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HEALTHY LIFESTYLES
FOR
HEALTHY AGING
J A N | 2010 | ISSUE 47
Testosterone: Back In The Forefront
New clinical trial underway
The battle against age-related disease
rages on with baby boomers scrambling to
hold on to health and youthful energy.
Although several factors come into play,
diminished hormones continue to command
their attention—and with good reason. The
1% to 3% hormonal drop yearly from age 30
onward translates to a 20% drop by age 50 .
. . and a 50% drop by age 80.
Now we’re not talking about macho
appearances or virility. The concern is
having a longer health span for a higherquality life.
One of the most pronounced health issues
facing boomer men is plummeting
testosterone levels, which can lead to
debilitating conditions with troublesome
signs and symptoms:
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erectile dysfunction
low libido
impaired physical functions, frailty
decreased vitality
increased fatigue
reduced muscle mass/strength
decreased bone density
depression
anemia
impaired cognition
Testosterone therapy for these
hypogonadal men is the focus of a new
$45 million clinical trial, which began
recruiting for study participants in
October 2009.
Why Important. An estimated 8 million men
in the U.S. are hypogonadal—yet, only a
small percentage may be receiving
treatment. Why? Some physicians in a
conventional medicine practice may not
connect the dots between low testosterone
levels and the “age-related” signs/symptoms
listed earlier. By the time the link is made,
Per principal investigator Peter J. Snyder, levels are drastically low and the health
MD, who is a professor of medicine in the consequences high.
Division of Endocrinology, Diabetes and
Another problem is testing. The “normal”
Metabolism at the University of
range for serum testosterone has a wide
Pennsylvania School of Medicine, this
upcoming trial will be “an unprecedented swing to it—250 to 1,100 nanograms per
deciliter (ng/dL). And those ranges are for
opportunity” to determine if testosterone
therapy improves “some of the afflictions 20-something men to 65 year olds. A bell
curve is determined for the standard ± 2.5
of old age.”
deviation to capture the “norm.”
The Testosterone Trial—conducted at 12
So testing may report your levels as
sites nationwide—will include 800 men
“normal” . . . but are they at the rock bottom
with low testosterone levels, age 65 and
over. They are looking for study subjects of that normal or at their optimal best level
with blood testosterone levels under 250 for ensured health?
nanograms per deciliter and one or more
Disease risk is evident in men whose levels
of these symptoms: impaired walking/
are in that lowest range—including higher
physical function, low vitality, reduced
incidence of cardiovascular disease and
sexual function, cognitive dysfunction or
more aggressive prostate cancer.
anemia. Support for the significant study
is from the National Institute on Aging
(NIA).
Trial Underway. Researchers will
evaluate testosterone treatment for its
therapeutic effect on older men with
hopes of filling in the blanks of some
unanswered questions on the 2004
Institute of Medicine report on
testosterone and aging.
Treatment groups will use a testosterone
gel, applied to torso, abdomen or upper
arms. The controlled groups will have a
placebo gel. Investigators will measure
serum testosterone each month for the
initial three months, then quarterly for one
year.
The trial is generating interest, particularly
since other studies suggest hypogonadism
is on the rise—and may be linked to higher
death rates from all causes, metabolic
syndrome and cardiovascular disease, and
may even be a risk factor for type 2
diabetes.
Continued on page 2
.
In an article a few years back coauthored
with Ernani Luis Rhoden, MD, Abraham
Morgentaler, MD—renowned Director of
Men’s Health Boston and Associate Clinical
Professor of Urology at Harvard Medical
School—stated that decades of research
haven’t shown compelling evidence that
testosterone has a causative role in prostate
cancer.
The Testosterone Controversy. And that
brings us to the revolving controversy
surrounding hormone replacement therapy
and its risks/benefits.
Abuse. We’ve all heard the stories that
circulated the media. Celebrities, sports
figures, bodybuilders and all the rest were in
the spotlight of their illegal, abusive use for
testosterone or other hormone therapies.
But that’s the antithesis of a medically based
testosterone treatment. Done right, it begins
with a clinically proven deficiency, followed
by periodic blood work and a physician’s
responsible, ongoing monitoring.
Our Comprehensive Approach. With
the recognized decline of hormones
from 30 onward, maintaining hormonal
balance is critical—including estrogen,
testosterone, thyroid, DHEA and
Morgentaler also is a leading expert on
cortisol—since each hormone not only
testosterone therapy and author of
Testosterone for Life, published by McGraw- has a specific job, but overlaps with
others to create a synergistic
Hill/Harvard Health Publications in
environment for good health.
November 2008 and the culmination of his
30 years of research.
Cenegenics takes a responsible,
comprehensive evaluation approach to
Among more recent studies . . .
hormone optimization, treating
clinically proven deficiencies with long• Research published in 2000 revealed
term monitoring for the best medical
low serum free testosterone in patients
outcome.
with prostate cancer (Journal of
Urology).
In fact, Morgantaler’s research, among
• Research published in 2002 revealed
others, support our established
low testosterone levels in patients with
approach.
prostate cancer (Journal Prostate).
• Research in 2004 showed no “causal
But hormone optimization is not a
link” between testosterone replacement
singular program component. We also
therapy and increased prostate cancer
recognize that low-glycemic nutrition,
(New England Journal of Medicine).
sensible exercise and high-quality
nutraceuticals work in tandem to
Furthering that, Jean-Pierre Raynaud,
ensure healthier living.
Université Pierre & Marie Curie, wrote the
following in the Journal of Steroid
Biochemistry and Molecular Biology:
Data from all published prospective studies
on circulating level of total and free
testosterone do not support the hypothesis
that high levels of circulating androgens are
associated with an increased risk of prostate
cancer. A study on a large prospective
cohort of 10,049 men, contributes to the
gathering evidence that the long standing
“androgen hypothesis” of increasing risk with
Prostate cancer. Imagine a graph where the increasing androgen levels can be rejected,
x-axis reflects your age increasing with the
suggesting instead that high levels within the
escalating incidence of prostate cancer. On
reference range of androgens, estrogens
that same graph, we see testosterone levels and adrenal androgens decrease aggressive
declining with age as those same cancer
prostate cancer risk. Indeed, high-grade
incidences rise.
prostate cancer has been associated with
low plasma level of testosterone.
The question is this: If testosterone levels are
decreasing while prostate cancer incidents
Furthermore, pre-treatment total
are increasing, how can you definitely link
testosterone was an independent predictor
testosterone therapy to the cancer risk? It
of extraprostatic disease in patients with
appears to us as counterintuitive.
localized prostate cancer; as testosterone
decreases, patients have an increased
likelihood of non-organ confined disease and
low serum testosterone levels are
associated with positive surgical margins in
radical retropubic prostatectomy.
Unfortunately, sports and Hollywood types
forego the diagnostic workups and physician
consultations, plunging into dangerous
waters—perhaps creating testosterone levels
5 to 7 times higher than the upper-normal
range. As a result, their levels fall in the
dangerous supra-physiologic zone.
In other words, Raynaud is saying
that men with lower testosterone
levels had more aggressive prostate
cancer types and more advanced
disease.
Experience the Cenegenics difference:
a dynamic shift in medical care backed
by ongoing support and an expert age
management medicine team who will
guide you toward your short- and longterm health goals.
A New Definition of Aging Is Waiting For You. Call Cenegenics Now. 866.953.1510.
Discussions are always confidential and without obligation.