Strength, Muscle and Extended Living Through Chemistry? Part 2
Part 1 was all about growth hormone, what it does and the pros and
cons of hormone-replacement therapy. This installment covers
testosterone.
Does Testosterone Prolong Life?
In 1993 a group of researchers from Germany, noting that women
usually outlive men, attempted to determine why. They analyzed more than
277 years of records of the life spans of castrati, who produce little
or no testosterone, and uncastrated male singers. They found no
significant difference between those with low and normal testosterone
levels in relation to life span.
20
A recent longitudinal study, however, found that having low
testosterone increased the risk of death in men over age 50. For 18
years, beginning in the 1970s, researchers tracked the causes of death
in 800 men aged 50 to 91 living in Rancho Bernardo, California. In the
early 1980s a third of the men had low testosterone. Over the term of
the study that group had a 33 percent greater death rate than the men
who had higher testosterone levels. The difference in death rate wasn’t
explained by negative habits, such as smoking, drinking, lack of
exercise or even such diseases as diabetes and heart disease.
The men with low T had more cytokines, which are markers of body
inflammation. They also had larger waistlines, a marker of the visceral
abdominal fat that is linked to insulin insensitivity, diabetes and
cardiovascular disease. Indeed, the amount of visceral fat is
proportional to testosterone levels and inflammation—more fat equals
less testosterone and more inflammation. Men with low T are three times
as likely to have the metabolic syndrome, characterized by insufficient
high-density lipoprotein (the good cholesterol), high blood fat,
hypertension and elevated blood glucose.
When men age, T tends to decline and bodyfat to increase. That leads
to an increase of estrogen levels because of the presence in peripheral
fat stores of aromatase, the enzyme that converts androgens such as
testosterone into estrogen. An imbalance between T and estrogen can lead
to insulin insensitivity, which boosts abdominal fat and its attendant
health problems.
Testosterone-deficient men experience a reduced quality of life and
such symptoms as heart disease, high blood pressure, lower bone density,
fatigue, depression, insomnia, erectile dysfunction and diabetes.
Recent studies directly link low T levels to insulin insensitivity and
diabetes in men. Some studies link lack of testosterone with the onset
of Alzheimer’s disease.
Bodybuilders are particularly affected by testosterone levels. One
study found that having low testosterone resulted in a decrease in
strength and muscle endurance of 90 to 100 percent.
21
Testosterone maintains the function of beta-adrenergic receptors in
fat cells, without which fat oxidation is severely blunted. That
explains the frequent emergence of potbellies in men over 40—along with
bad eating and not getting enough exercise. Conversely, testosterone
reverses that process, enabling a man to reduce both dangerous,
deep-lying visceral fat and superficial, subcutaneous fat. Dropping
subcutaneous fat may even return abdominal muscle definition when
combined with judicious exercise and a good diet. Testosterone inhibits a
fat cell enzyme called lipoprotein lipase, which advances the cellular
uptake and production of fat. It also keeps fat-cell precursors from
morphing into full-grown fat cells.
22
T-Therapy Concerns
As with GH, many doctors refuse to prescribe testosterone therapy
because of unfounded fears about prostate cancer. While testosterone is
contraindicated for those who already have prostate cancer, numerous
studies show that T doesn’t cause it.
23 In fact, men with the
lowest-level T develop the most aggressive cases of prostate cancer.
One study even found that giving testosterone to men who had advanced
prostate cancer that was androgen-insensitive caused a reduction in
prostate tumors. Besides, the majority of cases of prostate cancer are
diagnosed in older men, who have the lowest levels of testosterone.
Some scientists suggest that the increased bodyfat produced by men
low in testosterone leads to their producing more estrogen, which may
promote prostate cancer. That makes sense when you realize that, unlike
testosterone, estrogen is a known carcinogen.
The goal of testosterone-replacement therapy is not to produce the
results that anabolic-steroid-using athletes are after. Rather, therapy
aims at boosting depressed T levels to a mid-normal range, thus
preventing the side effects linked to T therapy, such as gynecomastia
and water retention. In fact, injecting testosterone to treat low T has
gone out of fashion. It causes a temporary surge that’s frequently above
the normal range—great for bodybuilding but priming the pump for side
effects. Supplemental forms of T such as creams and gels, which get
users only to the normal range, are preferred.
Considering that having low T leads to the production of cytokines
and considering the significant beneficial effects of T on body
composition, you have to conclude that testosterone likely does prolong
life when provided in the right dosage. Conversely, T-deficient men face
a shorter life span because of the risks of of cardiovascular disease,
too much bodyfat and possibly accelerated degenerative brain disease.
24
A recent study showed that testosterone may even help activate GH release.
25
Thirty-four men aged 65 to 88 who had low-normal T and IGF-1 counts
were injected with 100 milligrams of T every two weeks for 26 weeks.
That brought about a 33 percent increase in total T levels. Estrogen
rose by 31 percent, while sex-hormone-binding globulin, which transports
T in the blood, dropped by 17 percent, thus raising free, or active, T
levels. The supplementation increased release of GH by 60 percent at
night and a whopping 79 percent during the day, while IGF-1 rose by 22
percent.
You might grimace at the 31-percent elevation of estrogen, but keep
in mind that conversion of testosterone into estrogen is what pushes the
GH release.
26 Having abundant testosterone also blunts the ability of IGF-1 to shut down GH release.
Future Developments
Those who still fear testosterone-replacement therapy can turn to a
newly emerging option: a drug or supplement that inhibits the enzyme
aromatase from converting test into estrogen. Located in multiple body
tissues, including brain and muscle, aromatase is particularly
concentrated in peripheral fat stores, such as in the legs. So the more
fat you accumulate there, the greater the chance of increased estrogen
production.
Aromatase is particularly active in obese men. Their high-level
estrogen signals the hypothalmus to stop secreting
gonadatropin-releasing hormone and shut down testosterone synthesis in
the Leydig cells. The effect is so potent that obese men don’t respond
to replacement therapy.
27 On the other hand, studies show that obese men have normalized testosterone levels when they take aromatase-inhibiting drugs.
28
Aromatase inhibitors were developed mainly to treat
estrogen-sensitive breast cancer in older women. The drugs have gone
through several generations, and current versions are remarkably potent
estrogen blockers. Since testosterone and other anabolic drugs can
convert into estrogen and result in gynecomastia and water retention,
bodybuilders who use steroids usually also add an aromatase inhibitor,
such as Arimidex, to their anabolic stack.
About 8 percent of a man’s testosterone normally converts into
estrogen, so some researchers have suggested that aromatase inhibitors
may boost testosterone. A major advantage of that approach is that it
forestalls the potential side effects of T therapy. One study
investigated whether Arimidex could do the trick. For 12 weeks 37
testosterone-deficient older men received one of three treatments:
- One milligram of Arimidex daily
- One milligram of Arimidex twice a week
- A daily placebo tablet
Both doses of Arimidex effectively raised testosterone levels to
the mid-normal range of younger men. The drug also selectively
increased free, or active, testosterone, and it blocked test-to-estrogen
conversion and lowered estrogen an average of 40 percent. No side
effects occurred in any of the treated men, nor were there any adverse
effects on blood lipids, insulin sensitivity or inflammatory markers.
Nevertheless, doctors still resist prescribing the relatively benign
aromatase inhibitors to men with low testosterone. Their position is
that there’s not enough research to justify using aromatase inhibitors
as a form of T therapy and that the drugs should be used only to treat
older women with breast cancer. Another fear is adverse cardiovascular
symptoms, since estrogen helps maintain benefical HDL cholesterol in
men. Fortunately, over-the-counter aromatase inhibitors are available
that seem to work well as testosterone boosters, according to several
recent studies.
A further refinement in T therapy will likely ensue with the release
of selective androgen receptor modulators. SARMs, as they’re called, are
experimental drugs that are taken orally. They target specific androgen
receptors in various tissues, including muscle, and are designed to
avoid interacting with androgen receptors in the prostate gland, thus
bypassing the major health threats linked to T therapy.
As Ronald Klatz, M.D., president of the Academy of Anti-Aging
Medicine, notes,“Replacing the hormones that decline with age, such as
estrogen, testosterone, DHEA, melatonin and GH, is as important as
replacing normal levels of insulin to a diabetic.”
References
20 Nieschlag, E., et al. (1993). Life span and testosterone.
Nature. 366:216.
21 Kohn, F. (2006). Testosterone and body functions.
Aging Male. 9:183-88.
22 Dieudonne, M.N., et al. (2000). Opposite effects of
androgens and estrogens on adipogenesis in rat preadipocytes: Evidence
for sex and site-related specificities and possible involvement of IGF-1
receptor and peroxisome proliferator-activated receptor gamma-2.
Endocrinol. 141:649-56.
23 Wiren, S., et al. (2007). Androgens and prostate cancer risk: A prospective study.
Prostate. 67:1230-37.
24 Shores, M.M., et al. (2006). Low serum testosterone and mortality in male veterans.
Arch Intern Med. 166:1660-1665.
25 Muntiyappa, R., et al. (2007). Long-term testosterone
supplementation augments overnight growth hormone secretion in healthy
older men.
Am J Physiol Endocrinl Metab. In press.
26 Meinhardt, M., et al. (2006). Modulation of growth hormone action by sex steroids.
Clin Endocrinol. 65:413-22.
27 Cohen, P. (1999). The hypogonadal-obesity cycle: Role
of aromatase in modulating the testosterone-estradiol shunt—a major
factor in the genesis of morbid obesity.
Med Hypotheses. 52:49-51.
28 Boer, H., et al. (2005). Letrozole normalizes serum testosterone in severely obese men with hypogonadotropic hypogonadism.
Diabetes Obes Metabol. 7:211-215.
©,2015 Jerry Brainum. Any reprinting in any type of media, including electronic and foreign is expressly prohibited
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Strength, Muscle and Extended Living Through Chemistry? Part 2
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