Jun
21
2014

Older Grumpy People Have Higher Risk Of Dementia

Although in this recent study from Finland researchers found that grumpiness in older age seems to lead to dementia at a faster rate, I like to emphasize here that there may be an under lying problem of hormone deficiency.

Other studies have shown that in males low testosterone levels are associated with grumpiness and dementia is setting in sooner in those males who are deficient for testosterone. For older grumpy females it is the lack of progesterone that has been found to be deficient and when you replace it, memory comes back, symptoms of menopause reverse themselves and the grumpiness is gone. Testosterone replacement may be required by as many as 1 in 4 men in the their 40’s as is summarized in the article from Great Britain.

How can we tell whether there is a change in an older man? There are quite a few symptoms that can be seen by loved ones around this man: an increase in abdominal girth, shrinking muscles, lack of energy, irritability. The key is to get him to the doctor and ask the doctor to order a bioavailable testosterone blood test.

According to medical research 84% of men and 62% of women in the age group of 57 to 64 have been sexually active in the previous 12 months. Take an older age group of 65 to 74 and still 67% of men and 40% of women are sexually active. Fast-forward to age 75 to 85 and the rate has dropped to 39% of men and 17% of women (Ref.1). A person’s sexual activity is a barometer how well the hormones are balanced. These figures show that bioidentical hormone replacement has not been well accepted. Women have a reason as they were misled by Big Pharma as was shown in the

Older Grumpy People Have Higher Risk Of Dementia

Older Grumpy People Have Higher Risk Of Dementia

Women’s Health Initiative:

The National Institutes of Health had funded a large study (the Women’s Health Initiative) to clarify what was going on with regard to side effects and effects of HRT.

Unfortunately, synthetic non-bioidentical hormone products were used in these studies (Premarin and Provera) instead of bioidentical estrogen and progesterone. The results of the Women’s Health Initiative were devastating. In 2002 doctors were warned that Premarin and Provera used as HRT would cause increased heart attack rates and breasts cancer, which led to premature death. Overall the placebo group did better than the experimental group and this is why the trial was prematurely stopped.  As a result of the wide publicity regarding the negative results of the Women’s Health Initiative postmenopausal women either do not see their physician for hormone replacement or are advised by conventional doctors that only small amounts of Premarin could be used for not more than 5 years for fear of causing breast cancer. Medico-legal considerations are at play and the whole issue of HRT after menopause has been politicized.

Problems now for HRT:

It is like a negative shadow has been cast forward with regard to hormone replacement because of the Women’s Health Initiative. People are still confused and don’t understand that the synthetic hormone-like drugs from Big Pharma are like an ill-fitting key for the hormone receptors in the body whereas bioidentical hormones are the perfect fit.

Otherwise there would not be a 45% drop-off (from 62% to 17%) in sexual activities in women from age 60 to 80. Men have it somewhat easier: their drop rate between age 60 an 80 is also 45% (from 84% to 39%), but as they entered into male menopause 10 to 15 years later than women did with menopause, their sexual activity is still double that of women at the age of 80.

However, if people could overcome their unrealistic fear of bioidentical hormones, hormones that fit the body’s hormone receptors a lot more people would be encouraged to use bioidentical hormone replacements.

What, if the grumpy, old man is willing to see his doctor?

The doctor should look at all of the hormones including a fasting insulin level as hyperinsulinism often complicates hormone replacement. Thyroid, which often is also lowered at an older age should be also tested (T3, T4 and TSH). A saliva hormone test can show a panel of 5 hormones: cortisol, DHEAS, testosterone, progesterone and estradiol. As hormones are in a balance with each other this allows to compute the testosterone to estrogen ratio, which ought to be 20 or higher. But hormones alone are not the answer. There needs to be a combination of proper nutrition (cut out sugar, starchy foods, preferably switch to organic foods to escape the xenoestrogens that foul up your hormone balance), also exercise and use vitamins and supplements. I have summarized all of this in my recent book “A survivor’s Guide to Successful Aging” (Ref.2).

When the hormone tests come back the doctor will likely order the missing hormones (hopefully as bioidentical hormones).

It can take 2 to 3 months before the full effect of bioidentical hormone replacement is seen. But most men will be astounded how well they can feel. He will notice that he does not tire with exercising. His muscle mass builds up; his posture improves. His stamina comes back. He will find that the previously foggy thinking is gone and his thought processes have become clear again. And yes, his sex live comes back. So now he has to talk to his sex partner about her bioidentical hormone replacement so they both can enjoy the benefits!

Hidden benefits of bioidentical hormone replacement:

The bones become stronger, the heart beats harder and better, the brain thinks clearer, because the key organs like the brain, the heart and the bones have the appropriate hormone receptors (in both sexes).  No, this is no exaggeration. This can be measured by an exercise tolerance test (for the heart). Bone density can be measured and has been done (2% to 4% increase per year). Brain function is indirectly visible to the people around the person: apart from new vitality, improvements in mood and more energy, the grumpiness is gone and the person is perceived as a pleasant person once again.

Conclusion:

The observation of an “old, grumpy man” when he entered the male menopause is accurate, but should not distract from the fact that he has a responsibility to look after himself. It is important to recognize that it is not only women who enter the menopause, but that men 10 to 15 years later will do the same. Both sexes enter a state of hormone disbalance that is treatable. The answer is to replace the hormone deficiency with the missing bioidentical hormones.

More information on male menopause (=andropause): http://nethealthbook.com/hormones/hypogonadism/secondary-hypogonadism/male-menopause/

References:

1.Rakel: Textbook of Family Medicine, 8th ed., copyright 2011 Saunders

2.Dr.Ray Schilling: “A Survivor’s Guide to Successful Aging“, Amazon.com, 2014

Last edited Nov. 8, 2014

May
10
2014

The Full Story About Testosterone

Much has been written about what happens when women get into menopause. This begs the question: do men experience a change of life? As a matter of fact, they do. It is called “andropause”, and they can experience problems as a result. Here is a study from the Massachusetts General Hospital in Boston, MA, which was published in the New England Journal of Medicine (Sept. 2013) describing in detail what happens when men get into andropause (the male equivalent of the menopause).

We know from other studies that in obese men testosterone is converted into estrogen because of the enzyme aromatase that converts testosterone into estrogen resulting in erectile dysfunction and loss of sex drive. In lean men above the age of 55 there is a true testosterone reduction because the testicles produce less testosterone. This results in less sex drive, moodiness and lack of energy. But these men will do well with bioidentical testosterone replacement.

Main findings of the Massachusetts General Hospital study:

  1. Testosterone was responsible for thigh muscle development and leg press strength, for erectile function and sexual desire.
  2. Surprisingly, estradiol (the main estrogen component in both sexes) plays a significant part in sexual desire in the male. This became particularly apparent in the post-andropause male who desired hormone replacement. When bioidentical testosterone is used to replace what’s missing there was no problem with sexual desire or erectile function as a small amount of the testosterone was aromatized into estradiol. The researchers were able to measure both testosterone and estradiol levels.
  3. Here is a surprising fact: a lack of estrogen leads to abdominal obesity. This could also be verified by hormone measurements.
  4. In the past doctors used synthetic testosterone products like methyltestosterone, danazol, oxandrolone, testosterone propionate, testosterone cypionate or testosterone enanthate. The problem with these synthetic testosterone products is that the body cannot metabolize a portion of them into estrogen that is desirable for a normal sex drive, so the testosterone compounds alone are not doing their job as well as the bioidentical testosterone that the body can aromatize.

In obese men the problem is that there is too much estrogen in the system, which leads to a disbalance of the hormones in the male with a relative lack of testosterone. Overweight and obese men produce significant amounts of estrogen through aromatase located in the fatty tissue. Aromatase converts testosterone and other male type hormones, called androgens, into estrogen. Excessive levels of estrogen cause breast growth, muscle weakness, lead to abdominal fat accumulation, heart disease and strokes. Dr. Lee described what happens in men who enter andropause years ago as indicated under this link.

The Full Story About Testosterone

The Full Story About Testosterone

Testosterone to estrogen ratio:

Dr. Lee indicated that in his opinion saliva hormone testing is more reliable than blood tests (Ref. 1). One of the advantages of doing saliva hormone tests of estrogen and testosterone is that you can calculate directly the ratios of these two hormones. In hormonally normal younger males the testosterone to estrogen ratio is larger than 20 – 40 (Ref.2). The testosterone to estrogen ratio in obese men is typically less than 20 meaning it is too low. But lean men in andropause produce too little testosterone and their testosterone to estrogen ratio is also less than 20, because they may still have enough estrogen in their system from aromatase in the fatty tissue, but they are lacking testosterone due to a lack of its production in the testicles (Ref. 1 and 2).

When a man in andropause is given bioidentical hormone replacement with a testosterone gel or bioidentical testosterone cream this is absorbed into the blood and body tissues and then partially metabolized into a small amount of estrogen. This can be seen when saliva hormone tests are done; a higher level of testosterone is detected and much lower estrogen level so that the testosterone to estrogen ratio is now 20 to 40 or higher and the affected person will no longer be the “grumpy old man” that had been a source of distress to his partner before.

This New England Journal of Medicine study is important because it confirmed what anti-aging physicians had been saying for years: a small amount of estrogen is necessary for the male for bone health as estrogen receptors will regulate the bone density, it also helps for a normal sex drive. The same is true for women: a small amount of the opposite hormone (testosterone) will help a woman’s sex drive, but she needs the right mix of progesterone to estrogen (a progesterone to estrogen ratio of 200:1 using saliva tests) to feel perfectly normal as a women.

Health and well-being of a man depend on normal testosterone levels:

It is important to realize that testosterone is not only supporting a man’s sex drive and libido, key organs like the heart, the brain and blood vessels contain testosterone receptors as well. The body of a man was designed to respond to testosterone all along. It is when testosterone production is no longer keeping up that premature aging becomes apparent, as the target organs do no longer receive the proper signals.

A healthy heart in a man depends on regular exercise and testosterone stimulation whether he is young, middle aged or old. The same is true for the lining of the arteries where testosterone receptors are present to help with the normal adjustment to exercise and relaxation. The brain cells have receptors for all of the sex hormones and in a man they are used to higher levels of testosterone and lower levels of progesterone and estrogen. If you take the balance away, the aging man will feel miserable and grumpy. Depression will set in. Here is a brief review how one man’s life has been changed by testosterone replacement.

So, bioidentical hormone replacement is not just a matter of replacing one hormone, you need to pay attention to all of the hormones. Lifestyle issues enter the equation as well. I have reviewed the issue of bioidentical hormone replacement for women and men in this blog.

Conclusion:

When a man reaches the age of 55 or older there comes a point where a lack of testosterone and estrogen sets in. It is wise to start doing intermittent blood or saliva hormone tests before this point is reached in order to gage when bioidentical hormone replacement treatment should be given. Along with an assessment regarding the hormone status it would be wise to also assess lifestyle issues as often other factors play a role in premature aging. I have reviewed these factors systematically in a recent publication (Ref. 3). It is best to combine bioidentical hormone replacement with life style interventions to achieve optimal preservation of a man’s health.

More information about male menopause (=andropause): http://nethealthbook.com/hormones/hypogonadism/secondary-hypogonadism/male-menopause/

References:

  1. John R. Lee, MD: “Hormone Balance for men- what your doctor may not tell you about prostate health and natural hormone supplementation”. 2003 by Hormones Etc.
  2. George Gillson, MD, PhD, Tracy Marsden, BSc Pharm: “You’ve Hit Menopause. Now What?” 2004 Rocky Mountain Analytical Corp. Chapter 9: Male Hormone Balance (p.118-148).
  3. Dr.Schilling’s book, March 2014, Amazon.com:“A Survivor’s Guide To Successful Aging: With recipes for 1 week provided by Christina Schilling”.

Last edited Nov. 8, 2014