Aging Male Syndrome (AMS)

Therapies for healing mind, body, spirit

Men go through AMS between the ages of 35 and 65 (normally between 40 and 55) when their hormone levels (especially testosterone) go down. Testosterone is a hormone that helps maintain sex drive, sperm production, pubic and body hair, muscle, and bone. Testosterone levels decrease over time. This decline is normal in healthy males as they age. Unlike women who lose their fertility (ability to get pregnant) when they reach menopause, men do not lose their fertility. All men have different experiences. Some men's hormone levels go down more than others, and some have more symptoms than other men.

A decline in testosterone can affect a man's body. AMS has many signs:

• Feeling fat/weight gain
• Problems sleeping
• Less interest in sex
• Feeling irritable or angry
• Loss of motivation
• Loss of drive at work
• Erection problems
• Nervousness
• Problems with memory and concentration
• Indecisiveness
• Lower self-confidence
• Tiredness
• Muscle loss
• Increased urination
• Depression
• Mood swings
• Loss of energy
• Bone loss
• Hair loss

Tests for Testosterone Levels

If you're having these symptoms of low testosterone, talk to your doctor. You can get your testosterone level tested. It's a simple blood test. Get the test in the morning, when the testes release more testosterone. Because a normal level of testosterone is different for each man, it may be hard to know if you have low testosterone. It helps if you had a testosterone test earlier in your life, so you'll be able to see any change. If you do have low testosterone, think about visiting a specialized practitioner. If you decide to go naturally, which I recommend, acupuncture, naturopathy and/or herbology is what I would recommend. In western medicine you may want to consider an endocrinologist or urologist.

Treatment for Low Testosterone

The use of testosterone therapy is getting increasingly popular. But there are many things about this treatment that is not known:

• We don't know if testosterone therapy relieves symptoms of men with low testosterone.
• We don't know how low testosterone levels affect men's health.
• We don't know if testosterone therapy increases the risk of prostate cancer.
• We don't know if testosterone therapy is safe.

Testosterone Replacement Therapy is an option for men whose natural testosterone level is not within the normal range. Talk to your practitioner to find out if testosterone therapy is the right treatment for you.

Testosterone Replacement Therapy

The Holistic Approach

Dehydroepiandrosterone (DHEA)

This is a natural steroid hormone, one of the hormones produced by the adrenal glands. After being secreted by the adrenal glands, it circulates in the bloodstream as DHEA-sulfate (DHEAS) and is converted as needed into other hormones. DHEA is chemically similar to testosterone and estrogen and is easily converted into those hormones. DHEA production peaks in early adulthood and declines in production with age in both men and women. Therefore, many diseases which correlate with age also correlate with low levels of DHEA production. DHEA often has different effects in men, premenopausal women, and postmenopausal women. Supplementation with DHEA-S (a form of DHEA) has resulted in increased levels of testosterone and androstenedione, two steroid hormones.

DIM (diindolylmethane)

This is a plant compound called an indole, and has been shown to help regulate and promote a more efficient metabolism of estrogen, and an optimal ratio of estrogen metabolites. DIM balances estrogen levels, promoting health and well-being. This powerful phytonutrient is found in broccoli, cauliflower, cabbage and brussels sprouts, unlike other phytonutrients like soy isoflavones, has no hormonal properties in itself. Men can also benefit from DIM supplementation. Studies show it works indirectly by increasing the activity of enzymes that control estrogen production. DIM boosts levels of "good" estrogens called 2-hydroxy estrogens and reduces levels of "bad" estrogens which are 16-hydroxy and 4-hydroxy estrones. Both forms of "bad" estrogen are carcinogens, and studies show that women with elevated levels of 16-hydroxy estrone have a high rate of breast cancer. There's evidence that benign prostate enlargement and some types of prostate cancer may be related to a buildup of estrogen in that gland, not testosterone. In overweight men because fat cells convert DHEA and testosterone to estrogen, DIM supplementation can be especially helpful. A combination of DHEA and DIM together for one month is a recommended treatment for increasing testosterone levels.

Puncture Vine - Tribulus Terrestris

This herb found in the Chinese Materia Medica, Bai Ji Li (Chinese) also known as Gokshura and Gokhru (Ayurveda), traditionally has been used for sexual and kidney dysfunctions as well as colic pains, hypertension and hypercholesterolemia. It has a long standing use of being a revitalizer and energizer. Research indicates it actually may possess the ability to increase sexual desire verses just being a physical stimulant. It is a promising herb in the areas of menopause and infertility. Bulgarian studies have shown that this herb stimulates Luteinizing Hormone, which stimulates the production of testosterone in men.

Androstenedione

Androstenedione, (pronounced "an-dro-stene-dye-own") is a metabolite of DHEA and a natural precursor of testosterone. For those whose testosterone levels may need a boost, 25-50 mg of androstenedione taken at bedtime, and perhaps again first thing in the morning, will mimic the body's normal diurnal rhythms. The same dose may be taken 30-60 minutes before exercise (for enhanced performance) or after completion of exercise (to enhance muscle recovery and growth).

Serum levels of testosterone start rising about 15 minutes after oral administration and stay elevated for around 3 hours. Blood testosterone levels usually peak in around 1 to 1.5 hours after ingestion. Because the elevated testosterone levels swiftly return to normal baseline levels, there is little risk of negative feedback suppression of the hypothalamus, pituitary or testicles.

Chrysin

A bioflavonoid called chrysin has shown potential as a natural aromatase-inhibitor. Chrysin can be extracted from various plants. Body builders have used it as a testosterone boosting supplement. The problem with chrysin is that because of its poor absorption into the bloodstream, it has not produced the testosterone enhancing effects users expect. In a study published in Biochemical Pharmacology (1999, Vol.58), the specific mechanisms of chrysin's absorption impairment were identified, which infers that the addition of a pepper extract (piperine) could significantly enhance the bioavailability of chrysin. Pilot studies have found that when chrysin is combined with piperine, reductions in serum estrogen (estradiol) and increases in total and free testosterone result in 30 days.

Chrysin, for example, is also a potent antioxidant that possesses vitamin-like effects in the body. It has been shown to induce an anti- inflammatory effect. Chrysin has one other property that could add to its libido-enhancing potential. A major cause of sexual dissatisfaction among men is work-related stress and anxiety as well as "sexual performance anxiety" that prevents them from being able to achieve erections when they are expected to.

Nettle Root Extract

About 90% of testosterone is produced by the testes, the remainder by the adrenal glands. Testosterone functions as an aphrodisiac hormone in brains cells, and as an anabolic hormone in the development of bone and skeletal muscle. But testosterone that becomes bound to serum globulin is not available to cell receptor sites and fails to induce a libido effect. It is, therefore, desirable to increase levels of "free testosterone" in order to ignite sexual arousal in the brain.

A hormone that controls levels of free testosterone is called sex hormone-binding globulin (SHBG). When testosterone binds to SHBG, it loses its biological activity and becomes known as "bound testosterone," as opposed to the desirable "free testosterone." As men age past year 45, SHBG's binding capacity increases almost dramatically-by 40% on average-and coincides with the age-associated loss of libido.

A highly concentrated extract from the nettle root provides a unique mechanism for increasing levels of free testosterone. Recent European research has identified constituents of nettle root that bind to SHBG in place of testosterone, thus reducing SHBG's binding of free testosterone. As the authors of one study state, these constituents of nettle root "may influence the blood level of free, i.e. active, steroid hormones by displacing them from the SHBG bindings site." The prostate gland also benefits from nettle root. In Germany, nettle root has been used as a treatment for benign prostatic hyperplasia (enlargement of the prostate gland) for decades. A metabolite of testosterone called dihydrotestosterone (DHT) stimulates prostate growth, leading to enlargement. Nettle root inhibits the binding of DHT to attachment sites on the prostate membrane.

Testosterone Replacement Therapy

The Western Approach

Skin Patch

Applied daily to the upper arm, back, thigh, scrotum, or abdomen. It's easy to use, and you maintain a balanced amount of testosterone in your body. Your skin could get irritated from the patch. In some men, the testosterone doesn't get absorbed well through the skin.

Injections (shots)

Injections are given either every week or every two to three weeks. The cost is low. You will need to visit your doctor for injections. With injections, your symptoms of low testosterone may fluctuate because it creates abnormal highs and lows in hormone levels.

Testosterone Buccal System

You place a tablet in the upper gum area of the mouth. It sticks to your gum or cheek. It stays in place for 12 hours and releases testosterone into your body. The tablet can fall off and shouldn't be chewed or swallowed.

Gel

Applied daily to the skin on the shoulders, upper arms, and abdomen. It's easy to use, and you maintain a balanced amount of testosterone in your body. In some men, the testosterone doesn't get absorbed well through the skin.

Oral preparations of testosterone

This is rarely prescribed because it can severely damage the liver.

Benefits and Risks of Testosterone Therapy

There have been no large, long-term studies to tell us the benefits and risks of using testosterone replacement therapy. For the studies that have been done, researchers are not always in agreement about the benefits and risks of TRT. More research needs to be done. At this point, here's what studies are reporting.

Benefits

Testosterone replacement therapy may have these benefits:

• Improved libido
• More energy and improved sense of well-being
• Increase in bone and muscle mass
• Improved body composition
• Better mood
• Rise in hemoglobin levels to the normal range.
  Hemoglobin helps red blood cells carry oxygen from your lungs to all parts of your body.

Risks

Testosterone replacement therapy might have these risks:

• Higher chance of prostate cancer
• Rise in hemoglobin levels above the normal range
• Problems passing urine, also called voiding symptoms. This includes poor urine flow, feeling like you can't empty your bladder, or hesitancy before urinating.
• Liver damage from oral preparations of testosterone
• Sleep apnea (stopping breathing during sleep)
• Breast tenderness and swelling
• Testicles get smaller
• Fertility problems while using TRT
• Skin reaction from patches or gel
• Pain, soreness, or bruising from injection
• Fluid retention
• Acne
• Oily skin
• Increased body hair

I recommend following these guidelines when taking TRT:

Before you start taking TRT:

• Get a Prostate-Specific Antigen ( PSA) test and digital rectal exam.
• Have your hemotocrit or hemoglobin level tested.
• Tell your doctor if you have sleep apnea. If you're not sure, ask to be tested.
• Talk to your doctor about voiding (urination) problems.

One to two months after you've started taking TRT:

• Visit your doctor to see if the TRT is working.

Every three to six months:

• Visit your doctor to see how you're responding to treatment.
• Get your testosterone levels measured.
• Get your hematocrit or hemoglobin levels tested.
• Get a PSA and digital rectal exam.
• Let your doctor know if you have sleep apnea or problems passing urine.
• Get liver function tests if you're using oral preparations of testosterone.
• If you've had heart failure or renal inconsistency, use TRT with caution.
• Men with an abnormal result on a digital rectal exam or elevated PSA level should have a negative prostate biopsy before they use TRT.

Please Note

Before embarking on a testosterone-enhancement program a baseline blood PSA test and a digital rectal exam taken to rule out existing prostate cancer. When using testosterone drugs, PSA blood tests should be taken every 30-45 days for the first five months to rule out hidden prostate cancer.

When using slower acting testosterone boosting nutritional supplements, PSA testing can be reduced to every 60-90 days for the first eight months. Remember, the preponderance of the published literature shows that increasing free testosterone does not increase the risk of cancer in healthy men, but those with existing prostate cancer should avoid testosterone boosting drugs and supplements.