Testosterone Therapy For Longevity

Foreign. Talk about testosterone replacement therapy, testosterone levels and mortality or life expectancy. So there's a big interest in longevity. That's probably going to be the biggest industry that's current in healthcare. And there's a lot of things we should think about for the very basement steps of what should we be thinking about in terms of longevity from wellness and taking care of yourself? I'm just going to go over low testosterone and mortality. So it's something that is a very interesting concept because we have an easy way to address low testosterone. Testosterone and the incidence of low testosterone is definitely increasing in Western society. So low testosterone is typically measured with a testosterone blood test. That might not be perfect, but that's what we have typically, you know, the blood test should be done in the morning, about the same time twice in a row to get the most ideal levels. There's something called free or bioavailable testosterone. Now calculations, you can, we can talk about that, but they're really not too particularly helpful. And generally there's no testosterone level that predicts which men may benefit from testosterone replacement therapy in terms of their symptoms of low testosterone. Because it's such a variation. Just like if we took, say we're treating blood pressure, we would take a medication perhaps we're not checking a medication level in your body, we're checking your blood pressure. So for low testosterone, we might be looking at more symptoms. So study done, published in Evolution Medicine and Public Health in December 22, looked at where low testosterone had the biggest impact on features of longevity, which would be diseases, chronic diseases that occur in men that had the lowest testosterone levels versus men with the higher testosterone levels. And this is something we see consistently in the literature, is that low testosterone is associated with a lot of diseases, notably, you know, obesity and diabetes, but also cardiovascular disease, Alzheimer's and poor quality of life. What they found in this study was that right around 45 years old, if your testosterone is a lower range versus average testosterone, cerebral vascular disease increased at a higher rate even at that younger age. So that's something that we would think about younger men. Cardiovascular disease, the gap between the lowest and the normal testosterone levels was about 50. For cancer, it was around 70. In other words, men in their 60s had lower high testosterone. They had same rates of cancer, but once they got to seven years old, men with lower testosterone got many more metastatic cancers. Infections such as pneumonia and influenza occurred more often in men with low testosterone at about the 70 year old range. And then for Alzheimer's and dementia, it was in the 80s. So we can't say that a man with low testosterone in 40 is going to get more incidence of 80s and more incidence of Alzheimer's than a man with normal testosterone or higher testosterone level. We can say if that man is, maintains a low testosterone level for a long period of time, they're going to have more instances of Alzheimer's disease, infections like influenza and pneumonia, cerebral vascular disease such as a stroke, cardiovascular disease such as a heart attack, and more and more cancers, particularly metastatic cancers and more, all cause mortality or mortality from any cause. Another study done in Australia looking at about 4,500 men that were older men, 70s and 90s, and they ranked them from low testosterone to high testosterone. They found that the men with the lowest testosterone were far more likely to die than any other group. The men with the mid range testosterone had the most longevity, the men with the lowest testosterone had the lowest longevity. There's a clear link between testosterone levels and aging. The reason I say this is there was one article published in the uk, it's called a Mendelian randomization where they said, you know, high testosterone is associated with more mortality. That might be a unique subgroup of men that have naturally high testosterone levels. I, I don't know the answer to that. This is not borne out in more normalized literature. It's we, we see that low testosterone does shorten lifespan, lead more Alzheimer's disease, more cardiovascular disease, more cerebral vascular disease, more even things like emphysema, more infections such as pneumonia and influenza, and more diabetes and obesity and more premature death. So when we're thinking about longevity, that's something that we should check is the testosterone level. Now one thing that can't be answered is how many years could you potentially add with testosterone replacement therapy? If your testosterone is low, there's some estimates that it might be about 9 or 10% of lifespan. That's, that's, that's very possible. That's really kind of unknown because we have to base it on other evidence based medicine and making some assumption because there's no direct test or study showing the additional years gained by testosterone replacement. We can just infer it. We do know from a huge study done in 16 or published in 16 at the VA that men with low testosterone that weren't treated were twice as likely to die in a six year period. These men, there's 83,000 men studied, they were on average age about 66 years old. And the men with low T that did not treat it were twice as likely to die. Doesn't mean like half them die, but that they were twice as likely to die in the next year, six years. We know that there's more metastatic cancers, which are the ones that kill you. We know there's more Alzheimer's that can lead to death, more infection, pneumonia can lead to death. So we should think of testosterone as part of an anti aging program. Now, there's ways to naturally raise your testosterone level through lifestyle modifications and exercise. And sometimes it just doesn't take you far enough. We have to do testosterone replacement therapy, which is in form of an injectable, which is a shot once a week, which is in form of a topical cream that is not maybe studied as well for longevity. And as we have a pellet which is inserted under the skin in our practice, we only use the injection injectables or the pellets because that's more compelling information for safety. So testosterone and London, this, this is for men. I'm referring to. There's, there's another podcast and blogs on female and testosterone hormone replacement therapy. This is specifically for men. So if your testosterone is low, you're gonna have more obesity, more diabetes, more Alzheimer's, more cardiovascular disease, more infections such as pneumonia and influenza, more metastatic cancers and shorter survival. So this is something we should take seriously. We're looking, we're going through a period of rapid technology on longevity. And regardless of your age, you want to kind of go into that new era of medicine as healthy as possible, as many of your original parts as possible. I would avoid getting joint replacements as much as possible and keeping your organs intact and keeping yourself healthy, because we're going to see a point where there's drugs that will be coming online that can extend healthy lifespan. You want to be kind of in a good shape as possible. That way you have stronger years ahead of you. So thank you very much.