Page 7 - Testosterone Tests

Here are Some Important Things That Your Doctor May Fail to Tell You Before You Start Testosterone Replacement Therapy (TRT):       1- TRT decreases your sperm count.     Some doctor prescribe Clomiphene alone or hCG with TRT to preserve your fertility     2- TRT may increase your blood viscosity due to increased hematocrit, the amount of red blood cells in the blood.     Some doctors may want to stop your TRT when this happens, but this side effect can be managed easily with blood donations or therapeutic phlebotomy.   Just be careful: frequent blood donations can deplete iron and cause fatigue.     3- TRT shuts down your own testosterone production.     It may take up to 6 months for your testosterone to return to baseline after you stop.     4- TRT works to improve your sex drive, muscle mass, and burn fat.     But it does not work for everyone and dose/frequency are important along with other factors like side effect management.   TRT is not a magic bullet.     5- Testosterone can be injected under the skin (Most doctors think you should inject deeply into muscle)     6- Testosterone gels and creams are effective but some doctors do not adjust the dose based on your blood level and symptoms.     7- Many doctors still prescribe testosterone injections at 200 mg every two weeks.     Many are moving towards recommending 100 mg/week or 50 mg twice per week with an insulin syringe.     8- TRT can worsen sleep apnea.     Apnea can improve with weight loss and can be treated with a CPAP machine.     9- TRT improves erectile function in some men but not all.     It improves libido in most men regardless of age, though.     10- You can monitor your own blood tests via companies that sell discounted labs without a doctor visit.     11- You can access a testosterone doctor via telemedicine if you don’t have one close by.     However, most of them do not take insurance.     12- TRT does not cause prostate cancer or heart attacks.     Cardiovascular outcomes depend on proper monitoring of hematocrit, HDL, and blood pressure.     13- Many men do not know that they ask questions to TRT-experienced men by visiting the ExcelMale forum.     14- In follow up visits, some doctors only measure blood levels of total testosterone but forget to include free testosterone, DHT (metabolite), and thyroid function tests.     15- Most insurance companies only pay for certain TRT products but not others.     And most refuse to pay if your testosterone is over 350 ng/dL.     16- You can buy affordable TRT options with a prescription at compounding pharmacies like Empower Pharmacy.     17- Urologists are quickly becoming the most knowledgeable doctors of TRT management.     18- Some men fail to achieve benefits from TRT. Comorbidities and other issues can be to blame.     GO TO: DiscountedLabs.com/Resources for   Free Testosterone Book Doctor's Referrals Forums & More

Table of Contents Does Testosterone Increase Risks of Heart Disease? What is the Effect of Testosterone Therapy in Older Men? What Can You Do to Prevent Heart Disease While on Testosterone Replacement Therapy? BUY A TESTOSTERONE BLOOD TEST PANEL Reference:  Does Testosterone Increase Risks of Heart Disease? There is widespread misinformation that testosterone supplementation increases the risk of heart disease. There is no evidence to support this belief in men younger than 65 years of age. Testosterone administration to middle-aged men is associated with decreased visceral fat, triglycerides, lower blood sugar concentrations, and increased insulin sensitivity. Several studies have shown that low total and free testosterone concentrations are linked to increased intra-abdominal fat mass, the risk of coronary artery disease, and type 2 diabetes mellitus. Testosterone has also been shown to increase coronary blood flow. Similarly, testosterone replacement retards the build-up of plaque in experimental models of atherosclerosis. In 1994, Phillips and colleagues studied 55 men with angina. They found a strong correlation between very low levels of testosterone and increased severity of coronary artery disease as measured by arteriograms, suggesting that testosterone may have a protective effect. This is consistent with the observation that the risk for atherosclerosis increases with age in men, while testosterone levels decrease. Two other smaller studies found that the administration of testosterone decreased risk factors for coronary artery disease. The prospective European investigation into cancer in Norfolk (EPIC- Norfolk) Prospective Population Study examined the prospective relationship between the body’s own (endogenous) testosterone concentrations and mortality due to all causes, cardiovascular disease, and cancer in a nested case-control study based on 11,606 men aged 40 to 79 years surveyed in 1993 to 1997 and followed up to 2003. Among those without prevalent cancer or cardiovascular disease, 825 men who subsequently died were compared with a control group of 1489 men still alive, matched for age and date of baseline visit. Lower endogenous testosterone (the body’s own) concentrations at baseline were linked to mortality due to all causes (825 deaths), cardiovascular disease (369 deaths), and cancer (304 deaths). So this study found that in men, endogenous testosterone concentrations are inversely related to mortality due to cardiovascular disease and all causes and that low testosterone may be a predictive marker for those at high risk of cardiovascular disease.   What is the Effect of Testosterone Therapy in Older Men? But there are some emerging contradicting data from a much smaller study that showed that older men who have higher endogenous testosterone (without taking testosterone) might have a higher incidence of heart disease. A large U.S. multicenter study showed that older men with higher testosterone levels are more likely to have a heart attack or other cardiovascular disease in the future. The results were presented at The Endocrine Society’s 92nd Annual Meeting in San Diego in June 2010. Study participants were age 65 or older and included 697 community-dwelling men who were participating in the National Institutes of Health-funded study, called the Osteoporotic Fractures in Men (MrOS). None of these men were receiving testosterone therapy, according to the study abstract. All subjects had blood tests to determine their testosterone levels. The investigators then divided the men into quartiles, or four groups, of testosterone range to observe trends in rates of coronary heart disease events. This type of heart disease results from plaque-clogged or narrowed coronary arteries, also called atherosclerosis. A coronary heart disease event included a heart attack; unstable angina, which is chest pain usually due to atherosclerosis and which doctors consider a prelude to a heart attack; or angioplasty or bypass surgery to clear blocked arteries. During an average follow-up of nearly four years, 100 men, or about 14 percent, had a coronary disease event, in particular, heart attacks. After the researchers adjusted for other potential contributing risk factors for heart disease, such as elevated cholesterol, they found that higher total testosterone level relates to an increased risk of coronary disease. Men whose total testosterone was in the highest quartile (greater than or equal to 495 nanograms per deciliter, or ng/dL) had more than twofold the risk of coronary disease compared with men in the lowest quartile (below 308 ng/dL). So, this is contradictory data that may be concerning, but does it say anything about the cardiovascular risks of supplementing testosterone to men with testosterone deficiency? A report published in the New England Journal of Medicine in June 2010 about a study researching the use of testosterone gel in older men showed that such study was stopped early due to a higher incidence of side effects in men treated with the gel. Participants in this trial called the Testosterone in Older Men with Mobility Limitations, or TOM, were non-institutionalized men aged 65 and older who had difficulty walking two blocks or climbing ten steps and whose serum testosterone was 100 to 350 ng/dl (very low levels). So, these were frail older men. The goal was to recruit 252 men, but only 209 subjects had been enrolled by the time the trial, which started in 2005, was stopped on December 2010. Testosterone use had the desired effect of improving the men’s muscle strength and mobility. But they also experienced a high rate of adverse effects — not just cardiovascular problems but respiratory and skin problems. Unfortunately, they did not report hematocrit, estradiol, and bioavailable testosterone. I dream of the day when a study will be done the right way to include all of those variables. Only then we can draw the right conclusions about who is more prone to side effects. Managing high hematocrit with blood donation/phlebotomy and high estradiol with anastrozole can probably eliminate some of the reported side effects in older men, but there is only one way to find out: To have proper studies using those management strategies. To date, no study listed in clinicaltrials.gov is following men who are taking testosterone and who have access to phlebotomy or estrogen blockers to manage the two main side effects that may affect cardiovascular health in older men: high hematocrit and estradiol. Previous studies have shown that in general, older men have more side effects when using testosterone (polycythemia, gynecomastia, high blood pressure, prostatic hyperplasia) and more comorbid conditions. High hematocrit and estradiol increase clotting and viscosity, so it is not surprising to me that older men who use testosterone would have more cardiovascular risks if monitored poorly by their physicians. It amazes me how many older men using TRT are walking around with hematocrit over 54 and estradiol levels above 100 pg/dl without being offered phlebotomy or estrogen blockers. This is one of the main reasons I felt compelled to write this book. Older men also require more testosterone to reach normal levels since they have more sex hormone binding globulin that attaches to testosterone and renders it useless. So, physicians should carefully monitor these patients if they decide to provide testosterone replacement. The age cut off when the risk-to-benefit ratio of testosterone changes is not known yet. There are several studies that are currently being performed to provide more answers. A U.S.-based study showed that testosterone therapy does not increase men's risk for heart attack. The study, conducted by researchers at the University of Texas Medical Branch at Galveston, examined 25,420 Medicare beneficiaries 66 years or older treated with testosterone for up to eight years. It appeared in the July 2, 2012 issue of the Annals of Pharmacotherapy. So, the jury is still out. But if no complicating factors like high cholesterol, blood pressure or strong family history of heart disease are present, many doctors opt for prescribing testosterone to older men who need it to have a better quality of life. And most doctors keep an eye on hematocrit but few on estradiol. Hopefully, this will change as more doctors wake up to the risks associated with poor monitoring and management of TRT. It is the excessively high doses of testosterone used by athletes and recreational bodybuilders that are linked to significant decreases in the plasma concentration of HDL (high-density lipoprotein - the good cholesterol) and increases in LDL (low-density lipoprotein – the bad cholesterol). Replacement doses of testosterone have been shown to have only a modest or no effect on plasma HDL in placebo-controlled trials. Testosterone supplementation has been shown to decrease triglycerides, a dissolved fat that can lead to cholesterol increases and metabolic syndrome. In spite of these studies, some physicians continue to think that testosterone replacement can dramatically increase cholesterol levels.   What Can You Do to Prevent Heart Disease While on Testosterone Replacement Therapy? Given the state of the modern diet, all of us should have our doctor check our fasting cholesterol and triglycerides (another lipid-linked with heart disease risk). If you think that you have low testosterone, you may already have a problem with your lipids. The recommendations of exercise and diet (low in sugars and animal fats) apply for everybody but are especially important for men who have high LDL and high triglycerides at the time of starting testosterone replacement. Testosterone therapy can be an important part of your health regimen but don’t start it thinking that it will cure high cholesterol. Sometimes high lipids are related to poor diet, sedentary lifestyle, medication side effects, and bad genes. Your treatment for high cholesterol and triglycerides can also include statin and fibrates drugs prescribed to you by your doctor. I would try to modify your diet and to exercise before you jump on taking these medications since they may have muscle related side effects and do not correct the root cause of the problem, which is a metabolic abnormality that could be addressed with good adherence to lifestyle modifications. The key word is “adherence,” which seems elusive is many people who rather take a pill than watch their diet and exercise. For more on diet and exercise, refer to the chapter “ Miscellaneous Health Tips to Support Healthy Testosterone.” NOTE: I think you’re getting why I’m telling you that you need doctor’s supervision when on testosterone. So far you’ve read about the potential impact on hemoglobin and hematocrit, blood pressure, and estradiol, all of which can negatively affect your cardiovascular health. Imagine the even greater risk of those using testosterone at higher than replacement doses that usually buy it from underground sources and do not have a doctor who monitors them. No wonder testosterone and anabolic steroids get such a bad reputation. I tell bodybuilders that do not have a doctor to follow them to at least decrease their risks by getting a bodybuilder panel on DiscountedLabs.com that do not require a prescription. There are many around the United States, and you can find them by visiting DiscountedLabs.com . Of course, this is not the best solution and in no way a replacement for the supervision of a doctor. Irresponsible bodybuilders do more self-inflicted damage when their mistakes fuel the hysteria surrounding hormones in the United States. This hysteria has made it difficult for many men who need TRT to get it. Over-the-counter “testosterone boosters” may present problems with lipids, so do not think that because you are buying something at a health food store, that makes that product safe. Let your doctor know if you are taking any of those. Most do not work and those that did where banned by the FDA and taken off the market.   BUY A TESTOSTERONE BLOOD TEST PANEL   Reference:  From the book “Testosterone: A Man’s Guide” by Nelson Vergel (available on Amazon.com)

  The statistics are staggering regardless of where in the world they come from and the message they bring with them is the same – men are more likely to become infected with Covid-19 and die from it than women. In Europe, it has recently been estimated that 63 percent of all Covid-19 deaths are men. In one large subset of Covid-19 patients in China, more than 70 percent of those who died were men. And in New York City, as of early April, the rate of Covid-19 infection for women was 23 per 100,000, while for men it was nearly double that at 43 per 100,000. Data cannot lie, and there’s a lot more of it that all points to the same conclusion. Let’s first look at a few reasons why this trend exists then dive into a particular subset of men who are especially vulnerable to the coronavirus.   Men have More Preexisting Conditions We’ve heard it dozens of times. Anyone with a certain preexisting medical condition is more likely to be affected negatively by the Covid-19 virus, while those who do not have those conditions are more prone to a better outcome. Here’s the unfortunate part if you’re a man: Men have higher rates of nine out of the top 10 leading causes of death in the U.S. compared to women. All of those conditions are going to be problematic when you ask the human body to deal with another threat. But when it comes to Covid-19, conditions like heart disease, high blood pressure, and liver disease are all a concern and all conditions that men have in greater abundance than do women.   It’s in the Enzyme A recent study has shown that men have higher concentrations of angiotensin-converting enzyme 2 (ACE2) in their blood than women. Since ACE2 enables Covid-19 to infect healthy cells, researchers reported that this may contribute to men being more vulnerable to the disease than women.   Negative Lung Health Behaviors Research has suggested that smoking may play a role in Covid-19 deaths, as smoking is related to higher expression of those ACE2 receptors we mentioned above. However, it’s not just smoking that can have negative respiratory effects that may contribute to Covid-19 related problems. Air pollution is also a concern. And unfortunately for men, we’re the ones more likely to be working outside.   Women have Stronger Immune Systems It’s no surprise. A stronger immune system can ward off illness and disease more easily than an immune system that’s not working as it should. And thanks to an extra X chromosome, women appear more biologically capable of fighting those battles than men. According to Veena Taneja, who studies differences in male and female immune systems at the Mayo Clinic, the second X chromosome isn’t usually activated, but it can be activated. "Many of those genes are actually immune-response genes," Taneja said. She added this could provide women with an additional layer of protection against the coronavirus. That extra X chromosome is also thought to contribute to a higher rate of autoimmune diseases in women.   Low Testosterone in Men Makes Covid-19 Much Worse There are a number of reasons, as you can see from the above list, why men have a higher death rate when it comes to Covid-19. There are also a number of solutions: Be healthier in general. Don’t smoke. Make sure your immune system is getting the support it needs. But when it comes to Covid-19, there seems to be one factor in particular that separates strong males from susceptible males. A study published on April 27, 2020 has shown testosterone to be a key hormone in the context of the Covid-19 pandemic. The study points out that testosterone is reduced by age and many preexisting conditions and this, too, comes with higher rates of a poor Covid-19 outcome. The study found that low testosterone levels can cause a reduction in respiratory muscle activity, while normal testosterone levels have a protective effect on the respiratory system. Most importantly, researchers found a correlation between inflammation, testosterone, and the virus. The study highlights the role of proinflammatory cytokines in the progression of the Covid-19 infection and how any successful treatment must include reducing that cytokine activity. The study’s researchers also mention how testosterone may downregulate this inflammation and suggested, “testosterone may have a role in the cascade of events leading to progression of Covid-19 infection due to the cytokine storm.” According to another study, the majority of male patients with Covid-19 also presented with low testosterone levels on admission to the intensive care unit at University Hospital Hamburg-Eppendorf in Hamburg, Germany. According to the study, researchers “systematically analyzed sex hormones as well as cytokine and chemokine responses in male and female patients with laboratory-confirmed SARS-CoV-2 infections upon hospital admission.” Researchers also identified risk factors like hypertension (high blood pressure), cancer, obesity, type 2 diabetes, and chronic heart disease, with cancer being the only factor where the women admitted had a higher prevalence than the men. But it was their testosterone findings that were most surprising. Most male Covid-19 patients admitted to intensive care had low testosterone levels – 69 percent – and low dihydrotestosterone levels – 49 percent. Perhaps more shocking, most female Covid-19 patients had elevated testosterone levels – 60 percent. The study’s researchers concluded that “We here show that critically ill male Covid-19 patients suffer from severe testosterone and dihydrotestosterone deficiencies. Both androgens are required to mount antiviral immune responses to combat infection in males.” There is still much we don’t know about this virus and new information is coming in all the time. However, there are a few things that are becoming clear, like men having a higher prevalence of a bad outcome from Covid-19, but also how important testosterone levels are to every man’s chances of fighting this virus.   TIPS: Would you like to maximize your testosterone levels? Would you like to have more energy and enthusiasm for life? Would you like to increase your chances of successfully fighting Covid-19? Check out Nelson Vergel’s new 386-page illustrated book – Beyond Testosterone– for FREE. Simply follow that link to claim your copy. You can also find out if you have low testosterone by buying your own testosterone blood test cheaply online with no doctor order needed (U.S. only). Last but not least, chat with other men and experts about men's health and testosterone on the best men's health TRT forum.    

Table of Contents Diagnosing Your Fatigue Total and Free Testosterone Tests Thyroid Function Tests Adrenal Function Tests Glucose Tests Anemia Tests Immune Function Tests Iron Tests Order Fatigue Panel Here Fatigue is can be very frustrating for many people since it can have several causes. There's the normal tiredness we feel at the end of every day, the tiredness that comes from being a hard-working person. But sometimes that fatigue goes beyond just the "norm". It pervades your muscles, fogs up your brain, affects your mood and makes it impossible to focus and cope with stress. When this happens, you KNOW there's something wrong. You have tried taking supplements and energy drinks. You hoped that a healthy diet, a good exercise regimen and sleep habits would help, yet you're too exhausted to do anything. Does this sound familiar? If so, you may be at a loss to find out why you're so exhausted all the time. Diagnosing Your Fatigue If you find yourself exhausted all the time--and it goes beyond the tiredness from your normal daily activities--it's in your best interest to get checked out and have the cause of your fatigue diagnosed. Some physicians are trained in looking at different hormone deficiencies, but many people do not have access to them due to insurance or geographic limitations. Fortunately, Discounted Labs is happy to offer a brand new Fatigue Panel that includes a battery of tests designed to determine what's causing your fatigue. You can get this panel without the need of a physician’s visit. You can order this panel online in most states in the U.S. and go to a local lab to get your blood drawn. Your test results will be emailed to you and you will provide a free consultation with a trained clinician to guide you through your lab values. The truth is that there are A LOT of things that can cause your fatigue: everything from low testosterone to reduced thyroid function to adrenal gland problems. That is why this Fatigue Exploration Panel examines every one of these variables to determine the root of the problem. What does the Fatigue Exploration Panel include? Total and Free Testosterone Tests It's a well-known fact that low testosterone blood levels in men and women can lead to a reduction in energy, as well as a low sex drive, an increase in body fat accumulation, sleep problems, and decreased motivation. If these problems accompany your fatigue, it may be a sign that your testosterone levels are too low. The Fatigue Panel includes tests to measure both your total and free testosterone levels. Total testosterone includes the total testosterone (free and protein-bound) hormone in your body. Testing for total testosterone helps to determine if hypogonadism (under-production and secretion of testosterone) is the cause of your fatigue or other problems. Free testosterone is unbound to protein molecules, and thus more bioavailable. Low free testosterone can be another diagnostic tool since some men and women with normal total testosterone may have low free testosterone blood levels. Thyroid Function Tests Thyroid hormone deficiency is one of the most common types of fatigue a. The thyroid is a small butterfly-shaped organ that produces important hormones that affect just about every one of your body functions. Hypothyroidism, or an underactive thyroid gland, can cause fatigue, depression, weight changes, appetite changes, and even forgetfulness. Fatigue isn't the only sign you may have hypothyroidism. Other symptoms include: extreme sensitivity to cold, difficulty with weight loss even though you diet and exercise daily, brittle nails, and hair loss (especially on your eyebrows). If you notice any of these signs along with your fatigue, it's a good idea to get yourself checked out to determine whether or not your thyroid gland is functioning properly. Our Fatigue Panel includes a number of tests that will measure you thyroid function: TSH test -- This test measures the levels of thyroid-stimulating hormone (TSH) in your bloodstream. TSH is a hormone produced by your pituitary gland, and it's intended to signal to your thyroid gland to produce thyroid hormones to be released into your bloodstream. If your pituitary gland isn't producing enough or producing too much TSH, that may be the reason your thyroid gland isn't working properly. High TSH levels can indicate that your thyroid is working extra hard to stimulate T4 and T3 production, which can be the cause of your fatigue. Some physicians use TSH as the only measure of thyroid function, but we now know that TSH alone may not be accurate enough to do so. Free T4 Test -- This test is used to determine the unbound level of thyroxine, a hormone known as T4. This hormone converts into T3 to help your body produce energy, balance your heart rate, and maintain a steady temperature. Hypothyroidism can lead to insufficient production of this hormone, and may result in fatigue. Free T3 Test -- This test is used to determine the level of unbound triiodothyronine, a hormone known as T3. Free T3 helps to regulate your metabolism, heart rate, temperature, and more. Low free T3 levels can be a symptom of hypothyroidism, and may be behind your fatigue. Some physicians only measure total T3 and not its free, active portion which may be the main factor in diagnosing low thyroid function. Adrenal Function Tests Adrenal fatigue is the result of imbalances in your body, which can cause adrenal gland function to be reduced significantly. It's estimated that up to 40% of men over 60 years old suffer from "Stage 3 Adrenal Deficiency and Depression". That's a lot of people dealing with fatigue as a result of their adrenal gland problems. Your adrenal glands are responsible for producing the epinephrine ( adrenaline) that kicks in when you're stressed, excited, or scared. It's the "fight or flight" response that gets you "pumped up" in extreme situations. In normal situations, adrenal gland function returns to normal after the extreme situation passes. But in cases of chronic stress (work, home, health, family-related), the adrenal gland continues to produce cortisol and adrenaline, the two hormones that keep your "fight or flight" response on. The longer that response is on, the more energy is sapped. Adrenal fatigue is the result of over-production of these two hormones. Poor sleep quality worsens adrenal fatigue since the body tends to regenerate gland function during deep sleep. The use of stimulants is also an accelerator of this problem. What are some of the symptoms of adrenal fatigue? Aside from sheer exhaustion, there are a few others, including: dizziness, low blood pressure, depression, headaches, anxiety or panic attacks, low blood sugar, and other equally debilitating problems. DiscountedLabs.com’s Fatigue Exploration Panel includes two tests to measure adrenal function: -Salivary cortisol test -- This measures the amount of cortisol in your body. While most tests measure cortisol in your bloodstream, salivary cortisol tests kits can be taken home for sampling during the day to see changes in cortisol from morning to night time. This test allows for the collection of 4 samples during the day that you bring back to the lab. -DHEA test -- This test measures the levels of DHEA-S in your blood. DHEA-S is an androgen hormone produced in the adrenal glands. If levels of DHEA-S are too high, they may indicate adrenal hyperplasia, or overproduction of adrenal hormones. Low DHEA-S can be indicative of adrenal dysfunction and fatigue. Glucose Tests Glucose is the fancy name for "sugar", and blood glucose is your body's primary source of energy. When you eat, your body turns carbs and fats into glucose, which it then sends around your body to as fuel for all of your organs. Too-high levels of glucose can cause damage to your blood vessels, nerves, and organs, so your body is designed to respond by producing insulin, which helps to reduce blood sugar levels. Once your blood sugar is back to normal levels, insulin production stops and everything runs smoothly. But there's a problem: the more often you have high blood sugar and the higher your blood sugar levels, the more insulin your body has to produce. Excessive carb intake (a problem in our modern diet) can lead to excessive insulin production, which causes your blood sugar levels to drop TOO low. This can cause fatigue, and your body will respond by producing appetite hormones that encourage you to eat. Of course, these hormones will tell you to eat something that will give you a quick dose of blood sugar, which often leads to you eating something with too many carbs. Around and around the vicious cycle goes. If this continues over the course of years, your body becomes desensitized to insulin. This means it takes more insulin to have the same effect, so the insulin produced by your pancreas is insufficient to reduce your blood sugar levels. Chronically high blood sugar can lead to inflammation, slow your circulation, deprive your body of oxygen, and produce monocytes that can cause fatigue when they are absorbed into the brain. Diabetes fatigue is a very real thing, and even non-diabetics can suffer fatigue as a result of their high blood sugar levels. The Fatigue Panel includes an A1c test, a blood test commonly used to diagnose Type 1 and Type 2 Diabetes. This test measures your average blood sugar level for the past 60-90 days, examining the amount of glycated hemoglobin (sugar-coated oxygen-carrying red blood cell proteins) in your bloodstream. Higher levels of A1c can indicate poor blood sugar control, and thus point to an increase risk of diabetes--and diabetes fatigue! Anemia Tests Anemia is a condition in which your body doesn't have enough red blood cells to transport oxygen and nutrients to the various organs, functions, and systems. Without enough oxygen and nutrients, your body essentially starves, leading to fatigue, dizziness, weakness, irregular heartbeats, and more. The Fatigue Panel includes tests to measure both hemoglobin and hematocrit: -Hemoglobin tests measure the levels of hemoglobin, the protein molecule in your red blood cells that carry oxygen. Too-low levels of this molecule may be a sign of anemia. -Hematocrit tests determine your blood's red cell percentage. People with low hematocrit are anemic, and thus may suffer from fatigue. -Mean Corpuscular Volume (MCV) tests measure the size of red blood cells. If the red blood cells are large, they may indicate anemia due to vitamin B6 or folic acid deficiency. If the red blood cells are small, they may indicate anemia due to iron deficiency. -Mean Corpuscular Hemoglobin (MCH) and Mean Corpuscular Hemoglobin Concentration (MCHC) tests measure the amount of hemoglobin in red blood cells. Both hemoglobin and hematocrit are used to calculate this number. Low levels indicate anemia. -Red Cell Distribution Width (RDW) tests are often used with MCV results to figure out what could be causing the anemia. If anemia is the cause of your fatigue, it's vital to get diagnosed as soon as possible. Anemia can be a very serious problem if left untreated! Immune Function Tests Your immune system is responsible for handling all invading threats to your body, including bacteria, viruses, fungi, spores, and all other pathogens. It also handles injuries, cellular mutations, and other internal problems. But your immune system requires energy to function. Chronic inflammation, infection, and injury may lead to fatigue, as your body is constantly using energy to deal with whatever is going wrong in your body. The Fatigue Panel includes a White Blood Cell Count test, which is designed to determine if there is infection in your body that could be the root cause of your fatigue. Or, your bone marrow may no longer be producing the white blood cells, which could indicate a number of other (more serious) problems. Iron Tests Iron is needed to produce red blood cells, meaning a lack of iron (iron deficiency) can lead to anemia. The Fatigue Panel offers an iron test to determine if serum iron levels are high enough for normal body function. However, there are also two other tests included to help determine your body's ability to absorb, utilize, and store iron: -TIBC tests, or total iron binding capacity tests, measure the levels of iron in your blood. If the TIBC is high, it means there is insufficient iron. -Ferritin tests measure the levels of ferritin, the protein responsible for storing iron in your body. Low ferritin levels are an indication of iron deficiency, which can lead to anemia. These tests are very helpful to determine if iron is the reason behind your fatigue (anemia fatigue). Our Fatigue Panel is the lowest-cost fatigue exploration panel offered anywhere. Take advantage of these tests to find out exactly what's causing your fatigue, and take steps to deal with the problem today. Order Fatigue Panel Here For more information about how DiscountedLabs.com services work, please the read the frequently asked questions.  

Table of Contents High hematocrit: the main side effect of Testosterone Replacement Therapy (TRT) What are the symptoms of high hematocrit? What are factors that increase the risks of TRT polycythemia ? How to Lower Hematocrit? How to Manage Increased Hematocrit Caused by Testosterone Replacement Therapy High hematocrit: the main side effect of Testosterone Replacement Therapy (TRT) Testosterone replacement therapy (TRT) is one of the most effective ways to combat low testosterone levels, but it's vital that you understand the risks associated with the treatment. As with any form of hormone replacement therapy, there are a few downsides to receiving regular injections of testosterone. But do these risks outweigh the benefits? That's a decision you'll have to make for yourself! Note: Remember the purpose of TRT: to restore testosterone to NORMAL, healthy levels in the body. Ideally, testosterone levels should be normal after TRT. Even at normal levels, there is a risk of side effects. One of the primary risks of testosterone that is you need to be aware of is called polycythemia. This is a condition where your body produces too many red blood cells, also known as high hematocrit level. Hematocrit refers to the red blood cell content in your blood. If your hematocrit levels rise, your blood will become too thick or viscous. This can, in turn, make it more likely that you will develop strokes, heart attacks, and clotting events. Polycythemia is serious and potentially life-threatening if untreated.   What are the symptoms of high hematocrit? In recent years, there has been an increased association between TRT and polycythemia. With TRT becoming a more mainstream treatment, more people are experiencing the symptoms of polycythemia, which include: Weakness Fatigue Headache Itching redness of the skin bruising joint pain dizziness abdominal pain shortness of breath breathing difficulty when you lie down numbness, tingling, or burning in the hands, feet, arms or legs Turning very red or "flushing" after workout When polycythemia occurs, the blood becomes very thick. But instead of being able to carry MORE oxygen, the increase of red blood cells can be dangerous. The risk of clotting increases as a result of the red blood cell count increase. Note: While there is a risk of hematocrit increase, there is no proof that TRT increases the risk of clotting events. It's vital to be aware of the potential risk, so doctors need to be careful when prescribing TRT to men with high hematocrit levels, red blood cell disorders, and obstructive pulmonary disease. All of these things increase the risk of clotting events as a result of the hematocrit increase caused by TRT.   What are factors that increase the risks of TRT polycythemia ? There are a number of factors that can increase your risk of developing this problem. According to Dr. Michael Scally, polycythemia "occurs quite frequently in people who are on replacement testosterone." Age also plays a role in your polycythemia risk. Young men are far less likely to experience this problem than older men. The mode of delivery and the dose of testosterone affect the increase in your hematocrit levels. Men who receive formulations of pharmacokinetically steady-state delivery hormones are far less likely to develop the problem than men who receive intramuscular injections of testosterone. Topical preparations only cause the problem in up to 20% of cases. 5 to 15% of those who use testosterone patches develop polycythemia, while 10 to 20% of those using the testosterone gel develop the problem. Of course, the amount of testosterone delivered per day (50 to 100 milligrams) also affects the risk of developing polycythemia. Testosterone injections may increase hematocrit more than gels, patches, pellets, nasal or oral testosterone formulations.  Smaller injection doses given more frequently may increase hematocrit less rapidly than larger dose injections, but data are lacking to prove that fact. Men with sleep apnea or those who smoke are at the highest risk of high hematocrit since their bodies are trying to compensate for the decreased oxygen level by producing more red blood cells.  TRT enhances that red blood cell production.   How to Lower Hematocrit? So what can you do about the problem? Is there any way to manage it? Those undergoing TRT must be aware that polycythemia is a real risk, as do their doctors. They must keep a close eye on their hemoglobin and hematocrit levels. If hematocrit rises above 52%, further examinations may be necessary. Some doctors counsel reducing or stopping testosterone treatment. However, for those who are undergoing TRT as a means of restoring healthy hormone levels, this may not be an option. Some means of managing and reducing the risk of high hematocrit levels include: Scaling back on the amount of testosterone gel delivered per day (50mg or less) or injection dose. Changing the method of administration (using more frequent injections with smaller doses, or using a testosterone gel or cream) Making sure that you are hydrated when you get your blood drawn for lab tests Stopping smoking Getting sleep apnea diagnosed and treated with a CPAP machine to enhance oxygen saturation levels when sleeping. If these options do not work, a therapeutic phlebotomy (blood donation) may be the answer. Removing just one unit of blood can help to lower hematocrit by as much as 3%. For those with very high hematocrit levels, the therapy may continue for months, gradually reducing hematocrit to safe levels over time. Some physicians even prescribe regular phlebotomies (no more frequently that every 56 days is the safe frequency to avoid iron loss) as a means of preventing overly high hematocrit levels. While phlebotomies are not covered by your insurance, they can be performed at any blood bank. Even if your insurance company won't cover the cost, you can solve the problem by donating blood (provided you are free of hepatitis, HIV, and other blood-borne infections). Experts agree that donating every 2.5 to 3 months is safe, and it's a good way to keep your hematocrit levels under control. It is important to note that hematocrit can stabilize in men on longer term TRT, so many men do not have to donate blood after a few months on TRT. Warning: Donating more than 1 unit of blood more frequently than every 2.5 months can lower your iron and ferritin levels. This can cause fatigue. Make sure to replace the lost iron with a supplement in order to prevent anemia. You can check your iron and ferritin with this iron blood test. It's recommended that you donate when you are in the 51-52% hematocrit range. However, some organizations (like the Red Cross) will reject blood with a hematocrit higher than 53%, so it is good to avoid that hematocrit high level if you want to donate blood. Hematocrit is included in the CBC and other panels: Get Your Hematocrit Test Now Testosterone, Hematocrit, Ultrasensitive Estradiol and Prolactin Panel Hematocrit + Total and Free Testosterone   To find out more information, click  How to Manage Increased Hematocrit Caused by Testosterone Replacement Therapy

Table of Contents Brain Aromatase and Why It’s Not a Good Idea to Reduce Its Activity Estrogen and its beneficial effects in bodybuilding Estrogen function in men and why inhibiting its production can be detrimental.  High estrogen levels and prostate cancer Testosterone’s conversion to estrogen is important to eliminate anxiety and depression Testosterone activity in the brain High estradiol levels are not correlated with erectile dysfunction Estradiol improve endothelial function in healthy men Estradiol and libido, erectile function and reproduction How estradiol works when testosterone levels are low Estradiol and its influence in eugonadal men (men with normal testosterone levels.) Analyzing the role of estradiol on hypogonadal men who undertake testosterone replacement therapy Aromatase inhibition can decrease insulin sensitivity The relationship between estrogen and bodybuilding Estradiol and DHT can make you age more slowly Symptoms of low estradiol in men Estradiol and reproductive function in men Brain Aromatase and Why It’s Not a Good Idea to Reduce Its Activity Every man has free and bound testosterone circulating through his bloodstream. The bound testosterone is attached to either sex hormone-binding globulin or albumin. The free testosterone is available in small quantities in comparison with the bound testosterone. A small portion of it is converted to estrogen using the enzyme called “aromatase”. Although estrogen is a female sex hormone, it plays an important role in a male’s body too. For example, estradiol, a type of estrogen, is vital for proper sexual functioning and libido in men. However, too much estrogen can be detrimental, leading to poor sexual functioning, poor erections, accumulation of fat in the abdominal area and male boobs (gynecomastia). During testosterone replacement therapy (TRT), some men take drugs to inhibit aromatase and prevent it to convert too much testosterone into estrogen. these drugs inhibit the aromatase enzyme. Although this might sound like a good idea at first, altering the normal production of aromatase can lead to brain inflammation, studies suggest. The levels of aromatase and estrogen have been measured in injured brains and it has been discovered that the aromatase enzyme increased to protect the damaged neurons and the connections between them. Evidence concludes that inhibiting the normal levels of aromatase can lead to inflammation in healthy brains and more injury to already damaged brains. This happens because the aromatase/estrogen expression is moved from neurons to astrocytes which are a different type of brain cells. Astrocytes act as a cushion for neurons and they are usually more active when brain injury is detected. These cells can help with the healing process, but if they stay active for too long, this can lead to further damage to the brain. Studies also show that an insufficient amount of brain aromatase can indicate neurodegenerative diseases such as Alzheimer's. Low amounts of aromatase can increase plaque development which damages the brain. That’s why it is recommended to be careful when taking an aromataseinhibitor during testosterone replacement therapy as this drug might mess with the normal levels of aromatase and lead to brain complications.   Estrogen and its beneficial effects in bodybuilding Estrogen, one of the most important female sex hormone, is vital for professional athletes who aim at increasing their muscle mass. For example, estrogen can increase the anabolic response by modifying the way glucose is processed in muscle tissue. This hormone can influence the amounts of glucose 6-phosphate dehydrogenase which is directly correlated to muscle growth and repair. In other words, having adequate amounts of estrogen can maximize muscle gains and strength. In studies performed on rats, estrogen has also been correlated with a whopping 480% increase in methyltrienolone which is an androgen connected to the levator ani muscle. The production of growth hormone and IGF-1 (insulin-like growth factor) are also influenced by estrogen. This female sex hormone can increase the proliferation of IGF-1 in body tissues and liver which leads to greater muscle gains and protein synthesis. Estrogen also plays an important role when it comes to serotonin production. Serotonin is known for regulating the sleep/waking cycle. Bodybuilders who take aromatase inhibitors as drugs might have low levels of estrogen in the body. This can alter the serotonin production and lead to a thing called “steroid fatigue”. This is usually characterized by a general feeling of tiredness which can interfere with training regimes and prevent the athlete from performing at his peak. Maximizing muscle gains can be difficult in this case. Estrogen function in men and why inhibiting its production can be detrimental.  The aforementioned aromatase inhibitors are taken orally while one of them can be injected. There haven’t been studies assessing the short-term symptoms of these drugs on the physiology of an athlete. However, although drugs which inhibit aromatase and subsequently reduce estrogen levels are not usually used for a long period of time, they can cause problems when the estrogen drops under the normal range limit. Estrogen, particularly estradiol, is a powerful hormone which influences multiple body processes in both men and women. For example, estrogen can be anabolic in certain tissues such as bone and fat. It directly impacts bone density and can influence how much fat the body accumulates, particularly in the abdominal area. Estrogen can also have a stimulatory role and it influences protein production in the liver. It has a metabolic effect in the endocrine system and influences the binding globulins for vitamin D. Estrogen is also a neurosteroid influencing neurotransmitters in the brain. This can have an effect on emotions, motivation, and other functions. Since estrogen is so important in the human body, it is safe to assume that reducing it to dangerously low levels using drugs can have negative consequences on health. Similarly, having estrogen levels above the normal limit can also be detrimental for a male’s body. The key is to maintain balance when it comes to estrogen levels and make sure that estradiol E2 doesn’t drop below 20pg/mL.   The effects of aromatase inhibition on bone mineral density in older men A study was conducted at a tertiary care academic center in Boston, MA, measuring the levels of testosterone and estradiol of 69 men over 60 years of age. The participants had borderline or low testosterone levels and the study included a placebo group. The purpose of the study was to determine the effect of aromatase inhibition on bone mineral density and bone turnover. Each participant received 1 mg of an aromatase inhibitor daily or a placebo drug. At the end of the study, the serum testosterone increased from 319 ± 93 ng/dl at baseline to 524 ± 139 ng/dl in month 3 and dropped slightly after one year. The estradiol levels also decreased from 15 at baseline to 12 after 3 months and remained there. The bone mineral density decreased in the aromatase inhibitor group in comparison with the placebo group. Taking aromatase inhibitors reduce the amount of testosterone which is converted to estradiol and because participants had less estradiol in their bloodstream, their bone mineral density also dropped. This concludes that estradiol is important for bone mineral density, particularly in older men. Is anastrazole for men a good idea?   High estrogen levels and prostate cancer Some studies conclude that high levels of estrogen might help develop prostate cancer cells, but men who already have prostate cancer don’t have high levels of estrogen in the bloodstream. Other studies show that a sharp increase in estrogen levels might lead to prostate cancer, but more information is required to reach a definitive conclusion. A small part of the free testosterone which circulates through the bloodstream is converted into estrogen. This hormone is required for maintaining proper health and avoiding cardiovascular diseases as well as diabetes type 2. On the other hand, low testosterone levels have also been associated with an increase in prostate cancer cells. A significant body of evidence indicates that high estrogen levels might be dangerous for men and affect their prostate only when testosterone levels are too low. Increasing testosterone levels through TRT (testosterone replacement therapy) will also increase estrogen levels in a natural way, but this doesn't automatically mean that the risk of prostate cancer will be higher. Approximately 50 years of studies show that testosterone administration alone doesn’t lead to prostate cancer.   Testosterone’s conversion to estrogen is important to eliminate anxiety and depression It is estimated that approximately 20 million adults in the United States are affected by depression each year. Many of these people receive antidepressants and anti-anxiety drugs, but this medicine can have different effects on certain people and they don’t come without side effects. Testosterone plays an important role in reducing anxiety and depression feelings in men, while estrogen and progesterone also act together as a protective mechanism against depression in women. Women, in particular, are 70 percent more predisposed to depression during their lifetimes, in comparison with men. However, certain low-testosterone males also develop depression and antidepressants seem to be inefficient for them. New evidence suggests that the conversion of testosterone to estrogen is necessary to reap the antidepressant effects of testosterone. Professor Mohamed Kabbaj reached this conclusion during his studies which were promoted by the National Institute of Mental Health. It has been discovered that there is a link between testosterone conversion to estrogen and depression in animal studies, but this link might be valid in human studies as well. This might lead to new antidepressants which impact the brain differently and are more efficient for low-testosterone men. Testosterone influences a plethora of pathways in the brain and it can have multiple side effects. That’s why it is important to develop a drug which acts only on the pathways responsible with anxiety and depression. Some of the side effects caused by antidepressants include heart problems and these should be avoided. Better drugs are necessary to impact the brain differently and safely treat anxiety and depression feelings. Dr. Kabbaj discovered that the antidepressant effects of testosterone happen only after this hormone has been converted to estrogen. The conversion process is regulated by a special enzyme in the brain. Dr. Kabbaj inhibited this enzyme in the hippocampus area of the brain. This area is responsible for mood regulation and has a strong influence on how a person feels. When this enzyme has been inhibited, the antidepressant effects of testosterone weren’t present. This leads to the conclusion that the conversion of testosterone to estrogen is very important. Testosterone impacts the MAPK pathway in the brain to produce these positive and beneficial antidepressant effects. However, this pathway is also implicated in multiple other body processes, including cell growth and cancer. More work is required to find out ways to get the antidepressant effects of testosterone without increasing the risk of cancer. Testosterone activity in the brain Tests have been done on rats to discover the behavior of testosterone when it enters the brain. Castrated rats have been injected with estradiol instead of testosterone and the recovery process of intromission and ejaculation worked normally. The estradiol was injected into the hypothalamus. However, when DHT was injected instead of testosterone (DHT is a powerful androgen which doesn’t convert to estrogen), no recovery process was detected. This concludes that testosterone converts to estrogen when it is injected into the hypothalamus and facilitates sexual behavior. The aromatase enzyme is present in this part of the brain as well as estrogen receptors. It has also been discovered that injecting drugs which block the aromatization process of testosterone to estrogen can change the behavioral effects of testosterone and significantly influence sexual function. This means that testosterone must convert to estrogen to enable proper male sexual behavior. Further studies show that inhibiting the aromatization process in monkeys can interfere with their sexual behavior. Men who have a congenital deficiency of aromatase also have a low sex drive and they can benefit greatly from small doses of estradiol to improve sexual functioning. The testosterone’s effects on male sexuality are twofold. This hormone influences libido directly with the help of androgen receptors and indirectly using estrogen receptors. However, more work is necessary to determine the exact differences between these effects.   High estradiol levels are not correlated with erectile dysfunction Contrary to the popular belief, high estradiol levels are not associated with poor sexual function in males. A study was conducted on low testosterone centers in the United States, comprising more than 34,000 men. The participants had different ages, some of them being younger than 25 while others being older than 65. Estradiol levels were measured using electro-chemiluminescence immunoassay and it has been discovered that having too much estradiol in the bloodstream doesn’t lead to poor sex drive and erectile dysfunction. It has also been discovered that those with low or normal estradiol levels have a higher incidence of poor sex drive and potential erectile dysfunction.   Estradiol improve endothelial function in healthy men Studies show that estradiol (sometimes written as oestradiol) can improve endothelial function in healthy men. The endothelium is a very thin membrane which lines up the insides of your blood vessels and heart. It can also be found on lymph vessels. Its role is to release substances which help relax or constrict the blood vessels, depending on various factors. The endothelium is also important for controlling platelets, blood clotting and to regulate immune function in men and women. It is already known that supplementing with estrogen (particularly estradiol) is linked to a reduced incidence of cardiovascular disease in women who are deficient in this hormone. The purpose of the study is to determine if estrogen can also be beneficial for the endothelial function in healthy men. The study included 23 men aged 32 years, give or take up to 8 years. They were split into three groups. One group was given testosterone supplements alone, one group received a combination of testosterone and 10mg of estradiol and the third group received testosterone and 20mg of estradiol. These participants were measured one month and six months after multiple tests were performed to determine the influence of estradiol on their health. The study concluded that those who received estradiol supplementation had a better endothelial function. This means that administering estradiol to healthy men can improve their cardiovascular system.   Estradiol and libido, erectile function and reproduction Estradiol impacts multiple processes in a human body and it can have a strong influence on the brain. This hormone can directly influence the brain and dictate the sexual behavior of mammals, creating arousal states and moods which are conducive to reproduction. This is done by the release of pheromones. These substances can increase activity in the area anterior to the hypothalamus. Neurons play an important role in converting testosterone to estrogen using the aromatase enzyme. There are billions of neurons in the brain and they transmit electrical information 24/7, helping humans function correctly. Another important brain cell is the astrocyte. These cells help the neurons transfer information from one part of the brain to the other. They are star-shaped cells which play an important role, particularly when the brain is injured and they also use the aromatase enzyme to convert testosterone to estrogen. The anterior area of the hypothalamus contains numerous estrogen receptors. These receptors work similarly to selective serotonin reuptake inhibitors which are known for lowering sex drive. This might indicate that estrogen can significantly influence sexual functioning and behaviors in men.   How estradiol works when testosterone levels are low Having low testosterone levels can definitely lead to poor sexual functioning and lack of libido. To determine the efficacy of estradiol in men and what influences it has, it is important to analyze it in people who have normal as well as low testosterone levels. Studies have been done on men with low testosterone. They received doses of estradiol and reported an increased sexual drive. These human studies are supported by the ones performed on rats. Castrated rodents were given estrogen and it has been discovered that this increased their sexual activity. Another important finding consists of patients who had prostate cancer and received androgen deprivation therapy. This type of therapy is known to slow down or completely stop the advancing of prostate cancer since the cancerous cells require testosterone to grow. When the androgen levels reached a critical point, the patients reported symptoms which are commonly found in people who have a low sex drive and erectile dysfunction such as hot flashes and other adverse effects. It has also been discovered that androgen receptor blockers are more efficient in maintaining sexual activity in comparison with castration. This might happen as a result of testosterone conversion to estrogen. It is possible that supplementing with estradiol might make patients who undertake androgen deprivation therapy have increased brain activity in those areas responsible with sexual behavior.   Estradiol and its influence in eugonadal men (men with normal testosterone levels.) Eugonadal means men with healthy testosterone levels. Estradiol has been proven beneficial for people with low testosterone levels, increasing libido, and sexual desire. However, some studies show that the same positive results don't apply to eugonadal men. One study was performed on men with healthy testosterone levels. They received estradiol on a regular basis and they reported a decrease in sexual functioning, libido, masturbation, and erections. On the other hand, another study reported that administering estradiol to 50 men aged between 20 and 40 years didn’t influence their sexual function and libido at all. More research is required to understand how estradiol affects eugonadal men, but administering this hormone exogenously can be beneficial for people who have testosterone levels, increasing their libido and sexual desire.   Analyzing the role of estradiol on hypogonadal men who undertake testosterone replacement therapy Testosterone supplementation therapy aims to improve the quality of life of hypogonadal men as well as increase the levels of circulating testosterone in their bloodstream. This therapy also tries to increase the number of testosterone metabolites such as estradiol which is known for playing a vital role in sexual desire. In a test performed on men with secondary hypogonadism, c l o mi phene was used to increase the levels of testosterone by influencing the estrogen receptors directly. Secondary hypogonadism means that the testicles function correctly, but there is a scarcity of luteinizing hormone produced by the pituitary gland and this translates into low testosterone levels. The clomiphene citrate managed to increase testosterone levels in men with secondary hypogonadism as well as increasing the conversion of testosterone to estrogen. Other studies show that clomiphene citrate can increase sexual desire and libido. Another study performed in 2013 looked at the role of testosterone in healthy men and how it can influence sexual behavior. Some of the study participants received testosterone in combination with aromatase inhibitors, while others received testosterone without aromatase inhibitors. As a result, the sexual function was impaired when aromatization was inhibited. Other studies show that sexual desire increased significantly when men received testosterone supplementation therapy and had estradiol levels above 5 ng/dl. Even when testosterone levels were below 300 ng/dl and the estradiol levels were higher than 5 ng/dl, the sexual desire was increased. Yet another study looked at the sexual behavior of men who received l etr ozole which is a powerful aromatase inhibitor. These men had low testosterone levels and after being given le tro zole, their estradiol level dropped even lower. The result was that libido was significantly decreased. This means that both testosterone and estradiol are important in people who have testosterone deficiency to achieve and maintain healthy sexual desire and libido.   Aromatase inhibition can decrease insulin sensitivity Insulin sensitivity is extremely important when it comes to diseases such as diabetes type 2. Those who have low insulin sensitivity are more predisposed to become diabetic in the future. Inhibiting the aromatase enzyme through different types of drugs can have a significant influence on insulin sensitivity in both humans and rats. A study conducted at a clinical research facility tested 17 healthy men with ages between 18 and 50 years. This was a double-blind, controlled study. Each participant received an aromatase inhibitor, or a placebo drug for 6 weeks. The study concluded that inhibiting aromatase can lead to poor insulin sensitivity, particularly when it comes to peripheral glucose disposal.   The relationship between estrogen and bodybuilding It is well known that estrogen gives you a feeling of wellbeing and the lack of it can lead to depression, mood swings, emotional instability, and even depressive thoughts. Aromatase inhibitors can reduce the amount of estrogen the body produces and it usually makes a person feel lethargic and unhappy. For example, menopausal women seem to become more emotionally unstable and being haunted by feelings of anxiety and depression. Studies show that this can also be the case for bodybuilders and top athletes who regularly take aromatase inhibitors to convert less testosterone to estrogen. Estrogen is vital when it comes to sexual drive and libido as well and it is a well-known fact that aromatase inhibitors can negatively impact sex drive. A study on two groups of men reached the conclusion that estrogen is very important for libido. The first group received testosterone treatment alone while the second group received testosterone and an anti-estrogenic agent. At the end of the test, the group who received only testosterone treatment had better sexual drive and libido. Researchers also believe that lowering the estrogen levels too much in healthy men can lead to anxiety feelings, depression and even osteoporosis.   Estradiol and DHT can make you age more slowly Another study performed in Australia looked at the link between telomere length and the amount of serum estradiol and DHT in men. Telomeres are sequences of nucleotides at the end of each chromosome. They are used as a biomarker for aging. Having shorter telomeres means that the biological age is higher, regardless of the actual age of the person. Having longer telomeres correlated with a smaller biological age which basically means that the person is younger than his or her real age. The study performed in Australia looked at the telomere lengths of men aged 53, give or take approximately 15 years. The conclusion of the study was that estradiol and DHT correlate with telomere length and a small reduction in estradiol can amount to an approximate age increase of a decade. Estradiol alone can influence telomere length and that’s why it is important not to reduce it too much using aromatase inhibitors.   Symptoms of low estradiol in men A study performed in a medical center on several hundred men concluded that lack of estradiol can give certain vasomotor symptoms similar to those menopausal women have. These symptoms include hot flashes, sweats and flushes. The study participants were healthy men with ages between 20 and 50 years. They had normal serum testosterone levels and were split into two groups The first group of men was administered goserelin acetate which stops gonadal steroids. After 4 weeks, they received placebo drugs or different doses of testosterone gels. The second group of men received a treatment similar to those in the first group, but they also received an inhibitor of the aromatization of testosterone to estrogen. The study concluded that those who received aromatase inhibitors and had low estradiol levels experienced vasomotor symptoms such as night sweats and hot flashes. Similarly, those who received high doses of testosterone gel (approx 10 grams daily), as well as aromatase inhibitors, didn't experience the same symptoms. This means that when high amounts of testosterone are administered, it can suppress the effect of the aromatase inhibitor and leave estrogen levels intact.   Estradiol and reproductive function in men The sexual function in males is directly influenced by a mix of multiple substances and organs including testosterone, estradiol, estrogen receptors, testes, penis, and brain. The aromatase enzyme and estrogen receptors have a similar location in the brain and they are important in the development of sexual function early in life. They also influence sexual behavior in adulthood in combination with other substances called pheromones. Estrogen influences the mood and libido of a man, enabling him to alter his cognition for a mental state conducive to reproduction. Spermatogenesis is another important part of male reproduction. The creation of sperm cells relies on estradiol and these cells contain estrogen receptors and the aromatase enzyme. Men who undertake testosterone supplementation therapy should also be monitored for their estrogen levels. This is because an estradiol level below 5ng/dl can cause a significant drop in sex drive and libido.   Conclusion The role of estrogen in the male body is unquestionably important. Bodybuilders, professional athletes, and patients who undertake testosterone replacement therapy should be careful when it comes to managing estradiol levels since this hormone can significantly impact their wellbeing, sex drive, and bone density.   Get Your Estradiol Blood Test and Find Out More!

Table of Contents Today's Young Men Have Almost 30 Percent Less Testosterone Sleep Disruption: Stress and Fatigue Can Reduce Testosterone Levels Carrying Too Much Weight Can Reduce Testosterone Levels Poor Diet and Consumption of Marijuana Might Be a Problem Lack of Physical Exercise Leads to a Decrease in Testosterone Levels Check Your Testosterone Levels Often References: There is no need to emphasize the considerable importance of testosterone in the human body, especially for men. This hormone helps build muscle, maintains healthy bones, improves cognition, and enhances sleep quality, not to mention its essential role in fertility. However, recent studies show an alarming drop in testosterone levels, particularly for young men. In other words, today's teenagers have less testosterone circulating through their bloodstream than the youngsters of 15-20 years ago. If you're curious to learn the causes of this drop in testosterone levels, keep reading this article. You'll find insightful answers to questions you already have about testosterone and know what lifestyle changes you can make to increase the production of this vital hormone. Today's Young Men Have Almost 30 Percent Less Testosterone It might be hard to believe, but recent studies show that men between 15 and 39 have almost thirty percent less testosterone compared to men within the same age group of 15-20 years ago. More specifically, if the average testosterone level was around 600 nanograms per deciliter of blood almost two decades ago, now it's about 400 nanograms per deciliter for men aged 15-39. That's a significant decrease caused by multiple lifestyle and environmental factors. Let's look at some of these causes and see why today's young adults experience this significant drop in testosterone levels. Sleep Disruption: Stress and Fatigue Can Reduce Testosterone Levels One of the most important causes of testosterone decrease is excessive stress. Today's young adults are very busy, and they're constantly bombarded with information and stimulation from social media and other platforms. They are sleeping less and exposing themselves to light from electronics late at night. This light can disrupt sleep patterns.  Several studies have shown that most hormones, including testosterone, peak during the sleep cycle.  A disrupted sleep cycle and circadian rhythm negatively affects testosterone, growth hormone, thyroid, and other hormones. This makes the adrenal glands release more cortisol which is the main stress hormone in the body. Too much cortisol coupled with fewer hours of sleep per night results in testosterone levels that can plummet faster than ever. Ideally, adults should sleep around 7 hours per night and engage in activities that decrease cortisol levels in the bloodstream. One of the best ways to reduce your stress levels is to go to the gym, walk or run, practice yoga, or play a musical instrument, not to mention spend more time with people you love. Carrying Too Much Weight Can Reduce Testosterone Levels Obesity and being overweight is another important factor that can explain the testosterone decrease in young men. Several studies show that higher body mass index (BMI) can result in lower testosterone levels.  There is an obesity epidemic in the US and most countries not only in adults but also teenagers and children. At the same time, being overweight increases your chances for chronic diseases, reduces your stamina and energy levels, as well as makes the body produce more toxic hormones. Do your best to exercise at least three times a week and your testosterone levels will eventually get back to normal. Poor Diet and Consumption of Marijuana Might Be a Problem Eating a diet that lacks nutritional value is hands-down one of the key factors when it comes to testosterone production. In other words, if you eat a lot of junk food, drink many fizzy beverages, and don't take a multivitamin supplement, your testosterone levels might significantly decrease each year. You should provide your body with vitamins, minerals, and other nutrients to help it function optimally. Try to eat more vegetables, fruit, and lean meats such as chicken and turkey, as well as healthy fats coming from seeds and olive oil. The Mediterranean Diet is one of the best ways to increase testosterone levels and longevity. At the same time, an increasing body of evidence suggests that excessive marijuana consumption is associated with a decrease in testosterone levels. The occasional joint might not do too much harm but smoking every day can have an impact on your hormones, particularly your testosterone. Lack of Physical Exercise Leads to a Decrease in Testosterone Levels As mentioned earlier, doing just three or four workouts per week for a minimum of thirty minutes can prevent a decrease in testosterone levels. Today's young adults spend a lot of time in front of their computers doing their work or getting entertained. This sedentary lifestyle is one of the most important causes of disease in the United States and throughout the entire world. It also makes testosterone levels drop at an alarming rate. The solution is not to quit your IT job and go work in a field. Instead, you should compensate by consciously engaging in physical activities a few times per week. Go for a jog, take your friends, and play squash or another racket-based sport. If you love it, go for a swim, as this is a wonderful cardiovascular activity that works the entire body. The bottom line is not to get stuck in front of your computer or on your sofa all day long. Work out a few times weekly to help your blood move better throughout your body and improve your testosterone levels. Check Your Testosterone Levels Often You might be happy to find out that checking your testosterone levels is very easy these days. You don't even need to talk to your doctor. You can order a direct-to-consumer lab test from trustworthy providers such as DiscountedLabs.com. When you do this, you get a form that you use to visit a nearby clinic to draw blood. Your blood is analyzed in a certified laboratory by medical experts, and your results will be emailed in a few business days. The process is fast, confidential, and secure. Checking your testosterone levels often helps you to see where you stand. You can compare the results against reference values and see if you need to readjust your lifestyle. For example, most experts agree that normal testosterone levels should be between 350 and 1,000 nanograms per deciliter of blood. Go to DiscountedLabs.com today and order your own testosterone test today! This test is the most affordable in the U.S. for a gold standard accurate test based on liquid chromatography, the most trusted test by top physicians and clinics.   ============= References: Alarming Drop in Testosterone Levels Stress and Fatigue Affect Testosterone Obesity Decreases Testosterone Levels Testosterone Information | Mount Sinai - New York

It is suggested that you talk to your physician about the need for proper blood tests before and during testosterone. Read this first since it is the most common testosterone side effect: High hematocrit Problem Solution and Comments Acne/oily skin Caused by Dihydrotestosterone (DHT) effect on increased oil production · Accutane– a powerful prescription item - 40 mg/day for one week sometimes stops acne if started at the first sign or as directed by your doctor. Accutane is potentially highly liver toxic and can lower testosterone. Do not use unless as last resort. · Sporanox – Effective for some acne-like eruptions that are caused by fungi. Some doctors also prescribe antibiotics, like tetracycline, for acne with good results. . Minocycline . Shower with Nizoral shampoo· Anti-bacterial soaps - Use a scrubbing brush and wash twice a day, especially after sweating during a workout. · UV light or sunlight with moderation. . Zinc/copper supplements or zinc soaps may help some men with acne. . Other options: How to treat and prevent acne Hair loss Caused by DHT effect on hair follicles · Nizoral shampoo– Available by prescription and over-the-counter as a lower dose product. · Rogaine – Available over the counter · Propecia (finasteride) - Available by prescription. A few males experience decreased erections with finasteride. Do not use. Increased sex drive · A problem? Sex drive is part of quality-of-life. This is not necessarily a bad side effect. Enjoy it. Unresolved erectile function · ED Drugs– Available by prescription; enables robust erections. If you have sinus congestion or headaches/backaches take non-drowsy allergy medication and ibuprofen. ED drugs can be combined with alpha-blockers and/or nitric oxide precursor amino acids (arginine or citrulline) · Yohimbine (Yocon) - Available by prescription; increases sex organ sensitivity. Can increase heart rate and blood pressure · Muse - Available by prescription; pellet inserted into the urethra to produce an erection. Unpopular · Trimix – Available by prescription from compounding pharmacies. The best and cheapest formula for injection into the penis for lasting erections. · Caverject - Available by prescription. An injection into the penis that produces an erection that can last 1 to 2 hours. Be careful with injecting too much since it can produce dangerously ling erections that need to be treated in emergency rooms! Follow instructions from your urologist. · Papaverine – An older injectable medication, less expensive than Caverject. · Wellbutrin – Prescription at 300 to 450 mg/day; increases dopamine. · Human chorionic gonadotropin (HCG) – First dose is 2,000 IU, then 250-500 IU twice or three times a week. No protocol has been proven in controlled studies yet. Insomnia Usually, this is caused by dosages that are too high. Find the least amount that gives you a good result. · Sleeping medications – e.g. Ambien, Sonata, Lunesta, Restoril · Melatonin- 1 to 3 mg before bedtime. If you wake up groggy after 6 hours your dose should be lower. · Avoid working out too close to bedtime. · Limit caffeine, especially after 3 pm. · You may want to try a sleep formula with tryptophan, melatonin, and magnesium. Nutrients do not work as well as drugs, but they can help some people. Article: How to protect your circadian rhythm Sleep Apnea · Have your doctor prescribe a sleep study if you snore and wake up tired even after 7 hours of sleep. Some people may have to wear a C-PAP machine to breathe at night. Visit Home - SleepApnea.org for more information. There are also oral devices for those people who fail CPAP. Fatigue- When Testosterone Is Not Enough Testicular atrophy · Human Chorionic Gonadotropin (hCG)– One 2,000 unit injection per week for 2 weeks, followed by maintenance of 350-500 IU twice a week. For men who want to remain fertile while on TRT, 500 IU every other day has been studied. Watch this video on hCG and men Enhanced assertiveness or reactivity. · Make sure you are getting enough sleep. . Count until 10 and be aware of your interaction with others. · Decrease caffeine. · Meditation, mindfulness, yoga, breathe from your belly for a few minutes when overreacting. · The testosterone dosage may be too high. · Ask yourself: Do I need to always be right? . Vent extra energy at the gym, sex, and sharing with your buddies at www.excelmale.com High blood pressure: Can be caused by sodium retention, high hematocrit, being overweight, and other factors · Blood pressure medications - Elevated blood pressure may be transient or not. Try ACE or ARBs since they seem to have fewer sexual dysfunction related effects.  · Magnesium (600 mg/day); vitamin B6 (100 to 200 mg/day); may help reduce water retention. · Water - Drink extra water every day to help flush the kidneys. . Make sure you are doing cardio exercise at least 3 times a week for 30 min. Sweat and lower your salt intake since TRT increases sodium retention in some men. Gynecomastia- RARE in TRT (male breast development) Caused by overproduction of estrogen in the presence of low testosterone and high IGF-1 · Arimidex Inhibits estrogen production. Available by prescription. 0.5 mg/week max. Ensure that your estradiol is never under 20 pg/ml (by sensitive test) since it is needed for bone, skin, brain, lipids, libido, good lipids and hair health. Only 0.3-0.4% of testosterone is aromatized to estradiol. Current lab ranges were derived from men not on TRT. Most men on TRT do not need anastrozole. Be careful not to crash your estradiol. · Nolvadex (tamoxifen)– Competes with estrogen for receptors. Available by prescription, 10 to 20 mg/day. Use of Nolvadex during a steroid cycle may reduce the net anabolic effect, as it decreases the production of GH and IGF-1.  . Severe cases may require removal of the breast tissue by surgery. · DHT cream- Some people have obtained great results by rubbing a 10% DHT cream on their nipples. Not available in the US but some people order it online from Germany . Read about medications/foods to avoid if you have gynecomastia. . Those who do know to respond to the above, check other reasons Watch this video about estradiol in men Check your estradiol with the right sensitive test. To find out how long it takes testosterone replacement to potentially show benefits, read this article. For affordable blood tests in most cities in the U.S. (Prescription provided): DiscountedLabs.com We also highly recommend reading this and other articles from our friend Lee Myers from peaktestosterone.com : Testosterone Risks Metzger, DL, et al. Estrogen receptor blockade with tamoxifen diminishes growth hormone secretion in boys: evidence for a stimulatory role of endogenous estrogens during male adolescence. J Clin Endocrinol Metab (1994) 79(2):513-518. [ii] el-Sheikh, MM, et al. The effect of Permixon (saw palmetto) on androgen receptors. J Acta Obstet Gynecol Scand (1988) 67(5):397-399. [iii] Suzuki, K, et al. Endocrine environment of benign prostatic hyperplasia: prostate size and volume are correlated with serum estrogen concentration. Scand J Urol Nephrol (1995) 29:65-68. [iv] Gann, PH, et al. A prospective study of plasma hormone levels, nonhormonal factors, and development of benign prostatic hyperplasia. The Prostate (1995) 26:40-49.   Buy testosterone tests on DiscountedLabs.com

Sypolt Systems and ExcelMale.com today announced the immediate availability of a new Android and iOS app for men on Testosterone Replacement Therapy. The app allows users to enter treatment protocols and daily assessments which record how they are feeling while on a specific treatment protocol. The results are then displayed in graphs so that users and whoever they wish to share the data with can better understand important areas in quality of life for a given protocol. To download the app, visit: TRTData.com The app records data anonymously so that researchers can analyze results to look for more trends and patterns for more effective treatments. Men on Testosterone Replacement Therapy frequently have to adjust treatments because of age, health, and other issues, and it can become difficult to record and remember what works best and what areas need improvement. The new TRT Analyzer app allows users to record this data in a universal format so that patients and physicians stay informed. If you have any questions about the app, have feedback, have a problem, or want to see something added, please visit Sypolt Systems LLC develops custom applications. Jason Sypolt has been building web and mobile applications for over 16 years in healthcare, financial services, and many other industries. ExcelMale.com is a men’s health forum with over 13,000 members that include educated men, physicians, pharmacists, dietitians, exercise trainers, nutritional supplement experts, and other professionals in the field. The site’s forum topics range from testosterone replacement therapy, Trimix injections use for ED, HCG use for better fertility and libido, estradiol management, thyroid function optimization, peptide information, exercise routines, best supplements for men, high protein diets, testosterone side effect management and much more.