Balance My Hormones
The Truth About Testosterone and Heart Health | Insights for Men Over 35
This Video aims to educate and clarify misconceptions about testosterone therapy, advocating for a more open-minded and research-based approach to treating hormone deficiencies, particularly in relation to heart health
1. **Cardiology and Hormone Deficiency**:
– The video begins by addressing the importance of hormones in cardiology. It mentions that deficiencies in certain hormones, such as testosterone, can impact heart health and potentially lead to heart disease.
– It discusses the controversy and skepticism within the medical community regarding hormone therapies, particularly testosterone replacement therapy (TRT), and its effects on heart health.
2. **Holistic View of the Body**:
– The body should be viewed as a set of interdependent organ systems rather than isolating each organ. For example, heart health can be affected by other systems, such as the endocrine system.
3. **Testosterone Deficiency and Symptoms**:
– Men around the age of 30-35 might start feeling symptoms such as fatigue, erectile dysfunction (ED), and lack of libido, which could be related to low testosterone levels.
– There is a discussion about the fear and misconceptions surrounding testosterone therapy, especially concerns about it causing heart attacks, strokes, or raising cholesterol levels.
4. **Research and Studies on Testosterone**:
– The video references the Traverse Study, which involved 5,000 patients with cardiac disease treated with testosterone gel, finding no negative impact on heart health.
– It also mentions that low testosterone levels are associated with a higher incidence of atrial fibrillation (AF) and heart failure.
5. **Subclinical Testosterone Deficiency**:
– Even if testosterone levels are within the normal range but on the lower side, symptoms of deficiency should prompt further investigation and potentially more proactive treatment.
6. **Cardiovascular Benefits of Testosterone**:
– Testosterone has a vasodilatory role, meaning it helps blood vessels relax and improve blood flow.
– Small studies suggested that testosterone replacement might improve conditions like AF.
7. **Misconceptions and Fear in Medical Practice**:
– There is a critique of the medical community's hesitation and fear in prescribing testosterone therapy due to misconceptions and outdated guidelines.
– Emphasis on the need for proper studies to address these fears and provide clear answers on the safety and efficacy of testosterone therapy.
8. **Prolactin and Cardiovascular Risk**:
– Elevated prolactin levels, which can be caused by various factors including SSRI medications and elevated estrogen levels, might pose a cardiovascular risk.
– The script discusses the use of Cabergoline, a medication to lower prolactin, and its potential risks and benefits.
9. Personalized Approach to Treatment:
– It advocates for a personalized approach to testosterone therapy, considering individual patient's needs, symptoms, and potential benefits.
10. Quality of Life Considerations:
– The importance of improving patients' quality of life through appropriate treatments is highlighted, as long as the treatments are safe and backed by good research.
chapters
0:00 intro
0:54 Is testosterone good for the heart?
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but your knowledge is impressive for Cardiology deficiency in a hormone that would affect the heart heart disease and then how testosterone and other hormones might be able to help it or hurt it or what we have to look out for so what a lot of people do particularly in the medical profession is that we've got a medical degree you're talking nonsense you're not allowed shut up that's what they do that's completely the wrong thing to do art is very much the conductor of this Orchestra because it is responsible for pumping blood around the body it's very important to understand that the body is a set of interdependent organ systems and one of the big mistakes we make is that we see each organ in isolation oh this is heart this is not gut and therefore there's no connection and that is clearly not true one decision some patients reach kind of a fork in the road is they you getting to be up to 30 35 they're not feeling like well as they used to uh maybe have a touch of Ed lack of libido and and they're thinking hey I've heard about this testosterone treatment maybe I I ought to get tested for testosterone see if I have a deficiency but then they've been scared by the GP to say oh no that will give you a heart attack or a stroke uh raise your cholesterol so I mean what what what do we tell patients that are looking for testosterone now we know as balc hormons the company the clinic the pharmacy um we we we're up to date with the latest studies I think we talked about the Traverse study which 5,000 patients involved in that study who already had cardiac disease who put on testosterone gel which is probably one of the worst treatments and found that there was no negative effect on heart health I think there's like just a rare just couple patients had pulmonary embolism one I think had apib and another had I can't remember but it wasn't it was kind of scrubbed from the datas it wasn't really that significant of of an event so overall the message was you know testosterone is safe for the heart when it's given for people who need it and what is given with the gel but I would argue based on some subset of the data we did a video we put up here about one of the subset of the data said that oh but testosterone treatment will lead to further osteoporosis which I think they they drew the wrong conclusion or they were underdosed on that you know if you have if you don't have enough testosterone treatment you're not going to get enough estrogen estrogen protects the bone so just like that subset of this tra Traverse study yes there was no negative effect on the heart but it could have been a more beneficial effect if they looked at different in rather than gels could it have been more beneficial you know if the dose was a little or the end range because they only would let people be on the study if there were no higher than 700 nanograms per deciliter which you know isn't that high really and they would take patients off so it would have been interesting to see if they kept those patients on the study to see if they would have had even better results as far as health outcomes but I just you know in general we talked before you've been on the channel about testosterone and this it benefits to the heart not just for cardiovascular but I think for heart failure I guess Dil cardio myopathy apib what yeah maybe kind of review that I did quite a lot of reading around testosterone because I wanted to educate myself about it I also became interested in the fact that actually when I was doing my reading I found that low testosterone appeared to be associated with more AF people with heart failure tended to have more lower testosterone levels compared to you know age Mage age match controls and a lot of the symptoms of things like fatigue etc etc could also be explained by a degree of testosterone uh deficiency so and so I think again you know we should be encouraged certain to look for it secondly I think it's also important not to just stick with oh these are the recommended guidelines because there are subclinical things you know the you can have subclinically low things if you're demonstrating symptoms which may be in keeping with and your testosterone rides sort of on the ler edges of what is the normal range then I think we should be sort of a little bit more proactive and and my reading has not shown anything which makes me think that old testosterone is horrendously from what I've disco you know read on guideline not guidelines but um research papers review articles Etc I think that those people who have testosterone deficiency really do benefit you know in terms of quality of life and there's no really good data to say that oh this is a no no I I think that's that's really refreshing to hear because so many times I mean even when they did these studies I mean the reason why they would have capped the testosterone level at 700 because it's quite ignorant on their part they were afraid that they would be causing harm in in their thinking if someone went over 700 and I don't know where this comes from because you naturally we've seen patients luckily they didn't need testosterone treatment that the levels were higher or occasionally you'll see patients with higher levels of total testosterone but it's the fr and so it's very nuanced in in the sense that um you can't just look at levels and and you you alluded to that but also you know the range of total is one thing there's also the calculated free as as they used in the clinical studies but there's also something called KAG repeat so there's some people who genetically are more sensitive to testosterone than others so in in the genome or the Androgen receptor if they're long CAG repeats they seem to be more resistant to testosterone therefore they require higher amounts either endogenously or exogenously and those who have short Cal Pat more sensitive and therefore they they might not need as much and the these guys are usually ones that probably won't have the symptoms they won't come and say hey I need to get a blood test CU they probably feel absolutely fine even if the levels are maybe closer to that you know 5 or 700 nanograms per deser so it's really interesting that I think the people who do the research reading did do go back to school and do more research or really look into it before they just start throwing out these assumptions on the studies unfortunately this is what happens you know there's the journal or newspaper will publish headline news and then before you know it this uh whole field sort of becomes unpopular and so get stigmatized and uh and maybe we do our patients a disservice you know it as you say it has to be nuanced it has to be further research you always try and say okay well this is what we found how can we look a little bit further how can we be a bit more sophisticated and identify because if you found a deficiency it's certainly worth looking into it we do know that obviously testosterone has other benefits doesn't it for for for the body it's it has a vasod dil vasod dilatory role when I read I came across small studies which suggested that those people who were getting AF if you gave them if we replace their testosterone their AF got better so that to my mind is the interesting side of medicine where we start looking at this and saying okay on the basis of this I just need to be more aware I just need to be more alert to this if nothing else I just need to you know until further data come out what I'm not going to do is poo poo the idea you know that's that's the wrong thing because a lot of times people do that out of ignorance you know it's not because they're really well read on it it's because they've read the headline or they've just heard someone else say that oh no no no that's a very bad thing and there's a lot of that there's a lot of doctors who are uneducated in specific subjects the biggest argument they make for the testosterone is that oh well testosterone which if your anemic is a good thing it will raise your red blood cells your reth cytosis if you're not and you're on testosterone and sometimes the level gets a bit high you can get increased hematic rate hemoglobin yeah but then you can also get this from NAC you know what NAC is it's the supplement that an AAL cysteine that in some cases can also raise hemoglobin in a short period of time in about eight days the question really with all these is does it result in bad things that's the more important thing isn't it yeah but does it result in bad things and my my reading when I last read it didn't seem that there was a huge in there was a significant increase in this so I no I think I remember there was worries about prostate cancer there's been no convincing evidence there was worries about blood clots and there was a study by ramaswami Rami ramaswami published one on on the reyos it just came out this year and and but it was a retrospective study so they looked at people I think on insurance who were receiving prescriptions for testosterone and then those who had an elevated hematocrit stroke hemoglobin found a slightly higher incidence of some cardiovascular events on on those cases but I don't think that was a very I I like Dr am samio and and he's quite knowledgeable in lots of things testosterone but he was only one of the authors by the way so it must been the other authors have put some bad comments in I'm not sure what I'm not so sure I mean because especially goes counter to what the Traverse study has shown which was much larger which was an Interventional study they took the worst of the worst cardiovasc patients with cardiovasc good instance and they didn't see the same outcome so they're trying to make the assumption that the elevation of mat and hemoglobin sometime somehow puts you at a greater risk of some sort of cardiovascular event and this is why it's just so incredibly important that someone getson does a proper study and answers that question once and for all because if it doesn't do you harm yes then it's okay to use it for quality of life purposes because the patient will come and say since I started this I feel better or since I started this it's not made any difference in which case you stop it but if they feel better great you've made a difference but to not even give them that option because of Fe because of fear which has not been properly you know those those concerns have not been properly researched they should be answered shouldn't they someone should do a proper study answer that question is it harmful and if it is not then I think that in some way frees everyone to say okay well try it and see what happens to you does it make a difference or not so I can't understand that I can't understand why we end up depriving patients who who's you know where mainstream medicine is not actually helping them to improve their quality of life on the basis of some kind of fear that has not even been properly no it's not it's not healthy not helpful for the patient abely so on on the going back to the arthra is always misquote like they always use the wrong terminology they love to put uh polycythemia eror which is not what it is it's athoc cytosis secondary to testosterone treatment and the question then is that going to be dangerous so some of the guidelines for your treatment of testosterone are if those levels we can get over 54% hematocrit and don't forget hematocrit can vary based on your MCV and if and the blood tests are sit around too long or if you super hydrate before the test I know this happened to me it swells the blood cells and now you get this large MCV value which gets multiplied by the red cell count it divided by 100 and that gives you your hematic crate that's how hematocrite isn't a direct measurement it's a calculation obviously hemoglobin plays into it but yeah it's it's one of those things where the guidance talks about either reducing the dose because sometimes the the trough level the level at the lowest point of the free testosterone is a great predictor of how much increase you'll get and we've seen some patients who we just have to change the treatment modality they used to say that the the the topicals would cause less orthosis but then you're also getting a whole lot less testosterone in the first place and you may not be getting any the benefit um some patients may but a vast majority don't because we see that in our clinic and the other benefit uh and the other uh modality that we have is uh short acting testosterone propionate which is kind of in and out of the system very quickly which you can dose every other day or every day and and that seems to not we don't see as many patients so patients who have suffered with high levels of orth oyos is secondary in the testosterone treatment they we see a normalization of their levels when they're put on that and then occasionally the doctor will also say according to the guidelines guidelines again use a bit of a baby aspirin or then there's the therapeutic photomy now I mean do you see any risks in an occasional therapeutic foty other than if you do it too much you deplete the fertin but if you do it on the cycle of a a normal blood donation cycle which is like every 3 months it's a nice thing to well if they'll take your blood so if they're firstly but even if you didn't you know I think would that be reasonable every three months or yeah I mean I you know I think so I mean I think I think the important question really is does it make a difference to that patient's quality of life and what does that difference look like I'm very much not for giving people stuff regardless of whether it's medication or supplements or anything you know because because that's also a fallacy to think okay well all medicines are bad and every natural thing is good that's all you know because unfortunately wherever you are an industry will build up and every industry is out there to promote their product and I'm very much for we should be open we should be receptive to everything and we should work with the patient and say see their feedback does it make things better and if if something does make it better and if as long as the patient as long as there's good research to say it's not dangerous and that it's not horrendously expensive where someone's ripping someone off uh then then why not speak make you some patients feel better sometimes on testosterone treatment patients will have an elevated prolactin now elevated prolactin could be a cause of um hypothyroidism so and that could be Al of you can have elevated prolactin if you have an adenoma in your brain that's the more more traditional one some patients who are on SSRI medications along with their testosterone sometimes patients who are on testosterone treatment will get to an elevation easr dial or along with the SSRI or just Easter dial on their own will cause the quite a high amount or a high normal amount of prolactin and there have been studies that show high normal levels of prolactin may not be good for the body as far as cardiovascular risk as far as diabetes as far as metabolic syndrome some even go as far as saying potentially uh androgenetic alopecia might be linked to elevator prolactin the body and they're looking at prolactin antibodies to to redu it throughout the body not just the brain but throughout the rest of the body and that may show some benefit in hair loss we'll see have to watch the space but the question so what we have as far as the tools now are quite dirty old tools like the ergots Calene is is probably the most common one and probably one of the more preferential treatments that are used and and and needs to be used cautiously because in the uh like the mid naughties uh they had discovered in some Parkinson patients that uh they were seeing some valvular damage yeah and they've ascribed this to this receptor serotonin receptor and I guess ssris also some of them also hit this this receptor it's called the 5H t2b receptor and this curaline is an Agonist of this as well as a dopamine D2 Agonist but it does a nice job of lowering the prolactin and patient really only needs to take it once a week or once every two weeks or every 10 days and you know in a very tiny amount brings it brings it down not in all patients but some of those patients who suffer it and some of the sexual medicine societies talk about when patients are refracted the testosterone therapy alone fixing their sexual libido desire sometimes this this can help I guess the question is if you know what have you found in your research you know as a cardiologist I mean you know most of the data that I've seen says it's it's a minimal minimal issue absolutely so the the issue was that in patients who were prescribed kabalin and parkinsonian patients they were taking I think 3,000 milligrams do dose of 3,000 milligram cumulative dose yeah with prolactin Etc the dose is only 1 to 2 milligrams a week I think if that I mean well paronian patients is more I mean if a prolactin patients I mean I think it's um a quarter of of a milligram once or twice a week yeah and and the the issue was that about 26% of the patients in the parkinsonian group that were getting the really high doses they discovered that they had leaky valves which were uh stiffer and more sort of calcifi wer they califi but not just not just thicker but more calcifi calcified thicker and regurg and that was the Triad and that's where concerns about kabalin came people have looked at studies where for the doses that are used in hyperprolactinemia prolactinomas and no one's really found a significant there's like a couple case studies but but love this they love flashing around those case studies and scaring everyone and they say that would take up to 30 years for you to get to the cumulative dose that was used in the parkinsonian patient so to my mind it's not really a big thing from what I have read yeah would would you if if there were patient already for for other causes because what are the other causes of thickening of the valves what what else can cause a high blood pressure yeah high blood wear and tear high blood pressure Rheumatic rheumatic heart disease dat fibrillation or or heart failure calls are thickening not as far as we know but so certainly things like romatic fever could cause it and wear and tear or if you've actually had an abnormal valve to start with so those and if a patient already has a a mild thickening of the valve should they but they have these other problems with high prolactin you could just keep an eye on it and they can still use the kabine yeah I think so I mean I think so because at the end of the day you know the the elevated prolactin itself is harmful so you want to minimize that yeah you can just monitor the things CU I I because I know in um in heart failure patients women who have postp heart failure they they're given the kab burgling uh as a treatment you know I guess that's a shorter period of time but still it's something to consider so oh that's interesting I thought we'd we'd address it we have the cardiologist on and and you seem very knowledgeable about about all these I mean yeah I mean I you know I didn't come across much of this uh often but I have become more and more interested in the role of hormones and the heart so I came across that and uh certainly from what I had read I couldn't see any major issues with K berglin uh particularly in hyperprolactinemia so if you're considering testosterone replacement therapy trt why not reach out to one of our doctors at balance my hormones where you can get just a simple advice call for only 5995 also whilst you're watching the channel don't forget to subscribe like and hit the notification Bell so you get the latest content from balance my hormones until next time this is Mike and wishing you the best of help
#Truth #Testosterone #Heart #Health #Insights #Men
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Hi Mike, I have stable angina. Does this prevent me from going on a TRT treatment???
What is the Doctors name?
is this chap available for consultations
Thanks Mike for all your informative education on and around TRT
I’m 41 with free test at 420 and total 21.7. I’m been struggling with hip and shoulder pain for years now. Just came out of my 3 surgery on shoulders. Looking at TRT to help aid my healing injecting 0.5ml every 5 days.
What about blood pressure? If your extremely low and start getting shots will you blood pressure go up?
How do you guys feel about tongkat Ali
My levels are 460/55 and I’m 51
I feel week lost a ton of muscle mass and I have zero libido
Im on TRT from my
endocrinologist for low T,
and have been prescribed sustanon 250 1 injection every 3 weeks.
I had to come off previously due to the ups and downs it caused, However now im back on sustanon with testogel to be added on the 3rd before the nexk injection,
Do u think this will be better for me and avoid the empty feeling i had last time and keep my levels up…?
I went from 334 to 960 in around 3 months all natural no TRT. This book should be essential reading for all men. Written by a 50s guy with natural T levels of a 20s guy
Complete guide to testosterone by james Francis
Thanks guys, outstanding information
So I'm 52 and my total testosterone was 454ng/DL and free was 16.1ng/DL which was considered high per the reference range and I know free testosterone is the number to watch…my doctor still wants to prescribe TRT because I feel so bad… should I?
First