April 12, 2017
Doc, ” I am not strong anymore and I don’t have the energy to get a good work out in.” This is what I commonly hear from new male patients who seek my help. I like treating my patients with hormones in order to help them make the improvements that influence their quality of life.
Men want to stay strong, have good energy, improve their sex life and feel overall healthier as they get older. The sad truth though is that as we age, we typically lose hormones and this decline causes so many health consequences. The other sad fact is that physicians in general often don’t treat hormone deficiency adequately.
If we look at only one hormone — testosterone (T), which is the major sex hormone for men, we see that when it declines, men lose muscle mass, have brain “fog”, have increased belly fat and love handles and complain about poor libido.
I recommend hormone replacement with bio-identical hormones — in other words replacing whats missing with identical chemicals — natural hormones that the body identifies as normal.
I really want hormone levels in the youthful range — so even if you are 40 or 50 or even 60, I would prefer your hormone levels return to more youthful levels — like that of a younger, healthy male say 25 to 30 years of age. Actually I seek levels that are high normal and then over time we adjust the dose of the hormones according to how men feel.
What I see when patients follow up with me is often remarkable. I remember one gentleman who was in his mid 50’s and he was accompanied by his wife. He admitted fatigue but she volunteered that he was lethargic and moody, grumpy and even at times depressed. She said their primary care doctor was even considering starting him on an antidepressant medication to alleviate the symptoms. After only six weeks on testosterone, his depression was gone and he was energetic enough to get back into the gym and he felt amazing. As an aside, he sleep had also been poor and now on testosterone he slept so much better. And he looked better — his attitude was significantly better, he seemed self assured and confident and the wife felt like she got back the man she married.
Poor levels of testosterone in older men can cause low libido and very poor sexual performance. I often see men that admit that they don’t think much about sex anymore and some will even say that their wife believes they must be cheating. Poor erections or erectile dysfunction is common as well as loss of the normal morning erections. When testosterone is replaced, appetite for sex returns and men feel more vital and more sexual.
There are several myths about testosterone and often I have to tell it like it is. First off, testosterone does not cause cancer and it does not increase a man’s risk for cardiovascular disease. When testosterone is more in the youthful range, cardiovascular risk and cancer risk decline, obesity improves, the risk for diabetes lessens and men look and feel better and sex is better — who doesn’t want that?
So what do you do if you think more testosterone would be better for you and that you would like to optimize your levels? Talk with a physician who is experienced with testosterone replacement. Very often this doctor works in an antiaging medical clinic. You will need to have labs drawn in order to determine your testosterone level. As a general rule, if you have a testosterone level less than 350 AND you have low testosterone symptoms, you likely have hypogonadism — which is the medical term for low testosterone. A complete and thorough history and physical exam should be done and then treatment options will be given to you by the doctor. The most important next step is that you have adequate follow up to determine your response to testosterone replacement and to have specific dose adjustments and to have the appropriate follow up labs which should include blood counts, testosterone, free testosterone, estradiol and sometimes additional testing.
Hormone replacement with testosterone and other hormones can be life changing and is definitely something for all men to consider as they get older.
Don Fisher D.O.
Medical Director/ Physician
The BEST Program, Inc.