andropause - asheville integrative medicineatherosclerosis risk factors testosterone: “…in men...
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Andropause
James Biddle, M.D.
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Andropause
Men + Age = ↓ Testosterone Levels
Andropause (Male Menopause)
Ages 50- 70
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This is simply an educational
presentation and is not intended to
diagnose or treat any individuals.
Diagnosis and treatment of any
disease should be done by a licensed
health-care practitioner
in an office setting.
Disclaimer
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Who We Are…
Asheville Integrative Medicine
Evolving the Standard of Health Care for All,
While Empowering You to Enjoy Optimal Health.
832 Hendersonville Road, Asheville, NC 28803
828-252-5545
www.docbiddle.com
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Who We Are…
Physician-Selected Nutritional Supplements
832 Hendersonville Road, Asheville NC 28803
828-210-0188
www.nutrientsetc.com
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Who I am…..
BA in Biology 1984 , University of Missouri – Columbia
(genetics & evolution).
M.D. 1989 @ University of MO – Columbia.
Internal Medicine 1992 in Portland OR – Board
Certified; recertified in 2002 and 2012.
Practicing Integrative Medicine in Asheville since 1997.
www.earthaven.org , www.acam.org , www.ncims.com
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What I do….
“Integrative Medicine”
Holistic, Nature’s Template, Scientific, Orthomolecular, Sherlock Holmes…
Bio-Identical ‘Natural’ Hormones
Diabetes and Nutrition
Cardiovascular Support
Allergies, ADD, Autism
Arthritis and Fatigue
Toxic Metal Syndromes
“Challenging Cases”
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Age and Testosterone Levels
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Testosterone Deficiency
Loss of muscle mass
Increasing Fat Mass
Fatigue
Loss of Libido
Erectile Dysfunction
Penile Shrinkage
Gynecomastia
Prostate Problems
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Vasectomy and Dementia
Symptoms may occur more frequently
after vasectomy because of anti-sperm
anti-bodies.
May face higher risk of dementia, Primary
Progressive Aphasia (loss of language skills).
Of 47 men with PPA, 40% had vasectomy,
compared with 16% of 57 men without PPA.
> Cognitive & Behavioral Neurology; 2006:
19(4):190-193
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Vasectomy and Dementia
Primary Progressive Aphasia – nerve cells die in brain region responsible for language skills. Difficulty with name recognition, speech,
reading, writing, and comprehension.
Caused by Sperm Antibodies?
> Cognitive & Behavioral Neurology; 2006:
19(4):190-193
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Excess Estrogen
Less Testosterone = Excess Estrogens
Aromatase from fat cells Excess body fat =
excess female hormones
Prostate tissue growth BPH – Benign Prostatic Hypertrophy
Prostate Cancer
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Hypogonadism
Hypogonadism is present in 5% of males
aged 40-50, but in up to 70% of males
older than 70.
>Journal of Gerontology 2001; Series A56:M263-5.
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Four Causes of Erectile Dysfunction:
1. Testosterone Deficiency.
2. Peripheral Vascular Disease.
3. Nerve Damage.
4. Psychological.
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Atherosclerosis Risk Factors
“Testosterone Linked to MI Death”:
In 22 non-diabetic men with AMI, those with
death or CHF had lower testosterone
levels.
In another study, exogenous testosterone
improved the symptoms of angina.
>Endocrine Society Annual Mtg. Pugh, Peter, Univ of
Sheffield, England.
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Atherosclerosis Risk Factors
Testosterone:
“…in men selected for coronary arteriography, age, HDL-C, and FT (Free Testosterone level) may be stronger predictors of degree of CAD than are blood pressure, cholesterol, diabetes, smoking, and BMI.”
>Metabolism. 2004 Mar;53(3):324-9. Are major risk factors for myocardial infarction the major predictors of degree of coronary artery disease in men? Phillips GB.
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Cognition
Declining Testosterone levels predict physical frailty and declining cognitive function, while testosterone replacement can improve cognitive function in older men.
>Journal of Cognitive Neuroscience 12:407-414.
>Behavior Neuroscience 108:325-332.
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Testosterone Replacement
May protect against Alzheimer’s dementia.
> Journal of Clinical Epidemiology 44:671-684.
> Proctology National Academic Science USA 200; 97:1202-1205.
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Testosterone Replacement
Only when system fails to make enough.
Be careful to begin replacement therapy.
Inhibits own testosterone production,
may need testosterone replacement
indefinitely.
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Delay Andropause
Support man’s own production of
testosterone.
Proper Nutrition and
Exercise Fundamental.
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Options for Prevention
Control Your Weight
Decrease fat mass
Increase Muscle Mass
Reverse Insulin Resistance
> Diabetologia 1992;35:173-177.
> Psychoneuroendocrinology
1992;17(4):375-383).
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Options for Prevention
Tribulus Terrestris (Puncture Vine)
Boost LH production by up to 72%,
testosterone by up to 41%.
Also boosts Libido and
Sperm Production
(Chemical Pharmaceutical
Institute Literature).
1500mg daily
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Options for Prevention
Block Aromatase:
Converts
testosterone to
estrogens.
Arimidex
0.5 mg
2 - 3 times weekly
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Options for Prevention
Block Aromatase:
Reduce Alcohol, Boost Zinc, Reverse
Obesity.
Increase Estrogen Excretion:
DIM (di-indole-methane), I3C (indole-3-
carbanol) & ½ C broccoli sprouts daily.
Improve Metabolism of Estrogens.
Journal of Nat. Cancer Institute 1997;89:718-23.
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Options for Prevention
Block 5-alpha-reductase
Saw Palmetto - 160-320mg/ day Cur The Res 1994; 55(7):776-85.
Pygeum Africanum - 30-100mg 2x day 14% B-sitosterol or Phytosterols
Lancet 1995; 345:1529-32.
Stinging Nettles – 300mg 2-3x day
Progesterone - 5-10mg in topical cream, or
10-25 mg capsule orally at bedtime
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Options for Treatment
Lower Excess Estrogen
Weight Loss!
Ground Flax Seeds – 2-4 Tbsp daily Cancer Epidemiology Biomarkers
Preview 1998; 7(12:1101-8).
Calcium-D-Glucarate – 500 mg 1-2x daily Cancer Detection Prevention 1997;21(2):178-90.
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Options for Treatment
Avoid Testosterone Injections, which use
synthetic (methyl-testosterone).
Natural Testosterone Options:
Androderm patch
Androgel – topical gel
Compounding Pharmacy – topical cream,
50-150mg daily
Always test levels and metabolites!
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Options for Treatment
Trans-D Tropin
Supports own release of growth hormone.
6 wks, boost release of hGH by up to 1700%
at one hour post dose.
Works best with
aggressive exercise
program.
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Live Healthier, Live Longer