Grumpy Old Men: Maybe It's A Question of Testosterone

[IbPervert (imported)]

From todays Wall Street Journal...

Thought this was an interesting article, and just had to share...

---

Grumpy Old Men: Maybe It's

A Question of Testosterone

February 26, 2008; Page D1

Tampa, Fla.

They're bullish on testosterone here at the 6th Annual World Congress on the Aging Male.

Physicians and researchers from around the world gathered to review the latest findings on what low levels of the male hormone means for men, how replacing it might help and why it hasn't caught on broadly.

"If we had a drug that could restore sexual function in men, make them stronger, build their bones, reduce fat and get rid of the blues, you'd say, 'Oh my God, why doesn't everybody know about it?' " says Abraham Morgentaler, a urologist at Harvard Medical School and director of the Men's Health Boston clinic. "There is a drug like that -- but the public associates testosterone with cheating and illicit behavior and the fact that 40 years ago, it was thought to give people prostate cancer."

Whether it does or not is still an open question. But many studies have shown that low testosterone is associated with reduced muscle mass, bone density, sexual function and vitality, and increased fatigue, depression, Type II diabetes and obesity -- particularly belly fat. Evidence is accumulating that restoring testosterone to normal can alleviate many of those problems.

DISCUSS

[Go to forum]

Some studies suggest that boosting testosterone can boost muscle strength, bone density, sexual function and general quality of life in older men. But the risks remain unknown. So, is it a risk worth taking? Share your thoughts.

HEALTH MAILBOX

Melinda Beck answers questions about the long-term effects of nicotine gum and mercury levels in sushi.

"Men with low testosterone are miserable to live with -- they fall asleep after dinner and snap at everyone," says David Greenberg, a general practitioner in Toronto. "You restore it and they say, 'Wow, I feel like myself again.' "

But there's debate over which of the three forms of testosterone to measure, what level constitutes "low" and, most importantly, at what age. Testosterone declines naturally after age 40. So is a 70-year-old man deficient or just aging?

"The moment you add the element of aging, you add the element of ageism. It's giving things for sex to old men," says John E. Morley, director of geriatric medicine at Saint Louis University, who, like other experts quoted here has worked with makers of testosterone products.

"Everybody agrees that testosterone deficiency should be treated in younger men. Why not treat it in older age groups?" says Ronald S. Swerdloff, chief of the endocrinology at Harbor-UCLA Medical Center.

Women lose estrogen much more abruptly in menopause, and replacing it to alleviate symptoms and maintain bone health has been standard practice for decades, though questions remain about the risk of breast cancer.

There are even more unknowns about the risks and benefits of testosterone replacement. For one thing, many of the symptoms of low testosterone are very common in older men and could be related to other conditions. Some, like obesity, may lead to low testosterone rather than vice versa.

And there is lingering concern that testosterone could fuel prostate cancer -- largely because drugs that reduce testosterone seem to shrink enlarged prostates and lower the risk of developing prostate cancer by 25%, according to the National Cancer Institute's Prostate Cancer Prevention Trial.

On the other hand, an analysis of 18 studies in the Journal of the National Cancer Institute last month concluded that there is no correlation between testosterone levels and prostate-cancer risk. Another study in the Journal of Clinical Endocrinology and Metabolism found that men with low testosterone had higher mortality rates in general than those with higher levels, regardless of other risk factors.

Some drug makers are testing oral variations of testosterone that would deliver the benefits without the potential prostate hazards. For now, testosterone is available mainly in injections, topical gels and patches. Nearly three million prescriptions were written in the U.S. in 2007, according to IMS Health, a health-information company.

Everyone here agrees that large-scale clinical trials are needed to evaluate the safety and effectiveness of testosterone therapy. One such trial has been proposed to the National Institutes of Health; and the New England Research Institutes is starting a registry of 1,000 patients, half in the U.S. and half in Europe, to follow for two years.

[chart]

In the meantime, some doctors are wary of treating older men until more is known. "If your patient is an old man who's grumpy and not the stud he used to be, you could give him testosterone for a few months and see what happens," says Elizabeth Barrett-Connor, chief of epidemiology at University of California, San Diego. "But no epidemiological results justify giving it to older men in general."

[DonnyMac (imported)]

Wow, I here I though I was grumpy because of testosterone.

[mrt (imported)]

I think the article is correct. Thats not to say that some men are not better off without it.

MrT

[Kangan (imported)]

Not long after I castrated myself, my wife complained that I was getting very grumpy and disgruntled. Gee - I guess it worked!:D

[plix (imported)]

Good article, but I do notice a few issues that need to be pointed out.

First, they are right when they say that association of T with steroids is something that the public does, but it is also something that many doctors do, which is why many are hesitant to prescribe it. Not only are they concerned themselves about people who only want legal steroids, but they also have to worry about the DEA looking over their shoulders, even when the script is legit. There is some question I think as to whether it is actually legal to prescribe T to someone in the normal range (even barely normal, such as in the 200s). Although off-label prescriptions are legal for most medications, all bets are off when it comes to controlled substances. You are dealing with a completely different set of rules then. For instance, all doctors know the DEA would be at their doors if they scripted Vicodin or Oxy for OCD, even though at least anecdotal evidence (not sure about studies) have shown both to be highly effective in OCD. So what makes T any more legal to script for "anti-aging" when the T levels are in the normal range?

Second, it was not 40 years ago that it was thought T causes prostate cancer. It is now. Most doctors today believe it causes prostate cancer, and this is a big reason many refuse to prescribe it except where clearly indicated (e.g., castration). But I still find it unfair that men who have natural T get to keep it if they get prostate cancer, but I would be blacklisted from ever getting T again if I get it. Why aren't intact men forcibly castrated upon a diagnosis of prostate cancer just like I would be? If they are going to do it to me, the same should be true for all men.

The fact that people quoted here are working with Big Pharma is reason enough to call this whole article into question. But sadly everyone has an agenda, and there is no way you are going to get a truly neutral quote from anyone on anything.

At least this article mentions the potential for young men to have T problems. Previous articles have ignored it completely and insist that only older men can have these issues. A young man missing both nuts may be rare, but I speak from expeirence when I say it is possible. And I am sure there are other reasons that even intact young men can have low T.

This article mentions something important. We don't know the direction of the cause and effect relationship here. Does low T cause these problems, or do these problems cause low T?

If T levels are reduced to castrate levels, then the risk of prostate problems is lowered by nearly 100%, not just 25%. Of course age at which castration takes place also matters, and the younger the age the closer to the 100% risk reduction. If TRT is taken after castration, then all bets are off of course.

We really have no understanding of the relationship between T and prostate cancer. All we know is that castration slows the growth of exisiting prostate cancer and seems to prevent non-existing cancer from ever developing. These two pieces of evidence are why the most common theory is that T either aggravates or actually causes prostate cancer. But is it really that simple, or is the relationship more complex?

There are a lot of new theories coming out, including one by "anti-aging" proponents that it is actually E that causes prostate cancer. I think this one is prettly likely to be BS. If it were true, it would seem that nearly every MtF out there should have prostate cancer. But fewer than normal, if any, develop it.

My personal belief is that there are genes that make one susceptible to prostate cancer. If the genes are present, then T at least aggravates the cancer or maybe even causes it. But if the genes are not present, then no amount of T is going to cause prostate cancer.

I think the evidence that reducing T slows or prevents prostate cancer is far too overwhelming to say that T plays no role in contributing to prostate cancer. But I also believe that genetics are an important element.

If these new oral T drugs are the SARMs I have heard a lot about, then they sound interesting. They are not actually T, but something that acts on T receptors just as T does. Apparently they can be designed to only deliver the positive effects of T while not causing any of the negative effects. As long as they are safe and effective as T, then they could be worth taking. But they are still years away at best, and goodness only knows what they will cost when they first come out.

[devi (imported)]

Believe me!!! I myself neither fall asleep after dinner ever nor do I snap at everyone. In fact I'm very well known for my congeniality, smiles and level headedness. Yes every so often (maybe once a month) I will get very pissed at something or other but most people do. I have no pot belly nor am I much overweight. I do have a family history of type two diabetes and was told that I have hyperglycemia (210) the other day. I am fifty years old and am actually the last of my siblings (of which I am the oldest) to have been diagnosed with that. I actually thought for reason that that probably had bypassed me and so I wasn't being careful how I ate. I am also the only one that is not bald which may have been making me feel that I wasn't getting any older. What I'm getting at is that I really do seriously have issues with all these frivolous claims that these testosterone sales people keep making. Why are eunuchs such as myself (since I have always had very low testosterone) known for having the "eunuch calm" and yet there is this claim that keeps popping up about low testosterone making somebody grouchy? It absolutely does not make any sense whatsoever.

[Testman (imported)]

Older people have very low levels of GH. My grandmother has been on GH for her heart failure and I noticed the first thing to improve was her mood. She just feels better after getting on GH. It doesn't even take much either.

I would like to see both GH and testosterone used on older people. One doctor even said every old person, men and even women, should be on some Anavar too. (Another steroid) Why? The Anavar gives a little strength and speeds the metabolism up so their bodies function more like they were younger.

[Testman (imported)]

There are a lot of new theories coming out, including one by "anti-aging" proponents that it is actually E that causes prostate cancer. I think this one is prettly likely to be BS. If it were true, it would seem that nearly every MtF out there should have prostate cancer. But fewer than normal, if any, develop it.

You may have a point there. Bodybuilders maintain VERY high estrogen levels, far higher than any normal HRT man, yet none seem to be coming down with prostate cancer. But then again, they also maintain very high tesosterone levels and still no more prostate cancer than the average man. So, who knows. I'm starting to think all this cancer stuff is really mostly genetics and diet, mostly diet. There have been numerous people who simply started eating right and their cancer went away.

[BossTamsin (imported)]

On the flip side, there are people who eat right, get plenty of exercise, adn do all the right things yet still wind up with cancer.

[OneBallBoi (imported)]

Bob will tell you that I am a grumpy old man with or without T. Plus I am the old man and he is only 29. HeHeHe