Low T in Males = Worse Health, Shorter Life Span
Hormones are in the news.
Now it is gents!
Men with less testosterone (T), die earlier for all causes, but especially heart disease.
A recent meta-analysis (looking at 11 studies involving 24,000+ males) found that low baseline serum (blood) testosterone concentrations are associated with an increased risk of all-cause and cardiovascular disease (CVD) mortality.
This means if your testosterone (T) is low, or perhaps for you at the lower end (as we all have our own individual hormonal footprints) you can die earlier from anything. Especially earlier onset heart disease.
Let alone feel more depressed or simply worn out before your time.
The primary outcome measures for the study were all-cause mortality, CVD death, and incident CVD events.
This is a comprehensive analysis of T’s effects across the age span from males in Australia, Europe, and North America, with testosterone measured accurately using mass spectrometry and longitudinal follow-up for outcomes.
Lead author is Bu B. Yeap, MBBS, FRACP, PhD, a professor at the University of Western Australia Medical School and an endocrinologist at Fiona Stanley Hospital in Perth, Western Australia.
Overall, the study found that men with testosterone concentrations below 7.4 nmol/L (213 ng/dL) at baseline had a higher risk for all-cause mortality, even after adjusting for age, body mass index, lifestyle behaviors, and cardiovascular risk factors.
An increased risk of all-cause mortality was also observed among those with:
Luteinizing hormone (LH) concentrations above 10 IU/L at baseline and,
Those with estradiol concentrations below 5.1 pmol/L at baseline.
Men need estrogen, too. I like it not to go below 15 pmol/L.
Yeap, lead author, says, “The association of lower testosterone concentrations with higher all-cause mortality was present irrespective of luteinizing hormone concentrations, indicating that low testosterone was the main factor (and not whether the low testosterone was due to testicular causes or centrally mediated).
Data from the study also showed that men with testosterone concentrations below 5.3 nmol/L (153 ng/dL) at baseline had a higher risk of CVD mortality.
Testosterone and estrogen travel throughout the blood stream bound to a carrier protein: sex hormone binding globulin (SHBG).
If SHBG is creeping higher and higher, no matter your level of T, not much is available.
Researchers are writing throughout the world that not only is T lowering in younger males, SHBG is also rising. So less and less T is available. To protect our men. Against death, heart disease, and simply not feeling well.
Investigators found:
Low testosterone coupled with normal or high levels of sex hormone-binding globulin (SHBG) was associated with an increased risk of mortality,
But low testosterone and low SHBG was associated with a lower risk of mortality.
Overall, men with lower baseline SHBG concentrations had lower all-cause mortality (aHR, 0.85; 95% CI, 0.77 to 0.95) and lower CVD mortality (aHR, 0.81; 95% CI, 0.65 to 1.00).
Testosterone is metabolized to dihydrotestosterone (DHT).
DHT matters, too.
Lower (DHT) concentrations at baseline were associated with higher all-cause mortality (aHR, 1.19; 95% CI, 1.08 to 1.30) and higher CVD mortality (aHR, 1.29; 95% CI, 1.03 to 1.61).
The mortality risk increased for men with DHT concentrations above 2.45 nmol/L.
Additionally, DHT concentrations below 0.59 nmol/L were associated with increased CVD events.
Hormones ar hitting the radar. For the better this time.
All patients should be tested.
But you want/need a doc that understand hormones, prescribing, bases, and the actual science.
Consider recommending Everything Hormones, which is about to be up online for another year for 16 hours of CMEs for MDs, NPs, nurses and PAs.
NDs’ should reach out to their boards. We couldn’t get CME for DCs, sorry.
Knowledge is power.
Health needs healthy hormones. In both sexes.
If you don’t test the bigger picture, total testosterone, free testosterone, SHBG, LH, FSH. And much more. As hormones are a tapestry of many moving parts threading in and out together.
Hormones are a family that function and dysfunction together.
The thyroid must be stabilized.
Nutrients must be on board.
Digestion must be working.
Health is a tapestry. But hormones are foundational.
Dr. B.
References
Associations of testosterone and related hormones with all-cause and cardiovascular mortality and incident cardiovascular disease in men: Individual participant data meta-analyses. Ann Intern Med. 2024. doi:10.7326/M23-2781
Low testosterone in men associated with higher risk for death. News release. May 7, 2024. Accessed May 15, 2024. https://www.newswise.com/articles/low-testosterone-in-men-associated-with-higher-risk-for-death
https://www.urologytimes.com/view/study-finds-associations-between-low-testosterone-and-all-cause-cvd-mortality