There is a large body of evidence linking the onset and/or progression of cardiovascular disease to low testosterone levels in men. It is now apparent that an increased cardiovascular risk and accelerated development of atherosclerosis occurs not only in elderly men or men with obesity or type 2 diabetes mellitus, but also in non-obese men with hypogonadism.14 Current best evidence from systematic review of randomized controlled trials suggests that testosterone use in hypogonadal men is relatively safe in terms of cardiovascular health and do not produce unfavorable elevations in blood pressure or glycemic control, and does not adversely effect lipid profiles.4,15
Fortunately supplementation of Vitamin D3 has been noted to significantly boost testosterone levels up to 20%.[40,41] This occurs via a reduction in sex-hormone binding globulin (SHBG) and aromatase expression, which limits the breakdown of testosterone into estrogen. It’s also worth mentioning that Vitamin D3 has been shown to raise levels of the anabolic hormone IGF-1.[42,43]
Intramuscular testosterone injections were first used around fifty years ago. Commercially available preparations contain testosterone esters in an oily vehicle. Esterification is designed to retard the release of testosterone from the depot site into the blood because the half life of unmodified testosterone would be very short. For many years intramuscular preparations were the most commonly used testosterone therapy and this is still the case in some centers. Pain can occur at injection sites, but the injections are generally well tolerated and free of major side effects. Until recently, the available intramuscular injections were designed for use at a frequency of between weekly and once every four weeks. These preparations are the cheapest mode of testosterone treatment available, but often cause supraphysiological testosterone levels in the days immediately following injection and/or low trough levels prior to the next injection during which time the symptoms of hypogonadism may return (Nieschlag et al 1976). More recently, a commercial preparation of testosterone undecanoate for intramuscular injection has become available. This has a much longer half life and produces testosterone levels in the physiological range throughout each treatment cycle (Schubert et al 2004). The usual dose frequency is once every three months. This is much more convenient for patients but does not allow prompt cessation of treatment if a contraindication to testosterone develops. The most common example of this would be prostate cancer and it has therefore been suggested that shorter acting testosterone preparations should preferably used for treating older patients (Nieschlag et al 2005). Similar considerations apply to the use of subcutaneous implants which take the form of cylindrical pellets injected under the skin of the abdominal wall and steadily release testosterone to provide physiological testosterone levels for up to six months. Problems also include pellet extrusion and infection (Handelsman et al 1997).
Felt I was more sluggish than I should be,Went on TRT ’cause my bloodwork said I fell in the parameters for hormone therapy. When i started felt I was 17, (I was 50))I did everything possible and passed for type A, and physiologically, things seem to heal faster. But I missed memories, now that I was speeded-up I no longer could easily connect and be a part of them.
Hypogonadism is a disease in which the body is unable to produce normal amounts of testosterone due to a problem with the testicles or with the pituitary gland that controls the testicles. Testosterone replacement therapy can improve the signs and symptoms of low testosterone in these men. Doctors may prescribe testosterone as injections, pellets, patches or gels.