Testosterone replacement therapy improves the effectiveness of treatment for erectile dysfunction in men with low testosterone

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By: EPG Patient Direct

 

The TADTEST study examined whether adding testosterone replacement therapy could improve sexual function in men with erectile dysfunction(ED) who had not responded to the PDE5 inhibitor tadalafil, a prescription drug used to treat ED. It also investigated the effect that testosterone levels had on response to a PDE5 inhibitor to see if there was a threshold value for testosterone therapy to improve the effectiveness of PDE5 inhibitor therapy.

The 173 men (age 45–80 years) in the study had not responded to 4 weeks of treatment with the PDE5 inhibitor tadalafil 10 mg once a day. For the next 12 weeks men continued treatment with the PDE5 inhibitor with the addition of either testosterone gel once a day or a dummy drug (placebo gel). The dose of the testosterone gel could be doubled if sexual function did not improve sufficiently.

Key Findings

  • Improvements in erectile function and the ability to have successful intercourse were significantly better for men with testosterone levels ≤300 ng/dL or ≤10.4 nmol/L (a widely accepted definition of hypogonadism or low testosterone) at the start of the study when using the testosterone gel in addition to the PDE5 inhibitor than for men in the PDE5 inhibitor plus placebo gel group (see Figure)
  • Men with lower levels of testosterone at the start of the study responded less well to PDE5 inhibitor therapy alone.

Source: Hypogonadal men nonresponders to the PDE5 inhibitor tadalafil benefit from normalization of testosterone levels with a 1% hydroalcoholic testosterone gel in the treatment of erectile dysfunction (TADTEST study). Buvat J, Montorsi F, Maggi M, et al. J Sex Med 2011;8(1):284-293.

Background information
Around a third of men with ED receiving PDE5 inhibitor therapy do not benefit from treatment.

  • There is evidence that the effectiveness of these ED drugs depends in part on testosterone levels
  • Having testosterone deficiency seems to predict a poor response to drugs for ED
  • Other studies have also shown that adding testosterone therapy to ED therapy may help to improve erectile function in men with low testosterone
  • However, these studies did not compare results for men who did receive testosterone therapy or a dummy (placebo) treatment.

This comparative study shows that men with low testosterone levels may benefit from the addition of testosterone replacement therapy to optimal therapy for ED.

Testsoterone therapy improved sexual function

For more information on how we can help you visit: www.BostonTestosterone.com 

The importance of Vitamin D and How BTP can Test and Optimize your levels now

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Boston Testosterone Partners

www.BostonTestosterone.com

1-855-617-MEDS (6337)

 

 

 

Much has been said about the importance of Vitamin D in recent years.  It is essential that you supplement with vitamin D, if you want to reap all its benefits, which include better bone building, fewer colds and flus, higher testosterone levels, more strength, better mood and brain function, and even greater fat loss.

 

D Background

There are two forms of vitamin D: D-3 (cholecalciferol) and D-2 (ergocalciferol). Vitamin D-2 is found in plant sources and some supplements and can only enter the body through the diet. As mentioned above, sunshine triggers vitamin D production in the skin by converting cholesterol into vitamin D-3. That form can also be acquired through the consumption of animal products like fatty fish or by supplementation. However, both those forms are inert and must be converted to the active form of the vitamin, a steroid hormone called 1,25-dihydroxyvitamin D, before the body can use it. That work is done by the liver and the kidneys, and because D-3 is more readily converted to the active form, it’s considered the more potent form of the vitamin. Any extra D that’s not immediately needed by the body is stored in fat tissue for future use.

Although in theory, the body should be able to make all the vitamin D it needs, in reality, it doesn’t even come close, regardless of how much sun time you get. Supplementing with vitamin D is, therefore, essential.

 

The D You Know

Some of vitamin D’s functions have been so well-publicized that you likely don’t need us to tell you about them. The most obvious is its role in promoting bone health. Vitamin D helps to maintain bone health by aiding calcium absorption and regulating the movement of calcium in and out of bone tissue. Without D, you would absorb less than half the calcium you do from food and supplements. (This is why dairy products are almost always fortified with D.) Vitamin D also bolsters the immune system, triggering the killer T cells that fight off germs like colds and flu before they can beat you down and force you to miss workouts.

Vitamin D also may help to protect from certain cancers. One study in the American Journal of Preventive Medicine reported that women living in sunnier regions of the world had higher blood levels of vitamin D, as well as a significantly lower risk of ovarian cancer, than those in less sunny regions. Another study found that sun exposure and a diet rich in vitamin D lowered the risk of breast cancer. And sunshine exposure also has been correlated with a lower risk of colon cancer.

You may know that vitamin D boasts brain benefits. Low levels of vitamin D are associated with psychiatric and neurological disorders, as well as a greater cognitive decline with aging. One study from the Washington University School of Medicine in St. Louis reported that vitamin D deficiency was associated with depression and diminishing cognitive performance. In fact, Georgia State University researchers reported that individuals with vitamin D deficiency have an 85 percent greater risk of developing depression.

 

The D You Don’t Know

In addition to the many health benefits covered above, vitamin D has several physique and performance benefits that are worth noting. Given that vitamin D gets converted into a steroid hormone in the body, it makes sense that it has effects on muscle fibers. The active form of D binds to specific receptors found on muscle cell membranes and in muscle cell nuclei. When it binds to these receptors, it enhances muscle contraction and protein synthesis — the buildup of muscle protein. Research shows that certain types of these receptors may be responsible for greater muscle size and strength. Although you can’t alter the type of vitamin D receptors you have in your muscles, making sure you have adequate levels of D in your body can help ensure your receptors are activated for optimal muscle function, strength and growth.

Another study reported that female students at the University of Southern California who had lower blood levels of vitamin D had significantly higher levels of fat in their muscles than those with high blood levels of vitamin D. (Yes, the body can store fat in muscles as well as under the skin.) Having fattier muscles not only means that you have more total body fat, but it also can result in weaker muscles with less endurance. Muscles with higher fat content have impaired mitochondrial function, so they produce less energy and can develop reduced insulin sensitivity.

Although researchers are not sure precisely how vitamin D prevents fat accumulation in muscle, it is well-known that vitamin D and calcium work together to encourage fat loss. One recent study published in the journal Clinical Nutrition reported that when men and women consumed a breakfast containing more than 500 milligrams of calcium and about 350 IU of vitamin D, they burned more calories and fat and ate 320 fewer calories throughout the day as compared to when they started the day with a breakfast containing about half as much calcium and D.

Because vitamin D is produced in the body from cholesterol, as is testosterone, it follows that higher vitamin D levels can encourage higher testosterone levels in men. In fact, Austrian scientists from the Medical University of Graz reported that men with higher blood levels of vitamin D had significantly higher levels of testosterone and lower levels of sex hormone-binding globulin than those with low levels of vitamin D in their blood. Having lower SHBG means that more of the testosterone produced is free to get into muscles and increase muscle growth. This group of researchers did a follow-up study on men to see whether vitamin D supplementation actually could raise testosterone levels. They reported in a recent issue of Hormone and Metabolic Research that the men receiving just more than 3,300 IU per day of vitamin D for one year had a 25 percent increase in testosterone levels, while those getting a placebo had no such rise.

 

Testing and Dosing D

At Boston Testosterone Partners, we test all our patient levels of 25-hydroxyvitamin D, the storage form of vitamin D in the body, for deficiencies.  We will then prescribe a plan exactly matched to your deficiency.  With the purest, pharmaceutical grade Vitamin D injectables or pills available, Boston Testosterone Partners will optimize your specific D levels like no other medical clinic can.

Call today, 1-855-617-MEDS (6337)

Testosterone Replacement Therapy (TRT) reduces fat, waist circumference and reduces cardiovascular risk factors in men

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The aim of this study was to examine whether long-term testosterone replacement therapy could help improve risk factors for heart disease and reduce narrowing of the arteries in men with low testosterone levels who also had metabolic syndrome and/or type 2 diabetes.

For the first 12 months of the study, men received either an injection of testosterone undecanoate into muscle every 12 weeks, or a dummy drug (placebo). Delivering this form of testosterone into muscle means that testosterone levels are stably released from the depot in the muscle and maintained within the normal range without the need to take testosterone daily. Because there was such an improvement in risk factors during treatment with the testosterone replacement therapy, all of the men were given testosterone therapy for the rest of the 24-month study.

Key Findings

  • The testosterone replacement therapy, but not the placebo treatment, improved a number of important indicators that can provide warning of heart disease and narrowing of the arteries (atherosclerosis)
  • In particular, testosterone reduced waist circumference, reduced the amount of visceral fat, and improved the body’s sensitivity to insulin
  • Testosterone therapy also reduced signs of inflammation and artery disease related to thickening of the artery walls
  • By the end of the study, i.e. after two years of treatment, more than a third of men no longer had signs or symptoms of metabolic syndrome.

Source: Effects of testosterone undecanoate on cardiovascular risk factors and atherosclerosis in middle-aged men with late-onset hypogonadism and metabolic syndrome: results from a 24-month, randomized, double-blind, placebo-controlled study. Aversa A, Bruzziches R, Francomano D, et al. J Sex Med 2010;7(10):3495-3503.

 Background information

 Late-onset hypogonadism refers to the progressive decline in serum testosterone related to advancing age and characterized by a deficiency in serum testosterone levels below young healthy adult male levels.

Metabolic syndrome is a group of conditions linked to being overweight or obese: three or more of these conditions together is sufficient for a diagnosis of metabolic syndrome. These conditions or characteristics are:

  • A large waistline (which is linked to insulin resistance)
  • A higher than normal fat level in the blood – in particular raised levels of triglycerides
  • A lower than normal level of ‘good’ high-density lipoprotein (HDL) cholesterol in the blood
  • Higher than normal blood pressure
  • Higher than normal blood sugar levels.

People with metabolic syndrome are at greater risk of heart disease and diabetes.

Visceral fat is the hard-to-lose fat around the internal organs that makes people more susceptible to heart disease, stroke, diabetes and high blood pressure.

Insulin resistance is a condition that makes it harder for the cells of the body to use insulin effectively to process sugars and fats. If insulin resistance is present, as in metabolic syndrome, the normal response to insulin is reduced and more insulin needs to be secreted. Insulin resistance can precede the development of type 2 diabetes.

Atherosclerosis is the process in which fatty deposits build up in the inner lining of arteries, narrowing them and increasing the risk of heart disease and stroke. Reducing the narrowing and inflammation that are a part of atherosclerosis is a sign a treatment is beneficial in slowing the progression of atherosclerosis.

This is the first such study to show that long-term testosterone replacement therapy with a long-acting testosterone injection can improve body composition, insulin resistance and atherosclerosis in men with low testosterone and metabolic syndrome. This raises the possibility that testosterone replacement therapy may have an important role in delaying the progress of metabolic syndrome to heart disease.