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What Happens if Low Testosterone Goes Untreated?

An interesting article how to increase testosterone is important –

Hormone therapy offered by Student Health Service

Through hormone replacement therapy, transgender women can receive estrogen to counteract testosterone and transgender men can receive testosterone to counteract estrogen, said Patricia Kress, the medical director of Student Health Service on campus.

“It’s kind of amazing because some students, after you give them that first dosage of the hormone they need, they’re like ‘oh my gosh, a piece of the puzzle has been finally found.’ It’s really powerful,” she said. Kress spends a full hour with students at the first appointment, a half-hour at the next two meetings and then sees them in a follow-up within a month, she said.

https://www.google.com/url?rct=j&sa=t&url=https://www.spectatornews.com/campus-news/2019/11/hormone-therapy-offered-by-student-health-service/

What happens when a man’s testosterone is low? Watch the video to discover a simle treatment that will really help you.. Finally something that works:

Video Transcript

welcome back to Mayo Clinic radio I’m dr. Tom shibez and I’m Tracy McCray Tracy all made all of us guys experience a natural and a normal decline in testosterone levels as we get older and typically it’s about 1% a year after the age of 40 so when you’re 65 you’ve got probably 25% less testosterone than you did when you were 40 and in some men that declining testosterone level causes a decrease in energy and a decrease in sex drive but help is available through testosterone therapy a treatment that has become increasingly popular in recent years due to the aging baby boomer population a series of seven clinical trials sponsored by the US National Institutes of Health is being used to assess the effectiveness of hormone therapy in men 65 or older with symptoms related to low testosterone levels so here to talk to us about testosterone is urologist dr. Landon Trost dr. Trost good to have you on the program well thank you for having me on the program appreciate being with you so for a woman when she reaches menopause the estrogen sort of drops dramatically for a man it just sort of gradually subsides fades away in some cases that that’s the case there are of course disease states where their testosterone will drop immediately or after cancer if you’re treating for testicular cancer something like that but in the majority of men it is this slow steady decline and in these clinical trials at c7 clinical trials what do they show is it a good idea or not well and I’d say testosterone in general for the past decade or so has been increasingly popular increasingly investigated like you mentioned with the women’s health and estrogen that was really about the 1990s or so we had a big push towards supplementation should there be estrogen supplementation and so on and this is kind of the male equivalent to starting to come of age and these particular trials in general were an attempt to look at this in a more rigorous fashion so there were many small trials with either retrospective in nature are very limited kind of randomized trials and here the NIH essentially got together with some of the trials to put together a more robust set of data so this particular one was funded by industry but the goal was to really see does testosterone work or not and the key conclusion of the trials is that yes indeed it does work and appropriately selected men but it’s a modest benefit in general so it’s not gonna it’s not the Fountain of Youth it’s not gonna make you 20 years old again I think the key might be appropriately selected men I think that might be it so what does that mean well yeah but first of all what are we treating here is it really true has it been shown that if is testosterone levels go down that it does indeed decrease energy and decrease sex drive yep so it’s a good question I think there’s two parts to that question in certain men who have like metastatic prostate cancer for example for many years they’ve been treated by cutting out all the testosterone either through orchiectomy or through removing their testicles I was trying to think of a good way but in those cases no question we see a big and broad sweeping side effects and that includes energy hot flashes decreased bone mass diabetes all sorts of large and significant side effects throughout the body wait am I get hot flashes yep yeah so if you cut testosterone abruptly a percentage will get pretty severe hot flashes from it so we do know that the bigger question is if you have a very slow and steady decline do you get different symptoms with it and it appears that a lot of these symptoms are based on certain thresholds so the lower your testosterone goes the more likely or to have significant symptoms but perhaps even more concerning is there have been several trials showing now that as if you look at men with low testosterone versus normal testosterone values those who have low don’t live as long they have a much higher rate of hypertension hyperlipidemia diabetes high blood pressure fat’s in their blood yes exactly and so we’ve known for some time now that low testosterone is associated with multiple conditions and now we’re getting more and more data showing what can supplementing testosterone do to some of these disease states okay so you if you watch TV it suggests that every guy out there has got low tea and that ought to be taking some sort of supplement but there must be some criteria that you use to decide who’s a candidate get this and who is it a selection of the men that’s what I want to know no it’s a the golden question I think – no question so in the early 2000s this became very much direct-to-consumer marketing and this drug so testosterone supplementation has been grandfathered in by the FDA for this so it’s a very appealing target for a lot of companies because they don’t have to invest a lot of money in it they don’t have to go through regulation for it so there was really a boom and it became a above 1 billion dollar industry very quickly in the 2000s just the stuff you could get over-the-counter well in or you’d have to still get a prescription for it but as far as this idea of all men have low tea and this is going to reverse all these symptoms so there is no question that the appropriately selected men which is essentially men who are most guideline societies that put this around 280 as far as your blood test value for testosterone anyone below that is likely a viable candidate for testosterone supplementation if they have symptoms of low testosterone so you shouldn’t sorry you shouldn’t take it unless you have seen a position and had your testosterone level checked yep oh that’s correct and there are several studies actually showing that if you do supplement and you’re in the normal range there’s no added benefit if you compare it to placebo or a sugar pill or whatever it’s equivalent to that so this idea of over supplementing really should be non-existent just gives you expensive urine yep yep how is testosterone therapy given is it a cream or is it a pill how does it happen there’s multiple different ways to do it now so in the United States some of the most common are either injections or through a topical gel there are also patches there’s things you can put in your gums you can put in your nose you can do long-acting injections you can put pellets under the skin there’s a million different ways to do it so in Europe there’s an oral pill available as well that may be available in the United States at some point and then there’s off-label methods of giving it as well through other agents such as clomid or Arimidex or other things so they’re right as of today in the United States there is not a testosterone pill that you can take there’s an off-label version so you can take one like a clomid for example it’s a selective estrogen receptor modulator it’s a specific type of pill and it indirectly raises testosterone but you can’t take an oral form testosterone that’s correct just like you can in Europe mmm are there a nice I’m sorry go ahead so do you think it will be coming here in the near future it’s always tough to predict regulatory things so it would just be you know pure speculation on that it seems to have merit but the FDA in general is concerned about an overreach of of using testosterone it was originally indicated for you know young boys who never went through puberty who needed testosterone supplementation and now it’s been broadened into this very large category if all men as they age and or the majority of men as they age and get low testosterone values so are there any risks to testosterone therapy there are there generally mild has long and and the goal is if you keep someone in the normal range so we do see some who have used it for building muscles and things like that and that’s a whole different discussion but if you keep it within the normal range we do monitor things like your the red blood cell count so how thick your blood is and we also monitor PSA for things so the known risks are it may raise your red blood cell count it can increase acne it could potentially increase hair loss slightly there’s so there’s small things like that that we monitor the risks as far as heart disease strokes those are really unknown they’re unlikely but we just don’t have enough data or enough men to really know the risk for prostate cancer is really nothing if it does not cause new onset prostate cancer alright so the bottom line is there may be some men who would benefit from testosterone therapy but before you do that see your physician have your testosterone level checked and only use supplementation or testosterone if it’s low it’s an excellent summary and does insurance cover it at this point insurances are variable so most of them will cover some degree but a lot of times there’s out of pocket of up to a few hundred dollars each month alright there’s the bottom line on testosterone therapy dr. Landon trost urologist Mayo Clinic thanks for being with us thanks for having me and that’s our program for this week

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