Bryant Stamford, Special to the Courier-Journal Published 7:00 a.m. ET Sept. 7, 2017
A study suggests that exercise can reduce the risk of heart damage for middle-aged adults and seniors. According to the study, even those who are obese will benefit from physical activity. Wochit
Man working out(Photo: Minerva Studio, Getty Images/iStockphoto)
Testosterone (T) is a naturally occurring hormone in men, and most of it is produced in the testicles.
At puberty, T production escalates, bringing about masculinizing changes in muscle mass. also promotes sex drive, sperm and red blood cell production, bone massand determines how men store body fat.
It can impact quality of life issues as well, like mood, energy and motivation.
Beginning at about age 30, T production begins to decline on average by about 1 percent per year, plummeting late in life. This causes all sorts of problems, including lack of sex drive, inability to sleep, loss of muscle and bone mass, increased belly fat, the list goes on. Reversing these symptoms and improving the quality of life is the reason T replacement therapy (TRT) clinics supervised by physicians have sprung up around the country.
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Although it is considered a male hormone, women also produce a modest amount of T in the ovaries. After menopause, estrogen production declines, which alters the ratio of estrogen to T, explaining why women begin taking on some male characteristics, like storing more fat around the midsection, rather than on the hips, thighs and buttocks as occurs earlier in life.
Is TRT a good thing? It can bewhen managed responsibly. If you are older, and your T level is very low and falls below the normal range, it makes sense to address it with TRT because it can negatively impact health, increasing risks associated with diabetes, obesity and osteoporosis. Low T also may shorten life, but this is controversial because when TRT raises T levels it has not been shown to extend life.
More is not always better, and many TRT clinics are viewed with suspicion because they advertise that its possible to feel like you are 25 years old again, even though you are decades older. Perhaps this is possible, but at what price, and if you are taking huge doses of T, could you be damaging your health?
Research studies in 2013 and 2014 indicated that TRT increased the risk of heart disease in men 65 and older, and in younger men with a history of heart disease. However, subsequent studies refute these findingsand some show a deceased risk of heart disease. Another area of concern is an increased risk of prostate cancer, but this, too, is controversial. There does appear to be solid evidence that TRT can increase the risk of blood clots and stroke, plus sleep apnea, acne and breast enlargement.
All in all, some experts believe the benefits outweigh the risks, while others are more cautious because TRT hasnt been around long enough or impacted enough men to draw meaningful conclusions. Time will tell. In the meantime, like most things in life, moderation is the best approach.
Anabolic steroids (AS) are synthetic steroid hormones that resemble T. AS require a doctors prescription and were developed to promote muscle mass in postsurgical patients, particularly older patients. Unfortunately, AS use spilled over to strength athletes who wanted the advantages associated with increased muscle mass, and AS delivered as promised. This, in turn, inspired gross overdosing with AS as a means to producing freaky muscular proportions and super human strength.
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AS can cause a long list of negative side effects, the most serious being growth of tumors in the liver and acceleration of atherosclerosis (clogging of the arteries). AS suppress HDL (good cholesterol) production, which leads to a ratio of bad to good cholesterol that is out of whack, promoting clogged arteries and ultimately leading to a heart attack. Worse, because a doctors prescription is required, AS often are obtained illegally from foreign countries through the mail, with no sense of the quality of the product or the dangers involved.
When I was young, I was an enthusiastic weight lifter, working out hours every day. Some of my friends went the AS route and developed amazing physiques. Recently, I have endeavored to track them down to see how they are doing, and I was saddened to learn that too many have died prematurely, in their fifties and sixties, some even earlier. The most likely cause was a heart attack.
TRT has a place and can be beneficial if managed prudently. Just be careful of extreme approaches and promises that seem too good to be true. As for AS, there is no justifiable reason for athletes to be taking them. Ever!
Reach Bryant Stamford, a professor of kinesiology and integrative physiology at Hanover College, at stamford@hanover.edu.
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Is testosterone replacement therapy the right thing for aging males? - The Courier-Journal
