The Truth About Male Testosterone Replacement
by Paul Burke
Recently I received this question about male testosterone replacement:
Paul, I am 54 years old and I have been training with weights for over twenty years. Oddly enough, on my last physical my doctor told me that my testosterone was “dangerously” low and that I needed to go see an Endocrinologist. I am natural and I have a lot of muscle mass; So, how could I have low testosterone?
First off, you may just have what is called a low “total testosterone” count; and yet, still have enough “free” testosterone in your blood to indicate that your cells are saturated with the right amount of testosterone and what remains behind is “free.” The fact is, the “free testosterone” count is of greater importance. This is what happens biologically: You make testosterone through a series of hormonal communications with the hypothalamus, pituitary and your testes. That is the short course. Once the testes have released testosterone into the blood stream, cells begin to open up for what they require. Once the cells are full of what your body requires, a small amount is left in the blood and it is always circulating around each day because of the length of testosterone’s “half-life”—that is why they call this particular testosterone test “free,” because it is not binding with cells and left to circulate freely in your blood stream in case of a hormonal emergency. It is this measurement that is most indicative of whether you actually have “low testosterone” or not. Your total testosterone should be in the ranges between: 300-1,200. Even if you have 350 (which is on the low side); if you are making enough for your entire body, then the proper amount of “free” testosterone may show up in any blood test as normal. Naturally, it is best if you have a higher number in the total testosterone category also, but it is not most essential—as is the case with free testosterone.
Having low testosterone, especially that which is free, is a risk in the following ways: Possible prostate problems (including cancer—PSA levels rising); low red and white blood cells (iron deficiency and leukopenia), lethargy, poor serum hematocrit results; frequent urination; intolerance to moderately low or high outside temperatures; glucose problems; and the list goes on. Of course, if you take in too much testosterone (via anabolic steroids, or some type of prescription testosterone; these problems are as probable and as dangerous as with low testosterone). The key to “testosterone replacement therapy is to bring back your total and free testosterone to their “normal” ranges. (That is if they are not in normal ranges.)
Here is an oddity: Almost every bodybuilder whom I know has a low a “total testosterone” count. Some of them have used steroids and they never made the proper amount again once they stopped. Other bodybuilders, however, are clean—never used a thing, and they show low Total testosterone also. They are in the low but acceptable range of “free testosterone,” however, and probably do not need testosterone replacement therapy. How can this be that even natural bodybuilders have low testosterone? It seems obvious to me that bodybuilding, even “natural” bodybuilding has a double edged sword. You look good, feel good, have more strength than most men and more sexual vigor; however, for every time a cell is torn down, or split, for instance, something called a tolemere (involved with the making and using Mitochondria DNA) is shortened in the replication process. In other words, each time you break down and make new muscle tissue, the body goes through a process that actually causes some form of aging. As bodybuilders, we split and tear cells every time we workout. In other words; as bodybuilders; are we not building up quicker (and therefore using up more hormones) than the average man would? The answer is yes.
I did a simple study once of all the body builders who I knew from magazines to those whom I knew personally and the average bodybuilder lives to be 56–60 years old. Sound strange? Here’s something stranger: there are so few that make into their 80’s that I can count them on one hand—that is every bodybuilder who lived and died since Sandow! On various websites on the internet, most of them will point to steroid use as being the reason that a bodybuilder might have a shorter life; however, the facts are not about steroids at all—the realities are about how often we break down and build up; and, how often and how much we eat that determines, at least in part, how long we live. Testosterone plays a role in your life-span. Ask your doctor for a “Total” and “Free” testosterone blood test. You never know what you may find.
All The Best,
Paul T. Burke, M. Ed., PhD (Candidate)
CEO: Paul Burke Enterprises, LLC
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