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Archive for the ‘Low Testosterone’ Category

Welcome to Advanced Physical Medicine & Rehab of Miami's Low Testosterone Archive. Here you can learn more about Advanced Physical Medicine & Rehab of Miami, Physical Medicine, and Dr. Joseph Gambardella, today's choice for Pain Relief Physicians in Miami, FL. Read Dr. Joseph Gambardella's Physical Medicine Low Testosterone for the health of it.

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No Link: Testosterone Therapy And Heart Attack Risk

Testosterone prescriptions for older men in the United States have increased more than three-fold over the past decade. Recent studies linking testosterone use with increased risk of heart attack and stroke have caused widespread concern among patients and their families. A new U.S.-based study of more than 25,000 older men shows that testosterone therapy does not increase men’s risk for heart attack.

The study, conducted by researchers at the University of Texas Medical Branch at Galveston, examined 25,420 Medicare beneficiaries 66 years or older treated with testosterone for up to eight years. It appears in the July 2 issue of the Annals of Pharmacotherapy.

“Our investigation was motivated by a growing concern, in the U.S. and internationally, that testosterone therapy increases men’s risk for cardiovascular disease, specifically heart attack and stroke,” said Jacques Baillargeon, UTMB associate professor of epidemiology in the Department of Preventive Medicine and Community Health and lead author of the study. “This concern has increased in the last few years based on the results of a clinical trial and two observational studies,” he said. “It is important to note, however, that there is a large body of evidence that is consistent with our finding of no increased risk of heart attack associated with testosterone use.”

This is an excerpt from an article originally published by UTMB. Simply click here to read the complete article.

The Impact of Testosterone Therapy in Men on Cardiovascular Risk

In this issue of Mayo Clinic Proceedings, Morgentaler et al1 provide a timely update regarding testosterone therapy in men and cardiovascular risk. This review is important considering the recent controversy claiming increased cardiovascular risk in men receiving testosterone therapy. Morgentaler et al identified 4 studies suggesting that testosterone therapy increases the risk of cardiovascular events, but they also identified more than 100 studies demonstrating that normal testosterone levels (and, accordingly, physiologic replacement of testosterone) provide beneficial effects to men and minimize cardiovascular risk and mortality. They also critically evaluated the 4 positive studies and noted that 2 studies had serious methodology concerns, 1 was a meta-analysis with poor inclusion criteria, and 1 was a placebo-controlled study with too few cardiovascular events to make definitive conclusions.

Morgentaler et al are not alone when it comes to concerns raised about the recent studies reporting adverse cardiovascular effects of testosterone. For example, the methodology concerns in the report by Vigen et al3—one of the reports suggesting harm by testosterone—have been so great that 29 professional societies, including the International Society for Men’s Health, the International Society of Sexual Medicine, and the Sexual Medicine Society of North America, have demanded that the article be retracted.1

In the present review, Morgentaler et al stress that cardiovascular mortality and incident coronary artery disease are associated with lower levels of total testosterone, free testosterone, and bioavailable testosterone. In a study by Ohlsson et al,6 for example, men with serum total testosterone concentration levels of 550 ng/dL or more (ie, the highest quartile) had a 30% lower risk of cardiovascular events than did men in the 3 lower quartiles, even after adjusting for traditional cardiovascular risk factors and excluding men with known baseline cardiovascular disease. At first glance, these are somewhat paradoxical observations considering the recent inquiries by the Food and Drug Administration (FDA), a call for more stringent product labeling, and an outcry in the lay press that testosterone therapy is hazardous.

This is an excerpt from an article originally published by Mayo Clinic. Simply click here to read the complete article.

Rapid Response of Breast Cancer to Neoadjuvant Intramammary Testosterone-Anastrozole Therapy


Experimental and clinical data support the inhibitory effect of testosterone on breast tissue and breast cancer. However, testosterone is aromatized to estradiol, which exerts the opposite effect. The aim of this study was to determine the effect of testosterone, combined with the aromatase inhibitor anastrozole, on a hormone receptor-positive, infiltrating ductal carcinoma in the neoadjuvant setting.


To determine a clinical response, we obtained serial ultrasonic measurements and mammograms before and after therapy. Three combination implants—each containing 60 mg of testosterone and 4 mg of anastrozole—were placed anterior, superior, and inferior to a 2.4-cm tumor in the left breast. Three additional testosterone-anastrozole implants were again placed peritumorally 48 days later.


By day 46, there was a sevenfold reduction in tumor volume, as measured on ultrasound. By week 13, we documented a 12-fold reduction in tumor volume, demonstrating a rapid logarithmic response to intramammary testosterone-anastrozole implant therapy, equating to a daily response rate of 2.78% and a tumor half-life of 23 days. Therapeutic systemic levels of testosterone were achieved without elevation of estradiol, further demonstrating the efficacy of anastrozole combined with testosterone.

This is an excerpt from an article originally published by the US National Library of Medicine. Simply click here to read the complete article.

Flawed Testosterone Analysis Spurs Misleading Media Headlines

By Blake Gossard, Kira Schmid, ND, Luke Huber, ND, MBA, Steven V. Joyal, MD

The precipitous decline of men’s testosterone levels over the years is inevitable. Unless aging men replace their diminishing testosterone, they could succumb to any of the numerous health problems linked to low testosterone levels: frailty, muscle loss, weight gain, impaired cognition, fatigue, loss of self-confidence, depression, declining bone health, increased risk of type 2 diabetes, stroke, and cardiovascular disease.

Over the years, several studies have shown that testosterone replacement therapy improves multiple measures of men’s vitality, especially related to cardio-metabolic health.

Therefore, on November 5, 2013, we were startled to see headlines like “Testosterone Treatments Linked to Heart Risks” in the major news media.

This headline and others like it were prompted by a retrospective, observational study by Vigen and colleagues published in the September 5, 2013, issue of the Journal of the American Medical Association (JAMA). The study suggests testosterone therapy may increase the risk of death and certain cardiovascular events. However, there are several significant shortcomings in the study’s design and methodology, and the results conflict with an existing body of research.

Woefully Inadequate Testosterone Replacement

The goal of testosterone restoration in most cases is to restore youthful blood levels of the hormone. Typically, Life Extension® suggests men target a blood level of testosterone between 700 and 900 ng/dL for optimal health.

In studies designed to assess the impact of testosterone replacement therapy, one of the most important considerations is to measure subjects’ blood levels of testosterone regularly throughout the study period. This allows the scientists conducting the study to make sure subjects are taking their testosterone as directed and that their blood levels are rising as expected.

Unbelievably, in the flawed analysis by Vigen, only 60% of study subjects receiving testosterone had a follow-up blood test to assess their testosterone levels. Among them, average testosterone levels rose from a very low level of 175.5 ng/dL at baseline to a still far-from-optimal level of 332.2 ng/dL during testosterone therapy.

Raising testosterone levels from a paltry 175.5 ng/dL to only 332.2 ng/dL is unlikely to deliver robust health benefits. In fact, research has shown that restoring testosterone levels to 500 ng/dL or higher is associated with pronounced health benefits, whereas benefits may be less evident at lower levels.

This is an excerpt from an article originally published by LifeExtension. Simply click here to read the complete article.

Harvard Study on Testosterone and Success

A Harvard University study set out to determine the link between stress, testosterone levels, and successful men. The researchers found that the key to success has a lot to do with managing stress. That may seem to make sense emotionally, but how can you be expected to be a leader if you are stressed out? However, they also found a deep biological connection to stress and success.

Stress produces the stress hormone cortisol. Cortisol reduces your testosterone levels. According to the Harvard University study, that reduction of testosterone also reduces your ability to be an effective leader.

TestosteroneTestosterone Levels and Success

Basically, the researchers found that:

  • Men with high testosterone levels and low cortisol levels had the most employees under them and so were the most profitable businesses.
  • Men with high testosterone levels, but with HIGH cortisol had somewhat fewer employees and had somewhat less successful businesses.
  • Men with LOW testosterone levels and HIGH cortisol had the LEAST number of employees and the least profitable businesses.

Gary Sherman, Ph.D., lead researcher on the study said: “Stress reduction has leadership implications. It can unleash leadership potential in employees who might otherwise not show it.”

The study concluded that a man’s testosterone and cortisol levels could be a good indicator of his abilities as a leader.

Testosterone Replacement Therapy

Stress in the workplace can create a downward spiral of increased cortisol and decreasing testosterone levels. This can lead to the condition commonly known as “burnout.”

Men in their 40s or 50s are even more susceptible to this problem. Especially if they are running their own businesses or are working at a job facing younger competition.

Will testosterone replacement therapy make you a better leader? Can testosterone optimization improve your performance at work? Or can it help your business crush the competition? Maybe, but what I do know, is that men who have received testosterone replacement therapy from me have experienced:

Harvard Study on Testosterone and Success

  • Improved strength and vitality
  • Better sleep
  • Reduction of belly fat and increased muscle mass
  • Improved bone density
  • Improved cognition and better focus
  • Improved mood, less anxiety, and depression
  • Increases in sex drive and sexual performance

There is only one way to determine if you are a candidate for testosterone optimization. You must see your doctor and have your testosterone levels checked. If you are found to be suffering from low testosterone levels, you may benefit from hormone replacement therapy.

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