by Raymond Ishman, M.D. | President, Cenegenics Philadelphia
Just the Facts (about hormone optimization)
The goals of the Cenegenics program are to keep our patients at the lowest possible risk for various diseases associated with aging and to improve their quality of life. This is accomplished through early detection, identification of risk factors, and proactive strategies designed to prevent disease as much as possible, rather than treating it once it is established.
Treatment is centered around 4 basic principles:
- Low glycemic nutrition
- Appropriate exercise
- Directed nutritional supplementation
- Correction of metabolic and hormonal deficiencies as medically indicated.
The correction of hormonal deficiencies is the topic that draws the most attention, controversy and emotion. Are hormones safe? Do they cause cancer? Do they really help or do they just make us feel better? Even many physicians who are not familiar with more recent medical literature on the topic feel that optimizing hormones isn’t particularly important, and/or that it is potentially harmful.
The fact is that hormones decline with age. This decline is associated with many disease processes including heart disease, diabetes, Alzheimer’s and osteoporosis. Correction of these deficiencies does not stop aging. However, it can delay the onset of many of the diseases associated with aging and/or slow their progression, as well as improve quality of life.
Let’s put emotional arguments aside and look at the medical literature.
- “Aging in men is characterized by a progressive decline in levels of anabolic hormones, such as testosterone, IGF-1 (growth hormone), and DHEA. Age associated decline in anabolic hormone levels is a strong independent predictor of mortality in older men. Having multiple hormonal deficiencies rather than a deficiency in a single anabolic hormone is a robust bio-marker of health status in older persons.” (Archives of Internal Medicine, 2007)
- “.…testosterone concentrations are inversely related to mortality due to cardiovascular (heart) disease and all causes.” (Circulation, the Journal of the American Heart Association, 2007)
- “In older men, lower total testosterone levels predict increased incidence of stroke or TIA (mini stroke) after adjusting for conventional risk factors for cardiovascular disease. Men with low-normal testosterone levels had increased risk.” (Journal of Clinical Endocrinology and Metabolism, 2009)
- “Testosterone replacement therapy reduces insulin resistance and improves glycemic (glucose) control in hypogonadal (low testosterone) men with type 2 diabetes. Improvements in glycemic control, insulin resistance, cholesterol and visceral adiposity (belly fat) together represent an overall reduction in cardiovascular risk.”(European Journal of Endocrinology 2006)
- “In .…. men with low testosterone levels, testosterone treatment was associated with decreased mortalitycompared with no testosterone treatment.” (Journal of Clinical Endocrinology and Metabolism, 2012)
- “Low free testosterone is an independent risk factor for Alzheimer’s disease.” (Experimental Gerontolology, 2004)
- “Administration of testosterone to hypogonadal (low testosterone) men reverses part of the unfavorable risk profile for the development of diabetes and atherosclerosis” (hardening of the arteries). (Journal of Obesity, 2011)
- “In patients with coronary (heart) disease, testosterone deficiency is common and impacts significantly negatively on survival.” (Heart, 2010)
- DHEA-S concentration is independently and inversely related to death from any cause and death from cardiovascular disease in men over age 50. (New England Journal of Medicine)
- Low serum levels of DHEA-S predict death from all causes (Journal of Clinical Endocrinology and Metabolism 2010)
- Higher DHEA-S levels are independently and favorably associated with executive function, concentration, and working memory. (Journal of Clinical Endocrinology and Metabolism 2009)
Do hormones cause cancer?
- “Blood levels of androgens (like testosterone) and other sex hormones do not seem to be related to the risk for prostate cancer. The finding comes from a huge pooled analysis of data from 18 studies, published in the Journal of the National Cancer Institute (that) confirms the lack of evidence to support an androgen–prostate cancer hypothesis.”
- Urologist and Harvard Faculty, Dr. Abraham Morgantaler, states that “there is not now – nor has there ever been – a scientific basis for the belief that testosterone causes prostate cancer to grow” (European Journal of Urology, 2006)
- “Mortality due to malignancies (cancers) was not elevated in adults receiving hGH treatment.” (Journal of Clinical Endocrinology and Metabolism 2011)
With respect to hGH (human growth hormone) which is only recommended for patients who have been shown to be deficient based on strict FDA guidelines:
- “…relatively high circulating IGF-I (growth hormone) bioactivity in elderly men is associated with extended survival and with reduced cardiovascular risk.” (Journal of Clinical Endocrinology and Metabolism 2008)
- “Like HDL (good cholesterol), high (normal) levels of IGF-1 (growth hormone) confer protection against coronary artery disease.” (Atherosclerosis. 2011)
The above excerpts are a small sampling of the medical literature that supports the safety and efficacy of replacing hormone deficiencies. Everyone is entitled to an opinion. Our goal is to provide patients with the most up to date medical evidence to help them make informed decisions about their health. Making decisions out of fear and emotion, not based on the medical facts, is something that will undoubtedly negatively impact one’s health and well being.