The statistics about heart disease are ominous. According to the Center for Disease Control (CDC), the federal agency charged with monitoring health trends in the United States, about 610,000 people die of heart disease in this country every year
that’s one in every four deaths. Further, heart disease is the leading cause of death for both men and women, but it affects men more than women. And finally, every year about 735,000 Americans experience the pain and life-threatening trauma of a heart attack.
While heart disease has many causes – from genetics to diet and lifestyle – low testosterone in men has also been recognized as a culprit.
The Research Supports Testosterone Replacement Therapy
According to research published in the European Heart Journal , among a group of 83,000 patients, men whose low levels of testosterone were treated with testosterone replacement therapy experienced a reduced risk of heart attack and stroke. Terri was asked if this treatment for improving heart conditions was a new approach.
“Testosterone therapy has not been typically used for improving heart health,” she said. “However, those of us who have been using testosterone replacement therapy for men and women for many years know that the data are there to support using it. There have been studies going back to 2002 on elderly men with low levels of testosterone having much higher instances of heart attack and strokes.
“There’s another study from 2007 which suggests that testosterone replacement therapy could decrease heart attacks and strokes,” Terri continued. “It seem like we’ve just recently ‘dialed in’ on this strategy. Typically, hormones are more used for treating symptoms, so it is a fairly new concept.”
What Happens When a Heart Attack or Stroke Occurs?
“The arteries surrounding the heart are very rich in oxygen,” Terri noted. “The heart muscle, like any muscle, needs this oxygen to function. A heart attack or stroke occurs when carotid arteries become blocked. This may stop the blood flow to the areas of the heart muscle (causing a heart attack) and to the brain (causing a stroke).
“This causes damage, but typically the damage has been happening for quite some time. Unless a massive heart attack occurs, the symptom are usually ignored or confused with fatigue or stress. It does get missed, especially in men, because men tend to ignore those warning signs most frequently.”
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What is it About the Hormone Testosterone that Results in a Healthy Heart?
“There are so many things,” she noted. “Number one, testosterone is a powerful anti- inflammatory. Additionally, testosterone and HDL reverse the ‘bad cholesterol’ (LDL). Testosterone also decreases insulin levels, which decreases the incidence of Type II Diabetes.”
“There are some excellent studies indicating that men who were given aromatized testosterone had their blood flood to the coronary arteries increased. It reduced plaque in the coronary arteries. It does really great things to the lining of the arteries. It reduces visceral fat. The list goes on and on!”
What is a “Normal” Testosterone Level?
In the research noted above, the survey categorized men into three groups. One group was treated “until their testosterone returned to normal. The second group was treated, but their testosterone levels did not return to normal.” The third group did not receive testosterone therapy and their levels remained low.
Among these groups, researchers noted between the men in Group One, whose testosterone returned to normal, and those in Group Three whose testosterone was left untreated, a “significant contrast in health outcomes was observed.”
When asked about this, Terri had a question of her own.
“First of all, what’s normal,” she asked. “There really haven’t been any ‘normal’ ranges of testosterone in men and women. Unfortunately, the lab results of “expected” testosterone levels, (which may range from 200 to 1,100) are seen as a ‘normal’ range by some practitioners.
“What we’ve learned about testosterone is we need to pay attention to what is optimal,” she said. “What we see, when testosterone falls below 600, is a man’s chances for heart attack increase significantly. There is a lot of confusion in the medical literature as to what is considered normal. You really have look at what is optimal and what levels of testosterone have to be in order to be preventative.”
Other Benefits of Testosterone
Researchers also believe testosterone helps regulate many bodily functions, including bone mass, fat distribution and muscle size and strength.
Does this have any effect on benefits to the heart? Terri didn’t hesitate in her response.
“Absolutely,” she said. “Logic will suggest if one has stronger bone mass and greater muscle strength with less belly fat, you’re going to have a stronger heart. If you have stronger bones and muscles, you’re going to be able to exercise more often. Testosterone gives amazing energy, which is critical to exercising.
“Even taking a brisk, 20-minute walk may make a positive impact,” she said. “Many people are so fatigued that we don’t have the energy to do even this moderate amount of exercise.”
“It’s important to note that all testosterone therapy is NOT created equal,” Terri said. “Anabolic steroids, which are banned from professional sports but often used in high school sports, have the opposite effect. These steroids actually increase the potential for heart attacks and strokes and they increase the lipid levels.
“The most highly studied testosterone therapy involves the use of pellets for the delivery of the hormone. These are subcutaneous, meaning they go under the skin, and are bio-identical in nature. Try to find practitioners who specialize in this therapy. Many (not all) understand how to balance hormones. They understand what to look for in hormone metabolism, especially testosterone.”
When Should Men Check Their Testosterone Level to Avoid Heart Attack?
“At the very latest, men should check their level at age 40,” she said. “We’re seeing younger and younger men coming in with low testosterone levels – some guys in their 20’s. It has a lot to do with our food and the hormones that are now found there, as well as sleep deprivation. It’s really unfortunate, but I’m seeing more and more young men and women whose hormones are out of whack and this contributes to the obesity rates in this country.
“By the time one reaches 50 and has had lower testosterone levels for a decade, the damage is already starting. Waiting until you are 50 or 60, (although still beneficial, and better late than never) levels should be checked much sooner.
“The symptoms that would suggest to a man that his testosterone levels are critically low are often ‘brain’ symptoms – things like depression or anxiety – which tend to appear when testosterone levels get really low.
“Erectile dysfunction is also a part of this equation,” she said. “So many men think because they have a sex drive, without erectile dysfunction their testosterone level is fine. Unfortunately, this is not true. Sex drive is the very last thing to go in a man, so don’t let this be your litmus test.”
If you would like to listen to the complete interview with Terri DeNeui, just click on the podcast.
If you have a family history of heart disease or you are concerned about chest pains, see your family physician immediately. If you think you might benefit from testosterone replacement therapy, just click hereto schedule an appointment. Heart attacks and strokes can kill you. Don’t wait until it’s too late.
Speaker, Author, and Board-Certified Nurse Practitioner, Dr. Terri DeNeui, DNP, ACNP, APRN-BC, has extensive training in her field. She earned her B.A in Nursing from Texas Women’s University and her Master’s and Doctoral degrees at UT Arlington. In addition to her training in acute and emergency medicine, she has extended her education to include certifications in Preventative Wellness Medicine, Functional Medicine and Hormone Replacement Therapy.