Testosterone Replacement Therapy

Sometime people don’t realize how many factors are related to testosterone production. Testosterone isn’t simply about libido and lean muscle mass but rather it relates to overall wellness. Here is a nice breakdown worth reading from the Cleveland Clinic. I hope you enjoy – Dr. Collins

Testosterone is a hormone produced by the testicles and is responsible for the proper development of male sexual characteristics. Testosterone is also important for maintaining muscle bulk, adequate levels of red blood cells, bone density, sense of well-being, and sexual and reproductive function.

Inadequate testosterone production is not a common cause of erectile dysfunction (ED). When ED does occur with decreased testosterone production, testosterone replacement therapy may improve the ED.

What causes testosterone deficiency?

As a man ages, the amount of testosterone in his body gradually declines. This natural decline starts after age 30 and continues throughout life. The significance of this decline is controversial and poorly understood. Among other potential causes of testosterone deficiency are:

  • injury or infection to the testicles
  • chemotherapy or radiation treatment for cancer
  • genetic abnormalities such as Klinefelter’s Syndrome (extra x chromosome)
  • hemochromatosis (too much iron in the body)
  • dysfunction of the pituitary gland (a gland in the brain that produces many important hormones)
  • medications, including hormone analogues used to treat prostate cancer and steroids
  • chronic illness
  • cirrhosis of the liver
  • chronic renal (kidney) failure
  • AIDS
  • inflammatory disease such as sarcoidosis (a condition that causes inflammation of the lungs and other organs)
  • stress
  • alcoholism
  • congenital conditions, Kallman’s Syndrome (low hormones, inability to smell and other abnormalities)

What are the symptoms of testosterone deficiency?

Symptoms of testosterone deficiency include the following:

  • decreased sex drive
  • decreased sense of well-being
  • depressed mood
  • difficulties with concentration and memory
  • erectile dysfunction

What are the changes that occur in the body with testosterone deficiency?

Changes that occur with testosterone deficiency include:

  • a decrease in muscle mass, with an increase in body fat
  • variable effects on cholesterol metabolism
  • a decrease in hemoglobin and possibly mild anemia
  • fragile bones (osteoporosis)
  • a decrease in body hair

How do I find out if I have a testosterone deficiency?

The only accurate way to detect the condition is to have your doctor measure the amount of testosterone in your blood. It sometimes may take several measurements of testosterone to be sure if a patient has a deficiency, since levels of testosterone tend to fluctuate throughout the day. The highest levels of testosterone are generally in the morning. This is why doctors prefer, if possible, to obtain early morning levels of testosterone.

What options are available for testosterone replacement?

The options available for testosterone replacement are:

  • intramuscular injections, generally every two or three weeks
  • testosterone patches worn either on the body or on the scrotum (the sac that contains the testicles). These patches are used daily. The body patch application is rotated between the buttocks, arms, back or abdomen.
  • testosterone gels that are applied daily to the shoulders, upper arms, or abdomen.

Each of these options provides adequate levels of hormone replacement. Each has side effects and advantages and disadvantages. Intramuscular injections produce wider swings in hormone concentration, with higher levels shortly after the injection and lower levels just before the next injection is due. They may also produce increases in blood cell count that are higher than normal.

The body patches may produce skin irritation in a significant number of men, requiring discontinuation of the patch. The gels require care in making sure that the hormone is not accidentally transferred to another person or partner.

There are currently no pills available in the United States that provide adequate levels of hormone replacement. In addition, oral medications may produce liver abnormalities and are to be avoided.

The choice of hormone replacement therapy is best made with a thorough discussion between a patient and his physician.

Who shouldn’t take testosterone replacement therapy?

Testosterone replacement therapy may stimulate growth of the prostate. If early prostate cancer is present, testosterone may stimulate the cancer’s growth. Therefore, men who have prostate cancer should not take testosterone replacement therapy. It is important for all men considering testosterone replacement therapy to undergo prostate screening before starting this therapy.

Although it is a rare condition, men who have breast cancer should not take testosterone replacement therapy.

What are the side effects of testosterone replacement therapy?

In general, hormone replacement therapy is safe. It is associated with some side effects, including:

  • acne or oily skin
  • mild fluid retention
  • stimulation of prostate tissue, with perhaps some increased urination symptoms such as decreased stream or frequency
  • breast enlargement
  • worsening of sleep apnea (a sleep disorder that results in frequent night time awakenings and daytime sleepiness)
  • decreased testicular size

Many of these side effects are not common.

Laboratory abnormalities that can occur with hormone replacement include:

  • changes in cholesterol concentrations
  • increase in red cell count
  • decrease in sperm count, producing infertility (especially in younger men)

Please contact  us at 619-440-3838 to have your testosterone levels checked.


Adrenal Fatigue or Burnout?

Possibly you have been to a health care practitioner of some sort and when you mentioned you were feeling tired they might have said you have Adrenal adrenal fatigue san diego clinic of integrative medicineFatigue.

You’ve probably wondered what that even was or if Adrenal Fatigue even a real medical condition?

The answer is both yes and no.

Your adrenal glands are small glands that reside atop of your kidneys.  Their job is to release cortisol when there is stress in the body.  Cortisol gives you the extra energy to get through “the tiger chasing you” which is how we perceive our boss giving deadlines or our kid’s soccer schedule or both.  It also has to do with metabolism and glucose regulation. http://en.wikipedia.org/wiki/Cortisol

We are often moving targets in our daily life and we fuel up with venti lattes (caffeine, a stimulant) to get through our afternoons.

Over time, our adrenal glands can’t keep up with the demand placed on them.  Here is where the fatigue part comes in. You might start getting tired in the afternoons, soon you have trouble sleeping and then you notice your midback starts hurting.  You start getting more colds and you have higher inflammation which means more aches and pains. Worst of all weight gain.

There are complicated processes going on in the body that cascade into these symptoms and there are stages to all of these symptoms.  At any point things can get complicated and turn into more alarming conditions.

We can help get you back to great working order at any stage of symptoms.

Sometimes it as simple as the right supplements and lifestyle changes. Sometimes treatment for Adrenal Fatigue can be more aggressive in treatment, perhaps a series of IV nutrition.

So yes and no, Adrenal Fatigue is a series of symptoms lumped together to be called a condition.

Come in and let’s talk about it.