Also referred to at "Low T" or "Male Hypogonadism", low testosterone has been demonstrated to affect 38% of males aged 45 and up with increased prevalence in men with high blood pressure, diabetes and obesity. Emerging research is showing that if left untreated men are at increased risk for several serious health issues including heart disease, metabolic syndrome, depression and dementia. Classic symptoms of Low T include decrease in sex drive, erectile dysfunction, decreased muscle mass, decreased strength, weight gain, poor concentration, decreased work performance, irritability, depression and fatigue.
Although the exact incidence of Adult Growth Hormone Deficiency is not known, Growth Hormone production is known to decline by about 14% every decade starting in the early 30s. Thus by the age of 65 most males will produce about one-half of the amount they did earlier in life. Untreated GH deficiency in adults has several serious consequences and is strongly linked to blood vessel wall thickening, heart failure and decreased life expectancy. Symptoms may include changes in memory, processing speed and attention, lack of well-being, depression, anxiety, fatigue, adiposity, decreased muscle mass, decreased bone density, insensitivity to heat and cold.
As males age, the activity of the Aromase enzyme that converts Testosterone (T) to Estradiol (E2) tends to increase resulting in a higher ratio of E2 to T, especially in the obese patient. High Estrogen in men (in addition to low testosterone) can lead to enlarged and tender breast tissue, increased abdominal fat, enlarged prostate, decreased morning erections, erectile dysfunction and abnormal lipid profile in addition to osteoporosis. Some males that receive Testosterone replacement therapy may also need medication to lower the estrogen levels since restoring T levels to normal may result in elevated Estadiol (E2) levels.
Although not thought about much in males, Progesterone deficiency can have a number of relatively subtle yet negative effects that often go unrecognized because it is so rarely tested in men. Sometimes referred to as the "Other male hormone" because of its role in sperm motility, Progesterone is important in keeping Estrogen activity controlled. It is also the precursor hormone to the adrenal steroids Cortisol and Aldosterone that regulate the immune system, blood pressure and mineral handling by the kidneys. Progesterone opposes estrogen Progesterone is also thought to be neuroprotective in times of trauma and some of its metabolites are noted to be neuroactive with a calming effect.
Commonly known as the master gland that controls our metabolism, the thyroid gland is susceptible to a number of disorders that can result in decreased thyroid hormone production with age. If left untreated, Hypothyrodism can result in heart disease (cardiomyopathy), weight gain, dyslipidemia, myxedema, dementia, depression, and a whole host of metabolic disorders. Often times, correction of thyroid deficiency alone can help normalize other hormonal deficiencies. When treating hypothyroid patients, it is important to recognize that some patients require dual supplementation with the more active T3 hormone in addition to T4.
The adrenal steroids Cortisol and Cortisone are extremely important in energy regulation, blood sugar metabolism, immune function and response to physiologic stress and injury. Although complete adrenal failure ("Addisonian crisis") is not compatible with life and requires emergency Cortisol replacement therapy, partial adrenal failure is becoming more and more recognized with improving methods of testing. Cortisol deficiency may result from the effects of chronic stress, illness, medication, poor sleep and nutrition. Symptoms usually involve severe fatigue, muscle weakness, loss of appetite, digestive problems, irritability and depression.