Firstly, I want to make it really clear, I am not a fan of testosterone therapy. I think the whole low-T market is mostly a fabrication by the drug companies desperate for a new market segment. Statistics show than US male testosterone levels have been decreasing by at least 1 percent a year over the last few decades, according to a 2002 study in The Journal of Clinical Endocrinology and Metabolism. This on the flip side just happens to coincide with rising obesity, metabolic disease, Type-2 diabetes, environmental pollutants and our more sedentary lifestyle. Sales of all testosterone-boosting drugs are estimated to have been $2 billion in 2012, and are projected to hit $5 billion by 2017.
Low-T, or better yet, the common symptoms of Low-T, loss of libido and sex drive, decreased muscle mass and low energy are marketed as "natural" age related disorders. Yes, they are "partly" age related but the evidence and studies show that these symptoms are more related to lifestyle, environment and other factors more so than testosterone deficiency.
Testosterone therapy scares me not just because of the health concerns (more below) but also because once you are on it, you basically become hooked and your natural process of testosterone production shuts down; your body stops producing T as you come to rely on the gels, patches and pellets. It's a deal with the devil -- give me back my energy (forget about exercise, diet and nutrition) and I will be a customer for life!
My latest scare was the recent study in the journal PLoS ONE that found, within three months, taking testosterone doubled the rate of heart attacks in men 65 and older, as well as in younger men who had heart disease. Doubled!
Too many doctors are now writing testosterone prescriptions without even measuring the patient's testosterone levels, much less retesting for confirmation and adjusting the dose after prescription. Up to a quarter of these prescriptions are dispensed without a blood test. Any indication of symptoms is an easy reason to prescribe.
Every year I attend the annual Urology Convention (AUA). This is the convention that all the global Urologists attend to re-up their credentials. It is also a blood fest for drug companies looking to sell their drugs and treatments to those same 30,000+ Urologists that attend. For the last 5 years I have looked to see who is spending the most money and mostly this has always been the drug companies Pfizer and Lilly selling their ED drugs Viagra and Cialis. Last year however, guess what -- the glitziest most expensive stands at AUA were none other than the drug companies marketing testosterone therapy -- which is saying something. These companies are looking for something new to market to men as the ED drugs come off patent and competition sets in -- so the new frontier is men with low energy -- a broad enough term that most men would probably volunteer those symptoms on a majority of the days of the week right!
Here is the thing. Some men need testosterone therapy if they are clinically deficient AND they have symptoms. Clinical testosterone deficiency is generally defined as lower than 200 nanograms of testosterone per deciliter of blood (this can vary). But clinically low-T is actually not as common as you are led to believe. And if you have "general" symptoms and don't have low levels of the hormone it is not a reason to get a prescription. And if you do have low levels of testosterone and don't have any symptoms, again, it is not a reason to start taking the hormone.
"But I have low energy, my sex drive is low and I think I have symptoms of low testosterone" I hear you say. Firstly, get a blood test (or a saliva test which is also recommended by some practitioners). Then start to give yourself what I call the "Low-T Audit." Look at the lifestyle and other factors that may be contributing to your symptoms. There are many clinical studies that back up lifestyle and other changes that can significantly increase your natural testosterone levels. For example, according to findings presented at the annual meeting of the Endocrine Society in 2012, obese men who lost an average of 17 pounds saw their testosterone levels increase by 15 percent. Reducing your alcohol intake also has a massive positive effect as it's a double whammy -- alcohol not only adds to weight gain (higher levels of estrogen) it also damages the liver that processes testosterone. Reducing the amount you drink is a great first step.
Eating foods that have low estrogenic effect is also important. I don't eat any soy for example. It's a myth that soy is good for you, unless it is fermented like seitan or tempah. Eating or drinking out of plastics that are not "BPA Free" also have been shown to affect your fertility, sperm count and testosterone levels.
Similarly the foods you eat and the "type" of exercise you do have the ability to affect testosterone levels. High intensity short duration exercise known as HIIT -- "High Intensity Interval Training") boosts testosterone whereas long "marathon" style exercise has the potential to lead to adrenal fatigue and lower levels of the hormone. Of course, get more zzzzzz's as sleep is a natural promoter of testosterone in men so if you are burning it at both ends you may want to look at what you can do to get more rest.
And just as important in the equation is the need to monitor your estrogen levels. Yes, men have estrogen too and it's not just a female hormone. In men it's called estradiol and it is just as important to keep your T and E in balance than it is to focus on T alone.
What else do I do at 50 to stay healthy and live with vigor? Well I exercise religiously everyday with HIIT exercise as well as eating organic as much as possible as well as grass fed beef or wild caught salmon two to three times a week. I eat lots of vegetables and salads every day and fresh beet juice (which, by the way, is great for sexual health). All our plastics are "BPA-Free." I also take a natural supplement that promotes sexual health, energy and libido as well as natural testosterone levels in a formula shown not interfere with the bodies own production of testosterone.
If I was to leave you with one last thought it is this -- you will get old but you don't have to accept that your symptoms are a "natural" part of aging. Most men can get back the vigor of their former years (or close to it) by adjustments in lifestyle, exercise and nutrition as well as having a look at the environmental factors that may be influencing their symptoms. Don't be convinced by the ads on TV about low T. Do all you can naturally before seeking help from drugs. It may make you feel better in the short term but the symptoms are generally part of an underlying disorder (alcoholism, obesity, lack of sleep, poor nutrition for example) that need your attention first.
I hope this helps. Live with passion and vigor!