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Introduction Testosterone Replacement Therapy (TRT) is a commonly administered treatment for men grappling with hypogonadism or low testosterone levels. TRT has been shown to help ease the symptoms of low testosterone, but it also has a noticeable side effect: it raises hematocrit levels, which can cause a medical condition called erythrocytosis or polycythemia. Elevated hematocrit levels cause the blood to thicken, bringing about potential cardiovascular risks like strokes, heart attacks, and clotting events. This comprehensive guide seeks to elucidate various strategies to manage high hematocrit levels induced by TRT, fostering a well-rounded understanding for both patients and healthcare providers. Table of Contents Introduction Understanding Hematocrit and Its Normal Ranges Factors Contributing to High Hematocrit Levels in TRT When to Act on Rising Hematocrit Levels Testosterone Treatment and Blood Cell Production Managing High Hematocrit Levels Monitoring Adjusting TRT Dosage Lifestyle Modifications Sleep Apnea Management Medication and Supplements Comparative Effects of Different Testosterone Therapy Forms Therapeutic Phlebotomy Treating High Red Blood Cell Counts with Phlebotomy No Set Guidelines for Phlebotomy in Testosterone Therapy Yet Phlebotomy: A Temporary Solution? Conclusion References Footnotes Understanding Hematocrit and Its Normal Ranges Hematocrit gauges the volume of red blood cells in the blood, expressed as a percentage, illustrating the proportion of blood comprised of red blood cells. Normal hematocrit levels for men range from 41% to 50%, and for women, they range from 36% to 48%. Factors Contributing to High Hematocrit Levels in TRT Testosterone Replacement Therapy can trigger erythrocytosis, where an overproduction of red blood cells occurs. It is known that testosterone lowers hepcidin levels. Hepcidin is a hormone that is made in the liver and is closely connected to iron absorption pathways. This lowers hepcidin levels leads to erythrocytosis and raises hemoglobin and hematocrit levels. When to Act on Rising Hematocrit Levels If you're using testosterone therapy (TT) and your hematocrit—the percentage of red blood cells in your blood—reaches 54% or more, experts from the European Association of Urology (EAU) and the American Urological Association (AUA) recommend taking action. The EAU advises checking for other possible causes that might be increasing your hematocrit, which could include factors mentioned in their risk section [8]. Testosterone Treatment and Blood Cell Production Typically, the body produces more red blood cells in the first six months of testosterone treatment before this process levels off. If you stop TT, your hematocrit and hemoglobin (the protein in red blood cells that carries oxygen) usually return to normal within 3 to 12 months. Adjusting your TT dose or how it's administered might help prevent high red blood cell counts by mimicking the body's natural hormone levels more closely. Managing High Hematocrit Levels Monitoring Regular monitoring of hemoglobin and hematocrit levels is pivotal for patients undergoing TRT. It is recommended to get baseline hematocrit values before starting treatment and then to do regular measurements at 3, 6, and 12 months after starting treatment. Adjusting TRT Dosage In instances where hematocrit levels soar beyond 54%, healthcare providers might consider decreasing the TRT dosage or temporarily halting the therapy until hematocrit levels normalize. Additionally, switching to subcutaneous injections could also be contemplated as a strategy to modulate hematocrit levels. Lifestyle Modifications Adopting certain lifestyle alterations can significantly impact hematocrit levels. Hydration: Ensuring ample fluid intake to maintain high blood volume. Exercise: Engaging in regular physical activity to reduce blood thickness. Smoking Cessation: Avoiding smoking can decrease hematocrit levels Sleep Apnea Management TRT has the potential to make sleep apnea, a condition marked by intermittent breathing interruptions while sleeping, worse. Continuous Positive Airway Pressure (CPAP) devices or other medically approved treatments that help people with sleep apnea can also help people with high hematocrit levels improve their health. Medication and Supplements Medications like Losartan and supplements like Naringin have shown promise in helping manage high hematocrit levels. However, it's crucial to consult with a healthcare provider before embarking on any new medication or supplement regimen. Comparative Effects of Different Testosterone Therapy Forms While all forms of testosterone therapy, such as gels, pills, patches, and injections, are linked to increased hematocrit levels, injectable forms were once thought to have the most significant impact. Recent studies have shown that although injections like testosterone enanthate can significantly raise hematocrit compared to patches, usually no form of therapy increases hematocrit by more than 4.3%. This suggests that careful patient selection and monitoring could mitigate the risk of excessive red blood cell production. The risk does not seem to correlate with the duration of testosterone therapy but is more pronounced during the initial phase due to the abrupt hormonal shift. Typically, hemoglobin and hematocrit levels rise within the first six months of therapy and tend to normalize within a year of discontinuation. However, dosage is a critical factor, and selecting an appropriate dose requires considering individual patient factors. Therapeutic Phlebotomy Therapeutic Phlebotomy (TP) is a widely adopted procedure to manage testosterone-induced polycythemia, involving the removal of a pint of blood to diminish hematocrit levels. The frequency of  blood donations should not exceed once every 12 weeks to prevent iron loss due to frequent donations, contingent on individual responses to TRT. Treating High Red Blood Cell Counts with Phlebotomy Phlebotomy—the process of drawing blood—is a common treatment for polycythemia vera (PV) and high hematocrit caused by testosterone therapy, a condition with too many red blood cells, and there's no reason it can't be used for people with high red blood cell counts from TT [13]. A study by Marchioli and colleagues found that keeping hematocrit levels below 45% significantly reduced blood clots and other serious issues compared to allowing levels to be between 45 and 50%. While phlebotomy has been helpful in PV, its effectiveness for TT-related high red blood cell counts needs more high-quality research. An observational study by Hazegh et al. showed that men on testosterone who donated blood saw their average hemoglobin levels decrease over a year. The frequency of their donations varied widely, indicating that blood donation could be a useful strategy. There are No Set Guidelines for Plebotomy in Testosterone Therapy Yet Currently, there are no specific guidelines on how often or how much blood should be drawn if you're on TT and experiencing high red blood cell counts. Phlebotomy: A Temporary Solution? While phlebotomy can lower hematocrit levels, it may not be a permanent fix. Chin-Yee et al. evaluated patients who donated blood and found that many had high hematocrit levels even after donating. This suggests that while phlebotomy can help, it might not completely control red blood cell counts related to TT. In summary, phlebotomy can safely reduce hematocrit levels temporarily, but it should be used alongside other methods, like adjusting TT doses, to manage red blood cell counts effectively. More research is needed to define the role of phlebotomy in managing TT-related high red blood cell counts. Conclusion The meticulous management of high hematocrit levels in patients on TRT is pivotal to averting potential cardiovascular risks. A multifaceted approach can be used to effectively manage hematocrit levels. This includes monitoring, changing TRT dosages, making changes to the patient's lifestyle, managing sleep apnea, therapeutic phlebotomy, and medication or supplementation. It's incumbent upon healthcare providers and patients to collaborate and ascertain the most conducive management strategy, ensuring the efficacy of TRT while safeguarding the patient's health. References Footnotes Excel Male TRT Forum. (n.d.). How to Manage High Hematocrit Caused by Testosterone Replacement Therapy. Retrieved from Excel Male TRT Forum ↩ ↩2 Discounted Labs. (n.d.). High Hematocrit Caused by TRT: How to Lower and Manage it. Retrieved from Discounted Labs ↩ ↩2 ↩3 PubMed Central (PMC). (n.d.). Testosterone use causing erythrocytosis. Retrieved from PMC ↩ PubMed. (n.d.). Management of Erythrocytosis in Men Receiving Testosterone Therapy. Retrieved from PubMed ↩ Iron Mountain Men's Health. (n.d.). How to Lower Hematocrit While on TRT. Retrieved from Iron Mountain Men's Health ↩ American Journal of Clinical Pathology, Oxford Academic. (n.d.). Therapeutic Phlebotomy for Testosterone-Induced Polycythemia. Retrieved from Oxford Academic ↩ American Journal of Clinical Pathology, Oxford Academic. (n.d.). Therapeutic Phlebotomy for Testosterone-Induced Polycythemia. Retrieved from Oxford Academic ↩

Introduction Most men would not believe that estradiol is a male hormone, as they are unaware of the role that estradiol (E2) plays in the maintenance of men's health. E2 is important for many things, including the quality and quantity of sperm [1,] controlling the GH-IGF-1 axis [3,] bone growth and keeping bones healthy [4,] body composition and glucose metabolism [5,] vasomotor stability [6,] and brain function [8]. Estradiol is a hormone more abundant in women than men that is produced by the aromatization of testosterone in the liver, fat, and other cells [1]. It has been shown to be responsible for healthy bone density [2], but its role in men's sex drive, body composition, and other variables is debated [3]. High estradiol blood levels can cause gynecomastia in the presence of low testosterone [4]. Anastrozole, a blocker of estradiol production, is prescribed to men who start testosterone replacement therapy (TRT) [5]. However, there is no data on how high is too high when it comes to estradiol in men [6].   Table of Contents Introduction The Essential Role of Aromatase in the Production of E2 E2 and the Function of the Male Reproductive System The Effect of E2 on the Growth Hormone-IGF-1 Axis The Effects of E2 on the Development and Health of Bones and Skeletons The Influence of E2 on the Composition of the Body as well as Glucose Metabolism Regulation of Vasomotor Stability by E2 and Its Effects The Role of Nitric Oxide in Vasodilation The Effects of Estrogen on NO Production and Vasodilation The Need for Further Research Potential Side Effects of Testosterone Therapy and the Role of Aromatase Inhibitors A Critical Review of Current Evidence Potential Risks of Overuse of Aromatase Inhibitors The Case for Individualized Treatment Approach Estradiol: Overview and Effects Impact of High Estradiol Levels Low Estradiol: Risks and Treatment Testosterone and Estradiol: A Complex Relationship Estradiol's Role in Physiology Estradiol in Hypogonadism Studies and Findings Estradiol and Chronic Heart Failure Estradiol's Impact on Bone Density Estrogen in Men: Studies Conclusion References: The Essential Role of Aromatase in the Production of E2 Aromatase is an enzyme that converts androstenedione and testosterone into E2 in males [3]. According to the research that has been done, the hormone E2 is critically important in the control of a variety of different elements of male health [6]. E2 and the Function of the Male Reproductive System The modulation of spermatogenesis is one of the key functions that E2 performs in the male reproductive system. Working as a paracrine factor, it does its job in the Sertoli cells of the testis, where it helps germ cells mature and divide [1]. It also changes the hypothalamic-pituitary-gonadal axis, which controls the production of testosterone and the making of sperm [1, 7]. The Effect of E2 on the Growth Hormone-IGF-1 Axis It has been proven that E2 plays a significant role in the regulation of the GH-IGF-1 axis in men [3]. In healthy men, there is a positive correlation between the levels of E2 and the levels of serum IGF-1. It is possible that E2 uses negative feedback to limit GH secretion. The Effects of E2 on the Development and Health of Bones and Skeletons E2 is a crucial hormone for the growth and upkeep of men's bones, as well as their overall skeletal health. It does so by promoting osteoblast differentiation and activity and suppressing osteoclast differentiation and activity [4] [11]. In this way, it exerts an indirect influence on these features. The Influence of E2 on the Composition of the Body as well as Glucose Metabolism E2 has an effect on both the makeup of a man's physique as well as his glucose metabolism. It appears to selectively accelerate the accumulation of body fat in subcutaneous regions while at the same time limiting the accumulation in visceral regions [5]. Additionally, it has been demonstrated that E2 can improve glucose metabolism in hypogonadal men [5]. Regulation of Vasomotor Stability by E2 and Its Effects Additionally, E2 contributes to the regulation of vasomotor stability in males. People think that the production of nitric oxide (NO) plays a role in how ethyl ester affects blood vessels. The Role of Nitric Oxide in Vasodilation Nitric oxide, often known as NO, is an important physiological mediator that plays a role in a wide variety of biological activities, some of which are associated with the cardiovascular system. In the setting of the vascular system, NO plays an important function in vasodilation, controlling blood pressure, preventing blood clots, and stimulating angiogenesis [1, 2, 5]. The Effects of Estrogen on NO Production and Vasodilation It has been demonstrated that estrogens, in general, can have an effect on the generation of NO and, as a result, can mediate vasodilation. They can use both direct and indirect processes to achieve the desired vasodilatory effects. There are direct mechanisms that involve attaching to estrogen receptors on endothelial cells and making more NO. This, in turn, causes the blood vessels to become more dilated. One of the indirect ways that could be at work is by changing the production and release of other vasoactive chemicals, like prostaglandins, which could have an effect on NO production. The Need for Further Research Please be aware that despite the fact that the idea that NO synthesis mediates the vasodilation effects of E2 is reasonable based on the known actions of estrogens and NO, further research is required to determine the particular role that E2 plays in this process. Because of this, to get a better understanding, it would be important to look at the original research papers or more recent studies that focus on the part that E2 plays in changing NO production and vasodilation. Potential Side Effects of Testosterone Therapy and the Role of Aromatase Inhibitors When men undertake testosterone therapy (TTh), their estrogen levels may increase, and this may, in some instances, result in the development of nipple or breast soreness or even gynecomastia (the formation of male breast tissue in males). This can be a clear indicator that aromatase inhibitors should be used to reduce the amount of estrogen in the body. A Critical Review of Current Evidence Even so, there is not enough proof to support the regular use of aromatase inhibitors along with TTH when there are not any signs of estrogen overload. Although testosterone levels returned to normal after therapy with an aromatase inhibitor, the symptoms of low testosterone did not improve, according to the findings of one randomized controlled trial. Potential Risks of Overuse of Aromatase Inhibitors In addition, decreasing estrogen levels below a key threshold may raise the likelihood of developing osteoporotic changes and decrease insulin sensitivity, particularly in people who are receiving TTH. These risks may be increased in people who are already at higher risk for developing osteoporosis. The Case for Individualized Treatment Approach The study did not find any evidence to support the claim that taking TTH with aromatase inhibitors or other medicines would lead to lower levels of estrogen that would be better than taking TTH by itself. On the other hand, it was shown that certain TTH-treated men who had elevated estrogen levels but did not experience any clinical improvements from TTH did respond to actions taken to lower estrogen levels. These efforts included either a reduction in the amount of testosterone or the use of aromatase inhibitors. When this occurs, DXA monitoring is an option that should be examined. Estradiol: Overview and Effects Estradiol is a hormone more abundant in women than men that is produced by the aromatization of testosterone in liver, fat and other cells [1]. It has been shown to be responsible for healthy bone density [2], but its role in men's sex drive, body composition, and other variables is debated [3]. Impact of High Estradiol Levels High estradiol blood levels can cause gynecomastia in the presence of low testosterone [4]. Anastrozole, a blocker of estradiol production, is prescribed to men who start testosterone replacement therapy (TRT) [5]. However, there is no data on how high is too high when it comes to estradiol in men [6]. Low Estradiol: Risks and Treatment Low estradiol can be associated with higher fat mass and lower sexual function in men [7], so it is important to be careful when a clinic wants to put you on this drug without first justifying its use [8]. The most important details are that many clinics may be using the wrong estradiol test [9], and that most men on testosterone replacement therapy (TRT) do not develop gynecomastia even without using anastrozole [10]. Testosterone and Estradiol: A Complex Relationship Some physicians monitor estradiol blood levels after 6-8 weeks of TRT initiation using the sensitive estradiol test to determine if anastrozole use is warranted [11]. After 4-6 weeks on anastrozole, its dose can be adjusted to ensure that estradiol is not under 20 pg/ml [12]. The body of evidence suggests that after aromatase P450 inhibitors biotransform testosterone in the tissues, the ERs (estrogen receptors) in men mediate its effects [13]. Estradiol's Role in Physiology Some of the things that estrogen does are control LH feedback, skeletal homeostasis, lipid metabolism, cardiovascular physiology, brain development, and spermatogenesis [14]. Estradiol in Hypogonadism Estradiol serum concentration in adult males is around 20-30 pg/ml, with a production rate of 45 g/d [15]. Low levels of estradiol are associated with increased fat and decrease in sexual desire and erectile function compared to higher levels [16]. Studies and Findings This study found that estradiol levels of 21.80 pg/ml and > 30.11 pg/ml resulted in greater mortality in men with hypogonadism, suggesting that estrogen deficiency is largely responsible for some of the key consequences of male hypogonadism [17]. Estrogens have a fundamental role in the regulation of body fat and sexual function, and this suggests that measuring estradiol might be helpful in assessing the risk of sexual dysfunction, bone loss, or fat accumulation in men with hypogonadism [18]. Estradiol and Chronic Heart Failure A study examined the relationship between serum concentration of estradiol and mortality in men with chronic heart failure and reduced left ventricular ejection fraction (LVEF) [19]. Results showed that men in the lowest and highest estradiol quintiles had increased mortality, while those in the highest quintile had increased survival rates [19]. Estradiol's Impact on Bone Density Estradiol below 11 pg/ml was associated with increased bone loss [20]. Estrogen deficiency is common in men with chronic HF and is associated with increased morbidity and mortality [21]. Estrogen appears to play an important role in determining bone mineral density in men, but it is unclear if it also affects bone   Estrogen in Men: Studies Estradiol is a hormone more abundant in women than men that is produced by the aromatization of testosterone in liver, fat and other cells [1]. It has been shown to be responsible for healthy bone density [2], but its role in men's sex drive, body composition and other variables is debated [3]. High estradiol blood levels can cause gynecomastia in the presence of low testosterone [4]. Anastrozole, a blocker of estradiol production, is prescribed to men who start testosterone replacement (TRT) [5]. However, there is no data on how high is too high when it comes to estradiol in men [6]. Low estradiol can be associated with higher fat mass and lower sexual function in men [7], so it is important to be careful when a clinic wants to put you on this drug without first justifying its use [8]. The most important details are that many clinics may be using the wrong estradiol test [9], and that most men on testosterone replacement therapy (TRT) do not develop gynecomastia even without using anastrozole [10]. Some physicians monitor estradiol blood levels after 6-8 weeks of TRT initiation using the sensitive estradiol test to determine if anastrozole use is warranted [11]. After 4-6 weeks on anastrozole, its dose can be adjusted to ensure that estradiol is not under 20 pg/ml [12]. The body of evidence suggests that testosterone in men is mediated by the ERs (estrogen receptors) after its biotransformation by the aromatase P450 inhibitors in the tissues [13]. These estrogen-mediated actions include feedback regulation of LH, regulation of skeletal homeostasis, lipid metabolism, cardiovascular physiology, and brain and spermatogenesis [14]. Estradiol serum concentration in adult males is around 20-30 pg/ml, with a production rate of 45 g/d [15]. Low levels of estradiol are associated with increased fat and decrease in sexual desire and erectile function compared to higher levels [16]. This study found that estradiol levels of 21.80 pg/ml and > 30.11 pg/ml resulted in greater mortality in men with hypogonadism, suggesting that estrogen deficiency is largely responsible for some of the key consequences of male hypogonadism [17]. Estrogens have a fundamental role in the regulation of body fat and sexual function, and this suggests that measuring estradiol might be helpful in assessing the risk of sexual dysfunction, bone loss, or fat accumulation in men with hypogonadism [18]. A study examined the relationship between serum concentration of estradiol and mortality in men with chronic heart failure and reduced left ventricular ejection fraction (LVEF) [19]. Results showed that men in the lowest and highest estradiol quintiles had increased mortality, while those in the highest quintile had increased survival rates [19]. Estradiol below 11 pg/ml was associated with increased bone loss [20]. Estrogen deficiency is common in men with chronic HF and is associated with increased morbidity and mortality [21]. Estrogen appears to play an important role in determining bone mineral density in men, but it is unclear if it also affects bone loss in elderly men [22]. Another study assessed longitudinal rates of change in bone mineral density in young and elderly men and related these to circulating total and bioavailable estrogen and testosterone levels [23]. The rate of increase in bone mineral density at the forearm sites in the young men was significantly correlated to serum total and bioavailable estradiol and estrone levels, but not with total or bioavailable testosterone levels [23].  Elderly men with bioavailable estradiol levels below the median had significantly higher rates of bone loss and levels of bone resorption markers than men with bioavailable estradiol levels above 40 pmol/liter [23]. Ranjith Ramasamy and Larry Lipshultz conducted a study of 423 men on TRT and found that those with high testosterone and estradiol levels had significantly greater libido than those with low levels [24]. The results are expected to be presented at the American Urological Association annual meeting in Orlando [24]. Hyperestrogenism is believed to be harmful to male sexuality [25]. A study screening 34,016 men in Low T Centers revealed that 7,215 (20.2%) had high estradiol levels [26]. The age distribution of those with high estradiol levels was as follows: 132/989 (13.3%) were older than 65 years, 3,753/16,955 (22.1%) were between 45 and 65 years, 2,968/15,857 (18.7%) were between 25 and 44 years, 7/215 (3.3%) were younger than 25 years [26]. The correlation coefficient of serum estradiol to age was .53 [26]. Low blood levels of estradiol (E2) are associated with brittle bones in old men, according to a new study [27]. Age-adjusted models showed that E2 and free E2 but not testosterone (T) associated significantly inversely with cortical porosity [28]. Free E2 also associated significantly with trabecular bone volume fraction, but this association did not remain significant after further adjustment [28]. Low serum E2 may reduce cortical bone strength and increase fracture risk in older men [29]. Conclusion The hormone estradiol, also known as E2, has emerged as a key player in a myriad of biological functions in males. It is involved in the regulation of sperm health, the growth hormone-insulin-like growth factor-1 axis, bone health, body composition, glucose metabolism, vasomotor stability, and brain function. The key enzyme aromatase, which facilitates the conversion of androstenedione and testosterone to E2, is integral to these processes. Understanding the role of E2 in male physiology helps shape our approach to health issues like low testosterone and the potential side effects of testosterone therapy. While the use of aromatase inhibitors can sometimes be beneficial in managing the effects of elevated estrogen levels, more evidence is needed before they can be recommended for routine use alongside testosterone therapy. It is also crucial to consider the balance between testosterone and E2 in the male body, as overly suppressing estrogen levels might lead to unintended consequences such as osteoporotic changes and decreased insulin sensitivity. As we deepen our understanding of E2's role in the body, it becomes clear that a nuanced, individualized approach to treatment is needed to balance the benefits and risks. Finally, there are still many open questions about the specific mechanisms through which E2 influences different aspects of male health. For example, the relationship between E2 and nitric oxide in mediating vasodilation remains to be fully elucidated. Therefore, more research is required to continue building a comprehensive understanding of E2's role in men's health. As we continue to learn, our approach to male hormonal health will evolve, bringing about new strategies for maintaining and improving men's health.   Buy the best-priced  gold standard ultrasensitive estradiol test on DiscountedLabs.com.   References:   1 https://www.healthline.com/health/estrogen-in-men 2 https://www.medicalnewstoday.com/articles/estrogen-in-men 3  https://academic.oup.com/ejendo/article/181/1/R23/6654090 4 https://tctmed.com/estrogen-in-men/ 5 https://www.news-medical.net/health/The-Role-of-Estrogen-in-Mene28099s-Health.aspx 6 https://my.clevelandclinic.org/health/body/22353-estrogen 7 https://eje.bioscientifica.com/downloadpdf/journals/eje/181/1/EJE-18-1000.pdf 9 https://www.testosteronewisdom.com/role-of-estradiol-in-men-and-its-management-2/ 10  https://www.news-medical.net/health/What-does-Estradiol-do.aspx 11  https://eje.bioscientifica.com/view/journals/eje/181/1/EJE-18-1000.xml  

Although testosterone frequently overshadows estradiol, a hormone more commonly associated with women, estradiol plays a significant role in men's health. Derived from testosterone through a process known as aromatization, estradiol contributes to various physiological aspects in men. Although it's crucial for maintaining bone density, its role in sexual health, body composition, and other health parameters is subject to ongoing discourse. Here, we delve into the dynamics of estradiol in men, its implications, and the importance of accurate measurement. Understanding Estradiol in Men The hormone estradiol, although present in smaller quantities in men compared to women, is produced through the aromatization of testosterone in liver, fat, and other cells. This conversion is nature’s design, hinting at a purpose behind it. Besides promoting bone health, estradiol’s influence on men's libido, body composition, and other factors is a hot topic among researchers. Excessive levels of estradiol, especially alongside low testosterone levels, could lead to conditions like gynecomastia (enlarged breasts in men). Hormonal Balance: The HPT Axis The Hypothalamic-Pituitary-Testicular (HPT) axis is a hormonal cascade that adjusts testosterone production based on the levels of testosterone and estradiol in the body. When either hormone level goes up too high, the HPT axis responds by decreasing the production of testosterone to keep hormone levels in balance. Aromatase Inhibitors: Boon or Bane? Aromatase inhibitors (AIs) stop the production of estradiol and are often given to people who are getting testosterone replacement therapy (TRT) to help them look younger and stay healthy. While higher estradiol levels could potentially cause gynecomastia and water retention, there's speculation, albeit without scientific backing, linking high estradiol levels to erectile dysfunction. The use of AIs is thought to mitigate these issues by lowering estradiol levels. However, the exact threshold of estradiol levels in men, beyond which it could be detrimental, remains undefined. Unveiling the Optimal Range Recent studies have started to shed light on estradiol's optimal range. For instance, levels below 20 pg/ml have been associated with increased bone loss, higher fat mass, and diminished sexual function in men. It is very important to get a correct reading of estradiol, and it is better to use a sensitive estradiol test (LC/MS assay) instead of the more common ECLIA-based test to avoid getting wrongly high estradiol readings from things like CRP (C-reactive protein). Estradiol’s Diverse Effects: A Closer Look 1. Bone Density: A study showed that estradiol levels below 11 pg/ml were linked to increased bone loss in men, emphasizing estradiol's role in bone health (Source). 2. Libido and Erectile Function: One groundbreaking study revealed that lower estradiol levels were correlated with increased body fat and a decrease in sexual desire and erectile function (Source). 3. Mortality Rate: A study highlighted that men with estradiol levels either below 21.80 pg/ml or above 30.11 pg/ml had a higher mortality rate, indicating a potential sweet spot for estradiol levels (Source). 4. Testosterone Therapy: In men undergoing TRT, elevated estradiol levels were associated with heightened libido, suggesting a nuanced interplay between testosterone and estradiol (Source). Conclusion The journey to demystify estradiol's role in men is ongoing. While its importance in bone health is well acknowledged, the hormone's broader impact on male physiology is gradually being unraveled. Accurate estradiol measurement and a deeper understanding of its optimal range could pave the way for enhanced men's health management, particularly for those undergoing testosterone replacement therapy.     Here is a more detailed discussion on estradiol in men: Click here   How to Get a sensitive estradiol test  

Table of Contents How Does Bloodwork Get Processed? Top Issues Encountered When Ordering Blood Tests 1. My Doctor Doesn't Think I Need A Certain Blood Test 2. My Doctor Doesn't Order A Full Thyroid Test for Me 3. I Want to Order Blood Tests, but I Don't Have Health Insurance 4. I Have Insurance, But It Doesn't Cover the Full Cost of Bloodwork 5. I Have to Wait for Weeks and Pay for a Doctor Visit to Get My Bloodwork Results How Direct-to-Consumer Blood Test Can Save the Day The Solution - Order the Tests by Yourself! Order Discounted Lab Tests Online HOW DOES DISCOUNTEDLABS.COM WORK? In today's medical system we can all use lab tests to get a diagnosis for a wide variety of diseases such as diabetes, low testosterone, low thyroid, anemia, heart disease risk, etc.  After the lab analyzes your blood, health care providers can identify specific ailments quickly, helping you get the required treatment on time. However, the bad thing is that analyzing your bloodwork can be a seriously expensive and time-consuming procedure. Most people feel put off by surprising and unexpected medical bills of several hundred or even thousands of dollars for a blood test weeks after they got them done at their doctor’s office. How Does Bloodwork Get Processed? Let's say that you want to check the level of glucose or A1c in your blood or determine if your diabetes is in control. You can do that with simple blood tests which check for specific biomarkers. Based on that, the doctor can make lifestyle recommendations to avoid the disease or treat it successfully. But to get your blood test done, you need to speak with your primary healthcare provider first. This fact seems to make people run into a lot of different problems caused by a poorly managed healthcare system. This article strives to highlight some of these problems and help you find ways to deal with them. Luckily, direct-to-consumer blood tests are increasingly popular these days, and we'll be covering them in greater detail at the end of this article, so keep reading. Top Issues Encountered When Ordering Blood Tests You shouldn't merely avoid getting a critical blood test done just because the healthcare system puts a lot of hurdles in your way. One of the best things you can do is to continue to learn about the various situations encountered in a faulty American healthcare system and discover ways to avoid them. 1. My Doctor Doesn't Think I Need A Certain Blood Test In most cases, people go to a doctor when they experience specific symptoms. For example, they have headaches, stomach pains, lower back issues or high blood pressure. They mention these symptoms to their primary healthcare provider and based on that the doctor can order specific tests. However, thanks to the fact that the internet offers so much valuable medical information for free, people start to get educated about their health and make their own decisions. You can now order a test to check your testosterone level, whether you have issues of low testosterone or not. The problem is that most doctors wouldn't approve of a particular blood test unless you have specific symptoms. They might probably dismiss your request as unnecessary, a thing which is very frustrating for most health-conscious people who want the best for themselves. The good thing is that direct-to-consumer blood tests ordered online help you bypass the "doctor hurdle," so you can order any blood test you want to check the status of your health. 2. My Doctor Doesn't Order A Full Thyroid Test for Me Deficient clinician knowledge about best tests to use to diagnose thyroid function issues is another problem that many patients experience. The thyroid gland is an essential component of your body. It's responsible for producing a wide variety of hormones and metabolizing different substances. If some of these hormones such as TSH, free T3, and free T4 are in abnormal quantities, you can experience major endocrine problems. Some patients order a blood test to their doctors, but they only get approved for testing the TSH hormone, which is not a good thing because the other hormones are equally essential in the diagnosis of hyperthyroidism or hypothyroidism. For example, some patients deal with thyroid problems which run in families for generations. Testing the full spectrum of thyroid hormones is recommended in this case to discover thyroid problems early and attempt to fix them. 3. I Want to Order Blood Tests, but I Don't Have Health Insurance People who are not insured will find it much more difficult to get blood tests done. That's because no insurance bloodwork can get seriously expensive if you don’t have insurance. You'll eventually have to cover all expenses out of your pocket and depending on the blood test done, and the total cost can go up to several hundred or thousand dollars. No one will be happy to pay around $1,000 or more for a simple glucose or thyroid test. Also, keep in mind that people might require to have their bloodwork done several times a year so paying medical bills can cost a fortune. Direct-to-consumer lab test companies can mitigate this problem because you can find no insurance bloodwork discounted up to 85% or 90% in some cases. 4. I Have Insurance, But It Doesn't Cover the Full Cost of Bloodwork In some cases, having insurance doesn't automatically mean that you don't have to pay anything out of pocket. Some insurance companies might cover a portion of your medical of around 50% or 80%. The remaining cost will have to be covered by the patient, so you'll still have to pay with cash for specific blood tests. This out-of-pocket is called a co-pay. Many people get shocked at bills they receive from lab testing companies after months from their blood draw date. These companies alert patients that they have a large balance since their insurance company refused to pay for the blood tests that their doctor ordered. Some insurance companies may deem specific blood tests or test frequency not medically justified even if a doctor deems them necessary. Some patients have encountered situations when they had to pay around $1,000 just in co-pay. This considerable sum of money is a surprise that not everyone can afford to pay. The reason why a part of the medical bill is covered by the insurance company, and the other part is not is because the patient might work with out-of-network healthcare providers. In other words, if your provider is not within the network covered by your insurance company, you should expect to encounter co-pays. If you do accept to pay it because you need the bloodwork done urgently, at least ask how much you are expected to pay out of pocket, so you know what budget to prepare. 5. I Have to Wait for Weeks and Pay for a Doctor Visit to Get My Bloodwork Results It is a well-known fact that things don’t move very quickly in the American healthcare system. Some patients are usually forced to wait for weeks or even months before they can receive the results of their blood tests and also pay for a doctor’s visit. This fact is a huge inconvenience, especially if you need medical care urgently and your life depends on the results of your no insurance bloodwork. These long waiting periods are caused by various factors. For example, your doctor might establish an appointment to draw blood in one or two weeks. After you have given your blood sample, it will take a while until the lab analyzes it. Then you'll have to wait for the results to be communicated by your doctor and this whole process can take up to 2 months in some cases. Even worse, your hormonal levels differ from time to time. For example, people have certain levels of vitamin D test in their bodies during summer times and completely different ones in the winter when sun exposure is limited. If you take the test in August and you get the results back in October, they might show that you have plenty of vitamin D in your blood, but this might not be correct during the autumn. How Direct-to-Consumer Blood Test Can Save the Day Direct-to-consumer blood tests are sold by various companies such as DiscountedLabs.com You can choose from multiple types of blood tests and order them online. Some of the lab tests included are glucose tests, thyroid tests, testosterone and estrogen tests, etc. The list is broad, and you can find details about various hormones and biomarkers in your body. The main advantage of ordering direct-to-consumer blood tests is that they are ridiculously cheap, in comparison with those ordered by your doctor. For example, you can get a complete blood count test for about $25 and not have to pay hundreds of dollars for it if you choose to collaborate with your healthcare provider. Best of all, direct-to-consumer blood tests can be done in days because the middleman is eliminated. Instead of having your doctor send your blood to a lab, you send it by yourself. You visit a lab location close to your home to draw blood, and that's it. The results will be emailed to you in a few business days, and you can interpret them against reference values found on the internet or have your physician discuss them with you. Also, keep in mind that you’re still working with the same labs and the same experts as regular healthcare providers do. Your no insurance bloodwork is analyzed in safe conditions and adequately equipped rooms by specialized doctors. You get the same level of service and quality as if you're ordering the test with the help of your doctor. The Solution - Order the Tests by Yourself! In conclusion, it's important to remember that your healthcare provider is still your first line of defense against ailments and health problems. You should take his advice seriously and consult with him regularly if you have specific symptoms. With that being said, each time you need no insurance bloodwork, or you want to find out the level of certain hormones in your body, and you can take "shortcuts" and order the blood tests by yourself. Check out the list of most popular blood tests available online to see how many hormones and critical lab tests that you can use to monitor your health more economically.  DiscountedLabs.com has also created discounted lab test panels to make it easy to decide what lab test groupings work best for individual conditions or hormone replacement protocols.   Order Discounted Lab Tests Online Discounted Labs is a leading provider of blood tests that you can purchase without the need of a doctor's visit. Our range of self-pay blood tests can help you to identify underlying health issues and are an important means of staying at the peak of physical wellness.  If you live in one of the following states, you can take advantage of our discounted blood work: Alabama, Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nebraska, Nevada, North Carolina, New Mexico, Ohio, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Utah, Virginia, Washington, and West Virginia. Ordering lab tests online has never been easier than it is today. With our easy-to-use website, all you have to do is select the type of test you want and enter some basic information about yourself before submitting an order through a credit card. Your results will be sent directly to your email inbox as soon as they are ready! All orders come with a 100% money back guarantee if we don't deliver what we promise. HOW DOES DISCOUNTEDLABS.COM WORK?   1-     Go to the "Find a Location" page to make sure we serve your state and that there is a Quest Diagnostics location near you.  2-     Go to "Choose a Test" and add your selection (s) in the shopping cart. You can also save money by buying bundled lab test panels. 3-     If you have a discount coupon code, add it to your cart. 4-     If you don't have an account with us, you will be asked to create one by adding your name, address, gender, and date of birth. 5-     Place your order by using a credit card. 6-     You will receive three emails: an order confirmation & detailed instructions within minutes about how to download your lab requisition form to take to the lab near you. 7-     Print the lab requisition form (PDF file).  8-     Take that form to the  lab near you with a picture ID. You can walk in but we suggest that you make an appointment to cut down on potential waiting (instructions on how to do so are in our "Find a Location" page). Get your blood drawn at the lab.   9-    Your results will be ready within 2-7 business days (Depending on the test. Sensitive hormone tests done by liquid chromatography/mass spectrometry LC/MS take 5-7 business days). You will received them by email as soon as they come in. If you have any questions, please visit our FAQ page or email us at [email protected]

The prostate gland plays a pivotal role in men’s health, and its well-being is often a topic of great concern, especially when it comes to prostate cancer, a leading cause of death among men in the United States. This article delves into the intricacies of prostate health, detection methods for prostate cancer, and the debated connection between testosterone replacement therapy (TRT) and prostate cancer. Prostate Cancer Prevalence and Detection As men age, the occurrence of small, hidden prostatic lesions increases, which could potentially turn cancerous over time. The prevalence of these lesions is around 30% in American men aged over 45, and this figure soars to over 80% for those above 80 years of age. The transformation of these lesions into cancerous cells is often linked to genetic factors and lifestyle conditions, including diet. To detect prostate cancer, healthcare providers employ a variety of methods: Prostate-Specific Antigen (PSA) assays Digital Rectal Examination (DRE) Transrectal Ultrasound It's advisable for men, especially those above 40 or with a family history of prostate cancer, to undergo a DRE before commencing testosterone replacement therapy and every six months thereafter. While DRE may be uncomfortable, it's a small price to pay for ensuring good health. Any abnormal rectal exam findings, a PSA increase of more than 2 ng/mL, or a PSA level over 4 ng/mL usually necessitate further evaluation by a urologist, often involving an ultrasound and prostate biopsies. However, the PSA and DRE methods lack sensitivity and specificity. In some instances, benign prostatic hyperplasia (BPH), a non-cancerous inflammation, may falsely elevate PSA levels, while 25% of prostate cancer patients show normal PSA levels. As it turns out, needle biopsies can find hidden prostatic lesions in men whose PSA levels and ultrasound results are normal. Testosterone Replacement Therapy and Prostate Cancer: Unveiling the Connection The role of Testosterone Replacement Therapy (TRT) in PSA elevation or prostate cancer development has been a topic of considerable debate. Prostate cancer is initially androgen-dependent; thus, TRT is discouraged for men diagnosed with prostate cancer. However, a comprehensive analysis encompassing data from 18 studies revealed no significant link between blood levels of androgens and an increased risk for prostate cancer (Journal of the National Cancer Institute, 2008). Intriguingly, some emerging data suggest that high doses of testosterone may be beneficial in treating certain types of prostate cancer. A different study that looked at 149,354 men who were diagnosed with prostate cancer between 1991 and 2007 found that those who were treated with TRT did not have higher rates of death or use of Androgen Deprivation Therapy (ADT). The study, published in the Journal of Sexual Medicine (2014), concluded that TRT, post-prostate cancer diagnosis and treatment, doesn't exacerbate mortality rates or the necessity for ADT, even with prolonged TRT duration. Conclusion The dialogue surrounding prostate cancer, its detection, and the implicated role of TRT is complex. While the journey towards unambiguous understanding continues, regular screenings and open discussions with healthcare providers remain crucial for maintaining prostate health and making informed treatment decisions.   Reference: Kaplan, A. L., Lenis, A. T., Shah, A., Rajfer, J., & Hu, J. C. (2014). Testosterone Replacement Therapy in Men with Prostate Cancer: A Time-Varying Analysis. Journal of Sexual Medicine. For more insights on this topic, refer to: Does Testosterone Cause Prostate Cancer? Can Men Treated for Prostate Cancer Use TRT?

Starting Testosterone Replacement Therapy (TRT) is a significant decision that can have a profound impact on your health and well-being. While it offers numerous benefits, like enhanced mood, improved sexual performance, and increased muscle mass, there are also potential side effects and nuances that your healthcare provider might not fully explain. Below, we delve into critical aspects of TRT that every man should be aware of. But first, did you know that you can easily and affordably monitor your testosterone levels through DiscountedLabs.com? It's an excellent way to keep track of your health without the hassle of a doctor's visit. Table of Contents Impact on Sperm Count How TRT Affects Your Fertility Blood Viscosity and Hematocrit Managing Increased Red Blood Cells Shutdown of Natural Testosterone Production Recovery Post TRT Dose and Effectiveness TRT is Not a Magic Bullet Different Injection Methods Subcutaneous vs. Intramuscular Testosterone Gels and Creams Topical TRT: Right Dose, Right Results Optimal Injection Frequency The Shift Towards Frequent Dosing Sleep Apnea TRT and Sleep Quality Erectile Function and Libido The Added Benefits and Limitations Monitoring Your Blood Tests Taking Charge of Your Health Telemedicine for TRT Access to Expertise Prostate Cancer and Heart Attacks Debunking the Myths Community Support You're Not Alone Important Blood Tests Beyond Total Testosterone Insurance Limitations Navigating the System Consult a Urologist The Go-To Experts on TRT Comorbidities Risks and Workarounds The Estradiol Obsession Re-Thinking Estradiol Management Impact on Sperm Count How TRT Affects Your Fertility One aspect of TRT that is often overlooked is its effect on fertility. TRT reduces levels of LH (Luteinizing Hormone) and FSH (Follicle Stimulating Hormone), which are crucial for sperm production. If you plan on having children, it's essential to discuss fertility preservation options with your healthcare provider. Treatments like clomiphene or the addition of hCG can be useful. Blood Viscosity and Hematocrit Managing Increased Red Blood Cells TRT may lead to an increase in hematocrit, or the amount of red blood cells in your blood, thereby making it thicker. While some doctors may suggest pausing TRT, this condition can be managed through blood donations or therapeutic phlebotomy. However, frequent blood donations can lead to iron depletion and fatigue. Learn more about managing high hematocrit here. Shutdown of Natural Testosterone Production Recovery Post TRT Once you're on TRT, your natural testosterone production will decline. Usually, your body can recover its testosterone levels within a few weeks to six months after stopping TRT, but it's essential to know that this therapy isn't a temporary commitment. Dose and Effectiveness TRT is Not a Magic Bullet Though TRT can dramatically improve quality of life by enhancing sex drive, muscle mass, and fat loss, the effectiveness varies from person to person. Factors like dose, frequency, and side effect management play a crucial role. Learn about the average time to see benefits. Different Injection Methods Subcutaneous vs. Intramuscular There's a common misconception that testosterone must be injected deep into the muscle. However, you can also use a 1/2 inch 27-29 gauge insulin syringe for subcutaneous injections. Read more about injection methods here. Testosterone Gels and Creams Topical TRT: Right Dose, Right Results Gels and creams offer a less invasive way to administer testosterone, but the effectiveness depends on the right dose and concentration. Doctors often miss this, so make sure you monitor your levels closely. Optimal Injection Frequency The Shift Towards Frequent Dosing Traditionally, doctors prescribed testosterone injections at 200 mg every two weeks. However, many are moving towards more frequent dosing schedules, like 100 mg per week or even 50 mg twice per week, using insulin syringes. Sleep Apnea TRT and Sleep Quality Be cautious if you have central sleep apnea, as TRT can worsen this condition. However, weight loss achieved through TRT may improve obstructive sleep apnea over time. Erectile Function and Libido The Added Benefits and Limitations While TRT generally improves libido, the results regarding erectile function are mixed. Some men also use low-dose Cialis for additional cardiovascular benefits. Read more about the benefits of Cialis. Monitoring Your Blood Tests Taking Charge of Your Health One of the great advantages of modern technology is that you can monitor your own blood tests via DiscountedLabs.com, without needing a doctor's appointment. Telemedicine for TRT Access to Expertise For those living in areas without easy access to a TRT specialist, telemedicine is a viable option. Just note that most telemedicine doctors don't accept insurance. Prostate Cancer and Heart Attacks Debunking the Myths Contrary to common belief, TRT has not been proven to cause prostate cancer or heart attacks. Proper monitoring of hematocrit, HDL, and blood pressure is crucial, however. Community Support You're Not Alone Don't underestimate the value of community support. Platforms like Excel Male Forum offer a wealth of shared experiences and advice from men who have been on TRT for years. Important Blood Tests Beyond Total Testosterone Many doctors only measure total testosterone and often neglect other important markers like free testosterone, DHT, and thyroid function. Ensure these are part of your monitoring plan. Insurance Limitations Navigating the System Most insurance companies have limitations on which TRT products they cover. You can bypass insurance restrictions by going through a compounding pharmacy. Consult a Urologist The Go-To Experts on TRT Urologists are becoming increasingly knowledgeable about TRT, making them an excellent resource for anyone considering this treatment. Comorbidities Risks and Workarounds Some men might not see the benefits of TRT due to other health issues, such as metabolic disorders that can lead to water retention and high blood pressure. A full work-up with a cardiologist is advisable for these men. The Estradiol Obsession Re-Thinking Estradiol Management Many men obsess about their estradiol levels and are often prescribed high doses of aromatase inhibitors, which may not be necessary. Learn more about the role of estradiol in men here. In conclusion, TRT is a multifaceted treatment that requires proper understanding and management. Keep yourself informed and consider using DiscountedLabs.com for your testosterone level monitoring. Take control of your health today!

The Glutathione Blood Test: The glutathione blood test still isn’t a standard testing procedure like tests for checking your blood sugar or cholesterol. But, the role of glutathione in both health and disease has been extensively studied, and it’s understood that a chronically low glutathione level is associated with higher mortality. Table of Contents The Glutathione Blood Test: What is Glutathione The Impact Glutathione Can Have on Health Glutathione Levels and Disease Glutathione Can be Depleted The Importance of Glutathione Testing References One reason for this is that the level of glutathione will fluctuate throughout the day from its lowest in the early morning to depletion from routine exposure to toxic substances (like alcohol), pathogens, cigarette smoke, car exhaust, drugs, certain foods, stress level, illness, and many similar factors, so repeated testing could be required to set a baseline. Glutathione is also an integral part of the body’s antioxidant defense system, so other parameters need to be considered in conjunction with glutathione levels: Determination of someone’s antioxidant reserves Activity of protective antioxidant enzymes The level of cellular damage from oxidative stress What is Glutathione Glutathione is made up of three amino acids that are combined to create a peptide that behaves as a powerful antioxidant and also has several crucial roles in the body. According to recent studies, this peptide is so critical to human health that it could be possible to predict how long someone may live from the level of GSH in the cells (1, 2). Even though glutathione is also required to maintain a healthy immune system, it hasn’t been classified as an essential nutrient; because your body can synthesize glutathione from three amino acids: L-cysteine L-glutamic acid Glycine One reason that glutathione is so vital for our health is that it’s in every cell of the body. An antioxidant like glutathione helps to maintain good health by neutralizing free radicals, which are can cause cell damage by oxidation. Because glutathione is typically present in all kinds of cells, it’s in the perfect position to perform as an antioxidant. Researchers believe glutathione to be one of the most potent antioxidants in the human body (3). The Impact Glutathione Can Have on Health Glutathioneplays a powerful role in detoxifying and removing carcinogens. According to a recent study (4), any alterations in glutathione metabolic activity can have a profound effect on cell survival. Besides antioxidant activity, glutathione is responsible for several other vital roles within the cell (4): it detoxifies pathogens like certain bacteria and viruses, adjusts the body’s immune response and maintains the chemical reactions that modify the oxidative state of atoms in the cells. Glutathione Levels and Disease Researchers have concluded that glutathione deficiency can be a significant factor in several chronic conditions such as (5): HIV/AIDS Alzheimer’s Parkinson’s disease Asthma Various Cancers Cataracts and macular degeneration Open-angle glaucoma Diabetes Studies also indicate that low glutathione levels may significantly correlate with diseases of the liver, kidneys, lungs, and the digestive system (5). Diseases like rheumatoid arthritis and atherosclerosis can significantly reduce glutathione. Low glutathione levels have even been linked to diminished dopamine production in the neurons, which means a possible relationship to dopamine-based neurological diseases like Parkinson’s disease. Conversely, high levels of glutathione in the body have been linked to the development of chemotherapy resistance in cancer patients. Causes of Low Glutathione One of the most common ways that glutathione can be depleted is through the regular consumption of alcohol. Glutathione has a significant role in detoxifying dietary ethanol (alcoholic beverages), and anyone who drinks regularly will deplete their glutathione levels (6). Becoming older will unavoidably deplete glutathione. Low glutathione has also been associated with the retention of potentially toxic minerals such as; mercury, lead, arsenic, cadmium, manganese, and iron. As the body ages, glutathione levels will fall below what’s needed for optimal immune function and other critical processes (6). In addition to drinking alcoholic beverages and merely getting older, these are common household chemicals that can reduce the body’s glutathione levels (7, 8, 9, 10): Acetaminophen Aspartame The benzopyrenes in tobacco or wood smoke, car exhaust, etc. Detergents, fabric softeners, air fresheners, kitchen and bathroom cleaners, and bleach The Importance of Glutathione Testing Both chronically low and high levels of glutathione in the body are indicative of potentially debilitating health problems. Glutathione level is a crucial marker for many diseases, both chronic and acute. Given the importance of this protein to human health; discovering your glutathione levels could be one more way to monitor health levels, immune function, and the potential risk of diseases that have been associated with chronically low or high levels of this essential peptide. Buy your own glutathione test without a doctor's visit on DiscountedLabs.com References 1) Richie JP Jr, Leutzinger Y, Parthasarathy S, Malloy V, Orentreich N, Zimmerman JA. Methionine restriction increases blood glutathione and longevity in F344 rats. FASEB J. 1994 Dec;8(15):1302-7. 2) Cascella R, Evangelisti E, Zampagni M, Becatti M, D'Adamio G, Goti A, Liguri G, Fiorillo C, Cecchi C. S-linolenoyl glutathione intake extends life-span and stress resistance via Sir-2.1 upregulation in Caenorhabditis elegans. Free Radic Biol Med. 2014 Aug;73:127-35. doi: 10.1016/j.freeradbiomed.2014.05.004. Epub 2014 May 15. 3) Lu, Shelly C. “REGULATION OF GLUTATHIONE SYNTHESIS.” Molecular aspects of medicine 30.1-2 (2009): 42–59. PMC. Web. 2 Oct. 2017. 4) Balendiran GK1, Dabur R, Fraser D. The role of glutathione in cancer. Cell Biochem Funct. 2004 Nov-Dec;22(6):343-52. 5) Ballatori, Nazzareno et al. “Glutathione Dysregulation and the Etiology and Progression of Human Diseases.” Biological chemistry 390.3 (2009): 191–214. PMC. Web. 2 Oct. 2017. 6) Vogt, Barbara L., and John P. Richie. “Glutathione Depletion and Recovery After Acute Ethanol Administration in the Aging Mouse.” Biochemical pharmacology 73.10 (2007): 1613–1621. PMC. Web. 2 Oct. 2017. 7) Dimova S, Hoet PH, Dinsdale D, Nemery B. Acetaminophen decreases intracellular glutathione levels and modulates cytokine production in human alveolar macrophages and type II pneumocytes in vitro. Int J Biochem Cell Biol. 2005 Aug;37(8):1727-37. Epub 2005 Apr 26. 8) Abhilash, M., Varghese, M.V., Paul, M.V.S. et al. Comp Clin Pathol (2015) 24: 927. https://doi.org/10.1007/s00580-014-2013-8 9) Romero DL, Mounho BJ, Lauer FT, Born JL, Burchiel SW. Depletion of glutathione by benzo(a)pyrene metabolites, ionomycin, thapsigargin, and phorbol myristate in human peripheral blood mononuclear cells. Toxicol Appl Pharmacol. 1997 May;144(1):62-9. 10) National Research Council (US). Multiple Chemical Sensitivities: A Workshop. Washington (DC): National Academies Press (US); 1992. Considerations for the Diagnosis of Chemical Sensitivity.  

In this article, we will delve into an often overlooked but essential mineral - magnesium content. The body can't produce enough magnesium intake, meaning you must obtain it from your diet, such as green leafy vegetables, fruit, whole grains, cereals, legumes, and dairy products like breakfast cereals. Unfortunately, a large number of people in the United States are deficient in magnesium content for a long time due to poor dietary intake. In this blog, I will explore the reasons for this deficiency, its side effects, and the consequences of a lack of magnesium intake. Causes of Magnesium Deficiency First, let's look at what can induce a loss of magnesium. Chronic Stress The first factor is stress. Chronic, low-grade stress that's constantly present contributes to long-term magnesium suppression and deficiency. Diuretics Another common cause is diuretics, such as caffeine and alcohol. Regular consumption of these can contribute to a depression of magnesium storage in the body. Furthermore, blood pressure medications can also lead to a magnesium deficiency. Diet Lastly, a major common effect reducing magnesium levels in the US is diet, specifically a high intake of refined carbohydrates. These include breads, pastas, cereals, cakes, crackers, cookies and other processed foods with a lot of calories from carbs or sugars and very little nutritional value. These are the three major lifestyle areas in the US that induce a magnesium deficiency. Consequences of Low Magnesium Now let's explore the side effects of a deficiency in magnesium. Depression One of the first things that can happen is depression. Antidepressants are one of the top-selling drugs in America, and it's possible that magnesium deficiency contributes to some cases of depression. Vasoconstriction and High Blood Pressure Magnesium deficiency can cause vasoconstriction, which leads to high blood pressure. Interestingly, one treatment for high blood pressure is diuretics, which, as we've seen, can exacerbate magnesium deficiency. Bone Loss A lack of magnesium can lead to bone loss, contributing to conditions like osteoporosis or osteopenia. Often, hormone replacement therapy (HRT) is prescribed for these conditions, which can further deplete the body of essential vitamins. Muscle Spasms Magnesium deficiency can also cause muscle spasms, which in turn can lead to muscle pain and the need for pain medication. Many of these medications deplete the body of other important nutrients. Increased Blood Thickness Another consequence is the thickening of the blood, which can lead to increased blood pressure, increasing the risk of stroke and heart disease. Elevated Cholesterol Levels Lastly, magnesium deficiency has been linked to an elevation in cholesterol. The most common treatment for high cholesterol is statin medication, which can create other forms of heart disease. Testing for Magnesium Deficiency If your diet is high in refined carbohydrates, if you frequently use diuretics, or if you are under chronic stress, it's wise to check your dietary magnesium levels, especially for older adults. I recommend an RBC Magnesium test, which can measure the amount of magnesium that's actually inside your cells, providing a much more accurate result. According to the National Institutes of Health, it is difficult to accurately measure the amount of magnesium in a person’s body. In the United States, doctors estimate a person’s dietary intake of magnesium to establish their magnesium status. People with certain health conditions and in certain situations are at an increased risk of low levels of magnesium, such as 30% to 80% of people with alcohol use disorder. Dangerously low levels of magnesium have the potential to cause fatal cardiac arrhythmias. For healthy adults, including older adults, the recommended daily intake of magnesium is 310 to 420 milligrams. If you have loose, frequent stools or irritable bowel syndrome, consider using magnesium glycinate — a specific salt of magnesium that tends to have fewer GI side effects. The typical dose of magnesium is 250 to 500 milligrams daily. Remember, magnesium is necessary for more than 18,000 functions in the human body. These are just a few of the potential consequences of a deficiency. So, ask your doctor for a spectra cell test, measure your magnesium levels, and make sure it's not something you need to supplement. The Magnesium RBC Test vs The Serum Magnesium Test When evaluating magnesium levels in the body, two of the most common tests used are the Magnesium RBC (Red Blood Cell) test and the Serum Magnesium test. These tests, while both useful, have some significant differences in terms of what they measure and how accurately they can reflect the body's level of magnesium. However, if you have symptoms of magnesium deficiency or abnormal calcium or potassium levels, your doctor may refer you for a blood test or a urine test to diagnose magnesium deficiency in healthy adults. Your health care provider will also perform a physical exam to assess your overall health and inquire about your symptoms. It's important for people to know the signs of magnesium deficiency symptoms and consult their doctor if they're worried about a deficiency. Fatigue, leg cramping or twitching, and unexplained muscle weakness are some of the day-to-day symptoms that can indicate low magnesium levels, including abdominal cramping. These symptoms can be very vague, so that's where blood work is needed to determine whether magnesium levels are actually low. BUY A MAGNESIUM RBC TEST What is the Serum Magnesium Test? The Serum Magnesium Test measures the amount of magnesium in the clear part of the blood, or the "serum." This test gives an overview of the total amount of magnesium present in the blood. However, only about 1% of the body's total magnesium is found in the blood serum, making this test less accurate in assessing the body's overall magnesium status. Limitations of the Serum Magnesium Test The main limitation of the Serum Magnesium Test is that it only measures the magnesium in the serum, not within cells. This is a significant drawback because the majority of magnesium in the body is intracellular, meaning it resides inside the cells. Therefore, a normal serum magnesium test result does not necessarily mean that the body's overall magnesium status is adequate in clinical practice. It's possible to have a normal serum magnesium level while being deficient in magnesium within your cells, a condition known as "cellular magnesium deficiency." In severe cases of cellular magnesium deficiency, cardiac arrest may occur, highlighting the critical role of intracellular magnesium levels in maintaining proper heart function. Additionally, magnesium is essential for various cellular processes, such as DNA, RNA, and protein synthesis, which further emphasizes the importance of intracellular magnesium levels for overall cellular function. Benefits of the Magnesium RBC Test This test is considered superior for assessing the body's magnesium status because it better reflects the amount of magnesium stored in the body. A low result on a Magnesium RBC test can indicate a magnesium deficiency, even if a Serum Magnesium test result is normal. Conclusion In conclusion, while both tests are used to measure magnesium levels, they each have their strengths and weaknesses. The Serum Magnesium Test is useful for identifying severe deficiencies or excesses of magnesium in the blood, but may not accurately reflect the overall magnesium status of the body. The Magnesium RBC Test is considered more accurate for evaluating the body's total magnesium status, especially in cases of cellular magnesium deficiency. It's always best to discuss with your healthcare provider which test may be most suitable for you based on your symptoms, lifestyle, and overall health status. Questions and Answers: What are symptoms of low magnesium? Some common symptoms of low magnesium levels in the body include muscle cramps, tremors, spasms, fatigue, weakness, loss of appetite, nausea, vomiting, numbness or tingling in the hands and feet, irregular heartbeat, and mood changes. In more severe cases, low magnesium levels can lead to muscle weakness, seizures, and abnormal heart rhythm. If you are experiencing any of these symptoms or suspect that you may have low magnesium levels, it is important to consult with a healthcare professional for proper diagnosis and treatment. How can I raise my magnesium quickly? To quickly raise your magnesium levels, you can try incorporating magnesium-rich foods into your diet. Foods such as leafy green vegetables, nuts and seeds, whole grains, and legumes are good sources of magnesium. You can also consider taking a magnesium supplement, but it's always a good idea to consult with a healthcare professional before starting any new supplements. Additionally, Epsom salt baths or magnesium oil can be absorbed through the skin and help increase your magnesium levels. Remember that it's important to maintain a balanced diet and lifestyle overall to support optimal nutrient levels in your body. What are some of the causes of low magnesium? Low magnesium levels can be caused by several factors, including: - Inadequate dietary intake: Not consuming enough magnesium-rich foods, such as leafy green vegetables, nuts, seeds, and whole grains, can lead to low magnesium levels. - Certain medical conditions: Conditions such as gastrointestinal disorders (e.g., Crohn's disease), diabetes, kidney disease, and alcoholism can interfere with the absorption or excretion of magnesium. - Medications: Some medications, such as diuretics, proton pump inhibitors (PPIs), and certain antibiotics, can increase the risk of low magnesium levels. - Chronic stress: Prolonged stress and anxiety can deplete magnesium stores in the body. - Excessive alcohol consumption: Alcohol can interfere with the absorption and utilization of magnesium. - Aging: As we age, our ability to absorb and retain magnesium may decrease. If you suspect that you have low magnesium levels or are experiencing symptoms related to magnesium deficiency (such as muscle cramps, fatigue, or irregular heartbeat), it is important to consult with a healthcare professional for an accurate diagnosis and appropriate treatment. They may recommend dietary changes or supplementation to help normalize your magnesium levels. Is it possible to get enough magnesium from food? Yes, it is possible to get enough magnesium from food. Magnesium is found in a variety of foods, including leafy green vegetables, nuts, seeds, whole grains, beans, and seafood. By incorporating these foods into your diet on a regular basis, you can help ensure that you are getting an adequate amount of magnesium. However, some individuals may have difficulty meeting their magnesium needs through diet alone, especially if they have certain medical conditions or dietary restrictions. In such cases, a healthcare professional may recommend magnesium supplements to help meet their needs. It's always best to consult with a healthcare professional to determine the best approach for your individual situation. Who should not take magnesium? Magnesium is generally safe for most people when taken in appropriate doses. However, there are some individuals who should exercise caution or avoid taking magnesium supplements altogether. These include: 1. Individuals with kidney problems: If you have kidney disease or impaired kidney function, it is important to consult with a healthcare professional before taking magnesium supplements, as they may not be well tolerated and could potentially worsen your condition. 2. Individuals with heart or gastrointestinal conditions: People with certain heart conditions, such as heart block or bradycardia (slow heartbeat), or gastrointestinal conditions, such as bowel obstructions or inflammatory bowel disease, should speak with their doctor before taking magnesium supplements. 3. Individuals taking certain medications: Magnesium can interact with certain medications, including antibiotics (such as tetracycline), diuretics, bisphosphonates (used to treat osteoporosis), and certain medications used to manage high blood pressure. It is important to check with your healthcare provider if you are taking any medications to ensure that there are no potential interactions. As always, it is best to consult with a healthcare professional before starting any new supplement regimen to determine if it is appropriate for your specific health needs and circumstances. What kind of magnesium is best? There are several different types of magnesium supplements available, and the best one for you will depend on your specific needs and health goals. Some popular forms of magnesium include magnesium citrate, magnesium glycinate, magnesium oxide, and magnesium malate. Magnesium citrate is often used for its laxative effects and can help relieve constipation. Magnesium glycinate is known for its high absorption rate and can be a good option for those with low magnesium levels or individuals who experience digestive issues with other forms of magnesium. Magnesium oxide is commonly found in over-the-counter antacids and may be used to relieve heartburn or acid reflux symptoms. Magnesium malate is often used to support energy production and muscle function. It's important to note that individual responses to different forms of magnesium can vary, so it may take some trial and error to find the form that works best for you. It's always a good idea to consult with a healthcare professional before starting any new supplement regimen. What diseases cause low magnesium? There are several diseases and conditions that can cause low magnesium levels in the body. Some examples include: - Gastrointestinal disorders: Conditions such as Crohn's disease, ulcerative colitis, and celiac disease can interfere with the absorption of magnesium from the diet, leading to low levels. - Kidney disease: The kidneys play a crucial role in maintaining proper magnesium balance in the body. Chronic kidney disease or certain kidney disorders can impair magnesium excretion and lead to low levels. - Alcoholism: Excessive alcohol consumption can interfere with magnesium absorption and increase urinary excretion, resulting in low levels. - Diabetes: Poorly controlled diabetes or high blood sugar levels can increase urinary excretion of magnesium and contribute to low levels. - Hyperthyroidism: An overactive thyroid gland can affect mineral metabolism, including magnesium, potentially leading to low levels. It is important to note that these are just some examples, and there may be other causes of low magnesium levels. If you suspect you have low magnesium or have any concerns about your health, it is best to consult with a healthcare professional for an accurate diagnosis and appropriate treatment. Footnotes Elin RJ. Assessment of magnesium status for diagnosis and therapy. Magnes Res. 2010 Dec;23(4):S194-8. DOI: 10.1684/mrh.2010.0213. Nielsen FH. Magnesium, inflammation, and obesity in chronic disease. Nutr Rev. 2010 Jun;68(6):333-40. DOI: 10.1111/j.1753-4887.2010.00293.x. Coudray C, Rambeau M, Feillet-Coudray C, Gueux E, Tressol JC, Mazur A, Rayssiguier Y. Study of magnesium bioavailability from ten organic and inorganic Mg salts in Mg-depleted rats using a stable isotope approach. Magnes Res. 2005 Dec;18(4):215-23.    

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