Topping Up Testosterone?
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The Testosterone Drop
Testosterone levels decline amongst men over a certain age. Exactly when depends on the individual and also how we measure it, but the age of 45 is a commonly-given waypoint for the start of this decline.
(the actual start is usually more like 20, but it’s a very small decline then, and speeds up a couple of decades later)
This has been called “the male menopause”, or “the andropause”.
Both terms are a little misleading, but for lack of a better term, “andropause” is perhaps not terrible.
Why “the male menopause” is misleading:
To call it “the male menopause” suggests that this is when men’s menstruation stops. Which for cis men at the very least, is simply not a thing they ever had in the first place, to stop (and for trans men it’s complicated, depending on age, hormones, surgeries, etc).
Why “the andropause” is misleading:
It’s not a pause, and unlike the menopause, it’s not even a stop. It’s just a decline. It’s more of an andro-pitter-patter-puttering-petering-out.
Is there a better clinical term?
Objectively, there is “late-onset hypogonadism” but that is unlikely to be taken up for cultural reasons—people stigmatize what they see as a loss of virility.
Terms aside, what are the symptoms?
❝Andropause or late-onset hypogonadism is a common disorder which increases in prevalence with advancing age. Diagnosis of late-onset of hypogonadism is based on presence of symptoms suggestive of testosterone deficiency – prominent among them are sexual symptoms like…❞
…and there we’d like to continue the quotation, but if we list the symptoms here, it won’t get past a lot of filters because of the words used. So instead, please feel free to click through:
Source: Andropause: Current concepts
Can it be safely ignored?
If you don’t mind the sexual symptoms, then mostly, yes!
However, there are a few symptoms we can mention here that are not so subjective in their potential for harm:
- Depression
- Loss of muscle mass
- Increased body fat
Depression kills, so this does need to be taken seriously. See also:
The Mental Health First-Aid That You’ll Hopefully Never Need
(the above is a guide to managing depression, in yourself or a loved one)
Loss of muscle mass means being less robust against knocks and falls later in life
Loss of muscle mass also means weaker bones (because the body won’t make bones stronger than it thinks they need to be, so bone will follow muscle in this regard—in either direction)
See also:
- Resistance Is Useful! (Especially As We Get Older)
- Protein vs Sarcopenia
- Fall Special (How to Proof Yourself Against Falls)
Increased body fat means increased risk of diabetes and heart disease, as a general rule of thumb, amongst other problems.
Will testosterone therapy help?
That’s something to discuss with your endocrinologist, but for most men whose testosterone levels are lower than is ideal for them, then yes, taking testosterone to bring them [back] to “normal” levels can make you happier and healthier (though it’s certainly not a cure-all).
See for example:
Testosterone Therapy Improves […] and […] in Hypogonadal Men
(Sorry, we’re not trying to be clickbaity, there are just some words we can’t use without encountering software problems)
Here’s a more comprehensive study that looked at 790 men aged 65 or older, with testosterone levels below a certain level. It looked at the things we can’t mention here, as well as physical function and general vitality:
❝The increase in testosterone levels was associated with significantly increased […] activity, as assessed by the Psychosexual Daily Questionnaire (P<0.001), as well as significantly increased […] desire and […] function.
The percentage of men who had an increase of at least 50 m in the 6-minute walking distance did not differ significantly between the two study groups in the Physical Function Trial but did differ significantly when men in all three trials were included (20.5% of men who received testosterone vs. 12.6% of men who received placebo, P=0.003).
Testosterone had no significant benefit with respect to vitality, as assessed by the Functional Assessment of Chronic Illness Therapy–Fatigue scale, but men who received testosterone reported slightly better mood and lower severity of depressive symptoms than those who received placebo❞
Source: Effects of Testosterone Treatment in Older Men
We strongly recommend, by the way, when a topic is of interest to you to read the paper itself, because even the extract above contains some subjectivity, for example what is “slightly better”, and what is “no significant benefit”.
That “slightly better mood and lower severity of depressive symptoms”, for example, has a P value of 0.004 in their data, which is an order of magnitude more significant than the usual baseline for significance (P<0.05).
And furthermore, that “no significant benefit with respect to vitality” is only looking at either the primary outcome aggregated goal or the secondary FACIT score whose secondary outcome had a P value of 0.06, which just missed the cut-off for significance, and neglects to mention that all the other secondary outcome metrics for men involved in the vitality trial were very significant (ranging from P=0.04 to P=0.001)
Click here to see the results table for the vitality trial
Will it turn me into a musclebound angry ragey ‘roidmonster?
Were you that kind of person before your testosterone levels declined? If not, then no.
Testosterone therapy seeks only to return your testosterone levels to where they were, and this is done through careful monitoring and adjustment. It’d take a lot more than (responsible) endocrinologist-guided hormonal therapy to turn you into Marvel’s “Wolverine”.
Is testosterone therapy safe?
A question to take to your endocrinologist because everyone’s physiology is different, but a lot of studies do support its general safety for most people who are prescribed it.
As with anything, there are risks to be aware of, though. Perhaps the most critical risk is prostate cancer, and…
❝In a large meta-analysis of 18 prospective studies that included over 3500 men, there was no association between serum androgen levels and the risk of prostate cancer development
For men with untreated prostate cancer on active surveillance, TRT remains controversial. However, several studies have shown that TRT is not associated with progression of prostate cancer as evidenced by either PSA progression or gleason grade upstaging on repeat biopsy.
Men on TRT should have frequent PSA monitoring; any major change in PSA (>1 ng/mL) within the first 3-6 months may reflect the presence of a pre-existing cancer and warrants cessation of therapy❞
Those are some select extracts, but any of this may apply to you or your loved one, we recommend to read in full about this and other risks:
Risks of testosterone replacement therapy in men
See also: Prostate Health: What You Should Know
Beyond that… If you are prone to baldness, then taking testosterone will increase that tendency. If that’s a problem for you, then it’s something to know about. There are other things you can take/use for that in turn, so maybe we’ll do a feature on those one of these days!
For now, take care!
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I want to eat healthily. So why do I crave sugar, salt and carbs?
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We all want to eat healthily, especially as we reset our health goals at the start of a new year. But sometimes these plans are sabotaged by powerful cravings for sweet, salty or carb-heavy foods.
So why do you crave these foods when you’re trying to improve your diet or lose weight? And what can you do about it?
There are many reasons for craving specific foods, but let’s focus on four common ones:
1. Blood sugar crashes
Sugar is a key energy source for all animals, and its taste is one of the most basic sensory experiences. Even without specific sweet taste receptors on the tongue, a strong preference for sugar can develop, indicating a mechanism beyond taste alone.
Neurons responding to sugar are activated when sugar is delivered to the gut. This can increase appetite and make you want to consume more. Giving into cravings also drives an appetite for more sugar.
In the long term, research suggests a high-sugar diet can affect mood, digestion and inflammation in the gut.
While there’s a lot of variation between individuals, regularly eating sugary and high-carb foods can lead to rapid spikes and crashes in blood sugar levels. When your blood sugar drops, your body can respond by craving quick sources of energy, often in the form of sugar and carbs because these deliver the fastest, most easily accessible form of energy.
2. Drops in dopamine and serotonin
Certain neurotransmitters, such as dopamine, are involved in the reward and pleasure centres of the brain. Eating sugary and carb-rich foods can trigger the release of dopamine, creating a pleasurable experience and reinforcing the craving.
Serotonin, the feel-good hormone, suppresses appetite. Natural changes in serotonin can influence daily fluctuations in mood, energy levels and attention. It’s also associated with eating more carb-rich snacks in the afternoon.
Do you get 3pm sugar cravings? Serotonin could play a role.
Marcus Aurelius/PexelsLow carb diets may reduce serotonin and lower mood. However, a recent systematic review suggests little association between these diets and risk for anxiety and depression.
Compared to men, women tend to crave more carb rich foods. Feeling irritable, tired, depressed or experiencing carb cravings are part of premenstrual symptoms and could be linked to reduced serotonin levels.
3. Loss of fluids and drops in blood sugar and salt
Sometimes our bodies crave the things they’re missing, such as hydration or even salt. A low-carb diet, for example, depletes insulin levels, decreasing sodium and water retention.
Very low-carb diets, like ketogenic diets, induce “ketosis”, a metabolic state where the body switches to using fat as its primary energy source, moving away from the usual dependence on carbohydrates.
Ketosis is often associated with increased urine production, further contributing to potential fluid loss, electrolyte imbalances and salt cravings.
4. High levels of stress or emotional turmoil
Stress, boredom and emotional turmoil can lead to cravings for comfort foods. This is because stress-related hormones can impact our appetite, satiety (feeling full) and food preferences.
The stress hormone cortisol, in particular, can drive cravings for sweet comfort foods.
A 2001 study of 59 premenopausal women subjected to stress revealed that the stress led to higher calorie consumption.
A more recent study found chronic stress, when paired with high-calorie diet, increases food intake and a preference for sweet foods. This shows the importance of a healthy diet during stress to prevent weight gain.
What can you do about cravings?
Here are four tips to curb cravings:
1) don’t cut out whole food groups. Aim for a well-balanced diet and make sure you include:
- sufficient protein in your meals to help you feel full and reduce the urge to snack on sugary and carb-rich foods. Older adults should aim for 20–40g protein per meal with a particular focus on breakfast and lunch and an overall daily protein intake of at least 0.8g per kg of body weight for muscle health
- fibre-rich foods, such as vegetables and whole grains. These make you feel full and stabilise your blood sugar levels. Examples include broccoli, quinoa, brown rice, oats, beans, lentils and bran cereals. Substitute refined carbs high in sugar like processed snack bars, soft drink or baked goods for more complex ones like whole grain bread or wholewheat muffins, or nut and seed bars or energy bites made with chia seeds and oats
2) manage your stress levels. Practise stress-reduction techniques like meditation, deep breathing, or yoga to manage emotional triggers for cravings. Practising mindful eating, by eating slowly and tuning into bodily sensations, can also reduce daily calorie intake and curb cravings and stress-driven eating
3) get enough sleep. Aim for seven to eight hours of quality sleep per night, with a minimum of seven hours. Lack of sleep can disrupt hormones that regulate hunger and cravings
4) control your portions. If you decide to indulge in a treat, control your portion size to avoid overindulging.
Overcoming cravings for sugar, salt and carbs when trying to eat healthily or lose weight is undoubtedly a formidable challenge. Remember, it’s a journey, and setbacks may occur. Be patient with yourself – your success is not defined by occasional cravings but by your ability to manage and overcome them.
Hayley O’Neill, Assistant Professor, Faculty of Health Sciences and Medicine, Bond University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Outlive – by Dr. Peter Attia
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We know, we know; this diet, that exercise, don’t smoke or drink, get decent sleep”—a lot of books don’t go beyond this level of advice!
What Dr. Attia offers is a multi-vector approach that covers the above and a lot more.
Themes of the book include:
- The above-mentioned things, of course
- Rethinking medicine for the age of chronic disease
- The pros and cons of…
- caloric restriction
- dietary restriction
- intermittent fasting
- Pre-emptive interventions for…
- specific common cause-of-death conditions
- specific common age-related degenerative conditions
- The oft-forgotten extra pillar of longevity: mental health
The last one in the list there is covered mostly in the last chapter of the book, but it’s there as a matter of importance, not as an afterthought. As Dr. Attia puts it, not only are you less likely to take care of your physical health if you are (for example) depressed, but also… “Longevity is meaningless if your life sucks!”
So, it’s important to do things that promote and maintain good physical and mental health.
Bottom line: if you’re interested in happy, healthy, longevity, this is a book for you.
Click here to check out Dr. Attia’s “Outlive” on Amazon today!
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Rose Hips vs Blueberries – Which is Healthier?
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Our Verdict
When comparing rose hips to blueberries, we picked the rose hips.
Why?
Both of these fruits are abundant sources of antioxidants and other polyphenols, but one of them stands out for overall nutritional density:
In terms of macros, rose hips have about 2x the carbohydrates, and/but about 10x the fiber. That’s an easy calculation and a clear win for rose hips.
When it comes to vitamins, rose hips have a lot more of vitamins A, B2, B3, B5, B6, C, E, K, and choline. On the other hand, blueberries boast more of vitamins B1 and B9. That’s a 9:2 lead for rose hips, even before we consider rose hips’ much greater margins of difference (kicking off with 80x the vitamin A, for instance, and many multiples of many of the others).
In the category of minerals, rose hips have a lot more calcium, copper, iron, magnesium, manganese, phosphorus, potassium, and zinc. Meanwhile, blueberries are not higher in any minerals.
In short: as ever, enjoy both, but if you’re looking for nutritional density, there’s a clear winner here and it’s rose hips.
Want to learn more?
You might like to read:
It’s In The Hips: Rosehip’s Benefits, Inside & Out
Take care!
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Longevity Noodles
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Noodles may put the “long” into “longevity”, but most of the longevity here comes from the ergothioneine in the mushrooms! The rest of the ingredients are great too though, including the noodles themselves—soba noodles are made from buckwheat, which is not a wheat, nor even a grass (it’s a flowering plant), and does not contain gluten*, but does count as one of your daily portions of grains!
*unless mixed with wheat flour—which it shouldn’t be, but check labels, because companies sometimes cut it with wheat flour, which is cheaper, to increase their profit margin
You will need
- 1 cup (about 9 oz; usually 1 packet) soba noodles
- 6 medium portobello mushrooms, sliced
- 3 kale leaves, de-stemmed and chopped
- 1 shallot, chopped, or ¼ cup chopped onion of any kind
- 1 carrot, diced small
- 1 cup peas
- ½ bulb garlic, minced
- 2 tbsp rice vinegar
- 1 tsp grated fresh ginger
- 1 tsp black pepper, coarse ground
- 1 tsp red chili flakes
- ½ tsp MSG or 1 tbsp low-sodium soy sauce
- Avocado oil, for frying (alternatively: extra virgin olive oil or cold-pressed coconut oil are both perfectly good substitutions)
Method
(we suggest you read everything at least once before doing anything)
1) Cook the soba noodles per the packet instructions, rinse, and set aside
2) Heat a little oil in a skillet, add the shallot, and cook for about 2 minutes.
3) Add the carrot and peas and cook for 3 more minutes.
4) Add the mushrooms, kale, garlic, ginger, peppers, and vinegar, and cook for 1 more minute, stirring well.
5) Add the noodles, as well as the MSG or low-sodium soy sauce, and cook for yet 1 more minute.
6) Serve!
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Rice vs Buckwheat – Which is Healthier?
- The Magic Of Mushrooms: “The Longevity Vitamin” (That’s Not A Vitamin)
- Monosodium Glutamate: Sinless Flavor-Enhancer Or Terrible Health Risk?
- Our Top 5 Spices: How Much Is Enough For Benefits? ← 4/5 of these spices are in today’s dish!
Take care!
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How To Avoid UTIs
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Psst… A Word To The Wise
Urinary Tract Infections (UTIs) can strike at any age, but they get a lot more common as we get older:
- About 10% of women over 65 have had one
- About 30% of women over 85 have had one
Source: Urinary tract infection in older adults
Note: those figures are almost certainly very underreported, so the real figures are doubtlessly higher. However, we print them here as they’re still indicative of a disproportionate increase in risk over time.
What about men?
Men do get UTIs too, but at a much lower rate. The difference in average urethra length means that women are typically 30x more likely to get a UTI.
However! If a man does get one, then assuming the average longer urethra, it will likely take much more treatment to fix:
Case study: 26-Year-Old Man With Recurrent Urinary Tract Infections
Risk factors you might want to know about
While you may not be able to do much about your age or the length of your urethra, there are some risk factors that can be more useful to know:
Catheterization
You might logically think that having a catheter would be the equivalent of having a really long urethra, thus keeping you safe, but unfortunately, the opposite is true:
Read more: Review of Catheter-Associated Urinary Tract Infections
Untreated menopause
Low estrogen levels can cause vaginal tissue to dry, making it easier for pathogens to grow.
For more information on menopausal HRT, see:
What You Should Have Been Told About Menopause Beforehand
Sexual activity
Most kinds of sexual activity carry a risk of bringing germs very close to the urethra. Without wishing to be too indelicate: anything that’s going there should be clean, so it’s a case for washing your hands/partner(s)/toys etc.
For the latter, beyond soap and water, you might also consider investing in a UV sanitizer box ← This example has a 9” capacity; if you shop around though, be sure to check the size is sufficient!
Kidney stones and other kidney diseases
Anything that impedes the flow of urine can raise the risk of a UTI.
See also: Keeping Your Kidneys Healthy (Especially After 60)
Diabetes
How much you can control this one will obviously depend on which type of diabetes you have, but diabetes of any type is an immunocompromizing condition. If you can, managing it as well as possible will help many aspects of your health, including this one.
More on that:
How To Prevent And Reverse Type 2 Diabetes
Note: In the case of Type 1 Diabetes, the above advice will (alas) not help you to prevent or reverse it. However, reducing/avoiding insulin resistance is even more important in cases of T1D (because if your exogenous insulin stops working, you die), so the advice is good all the same.
How do I know if I have a UTI?
Routine screening isn’t really a thing, since the symptoms are usually quite self-evident. If it hurts/burns when you pee, the most likely reason is a UTI.
Get it checked out; the test is a (non-invasive) urinalysis test. In other words, you’ll give a urine sample and they’ll test that.
Anything else I can do to avoid it?
Yes! We wrote previously about the benefits of cranberry supplementation, which was found even to rival antibiotics:
❝…recommend cranberry ingestion to decrease the incidence of urinary tract infections, particularly in individuals with recurrent urinary tract infections. This would also reduce the [need for] administration of antibiotics❞
Read more: Health Benefits Of Cranberries
Take care!
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Eggs: Nutritional Powerhouse or Heart-Health Timebomb?
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Eggs: All Things In Moderation?
We asked you for your (health-related) opinion on eggs. We specified that, for the sake of simplicity, let’s say that they are from happy healthy backyard hens who enjoy a good diet.
Apparently this one wasn’t as controversial as it might have been! We (for myth-busting purposes) try to pick something polarizing and sometimes even contentious for our Friday editions, and pick apart what science lies underneath public perceptions.
However, more than half (in fact, 60%) of the subscribers who voted in the poll voted for “Eggs are nutritionally beneficial as part of a balanced diet”, which very moderate statement is indeed pretty much the global scientific consensus.
Still, we’ve a main feature to write, so let’s look at the science, and what the other 40% had in mind:
Eggs are ruinous to health, especially cardiometabolic health: True or False?
False, per best current science, anyway!
Scientific consensus has changed over the years. We learned about cholesterol, then we learned about different types of cholesterol, and now we’ve even learned about in some instances even elevated levels of “bad” cholesterol aren’t necessarily a cause of cardiometabolic disorders so much as a symptom—especially in women.
Not to derail this main feature about eggs (rather than just cholesterol), but for those who missed it, this is actually really interesting: basically, research (pertaining to the use of statins) has found that in women, higher LDL levels aren’t anywhere near the same kind of risk factor as they are for men, and thus may mean that statins (whose main job is reducing LDL) may be much less helpful for women than for men, and more likely to cause unwanted serious side effects in women.
Check out our previous main feature about this: Statins: His & Hers?
But, for back on topic, several large studies (totalling 177,000 people in long-term studies in 50 countries) found:
❝Results from the three cohorts and from the updated meta-analysis show that moderate egg consumption (up to one egg per day) is not associated with cardiovascular disease risk overall, and is associated with potentially lower cardiovascular disease risk in Asian populations.❞
Egg whites are healthy (protein); egg yolks are not (cholesterol): True or False?
True and False, respectively. That is to say, egg whites are healthy (protein), and egg yolks are also healthy (many nutrients).
We talked a bit already about cholesterol, so we’ll not rehash that here. As to the rest:
Eggs are one of the most nutritionally dense foods around. After all, they have everything required to allow a cluster of cells to become a whole baby chick. That’s a lot of body-building!
They’re even more nutritionally heavy-hitters if you get omega-3 enriched eggs, which means the hens were fed extra omega-3, usually in the form of flax seeds.
Also, free-range is better healthwise than others. Do bear in mind that unless they really are from your backyard, or a neighbor’s, chances are that the reality is not what the advertising depicts, though. There are industry minimum standards to be able to advertise as “free-range”, and those standards are a) quite low b) often ignored, because an occasional fine is cheaper than maintaining good conditions.
So if you can look after your own hens, or get them from somewhere that you can see for yourself how they are looked after, so much the better!
Check out the differences side-by-side, though:
Pastured vs Omega-3 vs “Conventional” Eggs: What’s the Difference?
Stallone-style 12-egg smoothies are healthy: True or False?
False, at least if taken with any regularity. One can indeed have too much of a good thing.
So, what’s the “right amount” to eat?
It may vary depending on individual factors (including age and ethnicity), but a good average, according to science, is to keep it to 3 eggs or fewer per day. There are a lot of studies, but we only have so much room here, so we’ll pick one. Its findings are representative of (and in keeping with) the many other studies we looked at, so this seems uncontroversial scientifically:
❝Intake of 1 egg/d was sufficient to increase HDL function and large-LDL particle concentration; however, intake of 2-3 eggs/d supported greater improvements in HDL function as well as increased plasma carotenoids. Overall, intake of ≤3 eggs/d favored a less atherogenic LDL particle profile, improved HDL function, and increased plasma antioxidants in young, healthy adults.❞
Enjoy!
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