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Category Archives: Testosterone Replacement Therapy

The Global Testosterone Replacement Therapy Market is expected to grow by $ 402.87 mn during 2022-2026, accelerating at a CAGR of 3.1% during the…

Posted: September 16, 2022 at 2:28 am

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Global Testosterone Replacement Therapy Market 2022-2026 The analyst has been monitoring the testosterone replacement therapy market and it is poised to grow by $ 402. 87 mn during 2022-2026, accelerating at a CAGR of 3.

New York, Sept. 13, 2022 (GLOBE NEWSWIRE) -- Reportlinker.com announces the release of the report "Global Testosterone Replacement Therapy Market 2022-2026" - https://www.reportlinker.com/p04046949/?utm_source=GNW 1% during the forecast period. Our report on the testosterone replacement therapy market provides a holistic analysis, market size and forecast, trends, growth drivers, and challenges, as well as vendor analysis covering around 25 vendors.The report offers an up-to-date analysis of the current global market scenario, the latest trends and drivers, and the overall market environment. The market is driven by initiatives to increase awareness about hypogonadism among population, rise in chronic diseases, and untapped potential in developing countries.The testosterone replacement therapy market analysis includes the product segment and geographic landscape.

The testosterone replacement therapy market is segmented as below:By Product Injectables Topicals Others

By Geographic North America Europe Asia Rest of World (ROW)

This study identifies the rise in novel therapeutic approaches as one of the prime reasons driving the testosterone replacement therapy market growth during the next few years. Also, patient assistance programs and the development of new therapies will lead to sizable demand in the market.

The analyst presents a detailed picture of the market by the way of study, synthesis, and summation of data from multiple sources by an analysis of key parameters. Our report on the testosterone replacement therapy market covers the following areas: Testosterone replacement therapy market sizing Testosterone replacement therapy market forecast Testosterone replacement therapy market industry analysis

This robust vendor analysis is designed to help clients improve their market position, and in line with this, this report provides a detailed analysis of several leading testosterone replacement therapy market vendors that include AbbVie Inc., Acerus Pharmaceuticals Corp., Acrux Ltd., Actiza Pharmaceutical Pvt. Ltd., Antares Pharma Inc., Aytu BioPharma Inc., Bausch Health Co. Inc., Bayer AG, BIOTE MEDICAL LLC, Cipla Ltd., Clarus Therapeutics Inc., Eli Lilly and Co., Endo International Plc, Novartis AG, Pfizer Inc., Sun Pharmaceutical Industries Ltd., Teva Pharmaceutical Industries Ltd., The Simple Pharma Co. UK Ltd., Upsher Smith Laboratories LLC, and Viatris Inc. Also, the testosterone replacement therapy market analysis report includes information on upcoming trends and challenges that will influence market growth. This is to help companies strategize and leverage all forthcoming growth opportunities.The study was conducted using an objective combination of primary and secondary information including inputs from key participants in the industry. The report contains a comprehensive market and vendor landscape in addition to an analysis of the key vendors.

The analyst presents a detailed picture of the market by the way of study, synthesis, and summation of data from multiple sources by an analysis of key parameters such as profit, pricing, competition, and promotions. It presents various market facets by identifying the key industry influencers. The data presented is comprehensive, reliable, and a result of extensive research - both primary and secondary. Technavios market research reports provide a complete competitive landscape and an in-depth vendor selection methodology and analysis using qualitative and quantitative research to forecast accurate market growth.Read the full report: https://www.reportlinker.com/p04046949/?utm_source=GNW

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The Global Testosterone Replacement Therapy Market is expected to grow by $ 402.87 mn during 2022-2026, accelerating at a CAGR of 3.1% during the...

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Testosterone injections most likely led to a very severe stroke – The Independent

Posted: September 16, 2022 at 2:28 am

FROM NORTH AMERICA SYNDICATE, 300 W 57th STREET, 15th FLOOR, NEW YORK, NY 10019

CUSTOMER SERVICE: (800) 708-7311 EXT. 236

TO YOUR GOOD HEALTH #12345_20220929

FOR RELEASE WEEK OF SEPT. 26, 2022 (COL. 4)

BYLINE: By Keith Roach, M.D.

TITLE: Testosterone injections most likely led to a very severe stroke

---

DEAR DR. ROACH: My 75-year-old husband was frustrated with not being able to retain an erection. He talked to his doctor about it, and she prescribed 200 mg of testosterone cypionate, which he would inject into his bottom once a week. He did this for four months, and then had a severe bilateral stroke (as in, he does not know where he is, what happened to him, cannot read or write, cannot walk, etc.).

After spending two weeks in the ICU, he went to a rehabilitation hospital for three weeks. The hematologist there told me his hemoglobin level was up to 20, and there was no reason a 75-year-old should have been prescribed testosterone when it can elevate his hemoglobin so much. I looked at my husband's labs over the last three years, and his hemoglobin was never above 15. Of course, I had no idea testosterone would elevate hemoglobin, or that it should not be prescribed to a 75-year-old.

What are the normal protocols for testosterone with older men? Could his testosterone injections have led to his stroke? -- D.H.

ANSWER: I am very sorry to hear about your husband.

Testosterone replacement therapy is commonly prescribed to men in their 70s and 80s. Elevations of the hemoglobin levels are certainly well-described, but levels above normal only happen about 1% of the time. Experts recommend checking a blood count to look for these elevations three to six months after starting treatment. Testosterone should be stopped if the hemoglobin level is above normal.

Sometimes, there are other causes for the hemoglobin to go up, but a rise that high, when he had never had it before, makes it seem very likely to me that the testosterone was the cause. A hemoglobin level that high, from any cause, is a risk for stroke and heart attack. It is very possible the testosterone prescription led directly to the stroke.

I am publishing this in the column so that men who are taking testosterone know they should be periodically tested for this unusual complication.

DEAR DR. ROACH: I had carpal tunnel surgery two years ago. I now have trigger fingers in my index and ring fingers. I had cortisone injections but that didn't cure it. I, at one point, was not able to open my fingers. Now, my fingers are really stiff, and I can't bend them. When they get down too far, they lock, but usually, they're so stiff I can't bend them. Surgery was suggested. I'm hesitant, because I'm wondering if this will get better on its own with exercises. -- J.T.

ANSWER: Trigger finger is caused by the tendon getting stuck inside one of the pulleys of the hand. To the best of my knowledge, carpal tunnel surgery doesn't predispose to trigger finger, but there are some conditions that put people at risk for both conditions. Initial treatment of trigger finger is conservative, with splinting and anti-inflammatory drugs. If that doesn't work, injection of cortisone by a hand surgeon is usually successful.

Most of the hand surgeons I know will try injection three times before recommending surgery. People who have not gotten better with conservative treatment and injection generally do not get better on their own; though, a few people will. Unfortunately, postponing surgery too long can lead to the finger getting a contracture, where it will not straighten at all. It's best to have surgery before this complication occurs.

* * *

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.

(c) 2022 North America Syndicate Inc.

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Testosterone injections most likely led to a very severe stroke - The Independent

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Best DHEA Supplement (2022 Updated) – The Island Now

Posted: September 16, 2022 at 2:28 am

Are you in your late 30s or beyond concerned about age spots, graying hair, and a sagging body? Or have trouble sleeping at night and face a harder time achieving orgasm? These are typical signs of low DHEA levels in your body.

What is Dehydroepiandrosterone (DHEA)? It is a parent sex hormone that your body naturally produces under stress. The production level of this hormone dips as you age. Since DHEA is converted into other sex hormones like testosterone and estrogen, there is a decline in their concentration as well.

Not only that but when your DHEA levels drop, so does your immune system. For this reason alone, maintaining a natural balance of sex hormones becomes imperative as we age.

Try the best DHEA supplements to get the energy, sex drive, and appearance you want without relying on harmful pharmaceuticals or other ineffective over-the-counter supplements.

Natrol is a leading brand in the health and wellness supplement niche, offering a range of supplements to improve sleep, anxiety, stress, and overall health. The brand has garnered a positive reputation due to its natural and clean supplement formulas.

It is an American brand that Elliot Balbert founded in 1980 with a vision of improving human wellness worldwide. Although the initial target of the brand was the cosmetic industry, the company eventually transitioned into a nutraceuticals (use of food ingredients for medicinal benefits) brand.

Over years of hard work, Natrol has developed into one of the top-notch supplement brands providing high-grade sleep products to the masses. Moreover, Natrol does not compromise on the quality and purity of its supplements.

Therefore, all of their products are USP-certified and non-GMO. Mainly, the brand has achieved an A rating from the Natural Products Association, adding to its reputation and supplements.

Furthermore, Natrol is a prominent award-winning supplement manufacturer, snatching Better Nutritions Best of Supplements Award 2017, and Delicious Living Award, among many others. The company has over 51.3K followers on Facebook, while 18.1K people follow them on Instagram, distinguishing its worth in the supplemental market.

Available In Different Strengths: The Natrol DHEA Mood & Stress supplement comes in various dosages. Whether you are starting your journey with DHEA or want to build your tolerance, Natrol provides options for all. These all-natural and safe DHEA supplements come in 10 mg, 25 mg, and 50 mg dosages. Apart from that, Natrol lets you choose between capsules and tablets, which consumers highly rate.

Ingredients & No Allergens: DHEA Mood & Stress contains all-natural ingredients like calcium and DHEA. It contains silicone dioxide, magnesium stearate, stearic acid, cellulose gum, gum arabic, microcrystalline cellulose, and maltodextrin. The supplement does not have synthetic dyes, preservatives, GMOs, artificial sweeteners, or flavors for the allergen profile.

Health Benefits: This supplement is 100% vegetarian and offers several health benefits with constant use. DHEA in the blend supports balanced hormone levels and promotes healthy mood, lively aging, and overall health. Most importantly, this supplement is not suitable for individuals under the age of 18. Also, if you are pregnant or nursing, do not consume it.

Recommended Dosage: According to the official website, you should take one tablet/capsule of this supplement once daily after having your meal.

=> Click here to visit the official website of Natrol

Life Extension is a brand in the natural supplement industry that manufactures supplements backed with scientifically researched ingredients. This health and wellness brand has been functioning for over 40 years since the 1980s.

With a broad catalog, Life Extension offers natural and nutritious supplements to improve brain function, energy, weight loss, and more. Everyone is sure to find a healthy and natural supplement for their personal needs on their convenient online store.

Life Extension has paved its way to outspread its vision of nutrition all around the globe. Based in Fort Lauderdale, FL, Life Extension is a US brand that manufactures high-quality supplements in cGMP-approved facilities.

With a simple mission to find new ways and empower people to live healthier and richer life, Life Extension strives to produce non-GMO supplements. To ensure the quality and potency of their supplements, the brand conducts experiments on the best ingredients in their in-house labs.

Life Extension has over 48K followers on Instagram and 344K on Facebook. With such a predominant social media impact, Life Extension is surely a brand many love. Life Extension has multiple options for first-time buyers as they have a team of personalized wellness specialists and magazine subscriptions to help you out.

Gluten-Free And Non-GMO: The experts at Life Extension scoured through the latest research and designed the formula for this DHEA supplement. The product contains DHEA as the main ingredient, while some other elements in the blend include cellulose, silica, gelatin, and microcrystalline. The product is non-GMO, gluten-free, and organic, offering the best pick for picky consumers. However, 15 mg, 25 mg, and 50 mg capsules contain gelatin obtained from animals. Thats why they are not suitable for vegans. Only 100 mg DHEA supplement by Life Extension comes in vegetarian capsules.

Available In 4 Strengths: Life Extension has formulated this supplement in capsule and tablet forms. Both are available in four potencies, with 15 mg, 25 mg, 50 mg, and 100 mg DHEA content per serving.

Dosage And Use: The brand recommends taking only one to three capsules in the morning. It strongly suggests that a physician should determine the exact number of servings after blood testing. Moreover, DHEA serum blood tests are recommended three to six weeks after starting DHEA replacement therapy.

Health Goals: The benefits of DHEA supplements by Life Extension include balancing youthful levels of bodily hormones and maintaining healthy sexual functions. Besides, it encourages healthy immune function and cardiovascular health.

=> Click here to visit the official website of Life Extension

PureFormulas is an online brand that manufactures and sells a wide variety of top-notch supplements from third-party brands. With a significant inventory of beauty, pet, and health supplements at affordable prices, PureFormulas is one of the best brands, according to TrustPilot.

To top it off, PureFormulas has also won the Bizrate Circle of Excellence Award, highlighting its superior retail experience. PureFormulas amazing customer support, free delivery, and accolades have captured the hearts of thousands of loyal customers and have a 10K Instagram following.

Established in 2007, PureFormulas is one of the brands having a successful history of customer satisfaction with its pure formulations. It is a Miami-based supplement brand that Jose Prendes founded.

Before he laid the foundation of PureFormulas, Prendes discovered VetAmerica, a leading store of pet supplies. Thanks to his commitment and conscientiousness, the Greater Miami Chamber of Commerce named Prendes as the CEO of the Year.

The brand operates with a mission to help people live a pure, happy life, PureFormulas is dedicated to earning your trust through its products and customer support. It is the go-to store for individuals to buy clean, third-party lab-tested products manufactured and wrapped in cGMP-approved facilities.

Quality Ingredients: Daily DHEA by PureFormulas contain 25 mg of pure DHEA. The strength is best suited for individuals who are initiating DHEA replacement therapy as this dose is tolerable by most individuals. Some other ingredients include microcrystalline cellulose, cellulose (capsule), and I-leucine. Since the company uses cellulose for its capsules instead of gelatin, it is best for vegans and non-vegetarians. Moreover, the supplement is GMP certified, non-GMO, and gluten-free.

Dosage: PureFormulas recommends taking one vegetarian capsule every day with your meal. If you have certain health conditions, you are pregnant, nursing, or under 18, you should not use this supplement and seek physician consultation.

Free Shipping: For individuals in the United States, PureFormulas offers standard free shipping on orders above $20. The company also offers an auto-ship program which provides you 10% off on specific products at regular orders.

Return Policy: You can use the hassle-free return policy of PureFormulas, according to which you can return your parcel within 30 days. This only applies to products that are unopened and unused.

=> Click here to visit the official website of PureFormulas

DHEA supplements are a boon for people who want to escape aging skin, bone, and cardiovascular problems and want to lead an energetic life.

Despite the effective results of using this product, there is no doubt that many users do not find it easy to pick up the best version. Most buyers are clueless about the difference between certain varieties, ingredients, etc.

This can be attributed to the lack of proper information regarding these natural hormone boosters available on the market. Here, we have tried to address all your queries with proper facts and figures in our dehydroepiandrosterone review and buying guide.

To have the best list of DHEA products, we followed strict evaluation criteria to probe other supplements on the market. Our team invested several hours in researching the DHEA market high and low.

With a primary goal to find out the safest and purest formula, we picked all the supplements brands offering DHEA supplements. Later, we looked into the company details, store policies, and health benefits of all the products on our list. We unhandled all the ineffective products and only picked the ones with the right formulas, dosage, and benefits.

The assessment criteria we designed for ranking the best DHEA supplements encompassed several factors. We check each product on our list against different benchmarks to ensure our just evaluation.

Brand Reputation: Brand reputation is one of the primary factors that helped our team to pick the best products. Primarily, we delved into the information of the supplement manufacturer offering DHEA products to learn if they opt for safe manufacturing.

For unbiased evaluation, we chose only brands with a prominent name in the industry with a wide portfolio of supplements. Additionally, we kept all the brands at arms length whose reputation was questionable. Hence, all the DHEA supplements on our list are from highly esteemed supplement manufacturers in the USA market.

Natural Ingredients: Prescription medications are great for instant benefits, but their effects are usually short-term. Contrary to that, natural health supplements offer long-term effects with constant use and often have minimal to zero side effects.

Therefore, our priority was to pick the DHEA supplements that contain a blend of natural and organic ingredients without unnecessary binders and fillers. Furthermore, we searched each ingredient in every product to know whether the company was using science-backed ingredients in the formula.

Safety: When there is low DHEA in the body, your immune systems ability to fight off the harmful chemicals also drops. Therefore, we confirmed the safety of all the ingredients and final products before referring the supplements to our readers.

Customer Reviews: DHEA supplements that received rave reviews from customers were our favorite. For this purpose, we visited official company websites and different forums to learn the pros and cons of each supplement. Hence, we preferred the products that were reviewed by hundreds of customers with a positive rating.

DHEA is great for fixing the natural declines in the concentrations of several human sex hormones. While DHEA supplements are great for boosting libido, they offer many health benefits that one cannot enjoy with growing age.

Similar to other health-boosting supplements on the market, hundreds of manufacturers are selling DHEA products. With that fact, the chances of buying risky and counterfeit DHEA supplements increase. Therefore, checking several important factors in a DHA supplement can be wise.

The first and foremost factor you should consider is what your body is trying to convey. Your body is the first to show symptoms in multiple ways, even before you realize something is wrong with you.

Generally, sexual function in the human body is of the least important as it is one of those functions you can live without. That is also why many forms of sexual enhancement have less than significant support from scientific studies.

When your body is under stress, the sexual system and related functions are one of the primary systems that collapse. Your bodys adrenal glands produce DHEA, which is the same gland that makes and secretes cortisol.

Both of these hormones are released as a response to your stress, increasing stress levels in the body. Therefore, sexual dysfunction is a common symptom obvious in people who handle high-stress levels. So, when you are stressed, your body will save energy and nutrients to build up stamina and protect you from the harmful effects of stress.

Several studies have concluded the positive health benefits of DHEA with doses of up to 200 mg. Therefore, the supplements that deliver up to 200 mg of DHEA to your system are considered safe.

Supplement manufacturers offer DHEA pills in different doses, but you should stick to lower doses (25 mg, 50 mg) only as a beginner. For instance, the featured supplements contain 25 mg to 100 mg of DHEA per capsule.

What we suggest is you should prefer DHEA supplements with 50 mg. Mainly, 50 mg DHEA capsules offer a strong enough dose to significantly change your DHEA levels with just one capsule per day.

However, most individuals will have to try and test these supplements by gradually increasing doses to find the best therapeutic amount. Another vital factor that can affect the DHEA dose is your age.

An important factor you must consider before purchasing any supplement with a stronger dose is the size of the capsules. Maximum strength DHEA supplements often come in large capsules and are difficult to swallow.

Also, if you intend to consume more products in your healthcare regimen, choosing such supplement with a smaller size is best. The good thing with safe and effective DHEA supplements is that the capsule size will be small enough if you choose a 50 mg dosage.

On the market, hundreds of DHEA supplements contain additional ingredients like minerals and vitamins. Many supplement manufacturers add them to the blend to boost the efficacy of the main ingredient.

However, it cannot always work out well as you might have insufficient DHEA dose to feel the effects. Moreover, the additional ingredients will be quite low in concentrations to cover your daily requirements.

You will probably have to invest in other products to get the ideal amount of both primary and secondary ingredients. Thats why we suggest you stick with the pure DHEA supplements only and consume other products for the health benefits you want.

DHEA is a shorthand for Dehydroepiandrosterone, a hormone produced by your adrenal glands. It acts as a precursor in synthesizing and releasing crucial male and female sex hormones in the human body.

For instance, it plays a great role in forming testosterone and estrogen. Both are vital hormones that boost the development of masculine and feminine secondary biological features. Not only that, but they also hold significant importance for your general health and well-being.

If you have excessive estrogen-like endocrine disruptors, your body will be disrupted by hormonal disruption, leading to reproductive weakening. Since testosterone and estrogen levels differ in both male and female bodies, their symptoms will differ.

Individuals with Y chromosomes will face many debilitating symptoms due to low testosterone production. This includes irrational mood swings, sudden weight gain, fatigue or low stamina, frequent memory failure, and underdeveloped muscle tone. Additionally, they might have underdeveloped testicles, low libido, erectile dysfunction, and joint/bone tissue loss.

Likewise, individuals who lack a Y chromosome will witness unwanted symptoms in response to low estrogen levels in the body. Some common signs are headaches, mental health problems, fatigue, mood swings, hot flashes, and trouble concentrating. Furthermore, many women have other symptoms like breast tenderness, irregular or absent menstrual cycle, lack of vaginal lubrication, and urinary tract infections (UTIs).

Other health effects of low DHEA levels that are common to both males and females are important, just like the regulation of sex hormones. DHEA synchronizes your energy levels, mental health, bone health, metabolic health, immune function, stress resistance, skin health, and cognitive and memory health.

Many double-blind, placebo-controlled research trials have shown the proven benefits that the human body can get from DHEA supplementation. Since DHEA levels dip with age, older men and postmenopausal women can greatly benefit by adding DHEA supplements into their regimens.

The research on DHEA supplementation mostly focuses on retrieving youthful health benefits as we age. Generally, DHEA has plenty of health benefits as it is involved in the complex process of hormonal production and balancing.

Science has proved that DHEA is good for the bones of postmenopausal women. If you are a gym-goer, adding DHEA supplements into your weight training routine can help to boost muscle strength.

Since its not only the muscle strength that counts for a youthful body, DHEA also plays a helpful role in shaping your body composition. While DHEA is thought to help you gain muscle strength, it also increases the fat-burning process.

One of the worst features of aging is the loss of sexual stamina and attraction, resulting in a lack of physical intimacy. In such situations, people can even try anti-aging products . However, sexual intercourse can help release the love hormone, oxytocin. So, as you age, you are not sexually interested in your partner, which keeps you from enjoying the benefits of oxytocin. No worries anymore; DHEA can help with that as it supports libido and sexual interest in both sexes.

Besides, DHEA can benefit adrenal insufficiency, healthy arteries, healthy glucose metabolism, youthful skin, optimal brain health, healthy inflammatory response, and more.

Scientific society considers DHEA an anabolic steroid. However, DHEA does not produce the typical results of anabolic steroids. While DHEA boosts testosterone levels, strength, and muscle mass, compared to steroids, it does so in much lower amounts. Therefore, DHEA has a nominal effect on your testosterone levels, and studies have not proven its benefits in boosting muscle size, strength or endurance yet.

Dosage is the primary factor that decides the effectiveness of DHEA supplementation. Some additional factors affecting its effectiveness are how consistently and for which health goals you are consuming it.

Still, the timeline for visible results from DHEA supplementation varies from a few weeks to a few months. Furthermore, not many scientific studies have analyzed the long-term effects of DHEA. Therefore, you should plan your DHEA consumption anywhere from a few months to a max of one year.

In the USA, DHEA was once banned for over-the-counter sales in 1985. Since then, all the DHEA supplements have been approved for retail distribution and are not forbidden in the United States. However, the World Anti-Doping Agency (WADA) has banned DHEA as it can alter user testosterone levels.

DHEA supplements are no longer just for people suffering from a low testosterone level or for postmenopausal women who want to reverse the effects of menopause. If you feel your health is declining and you know it has something to do with aging, DHEA supplements can be the best solution.

To help you ease your legwork, we have found the topmost DHEA supplement brands for you. Natrol, Life Extension, and PureFormulas offer effective DHEA supplements with the benefits of natural ingredients.

These products offer a safe, pure, natural alternative that can give your body all the hormones it needs to stay healthy and young, including DHEA and growth hormone. These are not aphrodisiac drugs, so there are no side effects or interactions with other drugs.

Multiplex Content Recommendation - 1

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Best DHEA Supplement (2022 Updated) - The Island Now

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Testosterone Replacement Therapy in the Aged Male: Monitoring Patients | IJGM – Dove Medical Press

Posted: September 8, 2022 at 2:31 am

Introduction

Hypogonadism (HG), or testosterone (T) deficiency, is referred to as the syndrome of symptoms resulting from insufficient serum levels of testosterone, which results in inadequate action in sensitive tissues. Its role has been investigated for thousands of years, and the Romans are reported to have observed its impact on energy, erectile function, and urination.1 The causes are several, but they can be categorized into two primary groups: primary hypogonadism or testicular failure, acquired or congenital and secondary hypogonadism, which implies the origin of the syndrome is found in the hypothalamus or the pituitary gland including complex mechanisms.2 Klinefelter syndrome (KS) represents one of the commonest, congenital causes of primary hypogonadism.3 Conversely, the aging of the testicles seems to be a natural phenomenon as men will experience roughly a 12% per year reduction of their circulating testosterone levels starting at the beginning of fifth decade, which eventually results in the development of the late-onset hypogonadism (LOH).4 The timing of the manifestations varies according to the cause as congenital causes will manifest primarily as incomplete or delayed sexual development at childhood whereas late-onset or acquired hypogonadism will present more frequently as loss of libido, fatigue, mood disorders, and erectile dysfunction in older age.5,6

Hypogonadism presents as a clinical syndrome. This includes a combination of a variety of nonspecific signs and symptoms is present in addition to the hormonal imbalance. Incomplete sexual development, erectile and sexual dysfunction, decreased energy, mood disorders, muscle weakness, fatigue, sleeping difficulties, infertility, and chronic pain are the main manifestations of testosterone deficiency, which alone or in combination will affect significantly the quality of life of affected men.710 In aged males, the condition warrants high suspicion as symptoms are not specific. A combination of low energy, sleep disturbances, loss of libido, underperformed sexual activity, and emotional stress should trigger screening for hypogonadism in men above (but not limited to) the age of 40.7,11

Testosterone replacement therapy (TRT) or supplementation therapy (TST) has positive effects on body weight and metabolism, bone and liver health, cardiovascular status, sexual, and micturition health, and sarcopenia.12 It has been offered in multiple pharmacological forms (oral administration, injections gel, transdermal patches, etc) for the restoration of normal testosterone levels in cases of both primary and secondary hypogonadism when clinically appropriate.1 When hypogonadism is complicated by infertility, special hormonal manipulations are needed as low testosterone interferes with the spermatogenesis, but pure TRT may negatively affect the reproductive axis.13,14 Testosterone replacement differs to treatment with human chorionic gonadotropin (HCG), which is used to treat secondary hypogonadism and improve spermatogenesis by stimulating the Leydig cells without the side effects on fertility seen in TRT.15 Apart from the beneficial effect on the hormonal status, TRT has been found efficient to improve the quality of life in hypogonadic men as part of a multidisciplinary team approach as illustrated in subjective tools and metrics.1618 Various questionnaires and scoring systems have been proposed as assessors for the standardized evaluation of the effect on quality of life (QoL) along with the measurement of clinical parameters and should comprise the routine approach as QoL endpoints might elude.19,20 Specific questionnaires such as the widespread used aging males symptom rating scale (AMS) have been well-established as they assess several views of quality of life including sexual, somatic, and psychological aspects.18 However, a more delicate and thorough tool might be needed in men where the chief complaint comes from the mental sphere, sexuality, or chronic pain.21,22 Moreover, lower urinary tract symptoms are quite common in aging men with hypogonadism, affecting quality of life warranting follow-up.23 However, a standard regime for monitoring the QoL in men on TRT is unknown and the optimal tools are yet to be established. So far, no specific tools affecting QoL in men on TRT has been suggested or included in international guidelines.24 In this paper, we review the indications and the rationality of the available tools monitoring QoL in adult men with LOH on TRT, and we provide the evidence for their usage.

A nonsystematic search in PubMed/Medline, Google Scholar, Web of Science, and Embase was performed using the terms testosterone replacement therapy and quality of life, chronic pain, lower urinary tract symptoms, general health, well-being, sexual health, questionnaire. Outstanding studies escaped from engine search were selected through the full texts of the reviewed papers. Exclusion criteria were non-English, animal, and retracted studies. We select the evidence related to the specialism of tools in the below domains: general health assessment, lower urinary tract symptoms, sexual health assessment, mental health, in men treated with TRT for LOH.

The aging males symptoms (AMS) scale was developed in 1999 as a tool to aid assessment of andropause including evaluation of symptoms, severity, and response to TRT. It consists of 17 questions of somatic, psychological, and sexual symptoms and the score varies from 17 (minimal significance) to 85 (severe symptoms consistent to TD).25 It has been one of the most extensively used assessors of quality of life in men treated with hypogonadism and reduction of the score indicates treatment success in terms of quality of life improvements.26 Domains of the questionnaires can also be used separately for the assessment of the chief complaint such as sleep disturbance/apnoea which is not an uncommon manifestation of HG.7 Furthermore, it seems that the tool follows reliably the severity of the symptoms and the complexity of HG. Jeong et al reported that men with metabolic syndrome showed less improvement in the AMS scale reflecting directly the effect of the complications on quality of life.27 Similarly, the androgen deficiency in the aging male (ADAM) questionnaire is another used tool initially designed for the screening of low testosterone. This questionnaire is shorter and consists of 10 questions with a binary response (yes/no) assessing sexual life, energy levels, mood, and activities performance. It has been used, but less frequently compared to AMS, for the assessment of the response to TRT and reduction in the score indicates improvement in quality of life.28 Similarly to AMS, the questionnaire can be used for the assessment of single complaints such as the psychological aspects and for the monitoring of men with chronic pain.22,29 Short-form health survey (SF) questionnaires have been developed for monitoring the QoL in patients with chronic conditions and other stressful circumstances.30 They assess aspects of general health, physical functioning, role physical, bodily pain, vitality, social functioning, mental health, and emotional status.31 The original questionnaire consisted of 36 questions (SF36) has been used in young male cancer survivors treated for hypogonadism. This study did not reveal any changes in QoL but the outcome might be the result of selection bias.32 A shorter version of eight questions, the SF-8 has also been reported to assess the response to individual symptoms and the treatment effect of testosterone.19

Evaluation of the QoL related to lower urinary tract symptoms (LUTS) in men treated for HG is clinically relevant as there is a theoretical effect of testosterone on prostate growth. A 12% significant increase on prostate volume in hypogonadic men (with no bothering urinary tract symptoms) treated with TRT has been reported.33 Moreover, LUTS are reported quite common in aging men treated for hypogonadism, likely the result of concurrent BPH.23 Although the association of hypogonadism and LUTS is weak, men with obstructive symptoms due for surgery and international prostate symptoms score IPSS >19 have been reported with higher testosterone concentrations compared with men with lower score.34 In contrast, a meta-analysis has reported that alterations in IPSS for an average follow-up of three years were similar between men who received TRT versus those not treated. As a result and compared to the previous dogma, TRT should not be regarded an absolute, but rather a relative, contraindication in men with severe BPH.23,35 However, a critical view in studies showing no deterioration in IPSS with TRT may reveal that relevant information regarding the anatomical risk factors (eg, prostate volume) were unreported, whereas in others, men with high IPSS were excluded.35 Therefore, it is advisable that assessment of urinary tract symptoms be included in the follow-up of hypogonadic men treated with testosterone replacement. In that regard, the IPSS represents a well-reported, reliable tool in monitoring and can facilitate as an indirect measure of quality of life.35 Using IPSS, changes in both voiding and storage type of symptoms can be detected promptly in men on moderate to severe scale, in the very early follow-up of treatment at three months and even if TRT is used as monotherapy without addition of BPH drugs.3638 Furthermore and of interest, alterations in urinary symptoms have been reported not to be linked with similar effects of testosterone on general body health such as weight loss and sexual health; thus, IPSS looks sensible to remain during follow-up and not to be substituted by other markers of clinical response.39

Hypogonadism has been a well-documented cause of loss of libido and reduction of sexual activity affecting the quality of life significantly and independently.40,41 TRT compared with placebo has been shown to achieve a significant improvement in sexual health in men with no comorbidities treated for over 30 weeks.42 For the assessment of the response and monitoring of QoL several questionnaires have been proposed. The International Index of Erectile Function (IIEF) is a validated assessment tool for the evaluation of the severity of sexual illness in the concept of hypogonadic men under treatment. It is the more widespread used tool for the assessment of sexual health outcomes.42 It is a self-reported questionnaire of 15 questions, which in its original form assess erectile function, orgasm, desire, intercourse satisfaction, and overall satisfaction. The lower the score, the higher the severity of the symptoms.43 A shorter version (IIEF-5) includes a series of five questions which has been used for the assessment of sexual health in men treated with TRT.20 Replacement therapy has been found to improve all domains of IEFF over a timespan of several weeks following improvements in quality of life.44 Derogatis interview for sexual functioning (DISF-SRII) - scored to 100, where 100 indicates better sexual function is a self-reporting tool which can also be used as an alternative for men in TRT.45 The psychosexual daily questionnaire (PDQ) is a six-question tool providing a useful aspect of the psychosexuality of men with hypogonadism.46 The limitation of the tool is the need of daily completion for a standard period of time, which may vary but should reflect the past period. However, the domains of the questionnaire (desire, pleasure, mood etc) can be used for the assessment of the response to TRT with adequate reproducibility.45 The brief male Sexual function inventory (BMSFI) is a similar questionnaire of 11 questions which include erectile function, ejaculation, personal view of the sexual problem, and overall satisfaction. It has been reported useful for the monitoring of QoL in terms of sexual health in men undergoing TRT.47 Other validated tools such as the mens sexual health questionnaire score could be potentially used, but they are infrequently reported in men on TRT. One study has assessed the usage of the tool in men with testosterone deficiency and profound ejaculatory dysfunction.48

Mental health disorders such as depression or mood fluctuations are one of the principal manifestations of hypogonadism.49 Older and andropause men may see their QoL decline as part of the syndrome.50 Younger men with congenital HG may experience more severe mental disorders (eg, alienation, shame) due to disrupted puberty, infertility issues, or delay to the final diagnosis.51 Much of this dysfunction in hypogonadism can be reversed or improved when appropriate with TRT.52 The domains from the short-form health survey (SF) questionnaires can be used for monitoring mental health in men under treatment.9 The symptom checklist 90 revised (SCL-90-R) is a sum of 90 questions which is used for the assessment of psychological well-being in patients with mental diseases or coming from traumatic situations.53 The questionnaire is quite analytic including questions related to feeling of guilt, agoraphobia, anger, etc. It has been used to assess the magnitude of psychological distress in men with Klinefelter syndrome. Fabrazzo et al reported that men with KS at their 40s experience significantly higher presence of obsessions, compulsions phobias and psychoticism compared to healthy controls based on the analysis by SCL-90-R.16 Domains of the AMS questionnaire (No. 4) can also be used for the assessment of mental health in periodical visits,54 whereas QoL associated with mental health has been found to remain significantly impaired in those with a high AMS score.19 When the chief complaint is depression, questionnaires such as the Hamilton depression rating scale (HAM-D) and the Endicott quality of life enjoyment and satisfaction scale (Q-LES-Q) can be used at diagnosis, follow-up and to alert for relapse.21 The first one assesses the short-term (past three days) anxiety and tension, fears, muscular tension and difficulty in concentration.55 Q-LES-Q comes in a long a short form; the latter one consists of 16 questions assessing the level of satisfaction of the past week related to general activities, feeling of strength and sociality, sexual drive, and others similar parameters. It has been reported to carry the highest specificity.56 It also exists in a pediatric form, which might make it attractive in young-onset hypogonadic patients for the assessment of depressive disorders.57 Finally, AMS and SF questionnaires include questions assessing mental health and well-being.32,58

Quality of life and the entity of hypogonadism are strongly related. Regardless of age of presentation and exact cause, hypogonadic men experience significant deterioration in their well-being. Therefore, both the assessment of the QoL at diagnosis and the re-evaluation during treatment should be regarded integral part of the management. Although all aspects of HG may affect QoL by causing disease-related symptoms, in this paper we focused on the four main domains.

The questionnaires are the cornerstone of the assessment of HG and response to TRT in terms of QoL as holding several advantages. They can be conducted quickly, with low-cost, can be easily repeated and can facilitate research. In contrast, it should be noted that they carry the risk of reporting bias, which may occur due to defensiveness, education, feeling of guilt, and may range from the underreporting edge up to the extreme response bias.59 Also, they lack specificity for HG and therefore, should be utilized after the diagnosis of HG through measurement of testosterone has been established.8 In that regard, if symptoms persist during follow-up other pathologies must be evaluated.

The optimal tool for the assessment of QoL is unknown as no comparison has been reported amongst questionnaires. The sum of the fundamental tools per domain is illustrated in Table 1. The AMS scale and the short-form health survey questionnaires look a wise choice for monitoring as they assess general, social, and mental health; AMS also assess sexual health, but SF does not. The AMS scale can provide rapidly the magnitude and the extent of the effects of HG and the course of TRT.60 Further on, specific tools could be selected according to patients main complaint. In men with profound erectile dysfunction, IIEF score should be used for the assessment of sexual health and repeated during treatment.20 If mental health is mostly impaired, the likelihood of a severe underlying mental condition should be considered. Questionnaires such as the HAM-D scale should be used to assess the possibility of depressive disorder within or additional to the spectrum of HG.21 Although the usage of such questionnaires is quite useful to the urologist, a referral to a specialized clinician should be considered prudent if any signs of mental illness. It is of outmost importance that an indisputable linkage of mental illness to HG be avoided and rather, further investigated. Finally, the presence of LUTS in men with HG is not uncommon, especially in older men. As aforesaid, the old dogma that TRT is contraindicated in men with BPH has been revoked. However, possible selection bias in the reported studies warrants a close follow-up in men with BPH until the safety of TRT is confirmed.35 In that regard, the IPSS should be regarded a great tool for the risk stratification of men on TRT. Furthermore, clinical assessment through biochemical markers (eg, serum testosterone, lipid markers, hematocrit, etc) should also be considered as indirect prognostic assessors of QoL as disease-related symptoms from untreatable disease may affect well-being significantly.61 The optimal schedule of re-evaluating QoL endpoints is not defined, but it would be sensible to be re-evaluated every 36 months as the routine assessment for men on TRT.24

Table 1 Tools for Monitoring QoL

Moreover, a special mention should be made regarding the association between TRT and prostate cancer. That diagnosis of prostatic malignancy is frequent in the male population might be a significant reason for QoL changes.62 It has been reported TRT may neither have an impact on decision-making nor undermine early diagnosis of prostate cancer as the effect on prostate specific antigen (PSA) readings is minimal.63 No effect on overall and specific mortality, and eventually in QoL is expected in selected men having received successful surgical treatment for prostate cancer who receive TRT.64 The findings are consistent with the so-called saturation model which supports that in normal and high testosterone levels prostate growth is insensitive; however, other authors advise that the available evidence should be critically reviewed and any decision-making in that concept should not be based on the model alone.65 Specific guidelines for the management of these patients are still under consideration.66 Given the limitations of our study, a suggested algorithm is illustrated in Table 2. Finally, the peculiarities regarding administration methods (gel, injections, patches, etc) needs to be appreciated as they may be related to patient experience, but the actual effect is unclear as recommendations may be guided by the clinicians.67 Cost and convenience may have an impact on choice, but satisfaction has been reported similar among gels, injections, and implantable pellets.67

Table 2 Suggestion for Monitoring QoL in Men on TRT

We appreciate some limitations in our study. We performed a narrative review, not a systematic one, and the selection of the discussed score systems and questionnaires was based on the panels judgment. Our goal was to present the strategy regarding the utilization of these tools and not to perform a comparative, qualitative, or quantitative analysis. Moreover, it must be noted that our research was focused on the clinical concept of LOH and the treatment with testosterone supplementation in the aging male. Our results may, or may not, have reproducibility in infertile men with secondary hypogonadism treated with HCG.15

Monitoring the QoL in men on TRT warrants a deep insight of the clinical spectrum of HG and thus, a cautious selection of surveillance tools. Questionnaires are the cornerstone, but the optimal tool is unknown. A tool assessing several domains of QoL should be selected. However, in order that all aspects of well-being are monitored, a clinician may need to combine the tools and target the chief complaint. Finally, as the clinical spectrum of HG is not specific, questionnaires can be used to unmask coexistent mental illness. In cases of high suspicion, a specialist referral must be considered.

The authors report no conflicts of interest in this work.

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17. Arver S, Luong B, Fraschke A, et al. Is testosterone replacement therapy in males with hypogonadism cost-effective? An analysis in Sweden. J Sex Med. 2014;11:262272. doi:10.1111/jsm.12277

18. Nian Y, Ding M, Hu S, et al. Testosterone replacement therapy improves health-related quality of life for patients with late-onset hypogonadism: a meta-analysis of randomized controlled trials. Andrologia. 2017;49:e12630. doi:10.1111/and.12630

19. Sumii K, Miyake H, Enatsu N, Matsushita K, Fujisawa M. Prospective assessment of health-related quality of life in men with late-onset hypogonadism who received testosterone replacement therapy. Andrologia. 2016;48:198202. doi:10.1111/and.12433

20. Almehmadi Y, Yassin AA, Nettleship JE, Saad F. Testosterone replacement therapy improves the health-related quality of life of men diagnosed with late-onset hypogonadism. Arab J Urol. 2016;14:3136. doi:10.1016/j.aju.2015.10.002

21. Seidman SN, Rabkin JG. Testosterone replacement therapy for hypogonadal men with SSRI-refractory depression. J Affect Disord. 1998;48:157161. doi:10.1016/S0165-0327(97)00168-7

22. Kato Y, Shigehara K, Kawaguchi S, et al. Efficacy of testosterone replacement therapy on pain in hypogonadal men with chronic pain syndrome: a subanalysis of a prospective randomised controlled study in Japan (EARTH study). Andrologia. 2020;52:e13768. doi:10.1111/and.13768

23. Lee MH, Shin YS, Kam SC. Correlation between testosterone replacement treatment and lower urinary tract symptoms. Int Neurourol J. 2021;25:1222. doi:10.5213/inj.2040234.117

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29. Yamaguchi K, Ishikawa T, Chiba K, Fujisawa M. Assessment of possible effects for testosterone replacement therapy in men with symptomatic late-onset hypogonadism. Andrologia. 2011;43:5256. doi:10.1111/j.1439-0272.2009.01015.x

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32. Walsh JS, Marshall H, Smith IL, et al. Testosterone replacement in young male cancer survivors: a 6-month double-blind randomised placebo-controlled trial. PLoS Med. 2019;16:e1002960. doi:10.1371/journal.pmed.1002960

33. Holmng S, Mrin P, Lindstedt G, Hedelin H. Effect of long-term oral testosterone undecanoate treatment on prostate volume and serum prostate-specific antigen concentration in eugonadal middle-aged men. Prostate. 1993;23:99106. doi:10.1002/pros.2990230203

34. Favilla V, Cimino S, Castelli T, et al. Relationship between lower urinary tract symptoms and serum levels of sex hormones in men with symptomatic benign prostatic hyperplasia. BJU Int. 2010;106:17001703. doi:10.1111/j.1464-410X.2010.09459.x

35. Kohn TP, Mata DA, Ramasamy R, Lipshultz LI, Catto J. Effects of testosterone replacement therapy on lower urinary tract symptoms: a systematic review and meta-analysis. Eur Urol. 2016;69:10831090. doi:10.1016/j.eururo.2016.01.043

36. Okada K, Miyake H, Ishida T, et al. Improved lower urinary tract symptoms associated with testosterone replacement therapy in Japanese men with late-onset hypogonadism. Am J Mens Health. 2018;12:14031408. doi:10.1177/1557988316652843

37. Ko YH, Moon DG, Moon KH. Testosterone replacement alone for testosterone deficiency syndrome improves moderate lower urinary tract symptoms: one year follow-up. World J Mens Health. 2013;31:4752. doi:10.5534/wjmh.2013.31.1.47

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39. Yassin D-J, El Douaihy Y, Yassin AA, et al. Lower urinary tract symptoms improve with testosterone replacement therapy in men with late-onset hypogonadism: 5-year prospective, observational and longitudinal registry study. World J Urol. 2014;32:10491054. doi:10.1007/s00345-013-1187-z

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ROACH: Testosterone injections most likely led to a very severe stroke – New Castle News

Posted: September 8, 2022 at 2:31 am

FROM NORTH AMERICA SYNDICATE, 300 W 57th STREET, 15th FLOOR, NEW YORK, NY 10019

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FOR RELEASE WEEK OF SEPT. 26, 2022 (COL. 4)

BYLINE: By Keith Roach, M.D.

TITLE: Testosterone injections most likely led to a very severe stroke

---

DEAR DR. ROACH: My 75-year-old husband was frustrated with not being able to retain an erection. He talked to his doctor about it, and she prescribed 200 mg of testosterone cypionate, which he would inject into his bottom once a week. He did this for four months, and then had a severe bilateral stroke (as in, he does not know where he is, what happened to him, cannot read or write, cannot walk, etc.).

After spending two weeks in the ICU, he went to a rehabilitation hospital for three weeks. The hematologist there told me his hemoglobin level was up to 20, and there was no reason a 75-year-old should have been prescribed testosterone when it can elevate his hemoglobin so much. I looked at my husband's labs over the last three years, and his hemoglobin was never above 15. Of course, I had no idea testosterone would elevate hemoglobin, or that it should not be prescribed to a 75-year-old.

What are the normal protocols for testosterone with older men? Could his testosterone injections have led to his stroke? -- D.H.

ANSWER: I am very sorry to hear about your husband.

Story continues below video

Testosterone replacement therapy is commonly prescribed to men in their 70s and 80s. Elevations of the hemoglobin levels are certainly well-described, but levels above normal only happen about 1% of the time. Experts recommend checking a blood count to look for these elevations three to six months after starting treatment. Testosterone should be stopped if the hemoglobin level is above normal.

Sometimes, there are other causes for the hemoglobin to go up, but a rise that high, when he had never had it before, makes it seem very likely to me that the testosterone was the cause. A hemoglobin level that high, from any cause, is a risk for stroke and heart attack. It is very possible the testosterone prescription led directly to the stroke.

I am publishing this in the column so that men who are taking testosterone know they should be periodically tested for this unusual complication.

DEAR DR. ROACH: I had carpal tunnel surgery two years ago. I now have trigger fingers in my index and ring fingers. I had cortisone injections but that didn't cure it. I, at one point, was not able to open my fingers. Now, my fingers are really stiff, and I can't bend them. When they get down too far, they lock, but usually, they're so stiff I can't bend them. Surgery was suggested. I'm hesitant, because I'm wondering if this will get better on its own with exercises. -- J.T.

ANSWER: Trigger finger is caused by the tendon getting stuck inside one of the pulleys of the hand. To the best of my knowledge, carpal tunnel surgery doesn't predispose to trigger finger, but there are some conditions that put people at risk for both conditions. Initial treatment of trigger finger is conservative, with splinting and anti-inflammatory drugs. If that doesn't work, injection of cortisone by a hand surgeon is usually successful.

Most of the hand surgeons I know will try injection three times before recommending surgery. People who have not gotten better with conservative treatment and injection generally do not get better on their own; though, a few people will. Unfortunately, postponing surgery too long can lead to the finger getting a contracture, where it will not straighten at all. It's best to have surgery before this complication occurs.

* * *

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.

(c) 2022 North America Syndicate Inc.

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Perform Your Best With Comprehensive Bloodwork – duPont REGISTRY News

Posted: September 8, 2022 at 2:31 am

Presented by Marek Health.

The best way to keep track of your overall physiological and psychological well-being is by doing regular blood testing. Routine testing allows you to monitor your bodys changes over time and be one step ahead of any health issues to ensure you are living optimally at your peak performance level.

We offer hundreds of markers that measure:

At Marek Health, we offer extensive blood testing that you arent going to get from your primary care Physician. The average doctor typically checks your levels only to diagnose diseases, but we take it further to help you identify what levels are optimal for performance.

We aim to help you reach your mental and physical goals while improving your health. Once you understand your biomarkers and their levels, we are here to help you make better decisions regarding your diet, lifestyle, fitness, and supplementation to achieve longevity and become the best version of yourself. Marek offers a variety of treatments such as testosterone replacement therapy, weight loss, sexual performance, hair loss, skincare, lipid management, fertility optimization, and more!

We can tell you why Marek Health is the future of health optimization all day long, but wed rather you hear it from one of our clients:

Within three months I felt so drastically different I cant believe I waited so long. I am able to go to the gym and go hard- it feels amazing and I have so much energy for my family and job.

If youre ready to get started, you can book your consultation through MarekHealth.com. You can also email info@marekhealth.com for more information.

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What I Learned When I Stopped Testosterone Replacement Therapy |… – Cushing’s Disease News

Posted: August 30, 2022 at 2:12 am

In 2018, I decided to stop using testosterone replacement therapy due to the side effects I was experiencing, most notably, increasingly aggressive behavior.

One concern I had at the time, though, was that ending the treatment would cause an increase in Cushings-related symptoms, because other hormones might be affected. This treatment had addressed my low testosterone levels caused by a pituitary tumor.

I do not recommend abruptly stopping treatment like I did without consulting a professional first. Although I am now seeing the benefits of my decision, it was not an easy road, and at one point, I began to question if my choice was the right one.

The first thing I noticed when I stopped taking my injections was that my mood deteriorated. Feelings of sadness led to an occasional lack of motivation. This sadness was partly due to my reluctance to stop the treatment. While I believed the medication was working, I became aware of how the side effects were affecting both me and those around me. Also, my body had grown accustomed to it over the past year, which led to more emotional imbalance.

The lows in my mood started to improve with effort, such as doing more research on ways to naturally balance testosterone levels, tinkering with areas of my life that were affected by testosterone, and being more active. Eventually, these strategies led to drastic change.

The second effect of stopping treatment was fatigue. The best way to describe it is like working outside all day in the heat. To combat it, what worked well for me was a combination of a plant-based caffeinated green drink, vitamin C, and vitamin B12. This drink has been part of my morning routine for the past four years, since ending testosterone replacement therapy.

I dont like coffee, so it was a good alternative. I also wanted to stay away from most store-bought caffeinated drinks due to their high sugar content.

Other issues I had to deal with again were pain and stiffness, mainly in my feet and lower back. If I was sitting or lying down, my feet would ache when I got up or tried to move. When standing, my lower back would get stiff. It didnt matter how long I was standing, it just appeared to happen randomly.Of the various side effects, the pain and stiffness took the longest to overcome.

To relieve the pain, my wife bought me some braces. I used them for a while but didnt experience much of a change. Then, one day, I started noticing that there was no more pain. This continued to improve each day. I suspect that the amount of weight I had been carrying due to Cushings disease was creating stress on the lower parts of my body, such as my knees. That might have compressed my spine, ankles, and feet. Once I began stretching and being more active including walking 2 miles a day these areas of my body grew stronger, which helped to alleviate the pain.

Given all of these experiences, I eventually learned that I had to give myself time. Quitting testosterone therapy wasnt a process with quick results. It helps to stay positive and motivated, and to take things one day at a time. The peaks and valleys of our journeys shouldnt discourage us from the goal of getting back to optimum health.

The decision to stop any treatment is not one to take lightly. Its always important to talk to your healthcare team before making any changes to a treatment regimen. Doctors can also help you develop a plan of action to replace a particular treatment, if needed.

Today, my energy levels are up again, Ive seen no signs of aggression in my behavior, and my overall sense of well-being has improved. For me, stopping testosterone replacement therapy was worth the trouble because it forced me to look at my mind and body as a whole. The trade-off has been beneficial, and it allowed me to live a healthier lifestyle.

Note:Cushings Disease Newsis strictly a news and information website about the disease. It does not provide medical advice,diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice,diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those ofCushings Disease Newsor its parent company, BioNews, and are intended to spark discussion about issues pertaining to Cushings.

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From White Plains Hospital: Feeling the Effects of Man-o-pause? – theLoop

Posted: August 30, 2022 at 2:12 am

Low testosterone levels known in some corners as man-o-pause are one of the byproducts of aging; according to the American College of Physicians (ACP), an age-associated decline in total testosterone levels begins in men in their mid-30s and gradually increases by an annual average rate of 1.6%. The ACP reports that the incidence of low testosterone in the U.S. stands at about 20% in men older than 60, 30% in those older than 70, and 50% in those older than 80.

I see a fair amount of patients in their mid-50s and older who tell me about how they feel more tired, that their erections arent what they used to be, and how they have less interest in having sex with their partner. With some of those patients, tests show that their testosterone levels are totally normal, so I find myself telling them, Welcome to middle age.

But that is not always the case. On average, a testosterone level of 3001,000 nanograms per deciliter (ng/dL) of blood is normal. Reduced testicular function is typically diagnosed when the total testosterone is less than 300 ng/dL.

Effects of declining testosterone levels can include a lower sex drive, erectile dysfunction, lack of energy, loss of muscle strength, moodiness and even depression. In some cases, the decline can be attributed to such factors as an injury to the testes, a pituitary gland issue, a history of cancer/radiation therapy, and/or a family history of stroke or heart attack. However, in many instances, the cause for this decline can be simply attributed to age. However, in most instances, the cause for this decline is idiopathic that is, we simply dont know.

Fortunately there are ways of addressing low testosterone for most men: testosterone replacement therapy (TRT). Offered by urologists and endocrinologists, TRT can take many forms: injections of testosterone cypionate (Depo-Testosterone) and testosterone enanthate can be done at home, usually bi-weekly, while those involving deep intramuscular injections of testosterone undecanoate (Aveed) are given at your providers office, usually every 10 weeks.

Note that Aveed is only available through your doctors office, clinic, or hospital, and therefore is not a medicine you can give yourself at home. You must also remain at the providers site for 30 minutes after injection so that the provider can watch for symptoms of POME or a serious allergic reaction. Symptoms of POME, or Pulmonary Oil Microembolism, include cough, difficult or labored breathing, chest pain, dizziness, and temporary loss of consciousness.

There are also a variety of topical creams, pills, nasal sprays application frequency varies widely and even implantable pellets, which involves your provider making a small incision, usually in the buttocks, every three to six weeks.

Quality of life usually improves within a few weeks, but the full effects of TRT can take three to six months. Patients tend to feel more energetic and can lose weight (with exercise and a proper diet), and see improvements in their sex drive. Pre-diabetic and diabetic patients can also benefit with improved insulin production.

However, there are side effects to consider. These can range from hair loss, acne and even breast enlargement to elevated red blood cell counts, changes in liver function, and in some cases cardiovascular issues, including heart attack and stroke. All of these will be discussed with your primary care physician and the TRT provider, and regular monitoring via blood and urine tests are necessary.

Interest in TRT continues to grow and, under the right circumstances, can make a very positive impact on ones quality of life physically, mentally and emotionally. Consult a provider to see if its right for you.

Dr. Aaron Hagge-Greenberg is a urologist and urologic surgeon at White Plains Hospital Physician Associates. For an appointment, call 914-949-7556.

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SARMs Before And After Results Real SARM Results And Users Review In 2022 – Outlook India

Posted: August 30, 2022 at 2:12 am

Whether you search for SARMs results 1 month or results after using them for a few months, we assure you these are some miraculous compounds that are recently proven to be more effective than anabolic steroids. SARMs results popularity has outgrown many bodybuilding supplements and this is because they can help pack on mass, ripped physique, and exhilarating strength in a faster manner.

Checkout Best SARMs Alternatives online that works without any side effects!

In this article, we will talk about the worlds best and most renowned SARMs for Bulking and Cutting. We will also point out multiple SARMs there are for female bodybuilders and those who simply want to lose weight using bodybuilding exercises.

What are SARMs?Recently, many people with no background in scientific studies asking are SARM a drug? This is in fact a fair question because SARMs have infiltrated bodybuilding and somehow managed to replace anabolic steroids.SARMs are actually Selective Androgenic Receptor Modulators, they do resemble to anabolic steroids structure wise but their binding capacity is what makes them different from them. SARMs are unlike steroids in bodybuilding which means they only act on selective receptors without alerting other biological processes in the body.SARMs are less risky than steroids because they do not convert into DHT or Estrogen which is the reason why many male bodybuilders get the side effects. In terms of testosterone suppression, SARMs only cause this phase for a shorter time than steroids which results in prolonged testosterone suppression for bodybuilders.

SARMs Before and After ResultsSome obvious changes/results that you can experience after the intake of SARM are mentioned below. Highlighted Muscle GrowthMost athletes and bodybuilders do take SARMs because they work like a magic for outrageous muscle mass growth. Most of them expect to gain over 30 pounds of lean muscle which they achieved within 4 months time frame, but for this legit SARM supplement with proper prescribed dosage shall be taken into account. For example, regular use of 20mg Ostarine considerably helps with muscle growth which has been experienced by thousands of bodybuilders in the US alone. Weight/Fat lossBest SARMs for fat burning is amongst the top searches on Google and this is because SARMs are capable of incinerating the fat reservoir in the body. Not the healthy fat but the lipids that your body has been storing for years. In recent days, SARMs are more preferred than Clenbuterol a steroid which is used to get rid of extra fat in the body because of less risk associated with Andarine, one of the best SARM for fat loss. Escalated StaminaWhat is the use of SARMs if not for improved stamina and physical power? Nearly every SARM works on physical power and maximized strength which is the demand of every athlete and sportsman. Under the right dosage, SARMs not only amplify the stamina in men and women but also keeps them energetic, focused, and alert throughout the day. Stops Muscle Wasting SyndromeMany bodybuilders during working out with peak performance tend to lose healthy muscle tissues which arent supposed to be this way. This will also accumulate the water content in muscles which gives your arms and chest a flabby appearance. SARMs allocate the muscle and hydro content in a suitable way that will stop muscle wasting. Faster and Superior Recovery against Muscle FatigueStudies have shown that SARMs long-term use makes the body endure the pain and pressure efficiently. SARMs improve the energy production in muscles which also makes them resistant to sprains, injury, and fatigue during the workout or in the outside world.

Bulking SARMS Before and After ResultsHere are the most effective SARMs for bulking in 2022 which are currently being used by bodybuilders and athletes to compliment muscle mass growth.1. Testolone (RAD140)2. Ligandrol (LGD-4033)3. Ibutamoren (MK 677)

Testolone RAD 140 SARM Before and After ResultsTestolone is regarded as one of the latest and potentially active SARM for muscle growth and bulking cycle. RAD 140 is still under many clinical studies and is not been approved by the FDA yet. Bodybuilders like Testolone so much because of the rapid results and it resembles a testosterone steroid.The main use of Testolone RAD140 is in chemotherapy patients whove lost significant muscle mass, this SARM is given to them for rapid recovery by halting the muscle degenerative disorder. Many physicians around the world refer to RAD 140 as an alternative to Testosterone Replacement Therapy (TRT).Speaking of Testolone results, a vast majority of its user reported elevated energy levels and significant improvements in muscle growth. The mechanism hints at escalated protein synthesis which is very beneficial for bulking workouts. Although RAD 140 results take some time occasionally the gains are reportedly permanent and more solid. With the use of RAD140, users tend to feel nauseated and have other symptoms very little.

The best way to take Testolone is by taking it for 60 days straight (if you are looking for 10-20 lbs muscle gain), but it also depends on the dosage of the compounds. For more remarkable results, Testolone is often combined with other SARM for bulking named Ligandrol.

Ligandrol LGD 4033 SARM Before and After ResultsIn 2022, a vast group of bodybuilders prefers Ligandrol for the best-looking body. The SARM is typically run for 12 weeks straight in a 10-20mg per day dosage after which you can expect to achieve 20 pounds of lean mass.First-time Ligandrol LGD 4033 SARM users take it in little dosage i.e. 6-10 mg for 6 weeks which is to experience a very little amount of side effects. As a suitable SARM for bulking cycle, Ligandrol is also being used for improved fat loss, the SARM binds to the androgen receptors located in the adipose tissues which tend to fasten the metabolism and this will lead rapid weight loss.Ligandrol is sometimes compared to Trenbolone because both compounds stimulate the production of trep muscles. Following a calorie-restricted diet and another regular workout, there are many results you can expect while using Ligandrol. Increased energy, sharpened focus, and lean abs are some of them.

Ibutamoren MK 677 SARM Before and After ResultsNot always a SARM but MK 677 sometimes referred to as Growth Hormone Secretagogue which produces growth hormone and protein in the body. In dire need of supplements, bodybuilders occasionally take Somatropin steroids for HGH stimulation but Ibutamoren is replacing the steroids as we know. Thats because very few side effects are associated with Ligandrol than Somatropin.Ibutamoren MK 677 SARM is the ideal compound for power-lifters who dont take no for an answer when it comes to showing their full body potential. You can also observe increased fertility while consuming Ibutamoren.In the latest reviews about Ibutamoren SARM, it was concluded that it may not be too much helpful to prevent muscle soreness and injury. It can shorten the muscle healing time but thats nothing compared to what Testolone RAD 140 does.In addition, the growth hormone stimulator like MK 677 aids peaceful and sound sleep which is another useful gimmick for muscle recovery. Ibutamoren users reportedly take a brief amount of sleep but they wake up feeling energetic and fresh like they have been sleeping for a day. You can experience the same Ibutamoren result but the condition is to take it in the evening. Stacking Ibutamoren is easy with other SARMs and the surprising part about the compound is there are no need for Post Cycle Therapy. In fact, some users take MK 677 SARM as a part of their PCT which is to replenish the dropped testosterone and HGH levels.Cutting SARM Before and After ResultsBest SARMs for Cutting in 2022 are reviewed by the experts on the reddit forum and other notable platforms online. Some of these SARMs are perplexedly made but the science justifies the results.

Cardarine Before and After ResultsMany reviews about Cardarine GW-501516 SARM say its not a proper SARM but rather a PPAR receptor agonist. The function of such molecules is to provide the fat-burning effects to the body by burning fats and not glucose entirely. The fat cells fulfill the energy demands more efficiently than glucose does and by this, we mean better muscle definition and improved stamina ahead.Cardarine is used by exceptional types of bodybuilders who want to build an ethos out of themselves. GW 501516 tells us about the eradication of stubborn fat from the belly, only 15mg daily dosage for 8 weeks is sufficient for the desired results. You can see at the end of the first month that your body begins to react to strenuous workouts and that it also loses around 5% of body fats.Most people in 2022 are looking for a supplement that can help them shrink their love handles, after spending a sedentary lifestyle most of us get determined to the workout that only stays for a few days. SARMs like Cardarine is the name of the game when you keep wanting to be dedicated and punctual to the workout without any compunction for laters.

Ostarine Before and After ResultsAn athletic physique means you will develop cuts as well as muscle mass which is a pleasant sight for the viewers. With the help of the Ostarine cycle, many users reportedly gained over 8 pounds of lean muscle mass but they also get immense energy levels that help them with fat eradication.Ostarine cycle results in improved bone density, and insulin resistance and it does not interfere with the hormonal system. Many steroids and SARMs end up disturbing the levels of Testosterone, Progesterone, Growth Hormones, and Estrogen but Ostarine is exempted from all those nasty side effects.Ostarine is considered the mildest SARM which means its also safer than most bodybuilding SARMs available in 2022. So many clinical trials are already done on Ostarine and its awaiting FDA approval, there are fewer side effects than any other SARMs. You can take Ostarine in conjunction with RAD 140 Testolone or Ligandrol but you have to be punctual during the workout sessions.

Stenabolic SR9009 SARM Before and After ResultsStenabolic SARM is an ideal SARM for every type of body whether endomorphs or ectomorphs, the SARM is greatest in fat eradiation while replacing them with healthy muscle mass. Recently, the SR9009 Stenabolic cycle has taken a new turn in which bodybuilders are taking it as a weight loss supplement.Stenabolic is indeed a REV-ERB agonist which means it manages and regulates a special type of protein called REV-ERB. This protein is located throughout the body, especially in the muscle tissue, upon activation the regulation of fat metabolism and energy generation takes place and this turns the user into a more energetic, result-oriented, and literally a beast in the gym.Stenabolic is the best SARM for females in order to accomplish their weight loss goals. Different men and women athletes are getting fond of gene expression effects of Stenabolic which seems to increase the mitochondrial energy in each muscle cell. Mitochondria are frequently referred to as the "powerhouses" of cells because they produce most of the cell's energy. Therefore, by increasing the number of mitochondria in muscle cells, Stenabolic SR9009 may help a woman's muscles to produce more energy and become stronger.

Conclusion - Are SARMs Before and After Results Real?You have the liberty to not believe what they say about mere bodybuilding supplements, but SARMs or steroids are not just any other bodybuilding supplements. It took years of research and critical studies to define them and make them available in the consumer market. Just like the SARMs results, SARM side effects are also real which takes a heavy toll on the body at times.To avoid such outcomes, you may start with the minimum dosage of any SARM that you have chosen, also make sure to stick with a healthy diet plan and workout session which gets the most out of the SARMs before and after results.(Disclaimer : The above is a sponsored post, the views expressed are those of the sponsor/author and do not represent the stand and views of Outlook editorial.)

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Larry Wheels Stops Using Steroids: "I Am Going To Be On Testosterone Replacement Therapy" Fitness Volt – Fitness Volt

Posted: August 22, 2022 at 2:23 am

Larry Wheels is known as one of the strongest men in the world because of the breath-taking feats of strength he performs. However, he has never attempted to deceive anyone into believing that he performed these accomplishments as a natural athlete. Despite Wheels openness when it came to his use of steroids and PEDs (Performance Enhancing Drugs), it became evident recently that he was pushing the limits, putting himself at risk for further injury and lasting damage.

Most recently, Larry Wheels injured his back because of rushing a process, which he hoped would help him deadlift 1,000 pounds (453.6 kilograms). The injury also forced him to withdraw from the 2022 Middle Easts Strongest Man contest. However, despite this deadlift being his greatest goal in life, the injury helped Larry realize how important his health is. So, he decided to stop using Steroids and will now try to maximize his off-cycle potential. The news was revealed in a new YouTube video that Larry posted on August 20th.

Related: Powerlifter Larry Wheels Describes Experience with Trenbolone as Living Hell

Having used steroids and PEDs for a decade, Larry Wheels describes his experience with them. Larrys use of these substances for such a long time has left some consequences, which affected his natural testosterone production.

Much like you dont know, I dont know what I am capable of off-cycle. Now, going completely off isnt an option for me. I cannot produce testosterone naturally. So, I am going to be on testosterone replacement therapy (TRT). I tried pull cycle therapy several times when I began cycling and I was unable to recover.

So Larry Wheels will no longer use steroids or performance-enhancing drugs, but since his body cannot produce testosterone on its own, he will have to undergo testosterone replacement therapy to reach a normal testosterone level. Having taken inspiration from a fellow YouTuber and fitness enthusiast, Derek from More Plates More Dates, he already has an idea of what he wants to do.

TRT for me would be anywhere from as low as 70 milligrams per week, as high as 175 I think 175 is a good place for me to start. If I speak with my doctor and we get my bloods done and we see that its more than whats necessary then I will decrease it, but I certainly wont increase it.

Wheels has been looking for a way to lift 1,000 pounds (453.6 kilograms) for some time now, and he does not appear to be giving up just yet. Currently, however, he will not be looking to do so since it is almost impossible to do so without the aid of performance-enhancing drugs. Larry has hinted that he may get back on PEDs in the future to deadlift 1,000 pounds, but it wont happen anytime soon.

I am not calling quits on it, but I am putting the brakes on attempting PRs like that at the moment Why do I have to do it right now? I am 27, I can take my time, it can be several years from now. Ill still be in my prime. Ill still be healthy.

It is likely that Larry Wheels greatest achievement in life will be deadlifting 1,000 pounds. This means that it cannot be easy and that it should not be rushed either. Its time for Larry to take care of his health and see what he can accomplish without the use of steroids in the future.

Seeing what Im capable of on TRT is more of a priority to me. Its more exciting. It makes me feel invigorated I dont know how I will perform without the assistance (steroids), because the fact of the matter is that PEDs make a tremendous difference in your physique, strength, psyche, recovery more than the general population understands.

Now that hes off PEDs, Larry Wheels will have to focus on his training, diet, recovery, and a whole lot more. He also does not plan to jump back on steroids and PEDs in the near future.

lbkg

Data Source: Open Powerlifting. Last Updated: August 3, 2022

Analyze Lifts

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He now wants to check out how different his deadlift program will be now that he is no longer on steroids. He will also regularly put out updates and training videos, so his transparency could help everyone understand the process he is going through. There is a lot to learn from Larrys experience, so it is exciting to envision what the future holds for him.

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