Dr. Gary Bellman, expert Los Angeles Urologist, and founder of the Male Anti-Aging Institute was recently interviewed by I magazine for his expert opinion on the benefits afforded to men through testosterone therapy.
In the following excerpts from the article, Dr. Bellman explains the causes of declining testosterone levels, the reason that over-the-counter testosterone supplements are ineffective, dispels misconceptions about side-effects of testosterone therapy, describes why healthy testosterone levels are vital for reproduction and answers common questions about testosterone therapy.
Read on for everything you ever wanted to know about testosterone therapy in Los Angeles.
WHAT YOU NEED TO KNOW ABOUT TESTOSTERONE HORMONE TREATMENTS
Middle age is filled with challenges. And for many men, one of them is low levels of testosterone. Here we offer a breakdown of the hormone and a candid look at the latest treatments.
By Steven Steifel
In any locker room or sports bar where men over 40 hang out, you’ll likely hear banter about testosterone – guys complaining about low levels, comparing therapy notes and debating, in some cases, controversial treatments.
Testosterone is a steroidal hormone, derived from cholesterol. The testes primarily secrete it; yet, women also have testosterone (just as men have estrogen).
Why do we need it? Healthy levels of natural testosterone help a guy feel and look like a guy. The hormone bolsters physical energy, sexual prowess and fertility; it encourages secondary sex traits such as muscle mass, body hair and even bone density. In addition, this key male hormone supports brain function, endurance and a sense of well-being.
Levels fluctuate throughout life. Natural testosterone levels peak for most men in their early 20s. By the time guys reach their late 30s or early 40s, many are in the lower third of normal range or even below. Then in later life, testosterone levels continue down that slippery slope.
“The most profound cause of declining testosterone levels for men is age,” says Gary Bellman, MD, a board-certified urologist and antiaging expert at the Southern California Urology Institute in West Hills. Other factors play a smaller role in the decline of T levels, he adds. These include smoking, ill health, alcohol consumption, narcotic use and obesity, among others. While you can address many of these secondary factors, you can’t reverse the aging process.
Or can you?
Testosterone therapy won’t make you younger, but many experts believe that boosting testosterone levels to appropriate, moderate levels may, at the very least, improve the way you feel and look for your age.
Therapy is not without controversy, how- ever, both among those who recommend differing types of testosterone therapy and those who are skeptical about it altogether.
All the Rage
Testosterone therapy has grown in popularity over the years; millions of American men now use prescription testosterone. You’ve likely seen the commercials for these products, targeting the same male demographic as cholesterol-reducing medications and prescriptions that address erectile dysfunction.
Medical testosterone is now available in many different formulations such as topical (transdermal), injectable, implant and oral. Topical forms include patches, creams and alcohol-based gels. Injectable prescription testosterone can be administered through intramuscular or subcutaneous shots, while pellets are implanted. And there are also oral options, although many doctors discourage the use of these because they can stress the liver.
Finally, there are multiple over-the-counter forms of oral supplements that also claim to boost T levels, but Dr. Bellman isn’t a fan. “I’m surprised by the number of well-educated patients I see who buy stuff from the liquor store or online rather than going to a medical professional to get the guidance to increase their testosterone levels safely and effectively.”
With so many options, choosing a treatment can be confusing. Further complicating the matter, many men and their partners are concerned about possible side effects�in particular potential behavioral changes�although Dr. Bellman downplays those concerns. “There’s a misconception that medical testosterone therapy will make a man aggressive,” he says. “Properly managed by a doctor, testosterone therapy will make a man more manly, but not more aggressive.” Dr. Bellman emphasizes one caveat�administering testosterone should only be done under an experienced medical practitioner’s care.
The “T” Timeline
Your pituitary gland stimulates your testes to produce testosterone and sperm. After naturally-produced testosterone enters your blood, it attaches to androgen receptors. This in turn increases anabolic signaling in muscle tissue, which encourages increased muscle strength, enhanced hand-to-eye coordination, quickness and other performance-related skeletal muscle effects. Higher levels of natural T also increase your metabolism and your body’s ability to use protein more efficiently.
When your body stops producing ideal levels of T, you’ll likely begin to notice it. You’ll start to feel more sluggish. You’ll add body fat and your muscle mass will decrease. Perhaps you’ll feel a little depressed. That’s the time when you might want to consider consulting a doctor.
“The first question I ask a patient once we’ve determined that he has low testosterone is: �What is your plan with reproduction?'” Dr. Bellman says. “That’s because all types of testosterone therapy have the potential to reduce fertility.” Once you provide your body with an exogenous (i.e., external) supply of testosterone, your testes don’t need to work as hard. This leads to a further reduction in production of both testosterone and sperm, decreasing your chances of reproducing.
Using prescription testosterone can also reduce the size of testicles by as much as 25%, according to Dr. Bellman. He adds that this effect is typically reversible if you stop testosterone therapy. On the other hand, young bodybuilders who abuse steroids may shrink their testicles far beyond this�to the point where the damage is not reversible.
Normal total testosterone levels for most men range from about 250 to 1100 ng/dL (nanograms per deciliter) in their blood. This includes both free and bound testosterone. The normal range for free testosterone should fall between 46 and 224 ng/dL.
The Endocrine Society recommends that doctors draw blood samples in the morning Could using medical testosterone harm my heart?
A study published in the Journal of the American Medical Association (2013) suggested that medical testosterone therapy could be harmful to the heart. This drew to determine peak T levels and if testosterone therapy is recommended, Dr. Bellman says. “Men who have a total level below 250 ng/dL at any time of day may have low testosterone,” he adds. It’s particularly important to deter- mine your peak level, and younger men (those 35-40) with low T at other times of day may be within normal ranges in the morning. Older men show less fluctuation throughout the day, Dr. Bellman explains.
WILL TESTOSTERONE THERAPY MAKE ME LEANER AND MORE MUSCULAR?
When you begin to use medical testosterone, your body will likely grow leaner and more muscular, especially when you follow a weight-training regimen and healthy diet. You’ll almost surely see better results than if you weren’t taking prescription testosterone.
COULD USING MEDICAL TESTOSTERONE HARM MY HEART?
A study published in the Journal of the American Medical Association (2013) suggested that medical testosterone therapy could be harmful to the heart. This drew a letter of condemnation from the Androgen Study Group, requesting a retraction. “Prior to the 2013 study, there were over a dozen peer-reviewed articles showing testosterone therapy is protective of the heart,” Dr. Bellman says. Today many doctors continue to support the conclusion that testosterone therapy is heart protective rather than harmful.
WILL EXERCISING MORE BOOST MY T LEVELS?
“Largely, it’s a myth that exercise will significantly boost testosterone for those with low levels,” Dr. Bellman says. In fact, it could reduce the hormone as exercise burns or uses testosterone to fuel activity. On the other hand, some experts suggest that exercise may make you more sensitive to the testosterone you do have. Bottom line: Do not reduce exercise expecting to boost T levels.
DOES CONSUMING TESTOSTERONE-BOOSTING FOODS DRIVE UP T-LEVELS?
It’s a nice idea that consuming specific foods will spike testosterone, but Dr. Bellman says this is mostly a fallacy. “Diet is only one small factor in testosterone levels. You can’t reverse time by consuming large amounts of kale and spinach.” Eat these foods for health, but don’t rely on them to boost your low T levels, he recommends.
Read the Ventura Blvd. article in its entirety.
As a Male Anti-Aging Expert and Southern California Urologist, Dr. Bellman has been named one of “America’s Leading Experts” and accolades including “Patients’ Choice Award.”
A member of the America Urological Association, the American Academy of Anti-Aging Medicine, the California Urologic Association, the Los Angeles Urologic Society, and the Endourology Society, Dr. Bellman is highly regarded amongst his peers and his patients as one of the top urologists in Southern California, and a trusted expert to turn to for second opinions.
For an appointment or consultation with Dr. Gary Bellman, please contact the Male Anti-Aging Institute online or call 818-912-1899.
For an appointment or consultation with Dr. Gary Bellman, please contact the office or call 818-912-1899