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testosterone

Irregular Menstrual Cycles as a Marker for Risk of Diabetes – (11-26-01)

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Irregular Menstrual Cycles as a Marker for Risk of Diabetes

Articles like this always seem a little surprising for me. The findings of this study are absolutely no surprise to anyone familiar with physiology. Hyperinsulinemia wreaks havoc on steroid hormones synthesis, typically leading to elevated testosterone at the expense of estrogen synthesis. So seeing a study like this seems only to confirm what we already know. However, I would turn it around. Any woman with menstrual difficulties needs to first address the way she handles her sugars and possible metabolic syndrome X. Exercise, supplementation with vanadium, chromium and other synergistic nutrients, and whole grain intake over refined carbs can be used as an approach. Additionally, proper elimination from the GI tract and balanced hepatic detoxification are also essential elements to addressing menstrual complaints. Ironically, the mainstream solution is the birth control pill, which will worsen insulin sensitivity and further disrupt hormone regulation without fixing the problem.

Long or Highly Irregular Menstrual Cycles as a Marker for Risk of Type 2 Diabetes Mellitus

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Low-Fat, Flaxseed-Supplemented Diet and Prostate Cancer – (08-20-01)

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Low-Fat, Flaxseed-Supplemented Diet and Prostate Cancer

This is a very interesting article that looked at flaxseed as a potential adjunct for prostate cancer treatment in the future. Flaxseed may have several potential routes by which this occurs. First, compounds in flaxseed have been known to inhibit aromatase ,the enzyme that converts testosterone to estrogen in fat cells. Since altered estrogen metabolsim in males (yes, estrogen!) has been linked with prostatitis, I don’t see it as a far stretch to believe that altered estrogen breakdown could also lead to cancer (we already know this occurs in the breast). Second, flaxseed is high in lignans and has some phytoestrogenic effects. So it is possible that the lignans in flax are hogging up the estrogen receptor sites and not allowing more harmful estrogens from binding.

Urology 2001;58:47-52 A low-fat diet supplemented with flaxseed appears to reduce the growth of prostate cancer cells, according to the results of a small pilot study. Dr. Wendy Demark-Wahnefried, from Duke University Medical Center, Durham, North Carolina, and colleagues studied 25 patients with prostate cancer who were about to undergo a prostatectomy. The patients were placed on a diet in which only 20% of total kilocalories came from fat. In addition, patients received 30 g/day of ground flaxseed, according to the report in the July issue of Urology. Over an average of 34 days, the subjects experienced a significant decrease in mean total testosterone, free androgen index and serum cholesterol. When the investigators looked at the prostates after prostatectomy, they found that prostate cancer cells were dividing much less rapidly and were self-destructing much more quickly in the treatment subjects compared with matched controls, Dr. Demark-Wahnefried said. The researchers are unsure which part of the diet produced this cancer-fighting effect. However, Dr. Demark-Wahnefried said that in cell-culture studies in which prostate cancer cells were exposed to the lignins from flaxseed, they found significant decreases in cell growth. “It looks like these lignins may be responsible for the results we saw,” she added. “If there is a synergistic effect [with] the low-fat diet portion of the diet, it is unknown at this time.

DHEA in Healthy Men with an Age-Related Decline of DHEA Secretion – (11-01-01)

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DHEA in Healthy Men with an Age-Related Decline of DHEA Secretion

This is an interesting article that address the normal process of reduced DHEA secretion as we get older. Remember that DHEA is produced in the adrenal cortex from cholesterol and goes on to produce estrogen, testosterone and progesterone. In previous updates, I’ve mentioned that many people believe that the body deliberately down-regulates production of certain hormones as a protective mechanism to protect against age related changes. This study found no changes in healthy adult males after 4 months of DHEA supplementation. Personally, in patients with low DHEA levels I feel it would be safer to support the adrenal glands and let them do what they’re supposed to do.

JCEM — Abstracts: Arlt et al. 86 (10): 4686

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Sex hormone binding globulin as prepubertal marker for hyperinsulinaemia – (01-10-02)

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Sex hormone binding globulin as prepubertal marker for hyperinsulinaemia

This is an interesting article that may give us some insight on preventing the startling rise in Syndrome X prevalence. Exactly what role SHBG plays is not yet known, but lower levels may increase free concentrations of hormones such as testosterone, and this hyperandrogenicity may be the real player. Either way, I feel that finding markers for those at risk so they can make lifestyle changes would be a moot point if everyone make healthier lifestyle choices…

ADC — Abstracts: Galloway et al. 85 (6): 489

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Prevalence and Features of the Polycystic Ovary Syndrome – (06-18-04)

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Prevalence and Features of the Polycystic Ovary Syndrome

This article suggests a prevalence as high as 8% of PCOS which puts it as the most common endocrine abnormality of reproductive aged women in the US. PCOS has been linked very strongly to insulin resistance.

This link seems to come from elevated insulin affecting 15,20 lyase, the enzyme that converts testosterone to estrogen. So, elevated insulin slows conversion to estrogen, essentially rising levels of testosterone  which messes up the ovulation process. The problem is that PCOS has traditionally been treated with oral contraception, which is know to worsen insulin resistance. Another perfect example of how we can actually screw the body up worse if we try to override human physiology instead of balance it.

JCEM — Abstracts: Azziz et al. 89 (6): 2745 –

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HEALTHY USE OF SOY – (05-29-06)

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Soy protein intake by active young adult men raises plasma antioxidant capacity without altering plasma testosterone

I remember an article in one of my trade journals a few years back. The author of an article on soy was blasting soy as harmful. I wrote a letter to the editor noting that this attitude flies in the face of much current literature. The editor allowed her to rebut. She (a registered dietician) gave about 7 or 8 articles to support her position. After tracking down these references, I almost had to laugh. Most were in support of soy being good for us!! She was obviously just regurgitating what someone else had told her and had little original thought.

This is yet another article supporting the healthy use of soy. Now, that being said, I am against the trend to “soy” everything. I truly do not feel that Mother Nature intended for soy to be mutated into a tofurkey to be eating day in and day out and taken in supplements to top it all off.

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POLYCYSTIC OVARY SYNDROME RELATED TO INSULIN RESISTANCE – (07-25-05)

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Clomid vs Metformin as the First-Line Treatment for Ovulation Induction in Nonobese Anovulatory Women with Polycystic Ovary Syndrome

Here’s the deal.  I personally think most, if not all, cases of PCOS are related to insulin resistance.  Most likely via high insulin levels inhibiting 15,20 lyase, the enzyme that converts testosterone to estrogen, so testosterone levels rise and inhibit ovulation.  So, really, the PCOS is just one other symptoms of a time bomb ticking in your body.

What do we do in mainstream medicine?  Diffuse the time bomb?  Of course not.  We ignore it and look at the more important issue–what to due with all that pesky smoke coming off the fuse.  So ob/gyns ignore the insulin resistance and try to force ovulation with Clomid.  Should be malpractice, but unfortunately is the standard of care.

So this study looks at using Metformin (not at all my preferred method for insulin resistance treatment) vs Clomid and finds that actually treating the underlying problem (what an innovative approach!!!) results in much better results.  Don’t expect change anytime soon though…

Read entire article here

DO YOU HAVE LOW TESTOSTERONE?

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The understanding is that mainstream medical research takes about 20 years to make it into clinical practice, specialists included (unless it’s blockbuster drug research, in which case it seems to make it to doctors’ offices overnight…).  That means that current research I comment on won’t be used appropriately for at least another 2 decades.  While I consider this completely inappropriate because, as a physician, it is my responsibility to my patients to stay current to some degree, it is a reality.

However, there is an occasional glimpse of the sun through the clouds when mainstream medical practioners try to apply functional medicine concepts in limited aspects.  Probiotics are a key one–106 years in the medical literature and some docs are starting to recommend Florastor in limited situations.  Unfortunately, Florastor can work great to lower the risk of antibiotic associated diarrhea, but is not considered a probiotic to restore normal flora in the gut.  So, great idea for mainstream medicine, but inappropriate application.

Strangely, I see the same thing with checking testosterone levels.  I’ve seen more and more of this over the years, and some clinics even hang their hats on the idea of testosterone checking and supplementation (usually as pellets implanted under the skin of the glut region).  But it seems so out of context with the rest of the bloodwork checked that I just scratch my head in wonder.

Why?  Several reasons.  First, checking testosterone in the blood is not my favorite method.  Salivary testing is much easier and checks the levels of unbound, active hormone in the body, which blood testing does NOT do (it checks the protein bound, inactive levels). 

Next, if the levels are low, their is never a question as to why they are low; it’s just replacement with creams, pills, injections or pellets.  Which–by the way, can really screw up the way your body works.  It would not be the first time I’ve seen a male patient with low testosterone pushed into sterility from exogenous testosterone use.

In functional medicine, we would ask WHY are the levels low and address that aspect of the issue.  Many times, it can be an adrenal issue.  A chunk of a male’s circulating testosterone is actually derived from the adrenal gland (on the range of 5%) and we need to evaluate and support adrenal function via supplementation, exercise and stress mangement. 

Toxicity from the environment can contribute greatly.  The principal agent are the phthalates, which are well known to produce a feminizing effect on the male.  So avoid things with that “new car” or “new shower curtain” smell as much as possible.

http://www.sciencedirect.com/science/article/pii/S0002934311002749