The Five Most Common Problems In Patients With Low Testosterone

Posted on

Replacing Testosterone Is The Foundation To Good Health After Age 50.

New patients rarely come to the BioBalance Health office with just low testosterone.

I find that if at the request of a patient I only replace their low testosterone and ignore the other deficiencies and medical problems that accumulate with aging, I often have to explain replacing testosterone is the foundation to health after 50, but individuals often collect other health problems that prevent them from being maximally productive as they age.  We find there are several common problems that occur with aging and interfere with the complete success of testosterone therapy.


#1 Insulin Resistance (Pre-diabetes)

 I consider testosterone pellet replacement the foundation of the treatment plan for Anti-Aging.  Treating the second most common problem that contributes to disability of aging is called Insulin Resistance (IR) or Pre-diabetes. Symptoms of this common problem are progressive fatigue that increases throughout the day and worsens with carbohydrate intake, and ever increasing weight gain in the abdomen. Patients with IR state they feel more and more tired as the day progresses, and eating carbohydrates makes this fatigue worse.  It is almost impossible to lose weight with this condition unless both testosterone levels are normal and insulin resistance is treated.  Lab that supports this diagnosis is an elevated blood sugar, triglycerides, a slightly elevated HBA1C.

If left untreated, Insulin resistance eventually leads to obesity, diabetes and heart disease.  We treat this condition with a low carbohydrate diet of 6 small meals a day, daily aerobic exercise, and the medication Metformin Extended Release or Victoza, both diabetic medications.  We are very successful at averting both the symptoms and the future diseases that usually follow this condition.  When our patients combine Testosterone pellets that increase muscle mass and lose fat, with treatment of IR, we find that they feel much more like their younger selves without a future of illness.  Most of my patients don’t have to take medication for this for the rest of their lives if they continue the dietary guidelines and exercise thereafter.


#2 Estrone Dominance

As testosterone decreases from the ovaries or the testes, estrone production increases from the adrenal gland.  This estrogen, made in both men and women make them feel old, gain belly fat and “man-boobs”, and alters the body’s composition to that of an old man or woman.

Estrone usually decreases somewhat, with testosterone pellet treatment but many habits we develop when we are younger begin to cause deleterious effects as we get older. Alcohol intake stimulates the production of estrone, as we get older and augments the physical changes we associate with aging: belly fat and man-boobs. Estrone elevation stimulates the development of belly fat and belly fat makes more estrone.

All of these problems are interwoven and treating with T pellets does help this issue, but if a person continues to drink excessively they will not benefit fully from the T replacement.

Estrone is treated with a medication called arimidex (an aromatase inhibitor), and a supplement called DIM (Di-indole-methane) as well as testosterone replacement with Pellets.  This is very effective and releases more free testosterone from circulation.  I often treat both the elevated Estrone as well as the low testosterone to bring normal testosterone levels back.


#3 Hypothyroidism

The thyroid gland in women is at risk from adolescence on but it often becomes hypo-thyroid after the age of 40.  I often diagnose this problem when others have deemed the thyroid normal because I use the symptoms of low thyroid as well as the T3, T4, and TSH levels, and basal body temperatures to diagnose this illness.

The thyroid is dependent on iodine, which is deficient in the diet of the Midwest, where I practice.  The symptoms include hair loss and breakage, weight gain, dry skin, swelling, slow heart rate, low blood pressure, fatigue and brittle nails.  Most women with hypothyroidism have cold hands and feet and feel cold when everyone else is comfortable.  In addition, the tests for thyroid are gender specific which is not noted on the lab test and they often look normal to most physicians who don’t understand the gender difference and the variability of the test.

I rely heavily on the basal body temperature (BBT) that reflects the heat stimulated by thyroid hormone on the cells.  If the BBT is > 97.9 in women and 98.4 in men then the thyroid is usually normal.  If lower then it is generally deficient.

Low thyroid that is untreated keeps the patient at a low metabolic rate and causes our patients to still feel old and not well.  We treat both men and women with Iodoral, an iodine supplement and if that is not successful or they are severe I treat with Synthroid or Armour Thyroid until the temperature is normal.


#4 Low Growth Hormone

Growth Hormone is a hormone that comes from the pituitary and decreases in parallel with testosterone.  This hormone is reflective of the muscle:fat ratio in the body composition, and it also stimulates the production of normal lean body mass and it stimulates the growth  and repair of every tissue in the body.  Without it or with low levels we “dissolve” losing muscle, bone, and neurologic tissue becoming old and fragile, or merely old slow and fat.

Testosterone stimulates growth hormone in most people, which helps in developing the normal strong muscular body of youth.  At some point in aging, testosterone is not enough and we must stimulate growth hormone with a compounded medication to achieve a healthier and younger looking body and brain.

Many of my patients have had head injuries and these folks often have both low GH and low testosterone, and GH does not increase with testosterone replacement.

Before resorting to a stimulator we increase exercise, protein intake and a supplement called arginine and ornithine to increase GH and muscle mass independent of free testosterone levels.


#5 High Cholesterol

Cholesterol is the primary ingredient of all cell walls in the body as well as testosterone and all other steroid hormones like cortisol.  When testosterone starts to decrease production from the ovaries or testicles, total cholesterol and LDL cholesterol begin to rise.  When that occurs, most men and some women are treated with a statin drug.  This lowers the cholesterol in the blood but does not increase testosterone levels.

When we replace testosterone with pellets, the cholesterol generally decreases without the help of statins and we can decrease the statins or stop that medication.  There seems to be a feedback system in the liver that responds by decreasing cholesterol when free testosterone increases.

We always recommend exercise and low carb diet in addition to testosterone to keep the cholesterol normal without other drugs if possible.

Knowing all the medical problems that can accompany testosterone deficiency is critical when choosing a doctor to take care of you.  Most doctors don’t know about these issues and even if they do they just treat low testosterone because these additional issues are complicated and require time to treat.  If you want to be really healthy, finding a doctor or a group of doctors and nurse practitioners who believe in this holistic method of preventing disease and promoting health no matter what your age is the key.

This Health cast was written and presented by Dr. Kathy Maupin, M.D., Bio-identical Hormone Replacement Expert and Author, with Brett Newcomb, MA., LPC., Family Counselor, Presenter and Author.

Related Post: