Men's hormones Flashcards
which comorbidities often contribute to decreased T. with aging?
Chronic pain with opioid use
dm, met syn
hiv
SHBG changes with age
increases
Primary versus secondary low T
Primary: failure at testes level, Leydig sensitivity to LH falls. Is related to age.
Secondary: gnRH drops, lh falls. “AOH” - NOT related to age
Diurnal T pattern change with age
blunts with age over 45
prev of low T in erectile dysfunction
Only 19%
LABS associated with MET SYN
low T
low shbg
fsh in men
sertoi cells, sperm
lh in men
leydig cells, T
17, 20 lyase inhib
Inflammation
hyper insulin,
stress
licorice
17, 20 lyase inhib
Inflammation
hyper insulin,
stress
licorice
Enzymes affected by insulin
17, 20 lyase - makes DHEA and andtostenedione
Five alpha reductase - t to dht
Aromatase
Percentage of AOH with met syn
70
Low T & mitochondrial density
decrease
imflamm-aging conditions associated with low T
Type 2 DM CAD and Vascular Diseases Psoriasis RA SLE Crohn's COPD/Asthma Multiple Sclerosis
imflamm-aging conditions with low T
Type 2 DM CAD and Vascular Diseases Psoriasis RA SLE Crohn's COPD/Asthma Multiple Sclerosis
Low T & atherosclerosis
causal!!!
Low T & atherosclerosis
YES LINKED
Low tea predicts increased CVD mortality
LOW T and mortality
88%higher
Lifestyle interventions for low T
Moderate intensity HV aerobic exercise>200
minutes/week produces greater improvements in sexual function, etc
Strength training increases T levels
hiit increases free total t and shbg
Botanicals for Low t
•Long Jack •Mucuna •Ashwagandha •Fenugreek black cumin
Nutraceuticals/vit for low T
vit d (increase in all T), vit A (sperm), zinc, selenium (with cadmium toxicity)
lifestyle interventions for prostate health
food
Walking decreases prevalence and severity of prostate cancer.
Exercise increases adiponectin which decreases risk of high-grade prostate cancer.
diet avoid AA and Grill’s food. Mediterranean diet, soy, Green tea, lycopene
Micronutrient interventions for prostate health
vit d, vitamin E, vitamin C, zinc, selenium
Botanicals for prostate health
B Sitosterol, Pygeum africanum Rye GrassPollen extract stinging nettle root** Not always saw palmetto** * together equals awesome
Lab eval for Low T
total t first, then SHBG and free t, followed by lh/fsh, ferritin estrogen, DHEA, DHT, PSA, cbc
t goal >300
ft goal > 6.6-18.1
shbg 30-80
SHBG and age
Increases
To give for LOW T when you can’t give T
DONT give it desiring fertility
Can give hCG instead - like lh
Clomiphene, increases LHFSH
H decreased at 30 yo for men
T, pregnenolone
proogesterone age 50
H decreased at 30 yo for men
T, pregnenolone
proogesterone age 50
DHEA decreases
E and DHT
Decreases metabolism so increased DHT levels and also increases DHT receptors at prostate
leptin and IR
Insulin resistance leads to TG’s which caused leptin resistance
side effects of T replacement
acne Apnea, PSA >4 four edema, male pattern baldness gynecomastia
Saw Palmetto
dec 5a reductase,
↓ inflammatory PG2/LT4,
(+) apoptosis,
↓E2/DHT receptors.
Studies mixed
•
Nettle Root
5a reductase inhibition , improves urinary flow;
inflammatory PG/LT & prostatic pain & swelling. Good evidence!
Pygeum africanum
((–)5 alpha reductase,
↓inflammatory PG/LT,
improves IPSS scores.
Rye Grass Pollen
–↓prostate cell growth,
inflammation,
↓prostatitis/prostatodynia.
Good evidence
Maca Root
decreased prostate size in rats
improved sperm counts/quality in humans
Beta Sitosterol
found in multiple supplements, ( (–) 5a reductase, aromatase
zinc
–↓ 5 a reductase,
reduces size of prostate,
(–) # of DHT receptors on
prostate by ( (–) prolactin & estrogen affects
Chronic prostatitis
Zinc saw palmetto rye grass pollen star Grass agrimony, nettle root, for certain, cranberry, Uva Ursi, marshmallow root, eryngo
