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A New Understanding on Testosterone Therapy

In today’s society, there is a prevailing belief that only men over the age of 60 suffer from low testosterone. Unfortunately, this is simply not true. The symptoms of low testosterone can affect men regardless of physical condition, age or health.

All men should be concerned about low testosterone, its symptoms, and what treatments are not only available, but safe.The primary and often most discernible symptoms of low testosterone include insomnia, hair loss, erectile dysfunction, irritability, fatigue, infertility, loss of muscular strength, depression, reduced lean body mass, decreased libido, elevated blood pressure, and increased breast size. An initial history using the ADAM (Androgen Deficiency in the Aging Male) questionnaire will help give a preliminary view of the severity of the problem prior to comprehensive blood work. At AMI, this questionnaire is available from our online quiz and a useful initial tool to diagnosis.

There are significant long-term health problems that result from low testosterone (low T). Low T is associated with chronic medical conditions including depression, diabetes, obesity, and possibly cardiovascular disease. The relationship between low T and chronic disease may also be inverse. For example, the same processes which lead to high blood pressure and insulin resistance, could potentially be the root cause of a patient’s low T. In this respect, low T serves as a marker of overall health.

Testosterone is a very important male hormone that is integral to bodily functions, quality of life, and general well-being. Low T testing is easily accomplished with a blood test and treatment can have a profound effect on longevity and vitality. In general, a testosterone level above 500ng/dl (nanograms per deciliter) is considered healthy. However, as men age the total testosterone binds more to SHBG (sex hormone binding globulin) which will make free testosterone less bioavailable. Simply, a “normal” total testosterone lab value may be an inadequate picture of symptom management. Treatment goals must also seek to normalize both total testosterone and free testosterone. At AMI, free testosterone is the main number valued when making the diagnosis along with symptoms and health history. What is considered to be “normal levels” of testosterone is for the most part a very individual and variable value. Most factors that influence testosterone levels are believed to be encoded within DNA and are thus genetic. However, external factors and lifestyle habits have a substantial impact on testosterone. A healthy, active lifestyle will favor optimal testosterone levels. This includes quality sleep, exercise, weight bearing activity, mental health, moderation of alcohol, avoiding tobacco, eating a balanced plant rich diet, and staying hydrated. Vitamins and minerals also influence free testosterone specifically Vitamin D3, Magnesium, and DHEA. At AMI, a comprehensive blood panel will be ordered to capture the full picture of an individual’s overall health and wellbeing. There are a variety of available low testosterone treatments or TRT (testosterone replacement therapy). While oral TRT therapies exist and are popular for ease of use, their short half-lives tend to yield a less than optimal clinical and physical result. Injectable testosterone is the gold standard. Injections are normally given intramuscular or subcutaneously in the buttock or thigh twice a week. Injectable testosterone possesses differing time release characteristics and do not disrupt liver function. The controlled release also allows a more stable level of free testosterone to be bioavailable. Thus, symptoms are appropriately managed. However, when an exogenous form of testosterone is taken, there becomes a negative feedback loop in which the testes can atrophy. HCG (Human Chorionic Gonadotropin) keeps natural testosterone production stable, which maintains testicular size and boost endogenous production of testosterone. At AMI, HCG is included with all TRT regimes.

As men age, the connection between testosterone and energy levels and sexual health becomes more important. Testosterone production actually peaks in adolescence and early adulthood. After the age of 30, testosterone levels decrease at a rate of about 1% each year. Decreasing testosterone levels dwindles over all energy, sexual libido, mood, mental clarity, and sleep. Testosterone levels are also greatly impacted by stress. Men who are constantly exposed to stressful situations on the job or even in hobbies are more likely to experience low T. In terms of quality of health, low T should be viewed as a serious health issue.

Ultimately, optimal testosterone levels are the levels that work best for the individual client. For most men, these levels are at or close to the upper end of laboratory range with focus being given to free testosterone. It is important to note that reference ranges are not optimal ranges. Optimal is symptom management combined with safe and effective laboratory values. At AMI, each client is closely followed to ensure the highest quality of care.

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MEET ELIZABETH BECKNER AND DAISHA ESCAMILLA

OUR CALIFORNIA LICENSED PHLEBOTOMISTS

Liz started doing personal blood draws after her son, Dashiell, was born with Zellwegers disease. His diagnosis required numerous blood draws and drug levels throughout his life. After sitting through long wait times at the labs followed by watching many different phlebotomists, many new to the job, struggle to find his veins, often poking him multiple times, as a seasoned phlebotomist, Liz decided to draw his blood at home and hand deliver it to the lab myself. Soon after she began doing personal touch blood draws so she can now offer that same personalized service to you.

Liz graduated from Pepperdine University with a degree in Biology in 1994. She moved to Santa Barbara and earned her phlebotomy certificate in 1995. Liz began working at St. Francis Medical Center in the Physical Therapy Department and quickly transferred to the Laboratory. Perfecting her venipuncture techniques on all floors of the hospital, including post-operative patients, pregnant women going into labor, sick or premature babies, and emergency room patrons, she then improved her patient care skills working for internal medicine doctors, one of whom was the Medical Director of Hospice and won Doctor of the Year. In 1999, Liz started working with a group of local retinal surgeons. Her primary job consisted of injecting dye into arm veins and photographing its flow through the patients retinal vessels. When patients are worried about their diagnosis or apprehensive about the procedure because of difficult veins, her quick, almost pain free needle stick and kind but professional bed side manner would put them at ease.

The various settings and patients Liz has encountered over the years have enabled her to become very skilled at finding the smallest and most fragile of vessels. Her specialities include infants and the elderly, diabetics of all ages, patients with rolling veins, on blood thinners or chemotherapy. She lives in downtown Santa Barbara, travels from Goleta to Carpintera and brings all the necessary supplies directly to you. All she needs from you is a lab request and your home or office becomes an instant draw station. Appointment times are very flexible, and she is friendly, reliable and punctual. Be kind to your arm and treat yourself to the luxury blood draw you deserve!!!

MEET MICHAEL BROOKINS; BS, CNMT, ABAAHP

Mike brings more than just a medical perspective to his clients; at the age of 14, he began an athletic career as a pole-vaulter that would end up taking him on an incredible journey over the next 13 years of his life. Throughout his athletic journey Mike was constantly working to find the ideal balance of fitness and proper nutrition in order to maximize his performances. Combined with his medical knowledge the years of athletic experience provide a unique and successful combination that serve to benefit his staff and clients.

“After I shifted the focus of my practice from Sports Medicine into Nuclear Medicine specifically Interventional Endocrinology. I found myself questioning our western medical paradigm…Here I was performing thyroid cancer and Hyperthyroidism treatments with harmful radical thyroid radioactive ablations which really made me take a hard look in the mirror and become more of a researcher to find safer and more effective options to better treat my clients. During my research I realized that there were very few, if any, medically directed programs focused towards achieving a “Healthier Lifestyle” rather than typical “Diet” fads.” A few years later after training and working with some of the worlds foremost Bio-identical Hormone Replacement specialists I became Board Certified in Anti-Aging and Regenerative Medicine. Sort of just found my passion and the answers I had been looking for with this new specialty finally after years of treating people with the Band-Aid “fix it when its broken” mentality instead of at the root cause.”

Mike has spent the last 10 years in Anti-Aging, Functional and Regenerative Medicine. He has trained over 120 physicians in Anti-Aging and Regenerative Medicine and consulting for their practices. Today his vision is a reality, and clients from all of the world come to benefit from the successful programs that have been established at Age Management Institute Santa Barbara. He firmly believes in educating the patient about the importance of good nutrition, hormone balance, stress management, and regular exercise is the key to aging well and having a high quality of life well into your golden years.