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Testosterone

Testosterone and Male Libido:

Testosterone is often tested because the patient talks of low libido. Declining testosterone levels are the number one cause of low libido in males, and plays a contributing factor in females.

Declining testosterone levels are commonly seen in men beginning in the fourth decade of life. Suboptimal or low testosterone levels in males are often associated with symptoms of aging and are referred to as Andropause or male menopause.

Testosterone is an important anabolic hormone in men. It increases energy, prevents fatigue, helps maintain normal sex drive, increases strength of all structural tissues such as skin/bone/muscles; including the heart and prevents depression and mental fatigue. Testosterone deficiency is often associated with symptoms such as night sweats, insulin resistance, erectile dysfunction, low sex drive, decreased mental and physical ability, lower ambition, loss of muscle mass and weight gain in the waist. The primary cause of this increase in girth is visceral fat, not excessive subcutaneous fat (fat under the skin).

The visceral fat cells are the most insulin resistant cells in the human body. As a person ages hormone levels change in favor of insulin resistance. The insulin levels rise while progesterone, growth hormone and testosterone decline. The visceral fat cell begins to collect more fat in the form of triglycerides. A vicious cycle is initiated, which if not interrupted with natural hormone balancing will lead to abdominal obesity, diabetes and high cholesterol levels. This phenomenon is known as "Metabolic Syndrome."  In males, metabolic syndrome results in lower testosterone levels, however, in females metabolic syndrome results in high testosterone levels and a phenomenon known as Polycystic Ovarian Syndrome (see below).

Stress management, exercise, proper nutrition, dietary supplements, and androgen replacement therapy have all been shown to raise androgen levels in men and help counter male metabolic syndrome symptoms. The trick is to know how much testosterone is required for each individual male. This is where knowing the salivary testosterone levels come into play.

Initial salivary testing and following salivary monitoring are crucial for determining the most optimal prescription.  Metabolic Syndrome and Polycystic Ovarian Syndrome (PCOS) in females results in the same visceral fat pattern, insulin resistance and triglyceride formation as in males, however, the female patients with PCOS and metabolic syndrome had high levels of testosterone and often DHEA. This results in a typical symptom pattern seen in women with metabolic syndrome – acne, increased facial and body hair, hair loss on the head, trunkle obesity and infertility. Salivary testosterone and DHEA levels are diagnostic for this syndrome and follow up testing is key for monitoring treatment. It is important to note that women do not need to have their ovaries to have metabolic syndrome. The adrenal glands in women who have a predisposition to metabolic syndrome can produce above normal levels of testosterone and DHEA.

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The Canary Club is an educational advisory group with a team of medical advisors headed by Richard Shames, M.D.