Introduction

The body’s entire system is controlled by hormones. Hormones are what make the body regulate temperature and control the organ system so it can function properly. When there is an imbalance of hormones the body can develop chronic problems causing pain to individuals and disrupting their everyday activities. Many of our patients over the last decade have asked complex and intuitive questions about hormone replacement therapies. Part one explains what happens when there is low testosterone in a male body followed by part three to complete this series. By referring patients to qualified and skilled providers who specialized in hormone wellness services. To that end, and when appropriate, we advise our patients to refer to our associated medical providers based on their examination.  We find that education is the key to asking valuable questions to our providers. Dr. Alex Jimenez DC provides this information as an educational service only. Disclaimer

What Is Hormone Replacement Therapy?

In older males, hormone replacement therapy can help replenish testosterone levels in the male body. When the hormones are off-balance, HRT can help reduce levels of androgen that the male body produces. With HRT it can help prolong prostate cancer progress and even lower the adrenal glands from overproducing unnecessary hormones that the body does not need.

What Constitutes “Stress”?

There are many factors that can cause body stress. There are two types of stress levels acute stress and chronic stress. Acute stress is caused by simple things like studying for an exam or running late to work. Chronic stress is caused by situations that can negatively affect a person’s health. Some examples include:

• “Fight or flight” responses
  – fear, anxiety, worry
• Depression, feelings of defeat or
  helplessness
• Pain syndromes
• Infection, inflammation
• Hypoglycemia
• Inadequate sleep
• Disrupted light cycles
• Toxic exposure

New Guidelines Presented at the American Academy of Anti-Aging.

Let’s Talk About Toxins…

There are some toxins that can affect the human body and can cause prolonged effects that can lead to chronic pain.

• Pesticides
• Food additives and preservatives
• Electromagnetic radiation
• Heavy metals
• Phthalates
• Bisphenol A
• And many more…

Toxins – Phthalates

Phthalates are a group of chemicals that are used to make plastics more durable. However, these toxins can cause male hormones to be off-balanced.

• Esters of phthalic acid and are mainly used as plasticizers
• As of 2004, 800 million pounds produced
• Introduced in the 1920bs
  – 1856: castor oil
  – 1870: camphor
  – Enteric coatings
• Current uses:
  – Enteric Coatings
  – Viscosity control agents
  – Binders
  – Lubricant

Phthalates can be found in hundreds of everyday products that we use in our day-to-day lives. These include:

• Personal care items
  – Make-up, shampoo, moisturizer, liquid soap, hair spray, cologne
• Detergents
• Cleaning materials
• Modeling clay
• Fishing lures
• Paints
• Children’s toys
• Food packaging

Bisphenol A

 

Bisphenol A or BPA has been primarily used to make certain resins and plastics for everyday items and has been used in commerce for the past 50 years. Some of the common products that BPA has produces include:

• Polycarbonate bottles (clear, flexible plastic)
• Baby bottles
• Water bottles
• Dental sealants
• Sports equipment
• Eyeglasses
• CD’s and DVD’s
• Toiletries

When males are exposed to BPA, it can cause male infertility and erectile difficulty to the body and even lower testosterone levels causing the body to go haywire.

Increased Risk From TD on Cardiovascular Events & Mortality

With testosterone has many important effects on the body including the cardiovascular system. When there is a decrease in testosterone that happens in men after they turn 40 has been associated with an increase in all-cause mortality and cardiovascular risk.

• A meta-analysis that investigated 16,184 community-based participants with a mean
  follow-up of 9.7 years found that low T levels were associated with an increased risk of Overall and CV-related mortality with an HR for CV mortality of 1.35 (95% CI, 1.13-1.62; P<.001). (Araujo, 2011)
• Meta-analysis of 70 studies showed a clear association between low T and CV disease Of those, 10 longitudinal studies demonstrated that overall mortality and CV mortality were highest in those with low T levels. Whether low T and increased mortality are simply covariates or a causal the relationship remains to be proven” (Corona, 2011)

Laughlin Rancho Bernardo Study

The prospective study of 794 men aged 50-91 with Testosterone at baseline and followed through mortality.
• Average 11.8 years f/u (but up to 20)
• Total and Bioavail Testosterone inversely related to the risk of death
in-depth of DM metabolic syndrome, CVD but attenuated for
adjustment by CRP ad IL-6
• Lowest vs highest quartiles of Testosterone conferred 40%
increased risk of overall mortality and 38% higher
risk of cardiovascular mortality

Khaw et al EPIC-Norfolk Study

“In men, endogenous testosterone concentrations are inversely related to mortality due to cardiovascular disease and all causes”

• N = 11,606 men (no cancer or CVD)
  – 825 men died matched with 1489 living men in the control group
  – Nested case-control looked at endogenous Testosterone at baseline
• Men have to have a follow-up 7 years

Testosterone Deficiency

A wealth of modern data accumulated over the past 2 decades has generally revealed that a low serum testosterone level is associated with increased risks of atherosclerosis, CV risk factors, and mortality. Testosterone therapy has beneficial effects on multiple risks factors and risk biomarkers related to these clinical conditions. Notably, TD has been projected to be involved in the development of approximately 1.3 million new cases of CV disease, 1.1 million new cases of diabetes, and over 600,000
osteoporosis-related fracture.

Testosterone and Sarcopenia

When testosterone levels start to lower in a male body it can correlate with the pathophysiology of sarcopenia. Sarcopenia is defined as skeletal muscle mass and strength loss due to age and low testosterone can contribute to decreasing sex hormones and changes to body composition.

• “Given the likelihood that age-related sarcopenia contributes importantly to frailty, and the importance of osteoporotic fractures as a cause of morbidity and mortality in elderly men, testosterone replacement is a potentially useful strategy for reducing age-associated disabilities in some aged men.”
  – Three months of Testosterone enanthate injections increased lean body
  mass in men over 60 yr of age.
  – Testosterone treatment improved hamstring and quadriceps muscle
  strength after 4 weeks in healthy older men
  – Testosterone replacement for 2 yr produced again in the bilateral grip
  strength in elderly hypogonadal men.

Testosterone and Erectile Dysfunction

The body produces androgen for the male body to function properly. When there are low levels of testosterone and high levels of androgen it can cause erectile dysfunction.

• “Visceral obesity, a component of metabolic syndrome, adversely affects endothelial function and testosterone levels, contributing to hypogonadism and erectile dysfunction. “
• Clinical screening for the risk of erectile dysfunction in obese
  patients should include:
  – Waist circumference
  – Testosterone levels
  – Body mass index
  – Physical inactivity
• Study of Testosterone levels and ED in 802 men showed moderate and
  severe ED assoc w/ lower T levels
  – lower serum testosterone levels were strongly associated (p < 0.001) with severe
  (OR 0.78; 95% CI: 0.62-0.86), and moderate ED (OR 0.85; 95% CI: 0.72-0.97)

Conclusion

All in all, hormones play a major role in the body. Hormones are what keep the body functioning properly and make sure the organs are doing their job. When unwanted pathogens start affecting the body, it can cause the hormones to be off-balance and cause major chronic problems that cause pain and illnesses that no one wants.

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