By: Corey Howard, MD, FACP
The testosterone boom is on and you need to know a few things before you decide to jump in. The questions to ask are: Is it right for me? What kind of specialized training and certifications does my doctor have for hormone therapy? Are there natural ways to increase testosterone? What are some other labs my doctor should check? On August 18, 2014 Time Magazine brought this issue to the front cover and titled it MANOPAUSE?! Aging, insecurity and the $2 billion testosterone industry. So, is testosterone right for you? Before I start let, me let you in on a trade secret. There is a point and counterpoint to every argument in medicine today. One group will push that something is the best thing ever and another group will say it is the worst thing ever. The bad part is that both groups will have data to support their position leaving you, the consumer, bewildered and paralyzed. The same is true with the data on testosterone. I am going to talk about the evidence based science available and give you a few tips that will help you decide if hormone therapy is right for you.
Testosterone will naturally begin to decline after the age of 30 and by the age of 40, it will decrease by about 1% per year. Every man will have varying degrees of decline and many may not notice anything well into their later years. The decline can be due to diabetes, obesity, smoking, chronic alcohol use, medications, stress and many other factors. The most common symptoms are body composition changes, (especially abdominal fat), fatigue, moodiness (none of you guys out there fit this one I am sure), decreased sex drive and muscle loss.
Here is where things get a bit confusing. Not all people with low testosterone need testosterone treatment. The reason is that there is a complex hormonal pathway to make this important male hormone and there may be other issues causing the problem. One of these is stress. Today’s world is filled with deadlines; sleep deprivation, too much to do in too little time, leaving little time to take good care of yourself. It is part of the reason why almost 70% of the United States population is overweight or obese. Unfortunately, this number continues to rise in spite of diet books, gyms, boot camps and online or DVD workouts. Stress plays a major role and here how it works. The main stress hormone is Cortisol, which is produced in your adrenal gland. When you are “stressed”, cortisol rises. When it is up for too long it can tire out the adrenal gland leading to other issues. The backbone of cortisol and testosterone is cholesterol. Therefore, if cortisol increases, testosterone may decrease. There are several other mechanisms just like this one that can lead to a decline in male hormones.
The reason why it is important to know this is that the evaluation needs to be complete so your doctor can help you heal and is not just putting a bandage on the underlying problem by writing testosterone for you. In addition to the cortisol levels, it is wise to check thyroid function, estradiol, diabetes markers and other metabolic markers that will aid your doctor in creating a more personalized program for you.
One of the most important areas to discuss is the nutrient content in your diet. Many times I see low micronutrient vitamins/minerals/amino acids/trace elements) levels and these can play a role on how your body makes and processes your hormones. Therefore, nutritional evaluation must go hand in hand with hormone testing to get a full picture. Nutritional issues can be handled in a more natural way with food and occasionally supplementation.
Finally, please make sure your doctor has obtained additional training or certifications in hormone therapy evaluation and management. This additional training helps your doctor maximize your care. If you are not sure, ask.
Declining testosterone is a common problem in men as they age. If you are having symptoms or are concerned that this may affect you, I strongly suggest you find a doctor who can look at you as a whole person and not just another guy with “Manopause”.
Dr Corey Howard is board certfied in internal medicine, digestive diseases and nutrition and Anti-aging and regenerative medicine. He also has specialized training in Plant based cooking. His unique office setting includes a functional kitchen and yoga stuido. Contact him directly at: firstname.lastname@example.org
Corey Howard, MD, FACP
Dr. Corey Howard, is a fellowship-trained gastroenterologist, board certified in internal medicine, Anti-aging, and Regenerative Medicine. He has done additional training and obtained professional certification in Plant Based cooking. His Lifestyle Medicine practice is in Naples. He has regular seminars on the importance of lifestyle in improving you health as well as cooking demonstrations.
1048 Goodlette Road, Suite 101, Naples, FL 34012 . 239-325-6504 . www.physicianslifecenters.com