When men think about heart disease, cholesterol is probably the first thing that comes to mind, and when asked about testosterone, libido comes to mind. But did you know that a testosterone deficiency can lead to heart disease? Optimal testosterone levels are extremely important for the heart, and testosterone levels naturally decline as men age. There is emerging evidence suggesting that testosterone deficiency is a risk factor for cardiovascular disease, so testosterone replacement therapy could reduce cardiovascular disease risk in men with low testosterone. (12)
Testosterone is one of the androgen hormones produced by the testes. It is the principle male hormone and is responsible for the development of the male sex characteristics. It is also the hormone of desire. Men produce testosterone primarily from the testes and also from the adrenal glands. Testosterone is an anabolic hormone with beneficial effects on men’s health and restoration of normal testosterone levels in deficient men represents an important key-point of male well-being.(12, 17)
Research on Testosterone for Treatment and Prevention of Heart Disease
Research shows that older men who were treated with testosterone did not appear to have an increased risk of myocardial infarction, or heart attack. For men with high risk of having a heart attack, testosterone was protective against it. (1) A regulatory body representing European Union Member States has agreed by consensus that there is no consistent evidence of an increased risk for cardiac problems in men who receive testosterone products to treat hypogonadism, or low testosterone production. (2)
Short-term administration of testosterone induces a beneficial effect on exercise-induced myocardial ischemia (reduced blood flow to the heart) in men with coronary artery disease. This effect may be related to a direct coronary-relaxing effect. (3) Administration of testosterone increases cardiac output, apparently via reduction of pressure in wall of left ventricle. (4) Research suggests a protective effect of testosterone against heart attack and strokes. Also, there was no evidence of worsening of pre-existing heart attack or strokes in patients treated with testosterone. (5)
Beneficial effects of administration of testosterone to men with low testosterone may be due to improved vascularization and to anti-inflammatory action.(6) In epidemiological studies, serum total and free testosterone concentrations have been inversely correlated with intra-abdominal fat mass, risk of coronary artery disease, and type 2 diabetes mellitus. Testosterone infusion increases coronary blood flow. Similarly, testosterone replacement slows down atherogenesis (the process of forming plaques in the inner lining of arteries) in experimental models of atherosclerosis. (7)
Research shows that testosterone is considered as a possible therapy for cardiovascular disease. It has been shown that the level of testosterone decreases in men as they age. Healthy men with low testosterone levels have increased cardiovascular risk factors, including high fasting and 2-hour plasma glucose, serum triglycerides, total cholesterol and low-density lipoprotein (LDL) cholesterol, and apo A-I lipoprotein. Injections of testosterone to raise the levels to midnormal range have been shown to decrease total cholesterol and LDL cholesterol, while increasing high-density lipoprotein (HDL) cholesterol. In men, testosterone has been shown to have anti-anginal (treating chest pain) effects, and levels have an inverse relationship to systolic blood pressure. There may be a role in administering testosterone to return men with low testosterone to normal physiologic range. (8)
Short-term intracoronary administration of testosterone induces coronary artery dilatation and increases coronary blood flow in men with established coronary artery disease. (9) In one study, oral testosterone had selective and modest enhancing effects on perfusion in myocardium supplied by unobstructed coronary arteries. The testosterone-related decrease in arterial stiffness may partly explain previously shown effects of testosterone on signs of exercise-induced myocardial ischemia. (10)
Testosterone therapy in the longer term has beneficial effects on signs of exercise-induced myocardial ischemia. Low-dose supplemental testosterone treatment in men with chronic stable angina (chest pain) reduces exercise-induced myocardial ischemia. (11)
Research on the Relationship Between Testosterone Deficiency and Heart Disease
A considerable body of evidence exists suggesting that androgen deficiency contributes to the onset, progression, or both of cardiovascular disease. Low testosterone produces adverse effects on cardiovascular health. Androgen deficiency is associated with increased levels of total cholesterol, low-density lipoprotein, increased production of proinflammatory factors, and increased thickness of the arterial wall and contributes to endothelial dysfunction. Testosterone supplementation restores arterial vasoreactivity; reduces proinflammatory cytokines, total cholesterol, and triglyceride levels; and improves endothelial (inner lining of blood vessels) function but also might reduce high-density lipoprotein levels. There is emerging evidence suggesting that androgen deficiency is a risk factor for cardiovascular disease, so androgen replacement therapy could potentially reduce cardiovascular disease risk in hypogonadal men. (12)
Research shows that the known association between lower testosterone and increased cardiovascular risk in men might be explained by altered vascular stiffness. (13) Another study showed that testosterone given orally significantly improved angina pectoris in 62 patients with coronary heart disease as compared to placebo. Of 30 cross-sectional studies, 18 reported reduced concentrations of testosterone (primarily), and/or DHEA(S) in coronary heart disease patients as compared to normals, and 11 found similar circulating levels of these androgens in controls and patients with coronary heart disease. Animal studies suggest an anti-atherogenic effect of testosterone and DHEA. In conclusion, studies suggest either a neutral or a favorable effect of testosterone and DHEA(S) on coronary heart disease in males. (14)
Low testosterone has been observed in association with myocardial infarction (MI) and its risk factors. The correlations found in this study between testosterone and the degree of coronary artery disease and between testosterone and other risk factors for myocardial infarction raise the possibility that in men low testosterone may be a risk factor for coronary atherosclerosis. (15)
Simultaneous measurements of serum estradiol, testosterone, cortisol, prolactin, total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol and triglycerides in Thai men and postmenopausal women aged over 50 years were carried out in four groups of subjects: healthy controls, and patients with essential hypertension, non-insulin dependent diabetes mellitus, and coronary heart disease. Men with coronary heart disease had the lowest testosterone levels compared with men with hypertension and diabetes mellitus. Decreased testosterone and/or increased estradiol may have an adverse effect on lipid profiles in elderly men. (16)
Androgen deficiency is frequently associated with increased levels of glucose, total cholesterol, low-density lipoprotein, increased production of pro-inflammatory cytokines, and increased thickness of the arterial wall that all contribute to worsen endothelial function. (17)
Symptoms of Testosterone Deficiency
As men age, their testosterone levels naturally decline and there are several symptoms that can reveal if a man might be deficient in testosterone:
Lack of initiative, assertiveness and drive
Decline in sense of well-being and self-confidence
Depressed, irritable moods
Increased body fat around the waist
Decline in sexual ability
Decreased mental sharpness
Lessened stamina and endurance
Loss of muscle mass, strength and tone
Gynecomastia (enlarged breasts)
Conventional Medicine’s Approach to Treating Low Testosterone
Most traditional doctors will check your free testosterone level if you ask, but the problem lies in how they measure the lab tests. The lab ranges are age-adjusted so they are often compared to the testosterone levels of a male in your age rage. You want the testosterone levels that you had when you were in your prime so that you will feel your best. Doctors may also prescribe medications for your various symptoms rather than addressing the underlying cause.
Natural Approach to Treating Symptoms of Low Testosterone
Left untreated, low testosterone levels can lead to serious health problems such as heart disease. If the symptoms above sound familiar, then there is a possibility that you are experiencing the effects of low testosterone. Like women, men experience a decline in their hormones during midlife, however the decline is less gradual. The key is to replenish your hormones and put back in what is missing – bioidentical testosterone.
What You Can Do To Protect Your Heart:
• Maintain optimal thyroid function, since hypothyroidism increases risk for inflammation and coronary artery disease.
• Maintain optimal testosterone levels, which positively affect heart health.
• Eliminate toxins from the body through detoxification.
• Eat plenty of organic fruits and vegetables.
• Supplement with vitamins and minerals (magnesium, fish oil, COQ10, Vitamin D, Vitamin C and alpha lipoic acid).
• Decrease prescription drug use.
• Exercise regularly.
• Get sound sleep.
5. Abstract # 1353 Testosterone Therapy is not Associated with Higher Risk of Myocardial Infarction or Stroke The Low T Experience. Abstract Book of the 2014 Annual Meeting of the American Association of Clinical Endocrinologists (AACE), p. 238