At the 23rd Annual World Congress on Anti-Aging Medicine (Dec. 11-13, 2015) in Las Vegas Dr. Joel Heidelbaugh presented a talk entitled “Examining the Correlation Between Androgen Deficiency and Cardiometabolic Risk”. In the beginning he mentioned that in the last few years many physicians have been over-prescribing testosterone for erectile dysfunction (ED), even just for a complaints of a lack of energy, without first taking blood tests to confirm low testosterone levels. Some of these patients have gone on to develop heart attacks, because coronary artery stenosis likely was the underlying condition to start with. Dr. Heidelbaugh explained that the longer men have ED, the higher the risk of developing a heart attack. Studies have shown that it takes an average of 3 to 5 years for a heart attack to occur after the onset of ED. He explained that the penile artery has a diameter of only 2 to 3 mm while the average diameter of the coronary arteries is 6 to 8 mm. The larger diameter of coronary arteries compared to the diameter of the penile artery is the reason why hardening of the arteries affects the smaller arteries first, causing ED. The closing of the coronary arteries 3 to 5 years later causes heart attacks at that time.
Dr. Heidelbaugh cited a number of trials that showed that co-existing other diseases have clouded some of the testosterone studies, such as obesity, type 2 diabetes, coronary artery disease, high blood pressure, end stage kidney disease and chronic emphysema. On the other hand, often in patients with these diseases low testosterone levels are detected with blood tests.
The following observations regarding testosterone were found in several trials that were cited:
- Testosterone levels of less than 300 ng/dL have been established as the lower cut-off for normal testosterone, meaning that the person suffers from hypogonadism (the medical term for “too little testosterone production from the testicles”). Lower testosterone levels than 300 ng/dL are associated with increased cardiovascular disease causing heart attacks and strokes.
- Several conditions are associated with low testosterone production: obesity (risk of 2.38-fold lower testosterone), type 2 diabetes (risk of 2.09-fold lower testosterone), high blood pressure (1.84-fold), high cholesterol/high triglycerides (1.47-fold), asthma or emphysema (1.40-fold), prostate disease (1.29-fold). This means that in any of these conditions the physician should measure the testosterone level, as it could be low and when replaced by testosterone would allow the patient to prevent the diseases associated with low testosterone levels.
- When aging male patients with low testosterone are observed without treatment, they have a higher mortality from heart attacks and strokes. Conversely, when they are treated with various forms of testosterone preparations and their blood tests are kept in the high normal range (around 700 to 800 ng/dL), their risk for heart attacks and strokes approaches the lower risks that men enjoy who naturally have these higher testosterone levels.
- In the EPIC-Norfolk study the highest 10-year survival rate was found in the group with the highest level of testosterone among 2314 men aged 42-78 yrs.
- Mortality was significantly reduced in a group of diabetics treated with testosterone over 6 years: the control group (no testosterone treatment) had a mortality of 19.2% while the mortality of the treatment group (on testosterone) was 8.4%. Another study followed patients with low testosterone for 4 years and found that this group had a mortality of 20.7%, while the testosterone treatment group’s mortality rate was 10.3%.
Low testosterone is an important factor in the mortality of older men, which makes sense in view of the fact that all major organs in a man contain testosterone receptors, particularly the heart, brain, muscles, lungs, liver and kidneys. The cell metabolism of a man needs testosterone to function normally. In this talk Dr. Joel Heidelbaugh presented evidence that cardiovascular disease and diabetes respond better to treatment when testosterone levels were normalized by testosterone replacement. Mortality studies were presented, and these were much improved with testosterone replacement. Later in 2016 the T-TRIAL will be released, which will reveal more information about the beneficial effects of testosterone replacement.
More about testosterone replacement: https://nethealthbook.com/hormones/hypogonadism/secondary-hypogonadism/male-menopause/