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The Importance of Bioidentical Testosterone Replacement

A multitude of studies in recent years has demonstrated that testosterone deficiency in men, also known medically as testicular hypofunction, is associated with an increased risk of a number of diseases and even an earlier death! This is why we screen men over the age of 40 for testosterone deficiency at the Stengler Center for Integrative Medicine. Research has shown that low testosterone levels in men predispose one to abnormal cholesterol levels and lipids, fatigue, insulin resistance, obesity,  high blood pressure, osteoporosis, muscle weakness and frailty, cognitive impairment (poor memory and focus), kidney disease, respiratory disease such as chronic obstructive pulmonary disease (COPD), Type 2 diabetes, and sexual dysfunction (low libido and erectile dysfunction).A study done here in California with men aged 51-91 found that those with low testosterone levels (defined by this study as less than 241 ng/dL) were 40% more likely to die than those with higher testosterone levels. Other variables were taken into account such as lipid levels, age, and other factors. The same study found low testosterone levels were associated with death from respiratory and cardiovascular disease.

[1]Another study included over 11,000 men aged 40-79 found that low testosterone levels were significantly associated with mortality from all causes, including cardiovascular disease and cancer. [2]Low testosterone increases the risk of blood blotting and worsens blood vessel health. And since it makes one more susceptible to central obesity (abdominal fat around the abdomen) this leads to elevated lipids and insulin resistance. One study even found that testosterone levels seemed to be a predictor of men who were admitted to the hospital with a heart attack and their likelihood of dying after 30 days! [3]And what about the issue of cardiovascular risk for men supplementing bioidentical testosterone? A recent update by the American Association of Clinical Endocrinologists sheds some light on this subject. Researchers analyzed data of almost 20,000 men who received testosterone therapy for 5 years (2009-2014). They found the “risk for a heart attack was 7-fold lower and the risk for stroke 9 times lower compared with samples from the general population. Further, there was no evidence of worsening of preexisting MI or stroke in patients treated with testosterone.  So their analysis found testosterone therapy in men was not associated with an increased risk for heart attack or stroke and may even be cardioprotective! [4]Lastly, the concern of testosterone replacement and prostate cancer risk must be addressed. Large, recent studies have refuted any connection. Reported at the 2015 American Urological Association Annual meeting, researchers used a meta-analysis of a variety of studies including 5091 patients with prostate cancer and 11,930 control subjects as well as 24 randomized placebo controlled trials of testosterone therapy that reported data on PSA and prostate cancer patients. Their findings found that testosterone replacement does not cause prostate cancer or increase PSA levels in men. [5]

In summary, the identification of testosterone deficiency and proper supplementation and monitoring of bioidentical hormone replacement therapy by a qualified doctor may reduce the risk of several diseases while improving quality of life. We encourage men of all ages to get their testosterone levels tested right away.

Contact us today to make an appointment at the Stengler Center for Integrative Medicine.

[1] Laughlin GA, Barrett-Connor E, Bergstrom J. Low serum testosterone and mortality in older men. J Clin Endocrinol Metab. 2008;93:68-75

[2] Khaw KT, Dowsett M, Folkerd E, et al. Endogenous testosterone and mortality due to all causes, cardiovascular disease, and cancer in men: European prospective investigation into cancer in Norfolk (EPIC-Norfolk) Prospective Population Study. Circulation. 2007;116:2694-2701

[3] Militaru, C., Donoiu, I., Dracea, O. et al. (2010) Serum testosterone and short-term mortality in men with acute myocardial infarction. Cardiology Journal, 17, 249–253.

[4] American Association of Clinical Endocrinologists (AACE) 23rd Annual Scientific and Clinical Congress. Presented May 16, 2014.

[5] Mulcahy, N. Meta-analysis. Testosterone Is Not a Risk for Prostate Cancer, But…Medscape website. Accessed