A Lucky Guy
This weeks article started with a question
This weeks article started with a question I received from a
subscriber to my LongevityPlaybook.com app:
Q: I’m a guy whose wife loves sex; but I just turned 63 and I have lost interest in sex even thou she is very attractive and wonderful (I’m a lucky guy) . I also am tired much of the time. It’s embarrassing to admit, but should I see a doctor about it? J. T., Miami, FL
HERE’s My Answer:
A: Yes, you should see a doctor—any time you notice a change in your wellbeing or functioning. I suggest an internist like me who focuses on longevity or a urologist—they specialize in diagnosis and treatment of testosterone deficiency (TD).
While only about one percent of men under age 30 have testosterone deficiency (TD), 30 percent of those over age 50, and as many as 50% of men over 80 years old may have it (https://www.urologyhealth.org/urology-a-z/l/low-testosterone). TD is also more likely if a guy is a smoker, has thyroid-related issues, elevated lousy LDL cholesterol, hypertension, diabetes, sleep apnea, chronic stress or anxiety and/or consumes more than 3 alcoholic drinks in a day more than 5 times a month. Between 40 and 50 percent of men with hypertension, diabetes, high LDL cholesterol or who are overweight have low testosterone.(http://www.urologyhealth.org/urologic-conditions/low-testosterone-(hypogonadism)/causes and https://www.auanet.org/guidelines-and-quality/guidelines/testosterone-deficiency-guideline)
TD can lead to fatigue, mood swings, erectile dysfunction, and lack of interest in sex. Treatment is available using testosterone releasing agents (that we prefer so your testes don’t shrink) or testosterone creams, pills, pellets, or injections—but many men worry about potential side effects, including cardiovascular disease (CVD).
The good news is the TRAVERSE ( https://www.nejm.org/doi/full/10.1056/ ) study led by the Cleveland Clinic looked at men age 45 to 80 with preexisting or a high risk of CVD and with symptoms of and measurably low testosterone levels and found testosterone supplementation didn’t increase risks of major cardiac events. But those receiving testosterone did show a higher incidence of atrial fibrillation, acute kidney injury, and blood clots. So you and your doctor have to weight your risks and benefits. There are also agents such as Ashwagandha that release testosterone and medications that do so as well, preserving testicular function (in other words, see a doc about treating TD, don’t do it yourself). These releasing agents plus a low dose aspirin (to prevent the complication of clots) with a lot of water (to help prevent kidney damage and to help prevent GI bleeding from the aspirin) may be better—that complexity means see a pro in this area, don’t do it alone (did I write that already).
Even better good news is that weight loss and physical activity often increase testosterone levels (Low Testosterone: Symptoms, Diagnosis & Treatment - Urology Care Foundation (urologyhealth.org). Diet also has a huge impact. Zinc, omega-3 fatty acids like those found in salmon, and vitamins C, E and beta carotene support testosterone production. The ultimate testosterone-boosting dinner is salmon, a bowl of grapes, pomegranate, and watermelon, and cabbage sprinkled with pumpkin seeds (https://www.medicalnewstoday.com/articles/322647#naturally-boosting-testosterone). The combo boosts testosterone levels and relaxes blood vessels to improve reduce erectile dysfunction. And you’ll maybe be an even more energetic guy.
Thanks for reading. Mike Roizen