Can Testosterone Be Good for You?

Bio-Identical Testosterone Treatment for Both Men and Women

Many anti-aging specialists are finding that natural bio-identical testosterone creams (not to be confused with high dose synthetics injected illegally by some athletes) keep those over 50 years old younger and healthier—and this is for both men and women! A rapidly expanding collection of research is showing that optimizing testosterone in men:

1.	Decreases the risk of heart disease, including angina, and helps reverse heart disease when present—while lowering cholesterol levels .
2.	Improves insulin sensitivity, thus improving blood sugar control in diabetics as well as decreasing a major cause of heart disease and diabetes called "metabolic syndrome."
3.	Improves muscle mass.
4.	Improves libido and sexual function.
5.	Decreases depression.

In women, optimizing testosterone along with using bioidentical hormones and progesterone seems to work the best, helping energy, libido and overall well being. As is usually the case, be sure to use bio-identical hormones. When looking at the overall safety and effectiveness data, one finds that treating testosterone deficiency in men (called "Andropause") as well as in women can help you feel young and vital late into life!

Doctor Offutt also is trained in bio-identical hormone replacement as do many Integrative medical specialist are.  Optimizing a low or low normal testosterone level can also have marked benefits for those with CFS and Fibromyalgia. For those of you who would like more details, let's look at the issue more closely.

The Reproductive Glands

Many people going through midlife develop fatigue, poor libido or depression.  This includes men and women alike. Researchers have found that if the estrogen and testosterone levels in females or the testosterone level in males is low, a trial replacement of these hormones can bring about dramatic improvement and is therefore worth considering. An under active adrenal gland can aggravate this problem.

Testing for Low Testosterone

Again, it is important to check the free (not just total) testosterone. Most laboratories can test free testosterone only if they also measure the total testosterone—this is a normal procedure. Be sure that the normal ranges for the lab results are broken down by ten-year age groups: thirty-one to forty years old, forty-one to fifty years old, and so on. It is meaningless to have a normal range that includes eighty year-olds if you're twenty-eight. Bizarrely, some labs even have a normal range for women's testosterone levels that begins at zero. This would be like having a normal range for women's heights that go from 0-72 inches! If your result is below normal, or even in the lowest 25 percent of the normal range, I would consider a trial of natural, bio-identical testosterone therapy. Some researchers find that checking the levels of proteins that "bind or carry" testosterone (SHBG—Sex Hormone Binding Globulin) and a total testosterone level and then calculating the free testosterone level is more reliable. For now, keeping the "free testosterone" in the upper one third of the normal range should suffice.

Treating Low Testosterone

For men under 50, it is often best to simply stimulate your body's own production of testosterone using a low dose of a medication called clomiphene (a "Clomiphene Stimulation Test" will tell you if this will work for you). In men over 50, I recommend using topical testosterone creams or gels, applying 25-100 mg to the skin each morning. This is available from regular pharmacies (Androgel or Testim 1 percent gel), but the form made by compounding pharmacies is much less expensive if you do not have prescription insurance. Be aware that if the skin where it is applied comes in contact with a woman's skin (e.g. after a hug or if you do not wash your hands after applying the cream), this can result in very high, undesirable and unsafe levels in that woman's body. Always be sure to wash your hands after applying the cream.

I do not recommend taking testosterone by mouth in males as it can dramatically worsen cholesterol levels since testosterone goes to the liver first when taken by mouth, which is where cholesterol is made. I also do not recommend injections because this results in very high levels for the first few days after the injection and in very low levels a week later. Testosterone pellets that are injected under the abdominal fat each 4-6 months may well be the best approach, but it is difficult to find physicians trained in this technique. There are newer injections that can slow release testosterone over several months that also hold promise.

For women, testosterone treatment is easier. I recommended the natural testosterone creams made by compounding pharmacies. The usual dose is 1-5 milligrams a day (1-2 mg is optimal for most women). If you also need estrogen or progesterone, all three of the hormones can be combined in the same cream, resulting in increased simplicity and a lower cost. With this dosing, most women feel more energy and have thicker hair, younger skin and improved libido.

Adjust the testosterone level to the dose that feels best, checking blood levels to make sure they do not go above the upper limit of normal. Most people feel best with a blood level around the 70th percentile of the normal range. Although testosterone treatment helps male diabetics, if the dose goes too high in women it can promote diabetes. So keep the testosterone blood level in the normal range.