Thinking Twice About Testosterone Replacement

Testosterone replacement therapy can be a necessary medical intervention in some men for conditions such as sexual dysfunction, depression, and chronic fatigue. However, there are known risks. Popularity of testosterone prescriptions are skyrocketing, but who is it safest for and who is at the greatest risk of early cardiovascular death and heart attack? How do consumers make decisions in combination with their doctor without knowing the consequences? Ultimately you have to rely on the experience and knowledge of your provider, but having the right information in front of you can only help the decision process.

In a recent publication from Endocrine Today, evidence suggests that a new subset of men should not use testosterone replacement therapy. Men with obstructive coronary artery disease have higher risk of death and heart attack when using testosterone replacement therapy.

But that leaves some questions, doesn't it? What if you've had a coronary angiograph which confirmed obstruction or perhaps had an angioplasty or stent to correct obstruction and also have confirmed or suspected low testosterone levels? Are you just out of luck with no therapy for the hormone imbalance?

Symptoms of hormone imbalance in aging men are not limited to sexual dysfunction. Rather, depression, poor sleep, poor recovery from activity, poor stamina, libido (sex drive), lack of energy, and decreased strength and performance may all be symptoms of hormone imbalance. We also note that stress and poor blood sugar control can deteriorate men's hormones at an accelerated rate as well. Does this sound familiar? If so, read on.

We often suggest lifestyle modification such as weight loss, stopping smoking, and increasing exercise, especially activities such as weight training and sprinting to improve hormone balance in aging men, but the reality is that besides stopping smoking, these are quite tall orders for those who have obstructive coronary artery disease. Thirty minutes of weight lifting or daily sprinting probably isn't going to be approved by the cardiologist or cardiac rehab therapist. Not to mention that poor hormone balance often makes losing weight difficult.

Getting back to the basics of health, the pillars of good living, may be the answer along with specific products to support hormone balance.

From a diet perspective, adequate protein is an absolute must to stop the breakdown of muscle in aging men. Supplemental protein shakes are often a good way to go if appetite isn't great or cooking isn't your strong suit. If you can tolerate whey protein, it seems to be one of the best sources. It raises glutathione levels which is important from an antioxidant perspective and also contains branch chain amino acids which support muscle health. Vegan protein powders are a bit easier on the body. These contain hemp, pea, and/ or rice but often times are much lower in protein content. Shoot for 20 grams per shake. Nuts and seeds provide excellent protein from plant sources as well. Vegetable and plant nutrients cannot be understated for general heart health and all doctors and practitioners should be encouraging this behavior.

From a dietary supplement side, Revolution Macalibrium is a tested formula of specific phenotypes of maca (Lepidium peruvianum). Maca has a rich history of supporting men's hormone health; however, research has shown that there are specific phenotypes ideal for men’s hormonal health. Revolution Macalibrium not only has these exact phenotypes but has concentrated levels of the full spectrum of active constituents ten to twenty times higher than the levels found in raw maca which is why doctors and patients are getting such strong results quickly. This is a foundational product that works through the hypothalamus-pituitary-adrenal axis to help a man make his own hormones versus relying on hormones from outside of the body. A man's own hormones made by him is much safer since nothing is more natural than your own hormones.

Omega-3 fatty acids, especially those rich in EPA and DHA are recommended. If a man has high triglycerides, the American Heart Association suggest 2.4 grams of EPA + DHA per day. This seems like a prudent suggestion for all men facing either hormone imbalance, obstructive coronary artery disease, or life in the modern world. Reducing inflammation and supporting cell membrane health are just two well known mechanisms of omega-3 fatty acids and since the human body doesn't make its own omega-3's it has to rely on us to ingest them every day. I prefer high EPA products. Some products contains as much as 1060 mg of EPA and 274 mg of DHA per 2 capsules. Two capsules twice per day is ideal to hit this goal dose of 2.4 grams. Be wary of lower doses or you'll end up taking 8 capsules per day. Many products will contain 180 mg of EPA and 120 mg of DHA. This is perhaps suitable for the percentage of the population that gets nearly adequate dietary omega-3 fatty acids and is already healthy.

Other interventions and supplements may be indicated given your history and complicating factors, and in that case we recommend working with a doctor who understands your condition and also natural approaches. Click here to find a practitioner close to you.

So, if you know a man considering testosterone replacement and also has obstructive coronary artery disease, arm them with this important information so he can make an empowered decision.

On Your Feet, Thyroid?

If you have a thyroid condition, you probably wish you could  whip it into shape in a few weeks of hard work, like a Boot Camp. But drill sergeants and obstacles courses are not what your thyroid needs. Think of your thyroid gland as your friend who cries at movies and hems and haws over rather small life changes. It is, like your friend, sensitive to feedback. 

When the thyroid is screaming for trouble, don't forget about its compadres (other organs) that offer direction and guidance to the thyroid gland.

• Gall bladder function impacts the thyroid gland because poor gall bladder function keeps the all important fat soluble vitamins from working. (Lots of thyroid sufferers have had gall bladder surgery). The gall bladder secretes bile, a necessary substance to take in vitamins A, D, E, and K.  If your gallbladder is bile deficient or you have had it removed, you may not be absorbing enough fats resulting in a lack of fat soluble vitamins like Vitamins A, D, E, and K. Your thyroid and adrenals needs vitamin A to work correctly and efficiently. Not just beta carotene but good old-fashioned, preformed vitamin A! Check your multivitamin as to the source of its Vitamin A. Post-surgically, I recommend micellized forms of vitamin A, D, E, and K.

• Digestive function modulates thyroid function as well as it is intimately involved with the immune system (lots of gluten sensitivity in thyroid sufferers). If you have any type of digestive dysfunction from heartburn to gas, diarrhea or constipation, addressing the root cause of it is important. Oftentimes, a pH balanced diet, probiotics, and stress reduction are the first steps to fixing a busted digestive system.

• Hormone balance is also key in both men and women with thyroid dysfunction. Low progesterone can actually hide the fact that a sluggish thyroid is actually a more sinister form called Hashimoto's Thyroiditis. As estrogen declines so too does thyroid function. So much so that a reported 30% of postmenopausal women suffer from hypothyroidism.

• Belly fat. That's right, fat is an organ too. Extra weight around the middle negatively impacts thyroid function. The more fat you have on your frame, the more inflammatory signals you release to the rest of your body. 

So where do you start? Well, you can't send your friend to Boot Camp and yell at them to be tough....you have to strengthen them. Revolution Macalibrium for men and Femmenessence for women are ideal foundational products to strengthen the stress response system in addition to meditation, proper sleep, and a diet rich in plant nutrients. Femmenessence has specific formulations for perimenopausal women and reproductive-aged women as well. These products help your thyroid gland but supporting a myriad of hormones in the body. Every hormone imbalance including stress hormone imbalance directly impacts thyroid function.

Realize that this is a place to start with thyroid conditions. Reducing fat through a primarily plant-based diet, resistance training, and supporting all organs through stress reduction and proper supplementation are all pieces to a potentially complex puzzle. For more information about these products or concepts, contact corey.schuler@naturalhi.com

Maca and Sexual Function by Tori Hudson, N.D.

Maca is a traditional plant common to the Andes Mountains and has been used for centuries to enhance fertility, improve sexual function, improve energy and more. Maca (aka Lepidium Peruvianum and Lepidium meyenii) belongs to the mustard family and is considered an adaptogen—helping us to adapt to a variety of stressors.

A systematic review was done to assess the clinical evidence for or against the efficacy of maca for sexual dysfunction. The review included only randomized clinical trials comparing maca to a placebo in men or women with sexual dysfunction. Four randomized controlled trials (RCT) met the inclusion criteria. Two of these trials suggested a positive effect of maca on sexual dysfunction or libido in menopausal women or adult. One other RCT did not show effect of maca in cyclists. The fourth study assessed the effects of maca in men with erectile dysfunction and did show significant effects.

While the evidence is limited, there does appear to be some effectiveness of maca in improving sexual function.

For more blogs by Dr Hudson go to http://drtorihudson.com

In addition for more information on maca, men and sexual function go to http://www.naturalhi.com/Products/Macalibrium.aspx

Reference

Shin B, Soo Lee M, Jin Yang E, Lim H, Ernst E. Maca (L. meyenii) for improving sexual function: a systematic review. BMC Complementary and Alternative Medicine 2010;10:44