Testosterone therapy: Potential benefits and risks as you age

Testosterone therapy: Potential benefits and risks as you age

Considering testosterone therapy to help you feel younger and more vigorous as you age? Know the risks before you make your decision.

The promise of testosterone therapy may seem enticing, but there are a lot of misconceptions about what the treatment can and can't do for you. As you get older, testosterone therapy may sound like the ultimate anti-aging formula.

Yet the health benefits of testosterone therapy for age-related decline in testosterone aren't as clear as they may seem. Find out what's known — and not known — about testosterone therapy for normal aging.

What is testosterone?

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Testosterone is a hormone produced primarilyin the testicles. Testosterone helps maintain men's:

·         Bone density

·         Fat distribution

·         Muscle strength and mass

·         Facial and body hair

·         Red blood cell production

·         Sex drive

·         Sperm production

What happens to testosterone levels with age?

Testosterone levels generally peak duringadolescence and early adulthood. As you get older, your testosterone level gradually declines — typically about 1 percent a year after age 30 or 40. It is important to determine in older men if a low testosterone level is simply due to the decline of normal aging or if it is due to a disease (hypogonadism).

Hypogonadism is a disease in which the body is unable to produce normal amounts of testosterone due to a problem with the testicles or with the pituitary gland that controls the testicles. Testosterone replacement therapy can improve the signs and symptoms of low testosterone in these men. Doctors may prescribe testosterone as injections, pellets, patches or gels.

Does a naturally declining testosterone level cause the signs and symptoms of aging?

Not necessarily. Men can experience many signs and symptoms as they age. Some may occur as a result of lower testosterone levels and can include:

·         Changes in sexual function. This may include reduced sexual desire, fewer spontaneous erections — such as during sleep — and infertility.

·         Changes in sleep patterns. Sometimes low testosterone causes insomnia or other sleep disturbances.

·         Physical changes. Various physical changes are possible, including increased body fat, reduced muscle bulk and strength, and decreased bone density. Swollen or tender breasts (gynecomastia) and body hair loss are possible. You may have less energy than you used to.

·         Emotional changes. Low testosterone or so called Low T may contribute to a decrease in motivation or self-confidence. You may feel sad or depressed, or have trouble concentrating or remembering things.

Some of these signs and symptoms can be caused by various underlying factors, including medication side effects, obstructive sleep apnea, thyroid problems, diabetes and depression. It's also possible that these conditions may be the cause of low testosterone levels, and treatment of these problems may cause testosterone levels to rise. A blood test is the only way to diagnose a low testosterone level.

Can testosteronetherapy promote youth and vitality?

Testosterone therapy can help reverse the effects of hypogonadism, but it's unclear whether testosterone therapy would have any benefit for older men who are otherwise healthy.

Although some men believe that taking testosterone medications may help them feel younger and more vigorous as they age, few rigorous studies have examined testosterone therapy in men who have healthy testosterone levels. And some small studies have revealed mixed results. For example, in one study healthy men who took testosterone medications increased muscle mass but didn't gain strength.

What are the risks of testosterone therapy for normal aging?

Testosterone therapy has various risks. For example, testosterone therapy may:

·         Contribute to sleep apnea — a potentially serious sleep disorder in which breathing repeatedly stops and starts

·         Cause acne or other skin reactions

·         Stimulate noncancerous growth of the prostate (benign prostatic hyperplasia) and growth of existing prostate cancer

·         Enlarge breasts

·         Limit sperm production or cause testicle shrinkage

·         Increase the risk of a blood clot forming in a deep vein (deep vein thrombosis), which could break loose, travel through your bloodstream and lodge in your lungs, blocking blood flow (pulmonary embolism)

In addition, testosterone therapy may impact your risk of heart disease. Research has had conflicting results, so the exact risk isn't clear yet.

Should you talk to your doctor about testosterone therapy?

If you wonder whether testosterone therapymight be right for you, talk with your doctor about the risks and benefits. Your doctor will likely measure your testosterone levels at least twice before discussing whether testosterone therapy is an option for you.

A medical condition that leads to an unusual decline in testosterone may be a reason to take supplemental testosterone. However, treating normal aging with testosterone therapy is not currently advisable.

Your doctor will also likely suggest naturalways to boost testosterone, such as losing weight and increasing muscle mass through resistance exercise.

Tongkat-ali is not a Placebo

Tongkat-ali is not a Placebo

Placebo-controlled: A term used to describe a method of research in which an inactive substance (a placebo) is given to one group of participants, while the treatment (usually a drug or vaccine) being tested is given to another group. The results obtained in the two groups are then compared to see if the investigational treatment is more effective than the placebo.

Placebo-controlled studies are a way of testing a medical therapy in which, in addition to a group of subjects that receives the treatment to be evaluated, a separate control group receives a sham "placebo" treatment which is specifically designed to have no real effect. Placebos are most commonly used in blinded trials, where subjects do not know whether they are receiving real or placebo treatment. Often, there is also a further "natural history" group that does not receive any treatment at all.

The purpose of the placebo group is to account for the placebo effect, that is, effects from treatment that do not depend on the treatment itself. Such factors include knowing one is receiving a treatment, attention from health care professionals, and the expectations of a treatment's effectiveness by those running the research study. Without a placebo group to compare against, it is not possible to know whether the treatment itself had any effect.

Patients frequently show improvement even when given a sham or "fake" treatment. Such intentionally inert placebo treatments can take many forms, such as a pill containing only sugar, a surgery where nothing efficacious is actually done (just an incision and sometimes some minor touching or handling of the underlying structures), or a medical device (such as an ultrasound machine) that is not actually turned on. Also, due to the body's natural healing ability and statistical effects such as regression to the mean, many patients will get better even when given no treatment at all. Thus, the relevant question when assessing a treatment is not "does the treatment work?" but "does the treatment work better than a placebo treatment, or no treatment at all?" As one early clinical trial researcher wrote, "the first object of a therapeutic trial is to discover whether the patients who receive the treatment under investigation are cured more rapidly, more completely or more frequently, than they would have been without it."^[1]p.195 More broadly, the aim of a clinical trial is to determine what treatments, delivered in what circumstances, to which patients, in what conditions, are the most effective.^[2][3]

Therefore, the use of placebos is a standard control component of most clinical trials, which attempt to make some sort of quantitative assessment of the efficacy of medicinal drugs or treatments. Such a test or clinical trial is called a placebo-controlled study, and its control is of the negative type. A study whose control is a previously tested treatment, rather than no treatment, is called a positive-control study, because its control is of the positive type.

Government regulatory agencies approve new drugs only after tests establish not only that patients respond to them, but also that their effect is greater than that of a placebo (by way of affecting more patients, by affecting responders more strongly, or both). As a result, "placebo-controlled studies often are designed in such a way that disadvantages the placebo condition".^[4]

Tongkat-ali is not a Placebo as i clinically proven in 2003 by the British Journal of Sports Medicine

 British Journal of Sports Medicine 2003 THE ERGOGENIC EFFECTS OF EURYCOMA LONGIFOLIA JACK: A PILOT STUDY Eurycoma longifolia Jack (ELJ), which contains quassinoids such as eurycomalacton, eurycomanon, and eurycomanol, has been reported to have aphrodisiac properties and to increase testosterone levels in men. Previous studies have established that the testosterone supplementation increases fat free mass, muscle strength, and muscle mass, which are important for physical function and athletic performance. {…}. The treatment produced 2.92% greater reduction in electrical activity of the muscle measured at the end of the experiment compared with placebo. The mean arm circumference of the treatment group increased significantly by 1.8 cm after the supplementation, from 30.87 (1.88) to 32.67 (1.96) cm (p = 0.011), but there was no significant increase in the placebo group. The results suggest that water soluble extract of Eurycoma longifolia Jack increased fat free mass, reduced body fat, and increased muscle strength and size, and thus may have an ergogenic effect. Further investigations are warranted. Sexual enhancement pills