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DR. BARTNOF'S PUBLISHED LETTER-TO-THE-EDITOR AT THE SAN FRANCISCO CHRONICLE
ABOUT TESTOSTERONE DECLINE IN MEN
DR. BARTNOF'S PUBLISHED LETTER-TO-THE-EDITOR AT THE SAN FRANCISCO
CHRONICLE ABOUT TESTOSTERONE DECLINE IN MEN San Francisco Chronicle Letters to Datebook SFGate.com Friday, February 13, 2009 See testosterone for all it is - not just a male sex hormone Editor - Thank you to Carolyne Zinko for her story about Jed Diamond's description of irritable male syndrome ("Grumpy not-so-old men," Monday). Andropause (testosterone decline with symptoms) is more widespread than the public (and many physicians) realize. According to the New England Journal of Medicine (Rhoden, January 2004), low testosterone occurs among about 9 percent of men in their 40s, 30 percent of men in their 50s, 42 percent of men in their 60s and 70 percent of men in their 70s. Three larger studies published in peer-reviewed medical journals during the past two years have shown that men with low testosterone do not live as long as those with normal levels. The largest of those studies (EPIC, Great Britain) enrolled more than 11,000 men. While Diamond's research has focused mainly on the psychological aspects of andropause, there are several physical sequelae as well: osteoporosis (associated risk of bone fracture); prediabetes and diabetes; increased body fat (especially around the midsection, the so-called beer belly that is linked with heart disease); abnormal lipids (blood fat); increased atherosclerosis (decreased circulation); and earlier heart attacks. It is time for men (and their spouses, partners and physicians) to become aware that testosterone in men is not just a sex hormone but a total body hormone, essential for normal psychological and physical functioning and to help offset risks for chronic life-threatening diseases. HARVEY S. BARTNOF, M.D. San Francisco Bartnof is Founder and Medical Director of the California Longevity & Vitality Medical Institute® in San Francisco. Original Letter appears online:http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2009/02/13/DDM015S8GH.DTL&hw=Bartnof&sn=001&sc=1000 Could a man's midlife crisis be more than a state of mind, but be linked to his endocrine system instead? Read Carolyne Zinko's review of Dr. Jed Diamond's book, "Irritable Male Syndrome," reflecting the negative psychological aspects of testosterone decline in men: http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2009/02/09/DDJ215H812.DTL&hw=Jed+Diamond&sn=001&sc=1000
DR. BARTNOF APPOINTED VISITING PROFESSOR OF MEDICINE DURING CHINA LECTURE TOUR Dr. Harvey S. Bartnof, Founder and Medical Director of California Longevity and Vitality Medical Institute, was recently appointed the honorary title Visiting Professor of Medicine at Liaoning Medical College in China. The title was bestowed during his recent Lecture Tour in China that spanned 3 provinces and 5 cities over a 2-week period in September, 2007. Dr. Wang Wei, Director at Jinzhou Central Hospital and Professor of Orthopedic Surgery at Liaoning Medical College, bestowed the honor and presented the Certificate immediately prior to Dr. Bartnof’s 1 ½ hour presentation to the medical and nursing staff there. His lecture was titled, “Introduction to Age Management Medicine.” Prior to Dr. Bartnof’s award, there was an Opening Session that included remarks by Dr. Liu Hua, Director of Jinzhou Public Health Bureau and Professor of Ophthalmology at Liaoning Medical College; Dr. Bao Baili, Vice Director at Jinzhou Central Hospital; Dr. Wang Ruxiang, Secretary General of China Shenyang Academy of Anti-Aging Medicine; and Dr. Wang Wei. The Conference also was facilitated and coordinated by Dr. Zhang Baojun, Vice Director of Jinzhou Public Health Bureau. During the same trip, Dr. Bartnof also was awarded the title of Visiting Professor at Shenyang Medical College in Shenyang, China. Professor Xiao Chun Ling, President at Shenyang Medical College, bestowed the honors to Dr. Bartnof during a meeting with the President and other faculty members, including Professor Pei Qing Shuang, Vice President of the college. Subsequent to their meeting, Dr. Bartnof presented a 1-hour lecture to 200 students in the division of Preventive Medicine. His lecture was entitled, “Overview of Age Management Medicine.” Dr. Bartnof was an invited Speaker at the 2nd International China Conference on Anti-Aging Medicine, that was held in Dalian, China at the beginning of his lecture tour. During the 2-day Conference that was attended by mostly physicians, Dr. Bartnof presented 5 lectures, including: Introduction to Age Management Medicine; Bio-Identical Hormone Therapy for Female Menopause; Bio-Identical Hormone Therapy for Andropause; Somatropin (Growth Hormone) Therapy for Deficiency; Vitamins and Nutraceuticals for Age Management; and Case Histories of Men in Age Management. The Conference was sponsored by the China Shenyang Academy of Anti-Aging Medicine; Dalian Association for Science and Technology and its Executive Vice President Mr. Wu Jihua; and Jinzhou Enterologic Hospital and its Director Dr. Sun Qingsheng. The other invited Speakers from the United States were Neal Rouzier, M.D. and Ms. Caroline Rouzier, both from the Preventive Medicine Clinic in Palm Desert, California. The Conference Organizer was Dr. Wang Ruxiang, Secretary General of China Shenyang Academy of Anti-Aging Medicine, and his Staff. In June of 2006, Drs. Bartnof and Rouzier were invited Speakers at the 1st International China Conference on Anti-Aging Medicine that was held in Shenyang, China. While in the city of Jinzhou, Dr. Bartnof toured Jinzhou Enterologic Hospital, a private institution. There he was awarded the title of Executive Consultant in Medicine by its Director, Dr. Sun Qingsheng. Also while in that city, Dr. Bartnof toured Jinzhou Women’s and Infants’ Hospital, and was hosted by its Medical Director, Dr. Wang Giu Shuang. Dr. Bartnof has welcomed the opportunity to teach physicians and other health providers in China about Age Management Medicine and State-of-the-Art practice of Bio-Identical Hormone Replacement Therapy. He is very grateful to the many hosting Chinese physicians, including Dr. Wang Ruxiang and Dr. Zhang Baojun, related Staff and Colleagues, and family members for their very kind hospitality that was extended to him during his stay in China. Dr. Bartnof is also very grateful to Ms. Jean Lee, Medical Student, for her excellence in translating English to Mandarin and vice versa at the 2nd International Chinese Conference on Anti-Aging Medicine, Dalian 2007. To see pictures of Dr. Bartnof’s Lecture Tour to China, CLICK HERE LOW TESTOSTERONE IN MEN LINKED WITH EARLIER DEATH Another major study has determined that low testosterone levels in men are associated with earlier death. Drs. Gail A. McLaughlin and Elizabeth Barrett-Connor of University of California at San Diego School of Medicine presented their findings at The Endocrine Society’s ENDO 2007 Research Conference in June. A total of 794 men, ages 50-91 years were followed for an average of 18 years. They were enrolled in the Rancho Bernardo Study in San Diego County. The results showed that those men with a low testosterone had a 33% greater risk (“confidence interval 1.1-1.6”) of dying during the 18-year observation period than men with higher testosterone levels. The results were controlled for age, waist girth, body mass index, and lifestyle. The authors concluded, “Androgen deficiency in older men is associated with increased risk of death, independent of age, adiposity, and lifestyle choices.” The findings suggest that maintaining healthy testosterone levels in middle age and beyond is important for men to avoid premature death. There are many studies that demonstrate cardiovascular benefits with optimal testosterone levels. For more information about Andropause (testosterone decline in men CLICK HERE. -Laughlin GA and others. Abstract OR55-2: Androgen Deficiency and All-Cause Mortality in Older Men: The Rancho Bernardo Study. The Endocrine Society's ENDO 07 Research Summaries: June 5, 2007; Toronto, Canada. In 2006, another large study had similar findings. Dr. M. Shores and colleagues reported their results of 858 male veterans in the Archives of Internal Medicine. Dr. Shores is from the Veterans Administration Puget Sound Health Care System in the state of Washington. The veterans who were at least 40 years of age with a low testosterone level had a nearly 2-fold increased risk of death after an average of 4.3 years (“hazard ratio” 1.88 with 95% confidence interval 1.3-2.6). The results were highly significant (p<0.001) even after adjusting for age, body mass index (weight related to height) and past corticosteroid use. After an average of 4.3 years, the mortality rate was 20% for men with a normal testosterone and 35% for those with a low testosterone. The findings are not surprising, given the demonstrated cardiovascular benefits of testosterone replacement therapy for men with Andropause. There are also studies linking low testosterone with an increased risk for dementia and other forms of brain decline—for more information CLICK HERE. Shores MM and others. Low serum testosterone and mortality in male veterans. Arch Intern Med. 2006 Aug 14-28;166(15):1660-5. HARVARD UROLOGY PROFESSOR DESCRIBES MYTH ABOUT TESTOSTERONE LINK TO PROSTATE CANCER For 60 years, many physicians have believed that testosterone replacement therapy in men would increase the risk of prostate cancer. Abraham Morgentaler, M.D., an Associate Clinical Professor and Urologist at Harvard Medical School in Massachusetts, has published several reports in peer-reviewed medical literature that documents how the “myth” regarding testosterone and prostate cancer has occurred. Dr. Morgentaler concludes, “This historical perspective reveals that there is not now-nor has there ever been-a scientific basis for the belief that testosterone causes prostate cancer to grow. Discarding this modern myth will allow exploration of alternative hypotheses regarding the relationship of testosterone and prostate cancer that may be clinically and scientifically rewarding.” He also has published information describing that low testosterone is a risk for prostate cancer. For more information about Andropause, CLICK HERE Morgentaler A. Testosterone and prostate cancer: an historical perspective on a modern myth. Eur Urol. 2006 Nov;50(5):935-9. Can J Urol. 2006 Feb;13 Suppl 1:40-3. Morgentaler A. Testosterone deficiency and prostate cancer: emerging recognition of an important and troubling relationship. Eur Urol. 2007 Sep;52(3):623-5. Epub 2007 Apr 9. Raynaud JP. Prostate cancer risk in testosterone-treated men. J Steroid Biochem Mol Biol.
2006 Dec;102(1-5):261-6. “…high levels within the reference range of androgens, estrogens and
adrenal androgens decrease aggressive prostate cancer risk. Indeed,
high-grade prostate cancer has been associated with low plasma level of testosterone.”
Rhoden EL and Morgentaler A. Risks of testosterone-replacement therapy and recommendations for monitoring. New England Journal of Medicine 2004 January. LOW ESTROGEN IN WOMEN LINKED WITH EARLIER DEATH AND DEMENTIA Two recently published studies have linked low estrogen levels in women due to ovary removal to premature death and dementia (decline in brain function, the main abnormality in Alzheimer’s disease). The dementia study was recently published in Neurology by Professor Walter Rocca and colleagues from the Mayo Clinic College of Medicine. The results of 2,961 women were that oophorectomy (removal of the ovaries) before menopause significantly increased the risk of subsequent dementia. This was due to the loss of estrogen (and possibly progesterone) that would have been secreted by the ovaries. Since the ovaries were removed, the body no longer had that source of these vital hormones. The findings underscore the need for hormone replacement therapy for women in or near menopause to preserve brain function, not just to treat hot flashes or night sweats. The results were highly significant (p < 0.0001, “hazard ratio” = 1.46; 95% CI 1.13 to 1.90); after adjustment for education, type of interview, and history of depression). Many women (and physicians) incorrectly assume that the results of the Women’s Health Initiative (WHI, horse estrogen plus synthetic progestin) should be applied to Bio-Identical Hormone Replacement Therapy (hormone replacement using only those hormones with an identical structure to those that occur naturally in women). There are a number of published studies indicating that Bio-Identical Hormone Replacement Therapy has a safer profile than the hormones used in WHI. To read more about Bio-Identical Hormone Replacement Therapy for Female Menopause, CLICK HERE Rocca WA Increased risk of cognitive impairment or dementia in women who underwent oophorectomy before menopause. Neurology. 2007 Aug 29; [Epub ahead of print] Previously, Professor Rocca and colleagues reported that ovary removal before age 45 years was associated with an increased risk of premature death for women. There was a 67% increased risk (“hazard Ratio” 1.67 with confidence limits 1.16-2.40, p=0.006, highly statistically significant) of premature death. There were 4,780 women in the study. The benefits of estrogen and progesterone to decrease cardiovascular have been reported in several studies. In general, the benefits are better with fewer side effects when using Bio-Identical hormones, rather that synthetic ones (or those derived from horses) with a different chemical structure than the naturally-occurring ones. To read more about Bio-Identical Hormone Replacement Therapy for Female Menopause, CLICK HERE -Rocca WA. Survival patterns after oophorectomy in premenopausal women: a population-based cohort study. Lancet Oncol. 2006 Oct;7(10):821-8.
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