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Testosterone Controversy: Can Supplements Make You Young Again?

Does "Low Testosterone" Need to Be Treated?

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You have probably seen a commercial or advertisement for a dietary supplement that promises to remedy the effects of the natural decline of testosterone that occurs during a man’s life. Perhaps an older gentleman with slick, toned muscles flexes on the bottle or promotional packaging, beckoning to aging men who could use a boost in vitality.  Before you buy, consider that research and evidence related to the effectiveness and safety of testosterone supplements is scant.
 
Testosterone is often associated with strength and youth and has several important functions.  Testosterone contributes to muscle mass, bone density, an adequate supply of red blood cells, and the development of sex organs. Men begin to experience a slow, yet steady, decline in the production of testosterone around the age of 30.  
 
Not all experts agree that decreasing testosterone needs to be treated; additionally, pinpointing testosterone levels as “low” or “normal” can be difficult. The Cleveland Clinic Foundation states that “the only accurate way to detect the condition is to have your doctor measure the amount of testosterone in your blood. It sometimes may take several measurements of testosterone to be sure if a patient has a deficiency, since levels of testosterone tend to fluctuate throughout the day. The highest levels of testosterone are generally in the morning.” 

 

Testosterone supplementation can shrink testicles

Low testosterone, or “Low T,” can certainly be a real problem for men. The issue with trying to correct low testosterone levels by adding extra testosterone is that the body can respond by shutting down its own testosterone-making machinery. That means the testicles shrink and soften and, if you stop taking the replacement therapy, your testosterone levels will drop even lower than they were before you started. It’s easy to get hooked, in other words.
 
The pituitary gland is located in the brain, and works as a hormone thermostat. The pituitary constantly monitors testosterone levels in the blood, and when levels are low, secretes a hormone called lutinizing hormone (LH).  Once released, LH travels to the testicles, and stimulates them to produce more testosterone. Testosterone levels decline with age because the pituitary ages and produces less LH. Your testicles also become less sensitive to LH as you age, and therefore produce less testosterone.  If testosterone is replaced all by itself, the pituitary thinks that the body has adequate levels, and therefore stops producing LH. The result is that the testicles receive no signal to produce testosterone, and because they aren’t being stimulated, they begin to shrink.
 
 
Home testing kits can effectively measure your current hormone levels. If you do detect a deficiency in one or more hormones, like testosterone, you can work with a health care professional to successfully correct the imbalance.  
 
Testosterone can be low for a number of reasons independent of aging. The following may cause testosterone deficiency:
 
  • stress
  • alcoholism
  • chronic illness
  • chronic renal failure
  • cirrhosis of the liver
  • hemochromatosis 
  • some medications
  • AIDS
  • genetic abnormalities
  • inflammatory disease
  • dysfunction of the pituitary gland
  • chemotherapy or radiation treatment
  • injury to or infection of the testicles
 
http://my.clevelandclinic.org/services/testosterone_replacement_therapy/hic_testosterone_replacement_therapy.aspx  
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The Risks of Testosterone Replacement Therapy

Although testosterone replacement therapy is sometimes viewed as the fountain of youth and can be legitimately utilized to correct certain conditions, men who are experiencing lower testosterone levels due to aging should carefully weigh the risks before beginning any type of treatment.  For example, testosterone therapy may: 
  • limit sperm production
  • cause testicle shrinkage
  • enlarge breasts
  • cause acne or other skin problems
  • contribute to sleep apnea
  • increase the risk of heart disease
  • stimulate noncancerous growth of the prostate
 
There are ways to naturally increase testosterone production, such as:Shed extra pounds if overweight, increase vitamin d levels, get plenty of sleep, avoid constant stress, keep low blood glucose levels, weight training and cardio exercise, zinc supplements, and eat healthy fats.
 
http://my.clevelandclinic.org/services/testosterone_replacement_therapy/hic_testosterone_replacement_therapy.aspx 
 
http://www.ncbi.nlm.nih.gov/pubmed?cmd=search&database=pubmed&term=%22Sabanegh+ES%22[Author]
http://my.clevelandclinic.org/staff_directory/Staff_Display.aspx?DoctorID=7284
http://my.clevelandclinic.org/disorders/androgen_deficiency/urology_treatment.aspx
 
Jennifer Cebulak, 
Research Editor
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The Canary Club is an educational advisory group with a team of medical advisors headed by Richard Shames, M.D.