all the published studies relating to
serum testosterone and prostate cancer. The appendix at the end of this
article provides quotations from the published literature as it relates
to the issue of whether testosterone causes prostate disease. Out of 27
MEDUNE studies we found, five indicated that men with higher testosterone
levels had a greater incidence of prostate cancer, whereas 21 studies showed
that testosterone was not a risk factor. One study was considered neutral.
The score was therefore: |
| 21 studies indicating testosterone
does not cause prostate cancer |
|
versus
|
| 5 studies indicating testosterone
causes prostate cancer (and one study that did not produce significant
results) |
| Before anyone starts a testosterone
replacement program, they should have a serum PSA test and a digital rectal
exam to rule out prostate cancer. Nothing is nsk free. A small minority
of men with low testosterone and prostate cancer will not have an elevated
PSA or palpable lesion detectable by digital rectal exam. If these men
use supplemental testosterone, they risk an acute flare up in their disease
state. That is why PSA monitoring is so important every 30-45 days during
the first 6 months of any type of testosterone augmentation therapy. If
an underlying prostate cancer is detected because of testosterone therapy,
it is usually treatable with non-surgical means. |
| Please remember that testosterone
does not cause acute prostate cancer, but if you have existing prostate
cancer and don't know it, testosterone administration will likely sharply
boost PSA and provide your doctor with a quick diagnosis of prostate cancer
(and an opportunity for very early treatment). We acknowledge that some
aging men will not want to take this risk. |
| As stated above, the MEDLINE score
was 21 to 5 against the theory that testosterone plays a role in the development
of prostate cancer. None of these studies took into account the prostate
cancer prevention effects of men who take lycopene, selenium, and vitamins
A and E. (135- 144) Nor did they factor in possible prostate disease preventives
such as saw palmetto, nettle, soy, and pygeum. (42-44,145-170,172) |
| In Dr. Jonathan Wright's book, Maximize
Your Vitality and Potency, a persuasive case is made that testosterone
and DHEA actually protect against the development of both benign and malignant
prostate disease. Dr. Wright also points out that natural therapies such
as saw palmetto, nettle, and pygeum provide a considerable degree of protection
against the alleged negative effects that higher levels of testosterone
might have on the prostate gland. |
| We eagerly await the results of more
studies, but the fear of developing prostate cancer in the future should
not be a reason to deprive your body today of the life saving and life-enhancing
benefits of restoring a youthful balance. |
| Once a man has prostate cancer, testosterone
therapy cannot be recommended because most prostate cancer cells use testosterone
as a growth promoter. This regrettably denies prostate cancer patients
the wonderful benefits of testosterone therapy. Men with severe BPH should
cautiously approach testosterone replacement. It would be prudent for those
with BPH who are taking testosterone replacement therapy to also use the
drug Proscar (finasteride) to inhibit 5- alpha reductase levels, thereby
suppressing the formation of dihydrotestosterone (DHT). (171-182) DHT is
ten times more potent than testosterone in promoting prostate growth, and
suppressing DHT is a proven therapy in treating benign prostate enlargement.
Saw palmetto extract suppresses some DHT in the prostate gland, but its
effectiveness in alleviating symptoms of BPH probably has more to do with: |
-
Its blocking of atpha-adrenergic receptor
sites on the sphincter muscle surrounding the urethra. (This is how the
drug Hytrin works.)
-
Its inhibition of estrogen binding to
prostate cells (like nettle).
-
Its inhibition the enzyme 3-kefosteroid
(that causes the binding of DHT to prostate ceUs).
-
Its anti-inflammatory effect on the prostate.
|
| It is unfortunate that many people
still think that restoring testosterone to youthful levels will increase
the risk of prostate disease. This misconception has kept many men from
availing themselves to this life-enhancing and life-saving hormone. |
| While it is clear that excess estrogen
causes benign prostate enlargement, the evidence for excess estrogen's
role in the development of prostate cancer is uncertain. (8,41,117-134,182-217,236)
Some studies show elevated estrogen is associated with increased prostate
cancer risk while other studies contradict this. For more information on
testosterone, estrogen and the prostate gland, refer to the February 1999
issue of Life Extension Magazine. (182-217) |
|
| Testosterone and Depression |
| A consistent finding in the scientific
literature is that testosterone replacement therapy produces an increased
feeling of well being. As stated earlier, newly published studies show
that low testosterone correlates with symptoms of depression and other
psychological disorders.(94-97,272) |
| A common side-effect of prescription
anti-depressant drugs is the suppression of libido. Those suffering with
depression either accept this drug-induced reduction in quality of life,
or get off the anti- depressant drugs so they can at least have a somewhat
normal sex life. If more psychiatrists tested their patients blood for
free testosterone and prescribed natural testosterone therapies to those
with low free testosterone, the need for libido- suppressing anti- depressant
drugs could be reduced or eliminated. As previously described, testosterone
replacement often enhances libido which has the opposite effect of most
prescription anti-depressants. |
| One study showed that patients with
major depression experienced improvement that was equal to that achieved
with standard antidepressant drugs. (97) |
| Androderm is one of several natural
testosterone replacement therapies that can be prescribed by doctors. A
12- month clinical trial on this FDA-approved drug resulted in a statistically
significant reduction in the depression score (6.9 before vs 3.9 after).
Also noted were highly significant decreases in fatigue from 79% before
the patch to only 10% after 12 months. (218) |
| According to Jonathan Wright, M.D.,
author of the book Maximize Your Vitality & Potency, the following
effects have been reported in response to low testosterone levels: |
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Touchiness/irritability
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Great timidity
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Feeling weak
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Inner unrest
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Loss of ability to concentrate
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Memory failure
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Reduced intellectual agility
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Passive attitudes
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General tiredness
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Reduced interest in surroundings
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Hypochondria
|
| The above feelings can all be clinical
symptoms of depression, and testosterone replacement therapy has been shown
to alleviate these conditions. Testosterone thus has exciting therapeutic
potential in the treatment of depression in men. |
|
| Testosterone and Aging |
| We know that many of the degenerative
diseases of aging in men such as Type II diabetes, osteoporosis, and cardiovascular
disease are related to a testosterone deficiency. We also know that common
characteristics of middle- age and older age such as depression, abdominal
fat deposition, muscle atrophy, low energy, and cognitive decline are also
associated with less than optimal levels of free testosterone.(58,219) |
| A consistent pattern that deals with
fundamental aging shows that low testosterone causes excess production
of a dangerous hormone called cortisol. Some anti-aging experts call cortisol
a "death hormone" because of the multiple degenerative effects it produces
such as immune dysfunction, brain cell injury, arterial wall damage, etc. |
| A group of scientists conducted two
double-blind studies where they administered supplemental testosterone
to groups of aging men and observed the typical responses of lower levels
of cholesterol, glucose and triglycerides, reductions in blood pressure,
and decreased abdominal fat mass. These scientists then showed that excess
cortisol suppressed testosterone and growth hormone production and that
the administration of testosterone acted as a "shield" against the over
production of cortisol in the adrenal gland. (289) |
| It is important to point out that
testosterone is an anabolic (or protein building) hormone while cortisol
is a catabolic hormone that breaks down proteins in the body. Normal aging
consists of a progressive decrease in free testosterone with a marked increase
in cortisol. As men age past 40, cortisol begins to dominate, and the catabolic
effects associated with growing older begin to dominate. |
| These findings have significant implications
in the battle to maintain youthful hormone balance for the purpose of staving
off normal aging and its associated degenerative diseases. |
|
| The Testosterone Doctor |
| Eugene Shippen, M.D., authored a book
in 1998 called The Testosterone Syndrome. He was a speaker at the American
Academy of Anti-Aging Medicine Conference held in December 1998 where he
provided extensive evidence documenting the pathology of the testosterone
deficiency syndrome in men. Here are some excerpts from Dr. Shippen's presentation
that appeared in the March 1999 issue of Life Extension Magazine: |
| First, Testosterone is not just a
"sex hormone." It should be seen as a "total body hormone," affecting every
cell in the body. The changes seen in aging, such as the loss of lean body
mass, the decline in energy, strength, and stamina, unexplained depression,
and decrease in sexual sensation and performance, are all directly related
to testosterone deficiency. Degenerative diseases such as heart disease,
stroke, diabetes, arthritis, osteoporosis, and hypertension are all directly
or indirectly linked to testosterone decline. (220- 223) Secondly, testosterone
functions also as a prohormone. (99) Local tissue conversion to estrogens,
dihydrotestosterone (DIII), or other active metabolites plays an important
part in cellular physiology. |
| Excess estrogen seems to be the culprit
in prostate enlargement. Low testosterone levels are in fact associated
with more aggressive prostate cancer. (201,205,224- 229) While fear of
prostate cancer keeps many men from testosterone replacement, it is in
fact testosterone deficiency that leads to the pathology that favors the
development of prostate cancer. |
Testosterone improves cellular bioenergetics.
It acts as a cellular energizer. Since testosterone increases the metabolic
rate and aerobic metabolism, it also dramatically improves glucose metabolism
and lowers insulin resistance.
(76,80,230) |
| Another myth is that testosterone
is bad for the heart. Actually, low testosterone correlates with heart
disease more reliably than high cholesterol. (231) Testosterone is the
most powerful cardiovascular protector for men. Testosterone strengthens
the heart muscle; there are more testosterone receptors in the heart than
in any other muscle. (232) Testosterone lowers LDL cholesterol and total
cholesterol, (69,81,111) and improves every cardiac risk factor. It has
been shown to improve or eliminate arrhythmia and angina. (9,106,113- 115,233,266
) A Testosterone replacement is the most underutilized important treatment
for heart disease. |
| Testosterone shines as a blood thinner,
preventing blood clots. 32 Testosterone also helps prevent colon cancer.
(235-236) |
| Previous research on testosterone
used the wrong form of replacement. Injections result in initial excess
of testosterone, with excess conversion to estrogens. Likewise, total testosterone
is often measured instead of free testosterone, the bioavailable form.
Some studies do not last long enough to show improvement. For instance,
it may take six months to a year before the genital tissue fully recovers
from atrophy caused by testosterone deficiency, and potency is restored. |
| Physicians urgently need to be educated
about the benefits of testosterone and the delicate balance between androgens
(testosterone) and estrogens. Each individual has his or her own pattern
of hormone balance; this indicates that hormone replacement should be individualized
and carefully monitored. |
| Dr. Shippen's book, The Testosterone
Syndrome retails for $21.95. Foundation members can purchase it for $15.00
by calling 1-800-544-4440. The book provides a persuasive argument in favor
of hormone modulation in the aged male, and contains many interesting case
histories. Dr. Wright's and Dr. Ullis's books on this subject are also
available. |
|
| Obesity and Hormone Imbalance |
| A consistent finding in the scientific
literature is that obese men have low testosterone and very high estrogen
levels. Central or visceral obesity (pot belly) is recognized as a risk
factor for cardiovascular disease and type II diabetes. New findings have
shed light on subtle hormone imbalances in obese men that are of borderline
character and often fall within the normal laboratory reference range.
Boosting testosterone levels seems to decrease the abdominal fat mass,
reverse glucose intolerance, as well as lipoprotein abnormalities in the
serum. Further analysis has also disclosed a regulatory role for testosterone
in counteracting visceral fat accumulation. Longitudinal epidemiological
data demonstrate that relatively low testosterone levels are a risk factor
for development of visceral obesity. (7,237) |
| One study showed that serum estrone
and estradiol was twofold elevated in one group of morbidly obese men.
Remember, fat cells synthesize the aromatase enzyme, and this causes male
hormones to convert to estrogens (278) Fat tissues, especially in the abdomen,
have been shown to literally "aromatize" testosterone and its precursor
hormones into potent estrogens. (80,237-242) |
| Eating high-fat foods may reduce free
testosterone levels according to one study that measured serum levels of
sex steroid hormones after ingestion of different types of food. High protein
or carbohydrate meals had no effect on serum hormone levels, but a fat-
containing meal reduced free testosterone levels for 4 hours. (243) |
| So obese men suffer from testosterone
deficiency caused by excess aromatase enzyme being produced in fat cells
and also from the fat they consume in their diet. (240) The resulting hormone
imbalance (too much estrogen and not enough free testosterone) in obese
men partially explains why so many are impotent, and suffer from a wrath
of premature degenerative diseases.(45) |
|
| Factors Causing the Estrogen-Testosterone
Imbalance in Men |
| If your blood tests reveal high estrogen
and low testosterone, here are the common factors involved: |
| Excess Aromatase Enzyme men age, they
produce larger quantities of an enzyme called aromatase The aromatase enzyme
converts testosterone into estrogen in the body. (17,240,241,244,245) Inhibiting
the aromatase enzyme results in a significant decline in estrogen levels
while often boosting free testosterone youthful levels. (279) Therefore,
an agent designated as "aromatase inhibitor" may be of special value to
aging men who have excess estrogen. |
| Liver Enzymatic Activity- A healthy
liver eliminates surplus estrogen and sex hormone-binding globulin. Aging,
alcohol, and certain drugs impair liver function, and can be a major cause
of hormone imbalance in aging men. Heavy alcohol intake increases estrogen
in men and women. (54,246, 285) |
| Obesity- Fat cells create aromatase
enzyme, especially abdominal fat. (241,242) Low testosterone allows the
formation of abdominal fat, (47,239,248) which then causes more aromatase
enzyme formation and thus even lower levels of testosterone and higher
estrogen (by aromatizing testosterone into estrogen). It is especially
important for overweight men to consider hormone modulation therapy. |
| Zinc Deficiency- Zinc is a natural
aromatase enzyme inhibitor. (247) Since most Life Extension Foundation
members consume adequate amounts of zinc (30 to 90 mg/day), elevated estrogen
in Foundation members is often caused by factors other than zinc deficiency. |
| Lifestyle changes (such as reducing
alcohol intake) can produce a dramatic improvement in the estrogen-testosterone
balance, but many people need to use aromatase inhibiting agents to lower
estrogen and to improve their liver function to remove excess SHBG. Remember,
aromtase converts testosterone into estrogen and can indirectly increase
SHBG. SHBG binds to free testosterone and prevents its from exerting its
biochemical effects in the body. |
|
| Correcting A Hormone Imbalance |
| A male hormone imbalance is correctable
by utilizing the proper blood tests and using available drugs and nutrients.
The following represents a step-by-step program to safely restore youthful
hormone balance in aging men: |
| Step # 1: Blood Testing |
| The following initial blood tests
are recommended for any man over age 40: |
-
Complete blood count and chemistry profile
(to include liver-kidney function, glucose, minerals, lipids, thyroid (TSH)
etc.)
-
Free and Total Testosterone
-
Estradiol (estrogen)
-
Progesterone
-
DHEA
-
PSA
-
Luteiizing hormone (LH)
-
Homocysteine
|
