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Testosterone is Your Friend
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Chapter 7: Cardiovascular Health ______________________________________________________
The biggest killer of Americans by far - especially men - is cardiovascular disease (CHD). Therefore an entire chapter will be devoted to CHD conditions. The vast majority of the medical profession still lives in the Dark Ages here and feels that men suffer from more CHD because they have much higher testo-sterone levels than women! There is overwhelming evidence to show that men with higher testosterone levels have much healthier hearts and circulatory systems with longer and better quality of life. We badly need similar studies in women, but current research, common sense and logic tell us that women with normal, youthful testosterone levels have the same protective benefits (women with hyper levels of testosterone, on the other hand, suffer from more cardiovascular problems). Ideally we would concentrate on supple-mental studies using transdermal (or sublingual) delivery, but such studies concerning heart and artery health are very hard to find.
The most impressive review was fourteen pages from the Danish Center for Clinical Research in 1996 (Atherosclerosis, v. 125, p. 1-13) with a comprehensive analysis of 85 studies. Such a lengthy review leaves no doubt about testosterone being a heart healthy hormone.“In conclusion, one intervention, eight cohort and several (there were 30) cross-sectional studies suggest either a neutral or a favorable effect of testosterone and DHEA(S) on CHD in males.”
The largest cross-sectional study in 1987 of 2,512 men (American Journal of Epidemiology, v. 126, pp. 647-57) concluded, “Subjects with prevalent ischemic heart disease were reported to have significantly lower serum testosterone levels than subjects without IHD.” That one sentence says it all.
The University of Sheffield in England did more studies in this area than any other institution. In 2000 (European Heart Journal, v. 21, pp. 890-4) ninety men were studied. They conclud-ed, “Men with coronary artery heart disease have significantly lower levels of androgens than normal controls, challenging the preconception that physiologically high levels of androgens in men account for their increased relative risk for coronary heart artery disease.” They exposed the unsubstantiated myth that testosterone is somehow bad for men - a myth which is still very prevalent today in the medical profession. They further said, “High androgen levels are presumed by many to explain the male predisposition to coronary artery disease. However, natural androgens inhibit male atherosclerosis.” Further, “There is also increasing evidence in the literature to show that low levels of androgens are associated with adverse cardiovascular risk factors including an atherogenic lipid profile, systolic and diastolic hypertension, obesity, insulin resistance, and raised fibrinogen in humans.” Free testosterone levels were emphatically emphasized, “This study shows that there is a positive associate between low serum androgen levels and the presence of coronary artery disease.” The heart patients also had high levels of LH and FSH. This is exemplary science! In the same journal (v. 24, 2003, pp. 909-15) they further said, “Administration of testosterone increases cardiac output acutely.”
In the same year at this university (Circulation, v. 102, pp. 1906-11) some more very smart doctors gave transdermal 5 mg (delivered) testosterone patches for three months to elderly men who suffered from chronic angina (heart inflammation) in a double blind study. The free testosterone levels rose from 46 to 73 (59%) on the average and their LH and FSH fell dramatically (which is good for men). Their estrogen levels did not rise. “Low dose supplemental testosterone treatment in men with chronic stable angina reduces exercise-induced myocardial ischemia (blocked arterial flow).” This means the men on testosterone could now exercise more freely. Aside from the cardiac benefits, these men improved greatly in general physical functioning, social functioning, mental health, overall vitality, freedom from pain and general perception of their health.
A fourth study there (Quarterly Journal of Medicine, v. 90, 1997, pp. 787-91) was a review of the literature. They showed that, “Low mean levels of testosterone have been found in populations of hypertensive men. In men, high levels of estrogen and estrone are associated with increased risks of myocardial infarction, angina, and CAD. Estrogens given to male survivors of myocardial infarction lead to an increased re-infarction rate. Giving estrogens to men with prostatic carcinoma is associated with increased mortality from CAD (coronary artery disease).” It is obvious that testosterone, androstenedione and DHEA are heart protective, while excess estradiol and estrone cause heart disease. Yet a fifth study there (Heart, v. 89, 2003, pp. 121-2) found,“…administra-tion of low physiologic replacement doses of testosterone over three months in men with chronic stable angina significantly improves exercise tolerance and angina threshold.”
From Imperial College in London in 1999 (American Journal of Cardiology, v. 83, pp. 437-9) men aged 35 to 75 were given intravenous infusions of 2.3 mg of natural testosterone. All of them were suffering from angina, so relaxing their arteries was very beneficial. They found the majority of these men to be testosterone deficient. Giving them the infusions, “increases time to onset of exercise-induced myocardial ischemia in men with CAD who have decreased plasma testosterone.” In plain English this means the supplemental testosterone improved the arterial constrictions during exercise and allowed more blood flow. They quoted 22 other studies showing the general benefits of testosterone supplementation for improved heart and artery health. Another study (Circulation v. 99, 1999, pp. 1666-70) from the San Raffaele Institute in Italy confirmed these same facts. “Short-term administration of testosterone induces a beneficial effect on exercise-induced myocardial ischemia in men with coronary heart disease.” What could be clearer?
One of the few studies that included women was from Uni-versity Hospital in Belgium in 1996 (Sex Steroids Cardiovascular Systems 1st, pp. 181-200). Women can naturally suffer from exces-sive testosterone levels while men cannot. Women who have such hyper levels do suffer from more heart and artery conditions, but youthful levels in women were correlated with less CHD problems. They went on to also discuss the beneficial effects of normal testosterone levels on insulin function in both men and women. We need a lot more work like this regarding women.
At the INSERM research facility in France the Telecom Study was done in 1997 (Journal of Clinical Endocrinology and Metabolism, v. 82, pp. 682-5). They found, “Compared to the men with higher testosterone, the men with low testosterone had a significantly higher body mass index, higher waist/hip ratio, higher systolic blood pressure, and higher fasting and 2 hour plasma insulin.” Here they saw an important inverse relationship where the higher the testosterone level the lower the insulin level. Hyperinsulemia and insulin resistance with excessive insulin levels are epidemic in Western societies in both men and women, so lowering insulin levels generally is very positive.
At the Hunan University in China in 1998 (Hunan Yike Daxue Xuebao, v. 23, p. 299-301) healthy men were compared to men with coronary heart disease and studied for their sex hormone levels as related to their blood lipids. Here the doctors found that the higher the testosterone the higher the “good” HDL cholesterol and the lower the triglycerides. They concluded, “The results suggest that the endogenous testosterone in males regulates the blood lipid metabolism, and the male with low plasma testosterone might be lead to blood lipid metabolism abnormality, is a risk factor of coronary disease.” Youthful testosterone levels help keep blood fats low.
Another Chinese study from the Tongji Medical University in 1998 (Zhongguo Bingli Shengli Zazhi, v. 14, pp. 745-7) found that men with low testosterone and low HDL cholesterol and high estrogen-to-testosterone ratios (too much estrogen and too little testosterone) were more prone to CHD problems. They also showed that the higher the testosterone the higher the HDL (“good”) cholesterol levels. They concluded, “The imbalance of sex hormones mainly induced by the decrease of testosterone level was a pathogenic factor for CHD in the male.” Well stated.
When it comes to cholesterol and blood lipids the literature on supplemental testosterone seems to be conflicting. Some studies on testosterone therapy show better total cholesterol, HDL, LDL, and triglyceride levels, while others show no benefits. The reason is that when the wrong forms are given in the wrong ways blood lipids are usually not improved. When transdermal natural testosterone is used there are always improvements in blood fats.
At Bielanski Hospital in Poland in 1996 (Atherosclerosis, v. 121, pp. 35-43) men with low testosterone were given 200 mg i.m. injections of enanthate ester every second week for a year. Total cholesterol fell from an average of 225 to 198 mg and LDL 139 to 118 mg with no change in diet. Even giving these men the wrong kind of testosterone in the wrong way resulted in dramatic improvement in their blood lipids. “The results of this study indicate that testosterone replacement therapy in hypogonadal and elderly men may have a beneficial effect on lipid metabolism through decreasing total cholesterol and atherogenic fraction of LDL cholesterol.”
Similar results were found at the University of Texas in San Antonio in 1993 (Journal of Clinical Endocrinology and Metabol-ism, v. 77, p. 1610-15). The researchers said, “In conclusion the authors observed a less atherogenic lipid and lipoprotein profile with increased testosterone concentrations.” This included DHEA as well. At the same university in 1996 (Journal of Clinical Endocrinology and Metabolism v. 81, pp. 3697-3701) some of the same researchers found that low testosterone levels in men equated clearly with high LDL (“bad”) levels. “In conclusion, we have shown that men with decreased concentrations of total testosterone and SHBG have an unfavorable composition of LDL.” They refer to other studies that found low testosterone is also associated with lower HDL levels and higher triglyceride levels.
We could go on with dozens and dozens of studies like this. To name a few more: At Vrije University in the Netherlands (Aging Male, v. 4, 2001, pp. 30-8) the evidence clearly showed, “Epidemiological studies show, however, that men with cardio-vascular disease have low rather than high circulating testo-sterone.” At the University of Bari in Italy (Metabolism & Clinical Experiments, v. 45, 1997, pp. 1289-93) a very in-depth and complex study was done on multiple cardiovascular factors. They concluded, “Thus, because of the increase of several prothrombic factors, men with central obesity, particularly those with lower androgenicity, seem to be at greater risk for CHD.” At Royal Brompton Hospital in London testosterone was given to men with CHD. “Short term intracoronary administration of testosterone at physiological concentrations, induces coronary artery dilation and increases coronary blood flow in men with established CHD.”
Heart disease in women was studied over a five year period in Chile (Maturitas, v. 45, 2003, pp. 205-12). Women 40 to 59 were evaluated and then re-evaluated five years later. The risk factors were found to be sedentarism (laying on their dead rear ends), high cholesterol and triglycerides, hypertension, obesity, smoking and diabetes. Hormone levels were not measured in this otherwise excellent study, however.
Testosterone
deficiency and female cardiovascular disease was covered in a very rare
report published in the Journal of Women’s Health in 1998 (v. 7, pp.
825-9). “Restoring a physio-logic level of testosterone to women after
hysterectomy not only can improve quality of life in terms of sexual
libido, sexual pleasure, and sense of well-being, but also can build bones
- and may be a key to protecting cardiovascular health. Women
developing testosterone deficiency as a consequence of natural
aging/menopause may similarly benefit from physiologic testo-sterone
supplementation.” There is no doubt that youthful testosterone levels in men is heart healthy. When we do more studies on women we’ll find the same situation. Women must be careful to maintain normal range levels, as excessive androgens are just as harmful as deficient ones. Youthful levels of androgens (including androstenedione and DHEA) for both men and women are vital to good cardiovascular health and long life.
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