Archive for the ‘Aging’ Category

Testosterone Safety In Men Receiving Hormone Replacement Therapy

August 10, 2015

The medical literature states that one of the adverse effects of testosterone replacement therapy is increased in the red blood cell count or polycythemia. The increased red blood cell count increases the viscosity or thickness of the blood and makes men amenable to clots forming in the lower extremities. These clots can break loose and go to the lungs and cause a medical emergency

Middle-aged and older men undergoing testosterone replacement therapy aren’t at increased risk of these fatal clots.

Researchers studied 30,572 men 40 years of age and older who were enrolled in one of the country’s largest commercial insurance programs between Jan. 1, 2007 and Dec. 31, 2012. They identified 7,643 cases, defined as men diagnosed with deep vein clots or pulmonary embolism at any time during the study period who received at least one prescription for an anticoagulant to prevent clots from reforming.

Exposure to testosterone therapy within 15 days of the event/index date wasn’t associated with increased risk of VTE (adjusted odds ratio, 0.90), nor were any of the routes of administration that the authors examined—topical, transdermal, or intramuscular. The finding extended to men who received therapy 30 or 60 days before the VTE diagnosis.

Bottom Line: I still recommend that men who are receiving testosterone replacement therapy have their red blood cell count checked every six months. If the red cell count is too high, I suggest that the man cut his dosage or decrease the frequency of testosterone replacement therapy. I still believe that testosterone is effective in men who have symptoms of low testosterone and have documented evidence of a low blood level of testosterone.

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Take Care of Yourself-How To Age Gracefully and Healthfully

March 24, 2015

We are living at a time of longevity. We can live longer and live better today than at any time in recorded history. It is possible with good health to live to 80,90, or even 100 years of age.

Start with setting a goal to live as long as you would like. Ask yourself, are you practicing habits today that will get you to that goal of your desired age.

The three areas that you need to keep in mind to achieve your goal.

1. Achieve an ideal weight. You need to get your weight under control. When you reach your ideal weight, make a commitment to remain at that level for the rest of your life. There should be no yo-yo of your weight but you must remain at the ideal weight for the rest of your life.

The best advice I have is to eat less and exercise more. The law of thermodynamics applies to weight loss. The law simply states the net heat supplied to the system equals the net work done by the system. Therefore, you need to consume fewer calories than you burn from exercise or you need to exercise harder and longer in order to burn more calories than you consume. There is no short cut. There are numerous websites that can help you with your diet and give you a ballpark on the caloric burning that takes place with every day exercises. (http://www.freedieting.com/tools/calorie_calculator.htm, http://calorielab.com/burned/, and http://www.myfitnesspal.com/exercise/lookup

2. Proper diet
Eat better quality foods and fewer of them. Eat more fruits, vegetables and good proteins such as lean meat, chicken, and fish. Eliminate soft drinks, deserts, candies and any other foods containing mostly sugar. Stop consuming extra salt. Eliminate any white flower products. Eat smaller portions and eat 4-6 times a day rather than 3 large meals. By taking control of your eating habits, you can take control of other areas of your life.

3. Exercise
A suggested exercise regimen is 200 minutes\week or 30 minutes a day. You can get all the exercise you need by going for a vigorous walk for 30-60 minutes 3 times a week.

You can even get exercise if you declare that you won’t take the elevator up the stairs or you can park your car 3-5 blocks further than your normal parking spot every day.

Bottom Line: set goals for your life regarding health and fitness and be disciplined to stick to those goals for the rest of your life. You need to make a daily plan and work your plan every day. This requires self-discipline but this self-discipline will help with the discipline you will need in other areas of your life.

DHEA For Low T: Facts and Warnings

February 27, 2015

I have treated many men with low testosterone and many ask for a solution that does not involve testosterone replacement therapy. This blog will discuss the use of DHEA in men and how effective it may be for solving the symptoms of low T.

DHEA is a hormone that is naturally made by the human body. It can be made in the laboratory from chemicals found in wild yam and soy. However, the human body cannot make DHEA from these chemicals, so simply eating wild yam or soy will not increase DHEA levels.

Athletes and other men use DHEA to increase muscle mass, strength, and energy. But DHEA use is banned by the National Collegiate Athletic Association (NCAA).

DHEA is also used by men for erectile dysfunction (ED) and in men who have low levels of testosterone in order to improve well-being and sexuality.

Like many dietary supplements, DHEA has some quality control problems. Some products labeled to contain DHEA have been found to contain no DHEA at all, while others contained more than the labeled amount.

How does DHEA work?
DHEA is a “parent hormone” produced by the adrenal glands near the kidneys and in the liver. In men, DHEA is also secreted by the testes. It is changed in the body to a hormone called androstenedione. Androstenedione is then changed into the major male hormones including testosterone.

DHEA levels seem to go down as people get older. Some researchers think that replacing DHEA with supplements might prevent some diseases and conditions.

DHEA is Possibly Effective for:
• Aging skin. Some research shows that taking DHEA by mouth increases the thickness and hydration of the top layer of the skin in elderly people. Early research shows that applying DHEA to the skin for 4 months improves the appearance of skin.

DHEA has Insufficient Evidence for:
• Aging. Taking DHEA does not seem to improve body shape, bone strength, muscle strength, insulin sensitivity, or quality of life in people older than 60 who have low DHEA levels.
• Hormone deficiency in men (partial androgen deficiency). Early research suggests that taking 25 mg of DHEA daily for one year might improve mood, fatigue and join pain in older men with hormone deficiency.
• Physical performance. Some research shows that older adults who take DHEA have improved measures of muscle strength. However, other research has found no effect of taking DHEA on muscle strength.
• Sexual dysfunction. Evidence on the effectiveness of DHEA for sexual dysfunction is inconsistent. Taking DHEA by mouth for 24 weeks seems to improve symptoms including erectile dysfunction and overall satisfaction in men. However, it does not seem to be helpful if erectile dysfunction is caused by diabetes or nerve disorders.
• Weight loss. Early evidence suggests that DHEA seems to help overweight older people who are likely to get metabolic syndrome to lose weight. It is not known if DHEA helps younger people to lose weight.

Bottom Line: DHEA is probably not a panacea for low T or a treatment for ED or erectile dysfunction.

Preventing Prostate Cancer

September 4, 2014

Prostate Cancer is a disease of aging and at this time there is no vaccine or sure fire way to completely prevent prostate cancer. However, there are steps you can take to reduce your risks.

• Advanced age increases your risk. Despite this, prostate cancer is not an “old man’s disease:” 35 percent of those affected are younger than 65.
• Family history may play a role. A strong family history of prostate cancer can increase your chances of developing the disease. While these factors are beyond our control, having awareness of increased risk can motivate us to focus on the areas we can affect.
• If there are factors that put you at higher risk, it’s important to be vigilant in areas you can control, including regular screenings. Talk with your doctor about the pros and cons of prostate screening. For African-Americans or those with a family history of prostate cancer, ask if screening should begin earlier.
1. Eat healthy. Avoid foods high in sodium, saturated fat, cholesterol, refined sugar and trans fat, which contribute to cancer risk. Instead, choose foods high in Omega-3 fatty acids (salmon, almonds) and monounsaturated fats (olive oil, peanuts) as well as fruits, vegetables and whole grains. Eating right doesn’t just lower your risk for prostate cancer, but prevents weight gain and improves your overall health.

2. Be active. Participate in 75 minutes of vigorous activity, or 150 minutes of moderate activity, weekly. This can include walking, swimming, biking or any exercise your doctor recommends.

3. Get screened. The National Comprehensive Cancer Network recommends baseline PSA screening for healthy men ages 50 to 70 every one to two years, and a majority of the panelists recommend baseline testing for men ages 45 to 49, too especially for men with a family history of prostate cancer or are of African American heritage.

Bottom line: Prostate cancer affects 250,000 men each year and causes 40,000 deaths making it the second most common cause of cancer death in men. Eating a healthy diet, exercising regularly and getting tested with a digital rectal exam and a PSA test on a regular basis is the best prevention strategy available today.

What You Need To Know About Low T (Testosterone) and Heart Disease

March 27, 2014

I have received dozens of calls from men who are concerned about the recent study that reports that testosterone replacement therapy increases the risk of heart attacks and strokes. This blog is intended to clarify some of the misinformation that is attracting so much media attention. The Androgen Study Group, a large group of physicians and researchers of which I am a member, is calling for the retraction of the paper that appeared in the Journal of American Medical Association linking testosterone and cardiovascular risks — data that its authors of the paper in the journal are standing firmly behind.

In a letter to Howard Bauchner, MD, editor-in-chief of the Journal of the American Medical Association, members of the group — formed in response to the paper and comprised of more than 125 doctors — said the study’s credibility was compromised by at least two corrections and should be pulled from the journal.
A close friend and colleague, Dr. Abraham Morgentalker pointed out the there’s no misconduct, no one faked any data, it’s just sloppy. The group called it “gross data mismanagement.”

The paper, published in JAMA in November by Michael Ho, MD, PhD, of the Eastern Colorado VA, and colleagues, found that testosterone therapy was associated with a greater risk of death, heart attack, and stroke in male veterans who’d had coronary angiography. (If the men were having coronary angiography, it stands to reason that they already had some heart disease or they wouldn’t have been subjected to this invasive procedure)

But two corrections have since been published. The first, in the Jan. 15 issue, was a clarification that the results were based on “estimates” and not raw data.

The second, which Morgentaler and colleagues focus on in their letter to the editor of the journal, involved reclassivication of patient who were excluded from the study. More than 1,000 excluded patients were assigned to different categories of exclusion, including 100 who were women!

The authors included almost 10% women in an all-male study, so why should we believe any of the other data? The Androgen Study Group points out that the data were so off that it’s hard to believe the data for the entire study are accurate.

However, Ho and colleagues said they “stand firmly by the results of our study,” noting that the overall number of excluded patients remains the same, as does the total number of included patients, and the main results of the study were not changed.

The study group said that these claims run contrary to 40 years’ worth of research on testosterone, which suggests that the hormone has some beneficial effects in certain heart patients.

But the testosterone therapy field has garnered much media attention for its financial relationships with industry. Several articles in the New York Times, including one on the marketing of “Low T”, another on the selling of testosterone gels, and an editorial, have questioned the potential overselling of the therapy.

It is true that several members of the Androgen Study Group, myself included, have relationships with testosterone drug makers, such as AbbVie, Watson, and Endo Pharmaceuticals.

It is my opinion that men who are symptomatic for low testosterone and have complaints such as lethargy, decreased libido, loss of muscle mass, and decrease in erections or potency AND who have a documented decrease in the blood level of testosterone, are good candidates for hormone replacement therapy. These men who are going to receive testosterone should have a normal digital rectal exam and a normal PSA test if they are less than 75 years of age.

Bottom Line: Low testosterone has effects that impact a man’s quality of life. If a man has symptoms of low T and a documented decrease in the blood testosterone level, he should speak to his physician about testosterone replacement therapy.

Restoring The Fountain of Youth-DHEA Just May Be The Youth Hormone For Women

January 28, 2014

American women (men too) are always looking to find a way to turn back the biologic clock. We all would like to look like the women in Cosmopolitan and Vogue Magazines. If your goal is to look younger, feel better, and improve energy level, then you might consider the benefits of DHEA.

DHEA, dehydroepiandrosterone, is a hormone produced in the adrenal gland, the small triangular structure that sits on top of the kidneys. DHEA is made by the adrenal glands and is then converted to androgens, estrogens and other hormones. These are the hormones that regulate fat and mineral metabolism, sexual and reproductive function, and energy levels. DHEA levels increase until our mid to late 20′s then gradually decline. DHEA is a very powerful precursor to all of your major sex hormones: estrogen, progesterone, and testosterone. (Its molecular structure is closely related to testosterone). DHEA is called the “mother hormone” — the source that fuels the body’s metabolic pathway.

When DHEA levels are low, your body does not have enough working material for proper endocrine function. This throws off your hormone production and you feel a general sense of malaise, along with other symptoms of hormonal imbalance — how severe depends on how many other demands are being made on your body at the same time.
There is a growing body of evidence that healthy levels of DHEA may help stave off Alzheimer’s disease, cancer, osteoporosis, depression, heart disease and obesity, but there is still no clear-cut consensus. There may be some increased risks associated with DHEA for women with a history of breast cancer — all the more reason to take DHEA under medical supervision.

Symptoms of low DHEA include extreme fatigue, decrease in muscle mass, decrease in bone density, depression, aching joints, loss of libido, and lowered immunity.
DHEA is stated to be possibly effective for these conditions:
1. Aging Skin – Taking DHEA orally seems to increase epidermal thickness, sebum production, skin hydration, and decrease facial skin pigmentation in elderly men and women
2. Osteoporosis – Taking DHEA orally 50-100 mg per day seems to improve bone mineral density (BMD) in older women and men with osteoporosis or osteopenia.
3. DHEA is also thought to contribute to a sense of well-being when used by those with adrenal and/or androgen insufficiency.
4. It may also support lean body mass in postmenopausal women.

DHEA has many potential benefits but does also have some side effects, which include hair loss, hair growth on the face (in women), aggressiveness, irritability and increased levels of estrogen. Calcium channel blockers may increase DHEA levels and those using calcium channel blockers should avoid supplementation. Anyone with a history of hormone-related cancer such as estrogen sensitive breast cancer should definitely avoid DHEA due to the probability of increased estrogen levels.

If you don’t feel DHEA is appropriate for you, it may be possible to increase the body’s natural production of DHEA with regular exercise and restricting the number of calories you consume. Calorie restriction is associated with a longer life span and the increase in DHEA production may be partially responsible. In fact, there are many studies that show you can improve your DHEA levels naturally by maintaining a body mass index of 19-25, getting adequate rest and exposure to sunlight, exercising regularly (including sexual activity), and fostering more “downtime” in your life — but more on that in a moment.

Without a medical test it’s impossible to know what your DHEA levels are. Using blood tests, your doctor can check for estradiol in the follicular phase (usually days 3–9 of a menstrual cycle); progesterone in the luteal phase (days 14–28); DHEA-S; and both free and total testosterone levels.
Treatment With DHEA Supplements

If tests indicate the need for DHEA supplementation, you may start off with as little as 1-5 mg, twice a day. The dosage can be slowly increased to 10–12 mg per day. Most doctors do not suggest any woman exceed 25 mg per day if capsule forms are used. Once balance has been restored and symptoms even out, most women produce enough DHEA on their own.

Bottom Line: Many women are suffering from hormone imbalance. Decreased DHEA can be a cause of many problems affecting middle age women and can even impact her libido and her energy levels. DHEA should never be taken casually or unsupervised, but its benefits are real for the women who need it.

Sex and The Male Senior Citizen

November 24, 2012

Couple in Love

Couple In Love


You are 60 years of age and you note that your erections are not as strong as there were at 40 years of age. It takes longer to get an erection than a decade ago and once you ejaculate it takes longer to get the next erection. Welcome, guys to the middle ages. These are normal consequences of aging for men. This doesn’t mean that you pack up your penis and never use it again. It means that you will use it differently than years ago.

What are the normal, expected changes in a man’s penis as he ages?

Appearance. There are two major changes. The head of the penis (glans) gradually loses its purplish color, the result of reduced blood flow. And there is a slow loss of pubic hair. You don’t have to worry about your manscape as nature will take care of your pubic hair for you.

Penis Size.
Weight gain is common as men grow older. As fat accumulates on the lower abdomen, the apparent size of the penis changes. A large clump of fat in the lower abdomen makes the penile shaft look shorter. If you want a bigger penis, check out your core and trim it down and your penis will grow larger….or at least it will appear to be longer.
In addition to this apparent shrinkage (which is reversible) the penis tends to undergo an actual (and irreversible) reduction in size. The reduction — in both length and thickness — typically isn’t dramatic but may be noticeable. “If a man’s erect penis is 6 inches long when he is in his 30s, it might be 5 or 5-and-a-half inches when he reaches his 60s or 70s.
What causes the penis to shrink? At least two mechanisms are involved, experts say. One is the slow deposition of fatty substances (plaques) inside tiny arteries in the penis, which impairs blood flow to the organ. This process, known as atherosclerosis, is the same one that contributes to blockages inside the coronary arteries — a leading cause of heart attack.
Another mechanism involves the gradual buildup of relatively inelastic collagen (scar tissue) within the stretchy fibrous sheath that surrounds the erection chambers. Erections occur when these chambers fill with blood. Blockages within the penile arteries — and increasingly inelastic chambers — mean smaller erections.

As penis size changes, so do the testicles. Starting around age 40, the testicles definitely begin to shrink. The testicles of a 30-year-old man might measure 2 inches in diameter, he says; those of a 60-year-old, perhaps only 1.5 inches.

Curvature. If penile scar tissue accumulates unevenly, the penis can become curved. This condition, known as Peyronie’s disease, occurs most commonly in middle age. It can cause painful erections and make intercourse difficult. The condition may require surgery.

Sensitivity. Numerous studies have shown that the penis becomes less sensitive over time. This can make it hard to achieve an erection and to have an orgasm.

Libido or sex drive
As men get older the testosterone level falls. Testosterone is the hormone produced in the testicles that is responsible for the sex drive. It reaches a peak in the 20’s and early 30’s and slowly declines at a rate of 2% a year. Men who have this problem can obtain a blood test, a serum testosterone test, and if it is low and there is no history of prostate cancer, then the man can receive testosterone supplements in the form of an injection every two weeks, the application of a daily gel to the lower abdomen or shoulders, or the insertion of a pellet under the skin which lasts for 4-6 months.

Bottom Line: Yes, there are changes that are going to occur as a man ages just as there are changes in muscle mass, bone density, memory, hearing, and vision. But this doesn’t mean the end of a man’s sex life. With good health, a willing partner, and a desire to pleasure your partner, you, too, can enjoy sexual intimacy in your silver years.

Male Hormone Deficiency-You Don’t Need To Wind Down When You Grow Older

November 13, 2012
Testosterone Deficiency

Don’t Wind Down With Hormone Deficiency

A decrease in the serum testosterone level may not be an inevitable part of aging but instead could be due to changes in smoking habits, body size, mental health status and chronic cardiovascular disease. And men who have declines in testosterone levels are more likely to be does to become obese, had stopped smoking, were depressed, or had persistent or new onset of heart disease.

It is also of interest that unmarried men had a significantly greater decline in testosterone levels compared to married man.

Bottom line: Testosterone deficiency can be a marker of underlying disease. Therefore, it is necessary if you are having the symptoms of low testosterone which include loss of energy, loss of muscle mass, and decreased libido, you should consider seeing your physician and being evaluated for these other comorbid conditions.

Advice on Daily Living From Lululemon Athletica

August 24, 2012

Cover of Lululemon carrying bag

I seldom go shopping but I did visit Lululemon Athletica with my wife and I was very impressed with the carrying bag that was given to each shopper. I would like to share the wisdom on Lululemon with my friends, family, and followers.

That which matters the least should never give way to that which matters the most.

Drink FRESH water and as much water as you can. Water flushes unwanted toxins from your body and keeps your brain sharp.

Practice yoga so you can remain active in physical sports as you age.

Listen, listen, listen, and then ask strategic questions.

Your outlook on life is a direct reflection of how much you like yourself.

Life is full of setbacks.

Write down your short and long-term GOALS four times a year. Two personal, two business and two health goals for the next 2, 5 and 10 years. Goal setting triggers your subconscious computer.

Visualize your eventual demise. It can have an amazing effect on how you live for the moment.

Jealousy works the opposite way you want it to.

Breathe deeply and appreciate the moment. Living in the moment could be the meaning of life

Do one thing a day that scares you.

Take various vitamins. You never know what small mineral can eliminate the bottleneck to everlasting health.

Dance, sing, floss and travel.

Do not use cleaning chemicals on your kitchen counters or floors. Someone will inevitably make a sandwich on your counter or a baby will crawl on the floor.

Creativity is maximized when you’re living in the moment.

Children are the orgasm of life. Just like you did not know what an orgasm was before you had one, nature does not let you know how great children are until you have them.

Friends are more important than money.

Don’t trust that an old age pension will be sufficient.

Live near the ocean and inhale the pure salt air that flows over the water, Vancouver will do nicely.

Stress is related to 99% of all illness.

A daily hit of athletic-induced endorphins gives you the power to make better decisions, helps you be at peace with yourself, and offsets stress.

Wake up and realize you are surrounded by amazing friends.

Observe a plant before and after watering and relate these benefits to your body and brain.

Coke, Pepsi and all other pops will be known as the cigarettes of the future. Colas are NOT a substitute for water. They are just another cheap drug made to look great by advertising.

SWEAT once a day to regenerate your skin.

Choose a positive thought. The conscious brain can only hold one thought at a time

Communication is COMPLICATED. We are all raised in a different family with slightly different definitions of every word. An agreement is an agreement only if each party knows the conditions for satisfaction and a time is set for satisfaction to occur.

Nature wants us to be mediocre because we have a greater chance to survive and reproduce.

Mediocre is as close to the bottom as it is to the top, and will give you a lousy life.

Move your body and your heart will follow.

DO IT NOW, DO IT NOW, DO IT NOW! The world is changing at such a rapid rate that waiting to implement changes will leave you two steps behind.

lululemon athletica was formed to provide people with components to live longer, healthier and more fun lives. If we can produce products to keep people active and stress-free, we believe the world will become a much better place.

Summary of Life

July 13, 2012

I received this in a recent Email and would like to pass it along to my fellow bloggers.

GREAT TRUTHS THAT LITTLE CHILDREN HAVE LEARNED:
1) No matter how hard you try, you can’t baptize cats.
2) When your Mom is mad at your Dad, don’t let her brush your hair.
3) If your sister hits you, don’t hit her back. They always catch the second person.
4) Never ask your 3-year old brother to hold a tomato.
5) You can’t trust dogs to watch your food.
6) Don’t sneeze when someone is cutting your hair.
7) Never hold a Dust-Buster and a cat at the same time.
8) You can’t hide a piece of broccoli in a glass of milk.
9) Don’t wear polka-dot underwear under white shorts.
10) The best place to be when you’re sad is Grandma’s lap.

GREAT TRUTHS THAT ADULTS HAVE LEARNED:
1) Raising teenagers is like nailing jelly to a tree.
2) Wrinkles don’t hurt.
3) Families are like fudge…mostly sweet, with a few nuts.
4) Today’s mighty oak is just yesterday’s nut that held its ground.
5) Laughing is good exercise. It’s like jogging on the inside.
6) Middle age is when you choose your cereal for the fiber, not the toy.

GREAT TRUTHS ABOUT GROWING OLD
1) Growing old is mandatory; growing up is optional…
2) Forget the health food. I need all the preservatives I can get.
3) When you fall down, you wonder what else you can do while you’re down there.
4) You’re getting old when you get the same sensation from a rocking chair that you once got from a roller coaster.
5) It’s frustrating when you know all the answers but nobody bothers to ask you the questions.
6) Time may be a great healer, but it’s a lousy beautician.
7) Wisdom comes with age, but sometimes age comes alone.

THE FOUR STAGES OF LIFE:
1) You believe in Santa Claus.
2) You don’t believe in Santa Claus.
3) You are Santa Claus.
4) You look like Santa Claus.

SUCCESS:

At age 4 success is . . . Not piddling in your pants.
At age 12 success is . . Having friends.
At age 17 success is . . Having a driver’s license.
At age 35 success is . . Having money.
At age 50 success is . . Having money..
At age 70 success is . . Having a drivers license.
At age 75 success is . . Having friends.
At age 80 success is . . Not piddling in your pants.