Dancing through MANopause

Testosterone Replacement Therapy (TRT) seems to be a topic that in recent years has emerged from the shadows and become more mainstream. We have seen it move from being considered glorified steroids to now a viable treatment to restore normal testosterone levels in those who are eligible. Many men will struggle with symptoms including: fatigue, weight gain, a loss of vitality, stress, erectile dysfunction, etc. In this episode of the podcast/newsletter, we thought we would shine some light on this subject to reveal a framework to understanding testosterone levels. With this clear picture in mind, it can help facilitate productive discussions with your doctor if TRT is something you are considering.

We begin by looking at how testosterone is made. Your pituitary gland in your brain will secrete two hormones (FSH and LH) that act on the testicles and tell them to make testosterone. A portion of this testosterone can then be converted to DHT, a more potent form of testosterone, or it can be converted to estradiol (estrogen). Testosterone travels in your bloodstream on a carrier protein called Sex Hormone Binding Globulin (SHBG) primarily and to a lesser extent on another carrier protein called albumin.

The big takeaway is that when you get your Total Testosterone measured, you also want to get your Free Testosterone measured as well. You ideally want your Free Testosterone to be 2% of your Total Testosterone. If this number is low, you want to start asking questions based on an understanding of the physiology explained above. It is low because your brain is not sending FSH and LH in sufficient amounts? Is it low because your testicles are not making enough Testosterone? Is it low because too much Testosterone is being bound up by SHBG? It it low because too much Testosterone is being converted to Estradiol? All of these could be possibilities and how you treat it will depend.

We end by discussing possible treatment doses depending on which issue it is and what your goals might be. We also briefly touch on some of the studies done on TRT and what the results showed. We also give a few shout outs of supplements that seem to aid in boosting Testosterone.

Give the podcast a listen… Apple Spotify Google Amazon

Simplified Takeaways…

1. You want your Free Testosterone to be 2% of your Total Testosterone

2. If this is low, you also want to know the levels of FSH, LH, SHBG, and Estradiol. This can help you form a more complete picture of why Free Testosterone might be low.

3. Studies have shown that TRT can improve lean mass, strength, bone mineral density, blood pressure, cholesterol, and blood glucose. There are many metabolic benefits.

4. It is possible to use HCG instead of Testosterone to boost testicular production of testosterone and preserve testicular function. This is good for younger men who may want to have children later.

5. Getting enough sleep and not drinking too much alcohol are important in producing testosterone.

Further Reading…

1.  Study showing metabolic and structural benefits of TRT

2.  Study on TRT and cardiovascular risk

3.   Study on TRT and overall cancer death risk

Disclaimer: This newsletter is for general informational purposes only and does not constitute the practice of medicine, nursing, or other professional healthcare services, including the giving of medical advise. No doctor/patient relationship is formed. The use of information on this newsletter or materials linked from this newsletter is at the user’s own risk. The content of this newsletter is not intended to be a substitute for professional medical advise, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advise for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions.