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Struggling with Obesity? Get Your Testosterone Levels Checked

As men age, their bodies undergo many changes that can lead to an abdominal obesity trap. Despite how healthy they eat or how much they exercise, these men are unable to shed the excess weight that accumulated in their belly over the years. Published studies have shown that low testosterone and obesity reinforce each other, trapping men in a spiral of weight gain and hormonal imbalance.

Specifically, low testosterone has been found to promote abdominal obesity in aging men. But in spite of the threat of low testosterone and its effects on men’s health, many physicians do not test for testosterone levels in their obese male patients. If they did, millions of men could be protected against metabolic syndrome, type 2 diabetes, high blood pressure, atherosclerosis, and cancer.

It is a known fact that sex hormones control how we look, feel, and even think throughout our lives. Recent studies show that low testosterone levels are strongly correlated with obesity and the metabolic syndrome in men. Now, compelling evidence suggests that low testosterone levels are likely to be part of the cause for metabolic syndrome.

Based on these results, experts strongly recommend testosterone blood testing in most older men, and especially those with type 2 diabetes or the metabolic syndrome. And many are recommending supplemental testosterone as a way of fending off obesity, insulin resistance, and the other components of the metabolic syndrome.

Traditionally, researchers thought that obesity came first, and that low testosterone was only a result. This view was based on the fact that fat tissue is an extremely active hormonal modulator, particularly for testosterone and estrogen. An enzyme in fat tissue known as aromatase converts testosterone into estradiol, the major estrogen in humans. Excess aromatase activity decreases testosterone and increases estrogen levels, resulting in many significant bodily changes for men. Low serum testosterone concentrations are closely correlated with high body mass index (BMI), along with elevated ratios of body fat to lean mass.

But now the researcher reveals this is only half of the story. New evidence shows that while obesity does cause low testosterone, low testosterone actually causes obesity.

The recent study focused on men undergoing testosterone-lowering androgen deprivation therapies for prostate cancer. Reducing men’s testosterone levels decreased insulin sensitivity and increased body fat mass. In one study, more than 50% of men undergoing long-term androgen deprivation therapy developed the metabolic syndrome, manifested in particular by increased abdominal obesity and elevated blood sugar. And men who have lost their testicles to cancer generally develop increased BMI and are at elevated risk for the metabolic syndrome.

On the other hand, men who receive testosterone replacement therapy for hypogonadism (diminished testosterone production) experience slower progression from metabolic syndrome to diabetes or cardiovascular disease. In those men, testosterone has beneficial effects on insulin regulation, lipid profiles, and blood pressure. And in healthy aging men, higher natural testosterone levels are associated with higher insulin sensitivity and a reduced risk of developing the metabolic syndrome.
Such findings are universally applied to aging men. Beginning in middle age men’s testosterone levels begin to steadily decline. During these years, men begin to gain weight as fat, and to lose lean muscle mass, leading to the “battle of the bulge.” Deep abdominal fat begins to build up which is symptomatic of metabolic syndrome.

Testosterone is a very important hormone in a man’s body. It plays a vital role in how the body balances glucose, insulin, and fat metabolism. In addition, it stimulates insulin sensitivity in men, so falling testosterone levels leave a major impact. In fact, experts now recognize low testosterone levels as an independent risk factor for insulin resistance (“pre-diabetes”), type 2 diabetes, and full-blown metabolic syndrome.

Because of the implications of low testosterone levels, it is vital for all men, not just the overweight or obese, to have testosterone levels checked regularly by a reliable laboratory. Both total testosterone and free testosterone should be ordered. Further, the PSA test should also be conducted to rule out existing prostate cancer.

In the event that your testosterone levels come back low, you may be considered to receive testosterone replacement therapy. Evidence suggests that this type of treatment may protect against many features of the metabolic syndrome and can enhance blood sugar control. If the treatment is begun early enough, testosterone therapy may slow or even halt the progression from early metabolic syndrome to diabetes or cardiovascular disease. Placebo-controlled studies have shown decreases in whole body, total, and subcutaneous abdominal fat mass, accompanied by increases in lead body mass, as a result of testosterone therapy.

If you are considering testosterone replacement therapy, consult your doctor. Achieving testosterone levels within the existing reference ranges may not be sufficient to combat obesity and metabolic syndrome. Some testosterone-dependent biological functions require higher levels than others, and those thresholds differ among men. Your physician will help you make an informed choice on which treatment options you should pursue.

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Study Proves Prostate Cancer is More Difficult to Detect in Obese Men

A recent study from Duke University revealed that prostate cancer may be more difficult to detect in obese men, causing an increased risk of death from a delayed diagnosis. Published in the Journal of Urology, researchers reported that, as obese men tend to have larger prostates, a biopsy may be more likely to leave tumors undetected.

Dr. Stephen Freedland and colleagues also reported that obese men often experience lower levels of prostate-specific antigen (PSA), which increases the likelihood of a false-negative PSA test. The data showed that increasing BMI was greatly associated with greater prostate weight in men younger than 63, but not in men age 63 or older. The trend leveled off and started to reverse in morbidly obese men (BMI of 35 or greater).

“Assuming an equal sized tumor, an enlarged prostate at biopsy would make cancer detection less likely,” the researchers reported. Additionally, the researchers reported that the combination of lower PSA levels and larger prostates could cause the general biopsy screening approach following an abnormal PSA test to miss as many as 25% of prostate cancers in obese patients.

With this in mind, Dr. Freedland warned that delayed diagnosis can place obese men at a heightened risk of dying from this disease. He also advised doctor to screen obese patients more aggressively, with a “careful” digital rectal examination and serum PSA measurement.

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