Hormone Replacement

For as long as I can remember, there has been a raging debate over hormone replacement in women. We are all well aware of the term menopause. It is common knowledge that somewhere between the ages of 40 and 60, women's hormones decrease. In fact, they come to a grinding halt. The estrogen, progesterone and yes even testosterone, effectively go down to almost zero!

There are wonderful well designed studies that have looked at this very carefully. There should be no raging debate. These well thought out studies that have looked at many thousands of women all come to the same conclusion. That is; early hormone replacement in women, decreases the risk of breast cancer, prevents heart disease, maintains muscle and bone density, decreases the risk of Alzheimer's disease, and improves cholesterol just to name a few of the benefits. Unfortunately, big pharma got involved and screwed it up for everyone!

News Flash, hormones ain't just for women! After the age of 35, many men will have a slow but steady decline in there testosterone, DHEA (dehydroepiandrosterone), and HGH (human growth Hormone). To the ignorant and uninformed, there is some controversy in male hormone replacement. To the well read and educated individual, the literature is replete with long term, well designed studies that tout the numerous health benefits of male hormone replacement. Some of the well known side effects of male hormone replacement are: building of bones and muscles, prevention of heart disease, decreases the risk of Alzheimer's disease, improves cholesterol and decreases the risk of prostate cancer, just to name a few. That's right, I said it decreases the risk of prostate cancer! There was even a recent study that looked at men that did develop prostate cancer while on testosterone, compared to men who developed prostate cancer with low testosterone. The men with higher testosterone developed a much less aggressive form of prostate cancer than did there low testosterone counterparts.

The big question is, do you need testosterone and if so, how much do you need? I'm sure you've seen the commercials for low T. So how low do you have to go before you should consider replacement?

Unfortunately, the so called "norms" haven't changed in 40 years. When these "norms" were set, we really didn't know much about testosterone, its safety profile, or it's wide range of benefits. Now, even though our knowledge has vastly increased, we still haven't moved the goal posts! Most labs have a very wide range of what they consider "normal" testosterone levels. Usually, the range is about 285 to 850, plus or minus a few points.

When you look at these numbers, even if we accept this range (which I don't), If you are at a testosterone level of 300, does that mean you "normal". In my office, the answer is a resounding NO! In the eyes of many physicians, the answer is yes.

The term of the near future will be optimization rather than normalization. What I mean by that is really, where do you want to be in this range (assuming you accept this range, which I don't). Do you want to be at 301 or 850? When you were a young man, your testosterone was probably around 1200 to 1500. So why would you shoot for old man levels?

This is an important conversation to have with your prescribing physician. Not all physicians subscribe to this philosophy or are comfortable with it. I am, because I have scoured the literature and it is overwhelmingly replete with the benefits of optimizing testosterone levels.

I want you to be a man with a plan. That means, don't accept myths and half truths. Fined out the real facts. Get tested and have a meaningful conversation with a Board Certified Urologist. Don't end up at one of those new age health clinics or "anti-aging centers", run by individuals that want to sell you thousands of dollars of so called medicines and therapies.

Incidentally, I hate the term anti-aging. There is no such thing! There is better aging and healthier aging, but we haven't figured that anti-aging thing out yet. So this is just a gimmick. It is a term everyone is attracted to, even though it really has no foundation.

I believe in adding life to your years rather than years to your life. If your serious about understanding your health and actually getting healthy, I'm the guy to see. If you are looking for the magic pill that will help you lose weight , get great abs, walk your dog, improve your stock portfolio, and make you smarter...well, fantasy does have its place!

Be a Man With a Plan