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The Problem: I see women and men every day who are deficient in their own production of testosterone because of age, testicular trauma, removal of their ovaries, chemotherapy, chronic illness, and medications. The cause of testosterone deficiency is as varied as the side effects and benefits of every different type of testosterone. This means that when you hear or read a headline like the one that came out last week:
“Testosterone Treatment Fails to Offer Protection Against Fractures in Men with Hypogonadism, Research Indicates”
You cannot take It at face value. This headline should read Testosterone replacement in the form of testosterone cream given at a low dose given at a low dose to men who already had osteoporosis doesn’t offer protection against osteoporosis.
The headlines that read the way this one is an example of the reality that everyone loves to hate testosterone. This makes informed decision making by a patient very difficult because of the jaundiced view by physicians and drug companies about replacement of one to the hormones that men and women both make when they are young, but which becomes deficient in most of my patient population as they age.
Why is there all this subterfuge and confusion about testosterone replacement? I believe it is the fact that allowing American’s to age out of jobs and make room for the younger workers; many people cannot afford testosterone on their own so they are jealous of those people who can and do afford it; The insurance companies don’t want to pay for anything they don’t have to; keeping people youthful and healthy is not a priority for American medicine based on acute care in the ER and operating room;
The group of naturalists who think aging is great, are people who either are out of touch or are very young; the use of testosterone by both sexes often makes the use of other medications unnecessary (anti-hypertensives, statins, autoimmune medications, etc, and also prevents patients from getting communicable diseases so the largest industry in the US, pharamaceutical companies cannot make more and more drugs to treat each symptom and disease individually; and lastly the government has made a very safe and natural hormone scheduled like amphetamines and pain killers by the DEA.
Now why are these tests misleading? All research studied are manipulated to have a desired outcome. You can do a lot with statistics…you can make a blue sky look black!
By given too little of a medication or vitamin, or by treating a disease for too short a time, or by picking the age group such that they won’t respond you can make any drug look ineffective!
So when you look at the studies on testosterone, you must look for the type of testosterone: is it a cream (which turns into estrogen as it passes through the skin? Or is it an injection of testosterone cyprionate which is not equivalent to natural testosterone and lasts 2 weeks because it keeps circulating through the liver and making more and more of the byproduct DHT than pellets or pure T injection?
Simply if the type of T is not the type that you are taking or are contemplating taking then you should ignore the studies conclusions because each type of T and each delivery system of T has a variety of effects, each different from one another.
“One testosterone is not equal to another form of testosterone. Therefore, a study that tests one type of testosterone does not apply to other forms of testosterone.” Dr Kathy Maupin MD
The factors that matter as to how much improvement you will get when you choose a form of T replacement are:
• Testosterone chemical structure (the best is pure testosterone like in sub dermal T pellets)
• Testosterone delivery systems (subdermal pellet, cream, vaginal tablet, oral, patches)
• The dose/day or week or month
• Duration of use
• What tissue or organ system you are studying (e.g., bone takes many years to show improvement, while muscle increases relatively quickly with T pellets)
• The age and condition of the patients studied
• The starting blood level of testosterone Total and Free testosterone.
• The resultant blood level of free T
• The length of time a man or woman has been without testosterone before treatment
I see research articles every day in the many journals I read that are shared with the public, that denigrate testosterone replacement in general, while in my practice, with the most effective form of T I have found, that T pellets literally transform men and women who have T deficiency, most of whom are recently menopausal or over 55.
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