June 05, 2007
Low Testosterone Men Die Sooner

Men with lower testosterone in their 50s and beyond do not live as long.

Low levels of testosterone may increase the long-term risk of death in men over 50 years old, according to researchers with the Department of Family and Preventive Medicine at the University of California, San Diego School of Medicine.

“The new study is only the second report linking deficiency of this sex hormone with increased death from all causes, over time, and the first to do so in relatively healthy men who are living in the community,” said Gail Laughlin, Ph.D., assistant professor and study author.

This result surprises me. I would have expected the testosterone to reduce life expectancies by upping the incidence of prostate cancer and by basically turning up the body's metabolism to a level that would cause the body to wear out more rapidly.

The men in this study have been tracked for the last 18 years.

“We have followed these men for an average of 18 years and our study strongly suggests that the association between testosterone levels and death is not simply due to some acute illness,” said Laughlin.

In the study, Laughlin and co-workers looked at death, no matter the cause, in nearly 800 men, ages 50 to 91 years, who were living in Rancho Bernardo, California. The participants have been members of the Rancho Bernardo Heart and Chronic Disease Study since the 1970s. At the beginning of the 1980s, almost one-third of these men had suboptimal blood testosterone levels for men their age.

The group with low testosterone levels had a 33 percent greater risk of death during the next 18 years than the men with higher testosterone. This difference was not explained by smoking, drinking, physical activity level or pre-existing diseases (such as diabetes or heart disease).

In this study, "low testosterone" levels were set at the lower limit of the normal range for young adult men. Testosterone declines slowly with aging in men and levels vary widely, with many older men still having testosterone levels in the range of young men. Twenty-nine percent of Rancho Bernardo men had low testosterone.

So them maybe testosterone patches would increase life expectancy in men who have lower levels of testosterone?

The men with lower testosterone had more fat on their wastes and more inflammation in their bodies.

Men with low testosterone were more likely to have elevated markers of inflammation, called inflammatory cytokines, which contribute to many diseases. Another characteristic that distinguished the men with low testosterone was a larger waist girth along with a cluster of cardiovascular and diabetes risk factors related to this type of fat accumulation.

This begs the question: If these low testosterone men took testosterone would their inflammation markers go down and their fat decrease? If so, would they then live longer? I would at least expect the reduction in body fat.

Share |      Randall Parker, 2007 June 05 10:14 PM  Aging Drugs

Mthson said at June 5, 2007 11:17 PM:

I wonder if part of the effect is due to individuals' general drive for life being depressed in correlation with their testosterone levels.

odograph said at June 6, 2007 6:53 AM:

This strikes me as correlation. That is, perhaps sex hormone production is a luxury that a healthy body can afford. A body that is in a slide may shift resources.

yorik said at June 6, 2007 7:52 AM:

Some doctors theorize that it's not the testosterone that causes prostrate cancer, but higher than normal levels of estrogen, since the prostrate has receptors for both testosterone and estrogen. Testosterone can be converted to estrogen by aromatization, and high levels of body fat increase the aromatase enzyme, hence the link between body fat and prostrate cancer. Testosterone also helps maintain muscle mass and prevent body wasting, and the application of androgenic steroids has been shown to improve life expectancy in AIDS patients.

Apparently "steroids" aren't the evil the government would like us to believe they are.

rsilvetz said at June 6, 2007 9:33 AM:

We know at a minimum that DHT and estradiol, alone and in combination, induce prostate cancer. This is at the level of known medical fact. What is mind-numbing is that men over 45 are not routinely screened for DHT and estradiol levels, and then not placed on appropriate drugs to squash both.

Manufacture of testosterone is not a metabolic luxury. Low levels are most often an endocrinologic failure, usually centering around Leydig cell exhaustion. But the whole hormone cascade needs to be looked at to see if there is another cause.

Cenegenics (Las Vegas, NV) claims that their database is reaching statistical significance and that they are seeing considerable drops in pathology in their patient base. They haven't made any claims on low testo patients living longer, but I would expect that to be the case.

And we really need to walk away from this BMI/waistline bs in the profession. It is such a terribly non-specific sign of everything as to be utterly useless in practice. Never mind it's not even age-adjusted. Give me a hard number on intra-abdominal fat by ultrasound and we'll talk. Give me a waistline number and you are just wasting my diagnostic time. This is a classic case of "be careful what you measure". They measure it because they can but it doesn't help you in any real sense.

Nick said at June 6, 2007 11:11 AM:

Two questions:

Is DHEA supplementation a useful replacement or supplement to testosterone replacement? and

Can stress/anxiety reduce testosterone levels?

rsilvetz said at June 6, 2007 3:12 PM:

Cortisol released by stress/anxiety will act against testo levels and yes, lower them.

As to DHEA, in younger men, yes, get some levels and supplement against the difference. In older men, get a PSA and follow it on DHEA supplementation and make sure to get DHT and Estradiol measured so that if they spike you can suppress them with appropriate drugs.

When you supplement like this YOU MUST EXCERSIZE as a concomitant therapy. Otherwise you turbocharge without using the underlying hormones and that will spell trouble.

adrian said at June 6, 2007 4:27 PM:

This would explain the female preference for testosterone-esque confidence over status in many cases, which is why average income black guys can score white girls, while rich-as-hell East Asian males can barely score fellow Asians.

Randall Parker said at June 6, 2007 10:13 PM:

Robert Silvetz,

What are Cenegenics doing therapeutically to lower pathology in their patient base?

rsilvetz said at June 6, 2007 11:40 PM:

Cenegenics is a high-end, hard-core medical science , hormonal replacement [growth and sex hormones] shop. Their home page.

They supplement on the basis of the difference between optimal levels and actual levels and monitor their patients as they go along, taking action as appropriate.

I had the opportunity to talk with their medical officer on a matter and he mentioned that their internal database is reaching statistical significance power and that they would be publishing sometime in the next few years.

John said at June 9, 2007 3:28 AM:

What we see here is nothing else but a natural protective mechanism that is activated when the health of the organism gets compromised.
In many diseases, the body tries to lower it's t levels in order to concentrate on healing. It has been shown that testosterone is an
immunosuppressant, as well as contributes to poorer outcomes in a number of debilitating diseases (one only need to check the survival rates for men vs. women in various diseases). Therefore, it is only logical that we should encounter low t among chronically ill men, not the opposite. A classic study that has been carried out in a Kansan mental asylum by Hamilton, showed that the 197 castrated patients lived by an average of 13.5 years longer than intact men, as well as a few years longer than women. In many animal species, castration has been documented to actually increase lifespan. Therefore it would be only logical that the body should attempt to limit it's own production of t in the presence of life-reducing diseases/risk-factors. Check http://ajprenal.physiology.org/cgi/content/full/289/5/F941 for more details.

Jefrey Dach MD said at June 14, 2007 3:10 PM:

Does Testosterone Cause Prostate Cancer?

See my newsletter for the answer.

Jeffrey Dach MD

Randall Burns said at January 2, 2010 6:18 AM:

John Lee was one of the doctors that thought the estrogen not testosterone was the cause of prostate cancer. Basically as men age, their testosterone tends to get converted to estrogen.

There are some herbs like stinging nettle that can lower estrogen levels. Also, progesterone tends to be protective against the effects of estrogen.


Bob Badour said at January 2, 2010 6:30 AM:

Fat cells do much of the conversion so staying skinny is a good idea too.

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