New evidence on testosterone therapy: Find out if it’s right for you

Testosterone research and therapy has ‘done a 180’ in just the last decade. In 2000, nearly all urologists were warning men who had declining testosterone levels that treatment with testosterone – even bio-identical testosterone – was risky and might increase the risk of prostate cancer.

But that view has been entirely disproved, thanks to the research of Dr. Abraham Morgentaler, Associate Clinical Professor at Harvard Medical School. Dr. Morgentaler’s research specifically concerning testosterone and male health includes 65 clinical research publications (of his 105 total since 1979) concerning testosterone and male health topics between the year 2000 and the present – including extensive re-examination of the so-called ‘proof’ that testosterone causes cancer.

One of Dr. Morgentaler’s earlier research papers,1 published in 2000, concluded: ‘Patients with prostate cancer and low free testosterone had more extensive disease. In addition, all men with a biopsy Gleason score of 8 or greater had low serum free testosterone. This finding suggests that low serum free testosterone may be a marker for more aggressive disease.’

This finding directly conflicted with the current ‘accepted opinion’, which was that higher free testosterone is bad for the prostate. (Of course, natural medicine practitioners have rejected this opinion for decades, instead making the commonsense observation that the age group of men with the highest free testosterone levels [ages 18 to 25] have always had the lowest risk of prostate cancer.)

Your prostate’s defence against testosterone overload

In 2008, Dr. Morgentaler published the landmark book Testosterone for Life, in which he introduced the ‘saturation theory’ of testosterone’s effect on the prostate gland. As explained in an expert review report,2 saturation theory is explained this way: ‘Testosterone stimulates the prostatic tissue in a dose-dependent fashion only to a saturation point, achieved at low testosterone concentrations. At these low testosterone concentrations, stimulation [of the prostate] is near maximal, and testosterone supplementation above this level would not lead to significantly greater stimulation [of the prostate gland].’

In other words: A sponge can only absorb so much water; after it’s totally soaked, any extra runs off, and doesn’t make the sponge any wetter. Dr. Morgentaler is saying that since prostate glands are ‘maximally soaked (stimulated)’ with testosterone at a relatively low blood level of free testosterone, higher but still within normal range levels of free testosterone don’t stimulate the prostate any further.

The ‘testosterone saturation theory’ now appears to be accepted by many authorities – including a few who told us just a few years ago that testosterone replacement is hazardous to the prostate.

This same expert review article goes on to state: ‘There is no conclusive evidence that testosterone therapy increases the risk of prostate cancer or even prostatic hyperplasia. There is also no evidence that testosterone therapy will convert sub-clinical prostate cancer to clinically detectable prostate cancer.’ Put together with the previously mentioned research, and translated into plain English, this says that testosterone treatment does not cause prostate cancer, and has not been proven to activate precancerous prostate cancer cells into active prostate cancer.

Is testosterone safe for men who already have prostate cancer?

Pushing testosterone and prostate cancer research even further, Dr. Morgentaler and his colleagues reported this year3 on the administration of testosterone to men who already have prostate cancer.

They concluded: ‘Testosterone therapy in men with untreated prostate cancer was not associated with prostate cancer progression in the short to medium term. These results are consistent with the saturation model… The longstanding prohibition against testosterone therapy in men with untreated or low-risk prostate cancer or treated prostate cancer without evidence of metastatic or recurrent disease merits re-evaluation.’

Note the two words: ‘merits re-evaluation’. It’s not that anything is absolutely proven yet. This expert review also includes a warning, asking: ‘Is there any unequivocal evidence that testosterone can stimulate growth and aggravate symptoms in men with locally advanced and metastatic prostate cancer? This is not a controversial point: The answer is yes. However, this evidence does not imply that prostate cancer is a result of testosterone or therapy…’

Obviously, mainstream opinion is changing, moving much closer to what natural medicine doctors have been saying all along: that testosterone does not itself cause prostate cancer, and that low testosterone is just as bad for the prostate gland as it is for the rest of the male body.

The ‘absolute prohibition’ against testosterone administration for men with simultaneous low testosterone and prostate cancer is gone. However, if there’s ‘locally advanced’ and/or metastatic prostate cancer, there’s unequivocal evidence that testosterone can stimulate growth and aggravate symptoms of that cancer.

How to know if testosterone therapy is right for you

If you have prostate cancer and also have lower than desirable testosterone levels, testosterone may be OK for you for these same reasons… but it also may not. However, the question is now open, instead of being an absolute ‘no-no’.

Obviously, you’ll need to work closely with at least two doctors: one skilled and knowledgeable in natural medicine and bio-identical hormone replacement, and the other a urologist (unless you’re fantastically lucky and find one doctor skilled in all these areas!) Whether it’s two doctors or just one, close monitoring will be absolutely necessary.

Wishing you the best of health,

Dr. Jonathan V. Wright
Nutrition & Healing

Volume 6, Issue 3 – March 2012

Full references and citations for this article are available in the downloadable PDF version of the monthly Nutrition and Healing issue in which this article appears.

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