
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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Why Everyone You Don’t Like Is A Narcissist
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
We’ve written before about how psychiatry tends to name disorders after how they affect other people, rather than how they affect the bearer, and this is most exemplified when it comes to personality disorders. For example:
“You have a deep insecurity about never being good enough, and you constantly mess up in your attempt to overcompensate? You may have Evil Bastard Disorder!”
“You have a crippling fear of abandonment and that you are fundamentally unloveable, so you do all you can to try to keep people close? You must have Manipulative Bitch Disorder!”
See also: Miss Diagnosis: Anxiety, ADHD, & Women
Antisocial DiagnosesThese days, it is easy to find on YouTube countless videos of how to spot a narcissist, with a list of key traits that all mysteriously describe exactly the exes of everyone in the comments.
And these days it is mostly “narcissist”, because “psychopath” and “sociopath” have fallen out of popular favor a bit:
- perhaps for coming across as overly sensationalized, and thus lacking credibility
- perhaps because “Narcissistic Personality Disorder (NPD)” exists in the DSM-5 (the US’s latest “Diagnostic and Statistical Manual of Mental Disorders”), while psychopathy and sociopathy are not mentioned as existing.
You may be wondering: what do “psychopathy” and “sociopathy” mean?
And the answer is: they mean whatever the speaker wants them to mean. Their definitions and differences/similarities have been vigorously debated by clinicians and lay enthusiasts alike for long enough that the scientific world has pretty much given up on them and moved on.
Stigma vs pathology
Because of the popular media (and social media) representation of NPD, it is easy to armchair diagnose one’s relative/ex/neighbor/in-law/boss/etc as being a narcissist, because the focus is on “narcissists do these bad things that are mean to people”.
If the focus were instead on “narcissists have cripplingly low self-esteem, and are desperate to not show weakness in a world they have learned is harsh and predatory”, then there may not be so many armchair diagnoses—or at the very least, the labels may be attached with a little more compassion, the same way we might with other mental health issues such as depression.
Not that those with depression get an easy time of it socially either—society’s response is generally some manner of “aren’t you better yet, stop being lazy”—but at the very least, depressed people are not typically viewed with hatred.
A quick aside: if you or someone you know is struggling with depression, here are some things that actually help:
The Mental Health First-Aid You’ll Hopefully Never Need
The disorder is not the problem
Maybe your relative, ex, neighbor, etc really is clinically diagnosable as a narcissist. There are still two important things to bear in mind:
- After centuries of diagnosing people with mental health maladies that we now know don’t exist per se (madness, hysteria, etc), and in recent decades countless revisions to the DSM and similar tomes, thank goodness we now have the final and perfect set of definitions that surely won’t be re-written in the next few years or so ← this is irony; it will absolutely be re-written numerous times yet because of course it’s still not a magically perfect descriptor of the broad spectrum of human nature
- The disorder is not the problem; the way they treat (or have treated) you is the problem.
For example, let’s take a key thing generally attributed to narcissists: a lack of empathy
Now, empathy can be divided into:
- affective empathy: the ability to feel what other people are feeling
- cognitive empathy: the ability to intellectually understand what other people are feeling (akin to sympathy, which is the same but with the requisite of having experienced the thing in question oneself)
A narcissist (as well as various other people without NPD) will typically have negligible affective empathy, and their cognitive empathy may be a little sluggish too.
Sluggish = it may take them a beat longer than most people, to realize what an external signifier of emotions means, or correctly guess how something will be felt by others. This can result in gravely misspeaking (or inappropriately emoting), after failing to adequately quickly “read the room” in terms of what would be a socially appropriate response. To save face, they may then either deny/minimize the thing they just said/did, or double-down on it and go on [what for them feels like] the counterattack.
As to why this shutting off of empathy happens: they have learned that the world is painful, and that people are sources of pain, and so—to avoid further pain—have closed themselves off to that, often at a very early age. This will also apply to themselves; narcissists typically have negligible self-empathy too, which is why they will commonly make self-destructive decisions, even while trying to put themselves first.
Important note on how this impacts other people: the “Golden Rule” of “treat others as you would wish to be treated” becomes intangible, as they have no more knowledge of their own emotional needs than they do of anyone else’s, so cannot make that comparison.
Consider: if instead of being blind to empathy, they were colorblind… You would probably not berate them for buying green apples when you asked for red. They were simply incapable of seeing that, and consequently made a mistake. So it is when it’s a part of the brain that’s not working normally.
So… Since the behavior does adversely affect other people, what can be done about it? Even if “hate them for it and call for their eradication from the face of the Earth” is not a reasonable (or compassionate) option, what is?
Take the bull by the horns
Above all, and despite all appearances, a narcissist’s deepest desire is simply to be accepted as good enough. If you throw them a life-ring in that regard, they will generally take it.
So, communicate (gently, because a perceived attack will trigger defensiveness instead, and possibly a counterattack, neither of which are useful to anyone) what behavior is causing a problem and why, and ask them to do an alternative thing instead.
And, this is important, the alternative thing has to be something they are capable of doing. Not merely something that you feel they should be capable of doing, but that they are actually capable of doing.
- So not: “be a bit more sensitive!” because that is like asking the colorblind person to “be a bit more observant about colors”; they are simply not capable of it and it is folly to expect it of them, because no matter how hard they try, they can’t.
- But rather: “it upsets me when you joke about xyz; I know that probably doesn’t make sense to you and that’s ok, it doesn’t have to. I am asking, however, if you will please simply refrain from joking about xyz. Would you do that for me?”
Presented with such, it’s much more likely that the narcissist will drop their previous attempt to be good enough (by joking, because everyone loves someone with a sense of humor, right?) for a new, different attempt to be good enough (by showing “behold, look, I am a good person and doing the thing you asked, of which I am capable”).
That’s just one example, but the same methodology can be applied to most things.
For tricks pertaining to how to communicate such things without causing undue resistance, see:
Seriously Useful Communication Skills
Take care!
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Intermittent Fasting for Women Over 50 – by Emma Sanchez
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Intermittent fasting is promoted as a very healthful (evidence-based!) way to trim the fat and slow aging, along with other health benefits. But, physiologically and especially metabolically, the average woman is quite different from the average man! And most resources are aimed at men. So, what’s the difference?
Emma Sanchez gives an overview not just of intermittent fasting, but also, how it goes with specifically female physiology. From hormonal cycles, to different body composition and fat distribution, to how we simply retain energy better—which can be a mixed blessing!
We’re given advice about how to optimize all those things and more.
She also covers issues that many writers on the topic of intermittent fasting will tend to shy away from, such as:
- mood swings
- risk of eating disorder
- impact on cognitive thinking
…and she does this evenly and fairly, making the case for intermittent fasting while acknowledging potential pitfalls that need to be recognized in order to be managed.
Lastly, the “over 50” thing. This is covered in detail quite late in the book, but there are a lot of changes that occur (beyond the obvious!), and once again, Sanchez has tips and tricks for holding back the clock where possible, and working with it rather than against it, when appropriate.
All in all, a great book for any woman over 50, or really also for women under 50, especially if that particular milestone is on the horizon.
Get your copy of Intermittent Fasting for Women over 50 from Amazon today!
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This Is Your Brain on Food – by Dr. Uma Naidoo
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“Diet will fix your brain” is a bold claim that often comes from wishful thinking and an optimistic place where anecdote is louder than evidence. But, diet does incontrovertibly also affect brain health. So, what does Dr. Naidoo bring to the table?
The author is a Harvard-trained psychiatrist, a professional chef who graduated with her culinary school’s most coveted award, and a trained-and-certified nutritionist. Between those three qualifications, it’s safe to she knows her stuff when it comes to the niche that is nutritional psychiatry. And it shows.
She takes us through the neurochemistry involved, what chemicals are consumed, made, affected, inhibited, upregulated, etc, what passes through the blood-brain barrier and what doesn’t, what part the gut really plays in its “second brain” role, and how we can leverage that—as well as mythbusting a lot of popular misconceptions about certain foods and moods.
There’s hard science in here, but presented in quite a pop-science way, making for a very light yet informative read.
Bottom line: if you’d like to better understand what your food is doing to your brain (and what it could be doing instead), then this is a top-tier book for you!
Click here to check out This Is Your Brain On Food, and get to know yours!
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Anxiety Attack vs Panic Attack: Do You Know The Difference?
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
The terms are sometimes used incorrectly, but have quite different meanings. Dr. Julie Smith, psychologist, explains in this short video:
Important distinctions
Anxiety attacks are not clinically recognized terms and lack a clear definition, often used to describe a build-up of anxiety before anticipated stressful events (e.g. social gatherings, medical appointments, etc, though of course what it is will vary from person to person—not everyone finds the same things stressful, or has the same kinds of anticipations around things).
Panic attacks, in contrast, are sudden surges of intense fear or discomfort that peak within minutes. They are characterized by symptoms including at least 4 of:
- palpitations
- sweating
- shortness of breath
- chest pain
- dizziness
- fear of losing control or dying
There’s a misconception that panic attacks never have identifiable triggers while anxiety attacks always do.
In reality, both can occur with or without a clear cause. Panic attacks can arise from various conditions, including trauma, OCD, or phobias, and don’t necessarily mean you have a panic disorder. They can also occur as a drug response, without any known underlying psychological condition.
You may also notice that that list of symptoms has quite a bit of overlap with the symptoms of a heart attack, which a) does not help people to calm down b) can, on the flipside, cause a heart attack to be misdiagnosed as a panic attack.
In terms of management:
- In the moment: breathing exercises, like extending your exhalation (a common example is the “7-11” method, inhaling for 7 seconds and exhaling for 11 seconds), can calm the body and reduce panic symptoms.
- More generally: to prevent panic attacks from becoming more frequent, avoid avoiding safe environments that triggered an attack, like supermarkets or social gatherings. Gradual exposure helps reduce anxiety over time, while avoidance can worsen it.
If panic attacks persist, Dr. Smith advises to seek help from a doctor or psychologist to understand their root causes and develop effective coping strategies.
For more on all of this, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
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Cows’ Milk, Bird Flu, & You
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
When it comes to dairy products, generally speaking, fermented ones (such as most cheeses and yogurts) are considered healthy in moderation, and unfermented ones have their pros and cons that can be argued and quibbled “until the cows come home”. We gave a broad overview, here:
Furthermore, you may recall that there’s some controversy/dissent about when human babies can have cows’ milk:
When can my baby drink cow’s milk? It’s sooner than you think
So, what about bird flu now?
Earlier this year, the information from the dairy industry was that it was nothing to be worried about for the time being:
Bird Flu Is Bad for Poultry and Dairy Cows. It’s Not a Dire Threat for Most of Us — Yet.
More recently, the latest science has found:
❝We found a first-order decay rate constant of −2.05 day–1 equivalent to a T99 of 2.3 days. Viral RNA remained detectable for at least 57 days with no degradation. Pasteurization (63 °C for 30 min) reduced infectious virus to undetectable levels and reduced viral RNA concentrations, but reduction was less than 1 log10.
The prolonged persistence of viral RNA in both raw and pasteurized milk has implications for food safety assessments and environmental surveillance❞
You can find the study here:
Infectivity and Persistence of Influenza A Virus in Raw Milk
In short: raw milk keeps the infectious virus; pasteurization appears to render it uninfectious, though viral RNA remains present.
This is relevant, because of the bird flu virus being found in milk:
World Health Organization | H5N1 strain of bird flu found in milk
To this end, a moratorium has been placed on the sale of raw milk, first by the California Dept of Public Health (following an outbreak in California):
California halts sales of raw milk due to bird flu virus contamination
And then, functionally, by the USDA, though rather than an outright ban, it’s requiring testing for the virus:
USDA orders testing of milk supply for presence of bird flu virus
So, is pasteurized milk safe?
The official answer to this, per the FDA, is… Honestly, a lot of hand-wringing and shrugging. What we do know is:
- the bird flu virus has been found in pasteurized milk too
- the test for this is very sensitive, and has the extra strength/weakness that viral fragments will flag it as a positive
- it is assumed that the virus was inactivated by the pasteurization process
- it could, however, have been the entire virus, the test simply does not tell us which
In the FDA’s own words:
❝The pasteurization process has served public health well for more than 100 years. Even if the virus is detected in raw milk, pasteurization is generally expected to eliminate pathogens to a level that does not pose a risk to consumer health❞
So, there we have it: the FDA does not have a reassurance exactly, but it does have a general expectation.
Source: US Officials: Bird flu viral fragments found in pasteurized milk
Want to know more?
You might like this mythbusting edition we did a little while back:
Pasteurization: What It Does And Doesn’t Do ← this is about its effect on risks and nutrients
Take care!
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Rutin For Your Circulation & More
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Rutin is a bioflavonoid so potent it’s also been called “vitamin P”, and it’s found most abundantly in buckwheat, as well appearing in citrus and some stone fruits (apricots, plums, etc) as well as figs and apples—it’s also found in asparagus, and green and black tea.
So, what does it do?
Quite a lot: The Pharmacological Potential of Rutin
There’s much more there than we have room to cover here, but we’ll pick out a few salient properties to focus on.
First, a word of warning
A lot of the extant science for rutin is in non-human animals. Sometimes, what works for non-human animals doesn’t work for humans; we saw a clear example of this here:
Conjugated Linoleic Acid For Weight Loss?
…in which CLA worked for weight loss in mice, hamsters, chickens, and pigs, but stubbornly not humans.
The state of affairs with the science for rutin isn’t nearly that bad and there are human studies showing efficacy, and indeed, rutin is given to (human) patients with capillary fragility, varicose veins, bruising, or hemorrhoids, for example:
So, we’ll try to give you humans-only sources so far as we can today!
Improving blood flow
Rutin does improve various blood metrics, including various kinds of blood pressure (diastolic, systolic, mean arterial, pulse) and heart rate. At least, it did in humans with type 2 diabetes, and we may reasonably assume these results may be extrapolated to humans without type 2 (or any other) diabetes:
As you may gather from the title, it did also significantly improve serum antioxidant levels, and quality of life (which latter was categorized as: emotional limitations, energy and freshness, mental health, social performance, and general health).
We couldn’t find studies for cardioprotective effects in humans (and of course those couldn’t be RCTs, they’d have to be observational studies, because no ethics board allows inducing heart attacks in humans for the sake of science), but here’s a study using rats (with and without diabetes), showing proof of principle at least:
Anti-Alzheimer’s potential
As ever, a good general rule of thumb is “what’s good for the blood is good for the brain”, and that’s true in this case too.
The title says it all, here:
In case that is not clear: everything in that title after the word “inhibits” is bad for the brain and is implicated in Alzheimer’s disease pathogenesis and progression; in other words, rutin is good against all those bad, Alzheimer’s-favoring things.
Other neuroprotective activity
You may remember from the above-linked research that it helps protect against damage caused by Advanced Glycation End-products (AGEs) (the golden-brown stuff that appears as a result of dry-cooking proteins and fats); it also helps against damage caused by acrylamide (the golden-brown stuff that appears as a result of dry-cooking starches).
Note: in both cases “dry-cooking” includes cooking with oil; it simply means “without water”.
Again, this was a rat study, because no ethics board would have let the researchers fry human brains for science.
Want to try some?
As well as simply enjoying the fruits and vegetables that contain it, it is possible to take a rutin supplement.
We don’t sell it, but here for your convenience is an example product on Amazon 😎
Enjoy!
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