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Hormone Replacement Therapy for Men | Understanding the Labs


Hormone replacement therapy for men can be extremely beneficial as men age and begin experiencing symptoms of andropause. Andropause (male menopause) is a combination of symptoms that are thought to be caused by declining testosterone. The decline in testosterone and other androgens with aging is called hypogonadism. For all practical purposes the two are basically the same. The exact cause of low T in andropause (or for any other reason) can come from any of the following:

  • Declining pituitary stimulation
  • Declining hypothalamus stimulation 
  • Declining output of testosterone from the leydig cells in the testes
  • Increased production of sex hormone binding globulin (SHBG)

When we refer to hypogonadism, we are referring to a relative deficiency of available testosterone in the body to be used at the androgen receptors throughout the cells of the body. As mentioned that can occur from any of the above bullet points. For example, declining pituitary function leads to reduced stimulation to the leydig cells in the testes, which produce the testosterone. Another scenario is the hypothalamus not stimulating the pituitary which then stimulates the leydig Man using hormone replacement therapy for mencells. In other cases the testes simply don't respond to the stimulation from the pituitary. Finally, with aging the liver begins to produce an increasing amount of SHBG. SHBG is a protein that binds hormones to transport them throughout the body. When SHBG goes up the amount of testosterone available to be used throughout the body declines. 

Each of these hormone levels in the body can be tested through a blood sample. Many men seeking hormone replacement therapy have been tested using one or more of these methods and were told they are not a candidate for testosterone replacement therapy. While not all men over 35 are candidates for testosterone therapy, a thorough look at all the factors creating symptoms of andropause should be done before ruling someone out as a candidate. Mostly because there are little side effects of this treatment and it can significantly reduce the symptoms associated with andropause and other metabolic conditions. The main culprit for under treatment comes from not fully understanding the difference in measuring total testosterone and free testosterone. In addition we also see under treatment in men when total testosterone is in low normal ranges. In both cases this under treatment is the result of doctors not fully understanding the tests for hypogonadism and or the correlations of andropause symptoms with low testosterone. Lets look at these misunderstandings and controversies in more detail.


Hormone Replacement Therapy for Men and the Variations in Testosterone Levels

Many get their testosterone levels checked by their doctor and are told that their levels on the lower range of normal are acceptable as they are.  Standard reference ranges for total testosterone range from 250-350 pg/ml on the low range and 847-1097 pg/ml on the high range. So for example, if your total testosterone level was 350-500 you may be low and the total testosterone should be viewed in conjunction with your free testosterone levels. Free testosterone should be about 1-3 percent of the total. Most tests will place this reference range at about 9-25 pg/ml (depending on your age) but it really depends on your total level. Using the same example, if your total testosterone is 350 and your free is at 10, then your free is in a good range. Conversely if your total is at 650 or 700 and your free is at 10, then you probably are suffering from excess SHBG rather than deficient testosterone. In some cases simply supplementing with testosterone will decrease the SHBG. In other cases testosterone supplementation creates aromatization into estrogen that causes an increase SHBG and lowers free testosterone. This often occurs when the body has too much testosterone and the enzymes systems become saturated. 


The Effects of too Much Testosterone with Hormone Replacement Therapy for Men

The effects of excess testosterone in hormone replacement therapy for men can cause many problems in the body. This is why anyone supplementing with testosterone should have their levels monitored. The most common issue that occurs is an excess of DHT (dihydrotestosterone). DHT it a derivative of testosterone that is about 5 times stronger than testosterone in terms of its androgenic activity at androgen receptors. When the body gets an excess of testosterone it begins to make DHT and estrogen. Both are associated with increasing prostate growth (benign hyperplasia). These enzyme systems can be manipulated with herbs and medications a bit, but in most cases the small amount of improvement in symptoms is not worth it. The bottom line when looking at testosterone levels and supplementation is to treat the patient and not the test. If you are asymptomatic and your levels are in a good range, pushing the upper limit of normal is not worth the added risk. On the other hand some men with low levels don't have symptoms and in these case, I would encourage some form of supplementation with testosterone for its health benefits and anti aging effects.


The Effects of Testosterone Replacement Therapy on the Body

Testosterone has many effects in the body from improved bone density to increased libido. Testosterone does this by activation of androgen receptors inside the nucleus of cells. The main results of this activation are:

  • Increase fat lypolysis (breakdown)
  • Increases mental energy
  • Increases physical energy
  • Maintenance of muscle growth
  • Improved exercise recovery
  • Increased bone density
  • Regulation of Hypothalamic-Pituitary Axis

If you are suffering from symptoms that are associated with testosterone deficiency, consider looking for bioidentical hormone doctors and getting your levels checked. If you have symptoms of testosterone deficiency and andropause and are curious if you are a candidate for hormone replacement therapy for men, take the low T test. You can also click on the link below for a free consult with bioidentical hormone doctors in Arizona. 


Andropause | Low T


Andropause also know as male menopause has a gradual onset and leads to Low T or low testosterone. The changes are so gradual that many men don't even recognize the changes that have occurred. Men going through andropause are at greater risk for other chronic health conditions. Specifically weight related health conditions such as cardiovascular disease, obesity, diabetes, depression, and GERD. In this article we will look at the physiological connection between weight and Low T. We will also explore how testosterone supplementation can help turn these weight related health conditions around. 


Weight and low testosterone

Weight loss can be a chanllenge for anyone. With low T, this challenge can seem impossible andropausebecasue testosterone helps maintain and build muscle mass. When testosterone is deficient a snowball effect occurs...... decreased muscle and increased fat.

As men age there is a gradual decrease in testosterone. This decline leads to a decrease in muscle mass and an increase in fat..... bad news for your metabolism.  You see, muscle plays a big role in metabolism and the more muscle you have the better your metabolism will be. With Low T there is a gradual decline in metabolism and more and more weight gain. The additional fat and lowered metabolism can create problems with balancing blood sugar and lipids too.  As fat increases around the abdomen testosterone levels will fall further as will energy and glucose control. This downward cycle of testosterone is know as andropause or Low T.  Many times men struggle trying to turn these health conditions around using diets and medications not knowing they may have Low T. 

Most of the health conditions related to Low T are a result of poor metabolism and weight gain. Conditions like metabolic syndrome, elevated lipids, type 2 diabetes, prediabtes, obesity, and high blood pressure are the most notable. Metabolic syndrome is a condition that causes cardiovascular complications but related to poor glucose control similar to diabetes or prediabetes. However, many times (but not all) the central problem in both is excess weight. Improving metabolism and thereby decreasing excess fat is where testosterone can help.


Treating andropause with testosteone

Supplementation with testosterone can turn this cycle of andropause. As testosterone levels return to normal levels men become more energetic and active. Often times the previous efforts in the gym go much further leading to muscle building and fat loss. With additional muscle mass, more calories are burned at rest thus increasing metabolic rate. The increased metabolic rate will reduce weight further given the right circumstances.

What are those circumstances? Well you do have to actually try to loose fat and increase muscle mass. Simply supplementing with testosterone will help improve your blood sugar and lipids. it will also help slow the decline in muscle mass attributed to age. However if you workout properly and eat the right diet you can amplify this effect and get some truly amazing results. The bottom line is by balancing hormones, men can increased metabolic rate making weight loss easier and gaining muscle mass faster.


Treating andropause without testosreone

If you are someone that is not interested in hormone replacement therapy but your testosterone levels are low, you have a few options too. First and most important loosing any central adipose tissue (fat around your abdomen). This fat actually acts like a hormone producing glans creating small amounts of a weak estrogen. This estrogen decreases the available testosterone (free testosterone) for your cells to use. By lowering the adipose tissue you increase the free testosterone. Resistance exercise will actually increase the amount of testosterone your body produces. Getting to the gym for about 30min 2-3 days a week will help increase your testosterone levels. For more tips on testosterone deficiency, click on the link.  

Hopefully you better understand the health benefits of hormone replacement therapy for men with andropause and metabolic conditions. For more information on Andropause and Low T, click oin the link below for a free consultation. 



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