“Mark” a 48 year old gentleman came to my office complaining of fatigue, an increase in aches/pains, an increase in irritability, and a decreased ability to build muscle. He still ha a good libido but had noticed a decrease in morning erections. He had seen his regular doctor who told him his labs were normal and that he needed to exercise more but he was too tired to do that. Mark knew there was something else going on.
When I reviewed his symptoms and his lab results we both agreed that he suffered from low Testosterone. At first he was concerned about the risks associated with replacing Testosterone based on recent news releases. We went over the study that the news was citing. The news reports were telling men that Testosterone replacement increased heart disease risk.
However, the study being cited had tested older, high heart disease risk men whose Testosterone level was never in an optimal range and they were treated for too short a time to even show a benefit. Optimal Testosterone levels are around 600-1400 depending on the male, men in this study were averaging levels in the 300 range. This was a poorly done study and it is a shame that it was used to scare men away from seeking help.
In fact, there are many studies showing that when Testosterone levels are optimized and given enough time to work, that Testosterone actually is protective for the heart as well as the brain.
Remember that the normal Testosterone lab values are not optimal–they are simply the expected values based on testing the male population—both ill and healthy. You want optimal levels if you want a life of vitality.
Optimizing a man’s Testosterone level involves replacing his Testosterone along with starting healthy lifestyle changes. Testosterone is best replaced with bio-identical Testosterone–biologically identical to what your body is designed to respond to. Mark was given the choices on replacing his Testosterone. Creams which are applied twice a day. There are synthetic gels and patches on the market but they are not bio-identical-using them can cause unforeseen complications since they are chemically different from what your body is designed to work with. A compounding pharmacy makes the bio-identical Testosterone. You can not buy it at a regular pharmacy. A quality compounding pharmacy offers safe and effective bio-identical creams.
Creams are painless but you do need to remember to apply them daily and there can be a pulse like absorption after application. In addition you do need to be careful about getting the Testosterone cream on others.
Testosterone injections are another possible form of Testosterone replacement and they tend to be more effective than creams but your liver has to process it into a bio-identical Testosterone. There is also a pulse like absorption and you need an injection once to twice a week. This mode of replacement requires the most monitoring by lab work.
Testosterone pellets are bio-identical and are absorbed on a more constant level with a natural increase when your cardiac input increases–similar to your natural physiology. They work very effectively. Testosterone pellets have been well documented to protect the heart, bones, and brain as well as resolve symptoms. It does involve an in office procedure where the pellets are inserted in the fatty tissue of your buttocks and it is the more costly of the three choices.
Which form of Testosterone replacement a man chooses depends on the individual.
Mark chose Testosterone pellets and after about 2-3 weeks he felt better-he has energy, is able to build muscle, feels mentally balanced and can pole vault out of bed again. He also has the focus to get back into the gym and fine tune his diet to include more vegetables (organic) and less processed foods.