Testosterone and heart disease
Thanks to those who abuse anabolic steroids, a misunderstanding of the difference between anabolic steroids and natural testosterone, and media sources that thrive on controversy, testosterone has gotten a bad rap. Contrary to public opinion, testosterone therapy is very health –promoting.
It is true that anabolic steroids are widely misused by those seeking to get bigger and faster in order to “get an edge”. It is also true that anabolic steroids are structurally similar to natural testosterone-similar, but not the same. It is this similarity which confers on anabolic steroids the ability to replicate the effects of testosterone. It is the fact that they are not the same, that there are differences in their 3 dimensional configuration that leads to the more pronounced effects and side effects of anabolic steroids.
As any biochemist knows, minor changes in the chemical makeup of a biologically active molecule like testosterone-sometimes as small as one atom- can alter the shape of that molecule. Altering the shape of the molecule affects its ability to bind with its receptor since they must fit together in a “lock and key” manner. Anabolic steroids often bind to the testosterone receptor more strongly than natural testosterone, leading to more pronounced effects. Over millions of years of evolution, our bodies have learned how to deal with natural testosterone effectively and safely, these “newcomer” anabolic steroids are a different story and as a result the effects of anabolic steroids are greater and they are more likely to cause side effects.
While its true that too much testosterone, like any “good thing” is not good, when taken in physiologic amounts by those who are deficient, testosterone is not only safe-its healthy! Correction of low testosterone levels can help prevent heart disease-the #1 killer of men (and women) in this country. It will also decrease the risk of diabetes and stroke, two of the other leading causes of death in the U.S.. There are many studies that document these benefits. Middle aged men with testosterone deficiency show increased carotid IMT.
Testosterone therapy has been shown to: decrease pro-inflammatory cytokines (chemicals in the body that lead to inflammation) and increase anti- inflammatory cytokines, cause coronary vasodilatation (increase the blood flow to the heart), improve insulin sensitivity (reduce risk of diabetes), reduce BMI (help men lose excess fat), reduce abdominal fat which is associated with an increased risk of heart disease and reduce angina or myocardial ischemia in men with CHD(1,2).
Men with low testosterone levels are at an increased risk of stroke as well as heart attack due to an increased accumulation of atherosclerotic (cholesterol) plaque in their arteries(1,3).
Appropriate testosterone therapy-supplementing with enough testosterone gel to increase a man’s levels to that of a typical 30 year old-does not turn him into an angry lunatic and give him high blood pressure. As these studies demonstrate, adequate testosterone levels support a healthy blood pressure as well as a healthy sense of wellbeing (which will be discussed in a later newsletter).
(1) Bhasin S. Effects of testosterone administration on fat distribution, insulin sensitivity and atherosclerosis progression. Clin Infect Dis. 2003;37 Suppl 2142-9
Testosterone administration is associated with decreased visceral fat and increased insulin sensitivity, increases coronary blood flow and retards atherosclerosis
(2) Jones RD, Nettleship JE, Kapoor D, Jones HT, Channer Testosterone and atherosclerosis in aging men:purported association and clinical implications. Am J Cardiovasc Drugs. 2005;5(3):141-54
Testosterone admin decreases proinflammatory chemicals and increases anti- inflammatory chemicals, causes vasodilatation , improves insulin sensitivity, reduces BMI, reduces visceral fat,, reduces myocardial ischemia in men with CHD,
(3) Makinen J, Jarvisalo MJ, Pollanen P, Perheentupa A, Irjala K, Koskenvuo M, Makinen J, Huhtaniemi I, Raitakari OT. Increased carotid atherosclerosis in anderopausal meddle-aged men. J Am Coll Cardiol. 2005 May 17;45(10):1603-8
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