TESTOSTERONE AND THE AGING
MALE
The age- reversal premise we are
espousing is the subject of three new books written by highly respected medical
doctors. These books provide a persuasive compilation of research findings and
clinical experience to document the safety and efficacy of using this approach
to treat aging. The books fail, however, to lay out an aggressive therapeutic
plan of action. In this protocol, The Foundation provides a novel step- by- step
program to enable members to immediately take advantage of this new information.
In
writing this protocol, the Life Extension Foundation reviewed several thousand
published scientific studies to validate safety and anti- aging efficacy. We
also received input from experts who have personally followed this system for
several years.
Foundation members are getting impatient. They don't want to see their bodies
ravaged by aging if a documented therapy is available that can control or
reverse this devastating process. In this case, proven therapies exist and many
are FDA-approved.
Implementing this protocol requires diligent medical testing, but the potential
for significant age-reversal is compelling.
Male Hormones and Aging
As men age past year 40, hormonal changes occur
that perceptibly inhibit physical, sexual, and cognitive function. The outward
appearance of a typical middle-age male shows increased abdominal fat and
shrinkage of muscle mass, a hallmark effect of hormone imbalance. A loss of
feeling of well-being, sometimes manifesting as depression, is a common
psychological complication of hormone imbalance. (94-97,271)
Until recently, these changes were attributed to "growing old," and men were
expected to accept the fact that their body was entering into a long
degenerative process that would someday result in death.
A remarkable amount of data has been compiled that indicates that many of the
diseases that middle- aged men begin experiencing, including depression,
abdominal weight gain, prostate and heart disease are directly related to
hormone imbalances that are correctable with currently available drug and
nutrient therapies. To the patient's detriment,
conventional doctors are increasingly prescribing drugs to treat depression,
elevated cholesterol, angina and a host of other diseases that may be caused by
an underlying hormone imbalance.
If doctors checked their male patient's blood
levels of estrogen, testosterone, thyroid, and DHEA (instead of prescribing
drugs to treat symptoms), they might be surprised to learn that many problems
could be eliminated by adjusting hormone levels to fit the profile of a healthy
21-year- old.
Few physicians know what hormone blood tests to order for men, nor do they have
the experience to properly adjust hormones to reverse the degenerative changes
that begin in mid-life. This protocol will provide the patient and physician
with the information necessary to safely modulate hormone levels for the purpose
of preventing and treating many of the common diseases associated with growing
older.
Too Much Estrogen
The most significant hormone imbalance in aging men is a decrease in free
testosterone while estrogen levels remain the same or precipitously increase.
Through a variety of mechanisms, as men grow older, they suffer from the dual
effects of having too little testosterone and excess estrogen. The result is a
testosterone/estrogen imbalance that directly causes many of the debilitating
health problems associated with normal aging. (1-12,28)
One cause of hormone imbalance in men is that their
testosterone is increasingly converted to estrogen. One report showed that
estrogen levels of the average 54-year-old man is higher than those of the
average 59-year-old women. (1,5,13-18,48)
The reason that testosterone replacement therapy by itself does not work for
many men is that exogenously administered testosterone may convert (aromatize)
into even more estrogen, thus potentially worsening the hormone imbalance
problem in aging males, i.e., too much estrogen and not enough free
testosterone. While there are studies showing that testosterone replacement
therapy does not increase estrogen beyond normal reference ranges, we are going
to show later how the standard laboratory reference ranges do not adequately
address the issue of estrogen overload. (4,8,9,17,22-25,27,29-32)
Estrogen is a necessary hormone for men, but too much
causes a wide range of health problems. The most dangerous acute effect of
excess estrogen and too little testosterone is an increased risk of heart attack
or stroke. (39-43, 261-270) High levels of estrogen have been implicated as a
cause of benign prostatic hypertrophy (BPH) (35- 44,46,47) and one mechanism by
which nettle extract works is to block the binding of growth-stimulating
estrogen to prostate cells .(42-44,48,49,50)
When there is too little testosterone present, estrogen attaches to
testosterone cell receptor sites throughout the body and creates many problems
in aging men. In youth, low amounts of estrogen are used to turn off the
powerful cell-stimulating effects of testosterone. As estrogen levels increase
with age, testosterone cell stimulation may be locked in the "off" position,
thus reducing sexual arousal and sensation and causing the common loss of libido
so common in aging men. (94,99,259)
High serum levels of estrogen also trick the brain into
thinking that enough testosterone is being produced, thereby slowing down the
natural production of testosterone. This happens when estrogen saturates
testosterone receptors in the hypothalamus region of the brain. The saturated
hypothalamus then stops sending out a hormone to the pituitary gland to
stimulate secretion of luteinizing hormone, which the gonads require to produce
testosterone. High estrogen can thus shut down the normal testicular production
of testosterone. (1,54,271-276,277)
One further complication of excess estrogen is that it increases the body's
production of sex hormone- binding globulin (SHBG). (280) SHBG binds free
testosterone in the blood and makes it unavailable to cell receptor sites.
(51-52,55,56)
Based on the multiple deleterious effects of excess
estrogen in men, aggressive actions should be taken to reduce estrogen to a safe
range if a blood test reveals elevated levels. We will discuss the appropriate
blood tests and steps that can be taken to lower estrogen levels later in this
protocol.
The Critical Importance of Free Testosterone
Testosterone is much more than a sex hormone. There
are testosterone receptor sites in cells throughout the body, most notably in
the brain and heart. (60, 180) Youthful protein synthesis for maintaining muscle
mass and bone formation requires testosterone. (59,61- 74, 87- 90,261- 264,287)
Testosterone improves oxygen uptake throughout the body, helps control blood
sugar, (68,75- 78- 80) regulate cholesterol, (67,69,81) and maintain immune
surveillance. (82,83) The body requires testosterone to maintain youthful
cardiac output and neurological function. (58, 65) Testosterone is a critical
hormone in the maintenance of healthy bone density, (59, 66,67,84-86) muscle
mass, (65-67,87-90,287) and red blood cell production. (6 7,69,92,93,98) Of
critical concern to psychiatrists are studies showing that men suffering from
depression have lower levels of testosterone than control subjects. (94-98) For
some men, elevating free testosterone levels could prove to be an effective
anti-depressant therapy. There is a basis for free testosterone levels being
measured in men suffering from depression and replacement therapy initiated if
free testosterone levels are low normal or below normal.
One of the most misunderstood hormones is testosterone. Body builders tarnished
the reputation of testosterone by putting large amounts of synthetic
testosterone drugs into their young bodies. Synthetic testosterone abuse can
produce detrimental effects, but this has nothing to do with the benefits a man
over age 40 can enjoy by properly restoring his natural testosterone to a
youthful level.
Conventional doctors have not recommended testosterone replacement therapy
because of an erroneous concern that testosterone causes prostate cancer. As we
will later show, fear of prostate cancer is not a scientific reason to avoid
testosterone modulation therapy.
Another concern skeptical doctors have about prescribing
testosterone replacement therapy is that some poorly conducted studies showed it
to be ineffective in the long-term treatment of aging. These studies indicate
anti-aging benefits when testosterone is given, but the effects often wear off.
What doctors fail to appreciate is that exogenously administered testosterone
can convert to estrogen in the body. The higher estrogen levels may negate the
benefits of the exogenously administered testosterone. The solution to the
estrogen- overload problem is to block the conversion of testosterone to
estrogen in the body. Numerous studies show that maintaining youthful levels of
free testosterone can enable the aging man to restore strength, stamina,
cognition, heart function, sexuality and their outlook on life, i.e., alleviate
depression.(261-270)
Why Testosterone Levels Decline
Testosterone production begins in the brain. When the hypothalamus detects a
deficiency of testosterone in the blood, it secretes a hormone called
gonadotrophin-releasing hormone to the pituitary gland. This prompts the
pituitary to secrete luteinizing hormone (LH) which then prompts the Leydig
cells in the testes to produce testosterone.
In some men, the testes lose their ability to produce
testosterone, no matter how much LH is being produced. This type of testosterone
deficiency is diagnosed when blood tests show high levels of LH and low levels
of testosterone. In other words, the pituitary gland is telling the testes (by
secreting LH ) to produce testosterone, but the testes have lost their
functional ability, so the pituitary gland vainly continues to secrete LH
because there is not enough testosterone in the blood to provide a feedback
mechanism that would tell the pituitary to shut down. In other cases, the
hypothalamus or pituitary gland fail to produce sufficient amounts of LH, thus
preventing a healthy pair of testes from secreting testosterone. Blood testing
can determine if sufficient amounts of LH are being secreted by the pituitary
gland and help determine the proper therapeutic approach.
If serum (blood) testosterone levels are very low, it is important to diagnose
the cause, but no matter what the underlying problem, therapies exist today to
safely restore testosterone to youthful levels in any man (who does not already
have prostate cancer).
As indicated earlier in this article, a major problem aging men face is not low
production of testosterone, but excessive conversion of testosterone to
estrogen. Again, specific therapies will be discussed later about how to
suppress excess estrogen and boost free testosterone back to youthful
physiologic levels.
The Effects of Testosterone on Libido
Sexual stimulation and erection begin in the brain when neuronal
testosterone-receptor sites are prompted to ignite a cascade of biochemical
events that involve testosterone- receptor sites in the nerves, blood vessels,
and muscles. Free testosterone promotes sexual desire and then facilitates
performance, sensation, and the ultimate degree of fulfillment.
Without adequate levels of free testosterone, the quality of a man's sex life is
impacted and the genitals atrophy. When free testosterone is restored, positive
changes in structure and function of the sex organs can be expected. (It should
be noted that sexual dysfunction can be caused by other factors unrelated to
hormone balance such as arteriosclerotic blockage of the penile arteries.)
The genital/pelvic region is packed with testosterone receptors that are
ultra-sensitive to free testosterone- induced sexual stimulation. Clinical
studies using testosterone injections, creams, or patches have often failed to
provide a long-lasting libido enhancing effect in aging men. (98) We now know
why. The testosterone can be converted to estrogen. The estrogen is then taken
up by testosterone receptor sites in cells throughout the body. When an estrogen
molecule occupies a testosterone receptor site on a cell membrane, this blocks
the ability of serum testosterone to induce a healthy hormonal signal. It does
not matter how much serum free testosterone is available if excess estrogen is
competing for the same cellular receptor sites.
Estrogen can also increase the production of sex hormone- binding globulin (SHBG),
which binds the active free testosterone into a non- active "bound
testosterone". Bound testosterone is not able to be picked up by testosterone
receptors on cell membranes. For testosterone to produce long- lasting libido
enhancing effects, it must be kept in the "free" form (not bound to SHBG) in the
bloodstream. It is also necessary to suppress excess estrogen as this hormone
can compete for testosterone receptor sites in the sex-centers of the brain and
the genitals.
Restoring youthful hormone balance can have a significant impact on male
sexuality (99-102)
Testosterone and the Heart
Normal aging results in the gradual weakening of the heart, even in the absence
of significant coronary artery disease. If nothing else kills the elderly, at
some point their heart just stops beating.
Testosterone is a muscle-building hormone and there are many
testosterone-receptor sites in the heart. (57) The weakening of the heart muscle
can sometimes be attributed to testosterone deficiency. (103- 108) Testosterone
is not only responsible for maintaining heart muscle protein synthesis, but it
is a promoter of coronary artery dilation (109-113) and helps to maintain
healthy cholesterol levels. (81,114)
There is an ever-increasing number of studies indicating an association between
high testosterone and low cardiovascular disease rates in men. (81) In the
majority of patients, symptoms and EKG measurements improve when low
testosterone levels are corrected. One study showed that blood flow to the heart
improved 68.8% in those receiving testosterone therapy. (9) In China, doctors
are successfully treating angina with testosterone therapy. (9,115,116)
The following list represents the effects of low testosterone on cardiovascular
disease:
1.
Cholesterol, fibrinogen, triglycerides, and insulin
levels increase (30-33)
2.
Coronary artery elasticity diminishes
3.
Blood pressure rises
4.
Human growth hormone (HGH) declines (weakening heart
muscle)
5.
Abdominal fat increases (increasing heart attack risk)
Those with
cardiovascular disease should have their blood tested for free testosterone and
estrogen. Some men (with full cooperation from their physician) may be able to
stop taking expensive drugs to stimulate cardiac output, lower cholesterol, and
keep blood pressure under control if they correct a testosterone deficit and/or
a testosterone/estrogen imbalance.
Despite numerous studies substantiating the beneficial effects of testosterone
therapy in treating heart disease, conventional cardiologists continue to
overlook the important role this hormone plays in keeping their cardiac patients
alive. (9,30,31,77,93,111-113,115,116,261-270)
Many doctors will tell you that testosterone causes
prostate disease. The published scientific literature indicates otherwise.
As readers of Life Extension Magazine learned in late 1997, estrogen has been
identified as a primary culprit in the development of BPH. (117-119) Estrogen
has been shown to bind to SHBG in the prostate gland and cause the proliferation
of epithelial cells in the prostate. (124, 182-184) This is corroborated by the
fact that as men develop benign prostate enlargement, their levels of free
testosterone are plummeting while their estrogen levels remain the same or are
rising. As previously discussed, aging men tend to convert their testosterone
into estrogen. The published evidence shows that serum levels of testosterone
are not a risk factor for developing benign prostate disease. (8,36,41,117-137)
The major concern that has kept men from restoring
their testosterone to youthful levels is fear of prostate cancer. The theory is
that since most prostate cancer cell lines need testosterone to proliferate, it
is better to not replace the testosterone that is lost with aging. The problem
with this theory is that most men who contract prostate cancer have low levels
of testosterone and the majority of published studies show that serum
testosterone levels do not affect one's risk for contracting prostate cancer.
Since the perception is so strong that any augmentation of testosterone can
increase the risk of prostate cancer, we did a MEDLINE search on all the
published studies relating to serum testosterone and prostate cancer. The
appendix at the end of this article provides quotations from the published
literature as it relates to the issue of whether testosterone causes prostate
disease. Out of 27 MEDUNE studies we found, five indicated that men with higher
testosterone levels had a greater incidence of prostate cancer, whereas 21
studies showed that testosterone was not a risk factor. One study was considered
neutral. The score was therefore:
21 studies indicating
testosterone does not cause prostate cancer
versus
5 studies indicating
testosterone causes prostate cancer (and one study that did not produce
significant results)
Before anyone
starts a testosterone replacement program, they should have a serum PSA test and
a digital rectal exam to rule out prostate cancer. Nothing is risk free. A small
minority of men with low testosterone and prostate cancer will not have an
elevated PSA or palpable lesion detectable by digital rectal exam. If these men
use supplemental testosterone, they risk an acute flare up in their disease
state. That is why PSA monitoring is so important every 30-45 days during the
first 6 months of any type of testosterone augmentation therapy. If an
underlying prostate cancer is detected because of testosterone therapy, it is
usually treatable with non-surgical means.
Please remember that testosterone does not cause acute prostate cancer, but if
you have existing prostate cancer and don't know it, testosterone administration
will likely sharply boost PSA and provide your doctor with a quick diagnosis of
prostate cancer (and an opportunity for very early treatment). We acknowledge
that some aging men will not want to take this risk.
As stated above, the MEDLINE score was 21 to 5 against the theory that
testosterone plays a role in the development of prostate cancer. None of these
studies took into account the prostate cancer prevention effects of men who take
lycopene, selenium, and vitamins A and E. (135- 144) Nor did they factor in
possible prostate disease preventives such as saw palmetto, nettle, soy, and
pygeum. (42-44,145-170,172)
In Dr. Jonathan Wright's book, Maximize Your Vitality and Potency, a persuasive
case is made that testosterone and DHEA actually protect against the development
of both benign and malignant prostate disease. Dr. Wright also points out that
natural therapies such as saw palmetto, nettle, and pygeum provide a
considerable degree of protection against the alleged negative effects that
higher levels of testosterone might have on the prostate gland.
We eagerly await the results of more studies, but the fear of developing
prostate cancer in the future should not be a reason to deprive your body today
of the life saving and life-enhancing benefits of restoring a youthful balance.
Once a man has prostate cancer, testosterone therapy cannot be recommended
because most prostate cancer cells use testosterone as a growth promoter. This
regrettably denies prostate cancer patients the wonderful benefits of
testosterone therapy. Men with severe BPH should cautiously approach
testosterone replacement. It would be prudent for those with BPH who are taking
testosterone replacement therapy to also use the drug Proscar (finasteride) to
inhibit 5- alpha reductase levels, thereby suppressing the formation of
dihydrotestosterone (DHT). (171-182) DHT is ten times more potent than
testosterone in promoting prostate growth, and suppressing DHT is a proven
therapy in treating benign prostate enlargement. Saw palmetto extract suppresses
some DHT in the prostate gland, but its effectiveness in alleviating symptoms of
BPH probably has more to do with:
·
Its blocking of
atpha-adrenergic receptor sites on the sphincter muscle surrounding the urethra.
(This is how the drug Hytrin works.)
·
Its inhibition of
estrogen binding to prostate cells (like nettle).
·
Its inhibition the
enzyme 3-kefosteroid (that causes the binding of DHT to prostate ceUs).
·
Its
anti-inflammatory effect on the prostate.
It is unfortunate that many
people still think that restoring testosterone to youthful levels will increase
the risk of prostate disease. This misconception has kept many men from availing
themselves to this life-enhancing and life-saving hormone.
While it is clear that excess estrogen causes benign prostate enlargement, the
evidence for excess estrogen's role in the development of prostate cancer is
uncertain. (8,41,117-134,182-217,236) Some studies show elevated estrogen is
associated with increased prostate cancer risk while other studies contradict
this. For more information on testosterone, estrogen and the prostate gland,
refer to the February 1999 issue of Life Extension Magazine. (182-217)
Testosterone and Depression
A consistent finding in the scientific literature is that testosterone
replacement therapy produces an increased feeling of well being. As stated
earlier, newly published studies show that low testosterone correlates with
symptoms of depression and other psychological disorders.(94-97,272)
A common side-effect of prescription anti-depressant drugs is the suppression of
libido. Those suffering with depression either accept this drug-induced
reduction in quality of life, or get off the anti- depressant drugs so they can
at least have a somewhat normal sex life. If more psychiatrists tested their
patients blood for free testosterone and prescribed natural testosterone
therapies to those with low free testosterone, the need for libido- suppressing
anti- depressant drugs could be reduced or eliminated. As previously described,
testosterone replacement often enhances libido which has the opposite effect of
most prescription anti-depressants.
One study showed that patients with major depression experienced improvement
that was equal to that achieved with standard antidepressant drugs. (97)
Androderm is one of several natural testosterone replacement therapies that can
be prescribed by doctors. A 12- month clinical trial on this FDA-approved drug
resulted in a statistically significant reduction in the depression score (6.9
before vs 3.9 after). Also noted were highly significant decreases in fatigue
from 79% before the patch to only 10% after 12 months. (218)
According to Jonathan Wright, M.D., author of the book Maximize Your Vitality &
Potency, the following effects have been reported in response to low
testosterone levels:
·
Touchiness/irritability
·
Great timidity
·
Feeling weak
·
Inner unrest
·
Loss of ability to
concentrate
·
Memory failure
·
Reduced
intellectual agility
·
Passive attitudes
·
General tiredness
·
Reduced interest
in surroundings
·
Hypochondria
The above feelings can all be
clinical symptoms of depression, and testosterone replacement therapy has been
shown to alleviate these conditions. Testosterone thus has exciting therapeutic
potential in the treatment of depression in men.
Testosterone and Aging
We know that many of the degenerative diseases of aging in men such as Type II
diabetes, osteoporosis, and cardiovascular disease are related to a testosterone
deficiency. We also know that common characteristics of middle- age and older
age such as depression, abdominal fat deposition, muscle atrophy, low energy,
and cognitive decline are also associated with less than optimal levels of free
testosterone.(58,219)
A consistent pattern that deals with fundamental aging
shows that low testosterone causes excess production of a dangerous hormone
called cortisol. Some anti-aging experts call cortisol a "death
hormone"
because of the multiple degenerative effects it produces such as immune
dysfunction, brain cell injury, arterial wall damage, etc.
A group of scientists conducted two double-blind studies where they administered
supplemental testosterone to groups of aging men and observed the typical
responses of lower levels of cholesterol, glucose and triglycerides, reductions
in blood pressure, and decreased abdominal fat mass. These scientists then
showed that excess cortisol suppressed testosterone and growth hormone
production and that the administration of testosterone acted as a "shield"
against the over production of cortisol in the adrenal gland. (289)
It is important to point out that testosterone
is an anabolic (or protein building) hormone while cortisol is a catabolic
hormone that breaks down proteins in the body. Normal aging consists of a
progressive decrease in free testosterone with a marked increase in cortisol. As
men age past 40, cortisol begins to dominate, and the catabolic effects
associated with growing older begin to dominate.
These findings have significant implications in the battle to maintain
youthful hormone balance for the purpose of staving off normal aging and its
associated degenerative diseases.
The Testosterone Doctor
Eugene Shippen, M.D., authored a book in 1998 called The Testosterone Syndrome.
He was a speaker at the American Academy of Anti-Aging Medicine Conference held
in December 1998 where he provided extensive evidence documenting the pathology
of the testosterone deficiency syndrome in men. Here are some excerpts from Dr.
Shippen's presentation that appeared in the March 1999 issue of Life Extension
Magazine:
First, Testosterone is not just
a "sex hormone." It should be seen as a "total body hormone," affecting every
cell in the body. The changes seen in aging, such as the loss of lean body mass,
the decline in energy, strength, and stamina, unexplained depression, and
decrease in sexual sensation and performance, are all directly related to
testosterone deficiency. Degenerative diseases such as heart disease, stroke,
diabetes, arthritis, osteoporosis, and hypertension are all directly or
indirectly linked to testosterone decline. (220- 223) Secondly, testosterone
functions also as a prohormone. (99) Local tissue conversion to estrogens,
dihydrotestosterone (DIII), or other active metabolites plays an important part
in cellular physiology.
Excess estrogen seems to be the culprit in prostate enlargement. Low
testosterone levels are in fact associated with more aggressive prostate cancer.
(201,205,224- 229) While fear of prostate cancer keeps many men from
testosterone replacement, it is in fact testosterone deficiency that leads to
the pathology that favors the development of prostate cancer.
Testosterone improves cellular bioenergetics. It acts as
a cellular energizer. Since testosterone increases the metabolic rate and
aerobic metabolism, it also dramatically improves glucose metabolism and lowers
insulin resistance. (76,80,230)
Another myth is that testosterone is bad for the heart.
Actually, low testosterone correlates with heart disease more reliably than high
cholesterol. (231) Testosterone is the most powerful cardiovascular protector
for men. Testosterone strengthens the heart muscle; there are more testosterone
receptors in the heart than in any other muscle. (232) Testosterone lowers LDL
cholesterol and total cholesterol, (69,81,111) and improves every cardiac risk
factor. It has been shown to improve or eliminate arrhythmia and angina.
(9,106,113- 115,233,266 ) A Testosterone replacement is the most underutilized
important treatment for heart disease.
Testosterone shines as a blood thinner, preventing blood clots. 32 Testosterone
also helps prevent colon cancer. (235-236)
Previous research on testosterone used the wrong form of replacement. Injections
result in initial excess of testosterone, with excess conversion to estrogens.
Likewise, total testosterone is often measured instead of free testosterone, the
bioavailable form. Some studies do not last long enough to show improvement. For
instance, it may take six months to a year before the
genital tissue fully recovers from atrophy caused by testosterone deficiency,
and potency is restored.
Physicians urgently need to be educated about the benefits of testosterone and
the delicate balance between androgens (testosterone) and estrogens. Each
individual has his or her own pattern of hormone balance; this indicates that
hormone replacement should be individualized and carefully monitored.
Dr. Shippen's book, The Testosterone Syndrome retails for $21.95. Foundation
members can purchase it for $15.00 by calling 1-800-544-4440. The book provides
a persuasive argument in favor of hormone modulation in the aged male, and
contains many interesting case histories. Dr. Wright's and Dr. Ullis's books on
this subject are also available.
Obesity and Hormone Imbalance
A consistent finding in the scientific literature is that obese men have low
testosterone and very high estrogen levels. Central or visceral obesity (pot
belly) is recognized as a risk factor for cardiovascular disease and type II
diabetes. New findings have shed light on subtle hormone imbalances in obese men
that are of borderline character and often fall within the normal laboratory
reference range. Boosting testosterone levels seems to decrease the abdominal
fat mass, reverse glucose intolerance, as well as lipoprotein abnormalities in
the serum. Further analysis has also disclosed a regulatory role for
testosterone in counteracting visceral fat accumulation. Longitudinal
epidemiological data demonstrate that relatively low testosterone levels are a
risk factor for development of visceral obesity. (7,237)
One study showed that serum estrone and estradiol was twofold elevated in one
group of morbidly obese men. Remember, fat cells synthesize the aromatase
enzyme, and this causes male hormones to convert to estrogens (278) Fat tissues,
especially in the abdomen, have been shown to literally "aromatize" testosterone
and its precursor hormones into potent estrogens. (80,237-242)
Eating high-fat foods may reduce free testosterone
levels according to one study that measured serum levels of sex steroid hormones
after ingestion of different types of food. High protein or carbohydrate meals
had no effect on serum hormone levels, but a fat- containing meal reduced free
testosterone levels for 4 hours. (243)
So obese men suffer from testosterone deficiency caused
by excess aromatase enzyme being produced in fat cells and also from the fat
they consume in their diet. (240) The resulting hormone imbalance (too much
estrogen and not enough free testosterone) in obese men partially explains why
so many are impotent, and suffer from a wrath of premature degenerative
diseases.(45)
Factors Causing the Estrogen-Testosterone Imbalance in Men
If your blood tests reveal high estrogen and low testosterone, here are the
common factors involved:
Excess Aromatase Enzyme men age, they produce larger quantities of an enzyme
called aromatase The aromatase enzyme converts testosterone into estrogen in the
body. (17,240,241,244,245) Inhibiting the aromatase enzyme results in a
significant decline in estrogen levels while often boosting free testosterone
youthful levels. (279) Therefore, an agent designated as "aromatase inhibitor"
may be of special value to aging men who have excess estrogen.
Liver Enzymatic Activity- A healthy liver eliminates
surplus estrogen and sex hormone-binding globulin. Aging, alcohol, and certain
drugs impair liver function, and can be a major cause of hormone imbalance in
aging men. Heavy alcohol intake increases estrogen in men and women. (54,246,
285)
Obesity- Fat cells create aromatase enzyme,
especially abdominal fat. (241,242) Low testosterone allows the formation of
abdominal
fat, (47,239,248)
which then causes more aromatase enzyme formation and thus even lower levels of
testosterone and higher estrogen (by aromatizing testosterone into estrogen). It
is especially important for overweight men to consider hormone modulation
therapy.
Zinc Deficiency- Zinc is a natural aromatase enzyme inhibitor. (247) Since most
Life Extension Foundation members consume adequate amounts of zinc (30 to 90
mg/day), elevated estrogen in Foundation members is often caused by factors
other than zinc deficiency.
Lifestyle changes (such as reducing alcohol intake) can produce a dramatic
improvement in the estrogen-testosterone balance, but many people need to use
aromatase inhibiting agents to lower estrogen and to improve their liver
function to remove excess SHBG. Remember,
aromtase converts testosterone into estrogen and can
indirectly increase SHBG. SHBG binds to free testosterone and prevents its from
exerting its biochemical effects in the body
