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Men’s testosterone levels drop as they age. Curiously, aging men may also experience loss of strength and muscle and bone, loss of vitality, cardiovascular problems, mental slowing and diminished sexual function and interest.
Doctors have long suspected the synchronous depletion of male sex hormones and rise in unwelcome decrepitude may be connected.
And some guys thought if they restored testosterone levels to what they were at age 25, they’d have the same sexual drive and fortitude as they did then. Hence, male aging has become an itch increasingly scratched by testosterone therapy, now routinely prescribed to millions of men who aren’t professional baseball players. For the record, doctors report that new medicines that specifically address erectile dysfunction work better on that.
 But nobody knows for sure whether natural hormone depletion causes the physiological problems, or if testosterone therapy can actually prevent or relieve the conditions of aging, according to Dr. S. Mitchell Harman, Director of Kronos Longevity Research Institute in Phoenix.
A new national study supported by the National Institutes of Health has taken on that very question. Conducted at 12 clinical sites across the country (none in Arizona), the study is designed to discover whether testosterone can reverse the debilitating quirks of male aging. For two years, it will track 800 men, 65 and older, who have low testosterone levels and suffer from anemia, decreased physical function, low vitality, impaired cognition or reduced sexual function. Researchers also seek to know if testosterone raises the risk for prostate cancer, since earlier studies have suggested a link.
“I’m kind of unhappy with the study,” admits Harman, who thinks its parameters are too narrow, given how little is known about testosterone therapy. Experts estimate the current study could cost around $100 million, but Harman, formerly a top investigator with the National Institute on Aging, would like to see an even wider study.
“For a long time, there’s been a proposal for a larger study of 8,000 to 10,000 men that would look at testosterone replacement in older men with low testosterone levels,” explains Harman, who estimates that such a study could cost as much as $300 million. “Men who haven’t yet experienced bone or muscle loss or prostate cancer could be tested to see if testosterone therapy prevents bone and muscle loss. We could see if cardiovascular events increase or if testosterone offers protection, or if it results in more prostate cancer.”
Thus far, the NIH, Veterans Administration and private drug companies have all seen the proposal and passed on funding it.
Harman, who has researched hormones and aging for most of his career, thinks the greatest potential for testosterone therapy is in disease prevention rather than therapy. KLRI’s clinical director Dr. Panayiotis Tsitouras recently analyzed existing research into the sex hormone and wrote a paper concluding that testosterone therapy has shown minimal to no benefits in terms of treating the diseases of aging. And associate director of exercise sciences Tinna Traustadottir analyzed exercise and dietary treatments and wrote that a regimen of exercise and dieting following proper guidelines is the most effective way for older men to prevent or reduce the changes associated with aging. Both papers were published in the July issue of Clinical Geriatrics.
Traustadottir says considerable data show that exercise can preserve and restore muscle and bone mass for older men, as well as improve physical function. Exercise also boosts insulin sensitivity, which fends off diabetes, a big issue for the elderly. Traustadottir, who has a doctorate in exercise physiology and teaches at Arizona State University, says a senior citizen workout requires a unique focus.
“Most workouts only focus on muscle strength,” she says. “My big interest is in muscle power, which is more related to function.” For power, the speed of the exercise is increased, while the resistance is decreased. It results in better agility, an ability to move quickly and retain balance.
“Older people walking down the street can trip,” Traustadottir points out. “They need to move quickly to avoid injury. That’s where muscle power comes in.”
Harman, the hormone expert, agrees but says some of the men he treats on rounds at the Phoenix Veterans Administration hospital aren’t capable of much exercise, due to injuries, arthritis or back problems. He says he would give them testosterone.
“If your testosterone is really low, you don’t get the benefit of exercise in terms of building muscle mass or bone density,” he reports. “Muscle doesn’t respond adequately without some testosterone. But prostate cancer is the 2000-pound gorilla. I and my former colleagues at NIH and Johns Hopkins found that while there is no increase in prostate cancer overall in men who used testosterone therapy, the men with the highest testosterone levels had the more deadly metastatic prostate cancer.”
In contrast, the sex hormone may help cardiovascular health. KLRI is now running a study called TEAAM, an acronym for Testosterone’s Effects on Atherosclerosis in Aging Men. More than 300 healthy men ages 60 and older in Arizona and at the Boston University School of Medicine are being treated with testosterone and monitored for three years. Data will track incidence of cardiovascular disease in addition to changes in muscle mass, bone density and cognitive function and suspected negative
effects such as increased red blood cells, a cause of clots. Results are still 18 months away, Harman says.
“There are reasons people use testosterone,” he concludes. “The athletes don’t use it because it doesn’t work. But testosterone is not benign. We need to see what it does and doesn’t do before moving forward.”
The Magic of the Chest Press
It’s an exercise that can improve a man’s agility as he ages—so long as he increases the speed of the exercise and does fewer reps. Here’s a guide to a new, improved chest press:
- Select weights based on your strength and size, but use a moderate or heavy weight. A lighter load will improve balance with the legs more. To work on the upper body, use a heavier weight.
- Press out as fast as you can and slowly bring arms back to position.
- For power, you don’t want to fatigue yourself, so do fewer reps at increased speed.
Do three sets of six to eight reps, with weights.
Source: Tinna Traustadottir, Ph.D.
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