Symptoms of Low Testosterone
The ADAM Male questionnaire (Androgen Deficiency in the Aging Male).
1. Do you have a decrease in libido (sex drive)? Yes No
2. Do you have a lack of energy? Yes No
3. Do you have a decrease in strength and/or endurance? Yes No
4. Have you lost height? Yes No
5. Have you noticed a decreased "enjoyment of life" Yes No
6. Are you sad and/or grumpy? Yes No
7. Are your erections less strong? Yes No
8. Have you noticed a recent deterioration in your ability to play sports? Yes No
9. Are you falling asleep after dinner? Yes No
10. Has there been a recent deterioration in your work performance? Yes No
If you answered YES to questions 1 or 7 or any 3 other questions, you may have low testosterone.
Benefits of Testosterone Therapy:
The Nobel Prize was awarded in 1939 for the synthesis of testosterone (read about it here). And, testosterone has been studied for over 70 years with massive amounts of research showing numerous health benefits.
Benefits include positive effects on mood, energy levels, verbal fluency, strength, increased muscle size, decreased body fat and increased bone density. There is also an anti-depressant effect.
Here are a few of these studies showing testosterone is good for the Heart and Circulation:
Dr. S. Dobrzycki studied men with known coronary artery disease and showed they had significantly lower levels of testosterone (J Med Invest 2003). He also showed that lower testosterone levels was associated with reduced pumping ability of the heart.
Dr. C.J. Malkin showed that testosterone therapy reduced the risk of death from abnormal heart rhythms (arrhythmias). This was published in the American Journal of Cardiology in 2003. Dr Malkin also reported that Testosterone acts a protective factor against atherosclerosis and plaque formation in arteries (J Endocrin 2003).
Dr. Gerald Philips at Columbia University, and Dr. Joyce Tenover of the University of Washington also showed that low testosterone correlates with increased heart disease. These are only a few of the many recent articles.
Dr. Eugene Shippen presented an impressive study at a recent meeting I attended, in which testosterone therapy was used to successfully reverse diabetic gangrene of the lower legs and avoid amputation in many cases.
For more information see my testosterone page.
Safety of Testosterone
Regarding the question of Prostate Cancer risk from testosterone, there is no evidence for this in the medical literature (see below).
Here are only three of the many medical literature references showing NO evidence that testosterone causes prostate cancer:
(1) Testosterone replacement therapy and prostate risks: where's the beef? Morgentaler A. Can J Urol. 2006 Feb;13 Suppl 1:40-3. Division of Urology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
"It has been part of the conventional medical wisdom for six decades that higher testosterone in some way increases the risk of prostate cancer. This belief is derived largely from the well-documented regression of prostate cancer in the face of surgical or pharmacological castration. However, there is an absence of scientific data supporting the concept that higher testosterone levels are associated with an increased risk of prostate cancer. Specifically, no increased risk of prostate cancer was noted in 1) clinical trials of testosterone supplementation, 2) longitudinal population-based studies, or 3) in a high-risk population of hypogonadal men receiving testosterone treatment. Moreover, hypogonadal men have a substantial rate of biopsy-detectable prostate cancer, suggesting that low testosterone has no protective effect against development of prostate cancer. These results argue against an increased risk of prostate cancer with testosterone replacement therapy."
(2) Monitoring androgen replacement therapy: testosterone and prostate safety. Morales A. J Endocrinol Invest. 2005;28(3 Suppl):122-7
"The aging of the world population has brought to the forefront of medical practice the diagnosis and treatment of hypogonadism in adult men. There is an increasing interest on the use of testosterone (T) and other androgens to manage men with clinical and biochemical evidence of hypogonadism. Although treatment with T has been used for 70 yr and it is, generally, safe and effective, there are a number of safety issues--ranging from cardiovascular and lipid alterations to hematological changes--that the physician needs to be aware of. Unquestionably, prostate safety constitutes the most important one. No evidence exists that appropriate androgen administration with knowledgeable monitoring carries significant or potentially serious adverse effects on the prostate gland. Men with symptomatic lower urinary obstruction need to be assessed carefully prior to androgen administration. The suspicion of prostate cancer is an absolute contraindication for T use. Recommendations are available for the judicious and safe use of T in aging men."
(3) Risks of Testosterone-Replacement Therapy and recommendations for Monitoring. N Engl J Med 2004;350:482-92. Rhoden and Morgentaler “Despite decades of research, there is no compelling evidence that testosterone has a causative role in prostate cancer.”
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Jeffrey Dach MD
7450 Griffin Rd Suite 180/190
Davie, FL 33314
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