Saturday, July 27, 2013

Dates And Health Benefits

Dates from more kinds of fruit spread a healthy diet center and normal, characterized by dates on many of the food its proximity nutrients beneficial to the human body and feeds on the fruit of many people around the world, r rich in sugary 65-75% as it is rich in minerals and several vitamins.


Of benefits :

Easy to digest food not exhausting the stomach.
Limit feeling very hungry
Create stomach Dates for reception food
Prevent injury arrest constipation.
Diuretic and kidney wash.
Cleans the liver from toxins.
Calm nervous irritability
Dates and tonic for the liver and eat it on an empty stomach kills the worms and also with many different kinds of benefits
First: it is the element magnesium-rich foods that protect against cancer
Second: it has a significant impact on calm nerves for people with neurological diseases
Third: the natural mix of iron and calcium digest the body and easily received .

Nutritional Value of dates :

Composed of 21% water, and a large number of vitamins, 1.2% protein, 18% fat, and 73% sugars, fiber and 3%
Dates contain high nutritional value and are the fruits of dates from more fruits contain sugars, and vary the ingredients depending on the nature of the fruit, whether wet or semi-dry or dry, as well as by environmental conditions surrounding trees, as different components of fruits in different varieties and increase the proportion of sugars in it between 70 78% of the components of the fruit is characterized by these sugars quickly absorbed and transmission of blood directly digested and burned.


Here is a selection of the health benefits of dates, it is food and a cure for many diseases at the same time:

• general tonic for the body and addresses anemia and prevent nerve disorder, as it contains a high percentage of sugar and potassium.

• increase the secretion of hormones that stimulate the secretion of milk for nursing mothers (such as hormone Pro actin).

• used to treat chronic constipation to activate bowel movement and flexibility, including the content of cellulose fibers.

• prevents cancer and plays a protective role against cancer and what they contain fruits dates of phenols and antioxidants.


• contains anti-cancer and important hormones such as hormone Albetosen which has organized outdoor property in women as well as it prevents bleeding during and after birth and reduced blood pressure when they consume pregnant.

• contains vitamin A which doctors called the growth factor.

• Contains vitamin )B-1((b2)(bb) Such vitamins to strengthen the nerves and vascular softening and moisturizing and saved from bowel inflammation and weakness.

• Needless phosphorus by high.

• preserve eye moisture and luster and prevents blurred vision night vision and makes effective and incisive in the day as well as night.

• According to the elders who began to suffer from lack of hearing and sense of ringing ears or rather weak auditory nerves.

• brings serenity and tranquility to troubled souls worried.

• post stomach digest the dates and absorption of sugars in it within an hour or a few times.

Reasons why you can't lose weight no matter how hard you try


Have you been struggling to lose weight all of your life? You may have already learned the hard way that fad diets don’t work for the long run; they are just a quick fix. Once you’ve come to this realization, you should also be aware of the other reasons why you might not be losing weight no matter how hard you try; here are 5 of them.
  1. One of the biggest mistakes people make when they’re trying to lose weight is not planning their meals. If you don’t carefully think about what you are going to eat tomorrow, you will end up eating the wrong foods out of hunger and convenience. Take a moment every Sunday and write down your meal plan for the week, buy the groceries and maybe even make a few dishes beforehand. Being aware of what you are putting into your body and how much you move each day are the two driving forces to losing weight.
  2. Comparing yourself to others is a mistake. Just because your friend is able to maintain her weight and look great in a bikini by doing yoga and eating burgers doesn’t mean that’s going to work for you. This is your own personal journey. Everybody’s biological makeup is different so you have to find what works best for you and then stick with it. The rule of thumb in weight loss and maintaining a healthy lifestyle is to keep food as simple as possible. Low fat proteins like grilled chicken, lots of vegetables and a little whole grain will enable you to look and feel your best for life.
  3. Eating when you’re not hungry because it’s “lunch time” is another reason why you can’t shed the pounds. It’s best to wait until you are actually hungry before eating something and keep in mind that it doesn’t have to be a big meal. Eating a snack every few hours is a healthier option than large portions of food at a specific time. Don’t let eating become a hobby to comfort yourself. Instead, learn to eat so that you are nourishing your body. This will also help you make better food choices.
  4. Doing the same form of exercise everyday isn’t going to change anything. If you’re new to exercise you probably lost weight when you first started to workout. But once you commit to exercise for life one particular form of exercise isn’t going to continue to change your body. Switching up your workouts (muscle confusion) is essential to weight loss. Alternating between circuit training, cardiovascular exercise, yoga and weights will not only sculpt your body into it’s best self, it is how to look good naked for the rest of your life.
  5. On that subject, a lot of women are afraid to incorporate weights into their workouts with the fear of a masculine look. This couldn’t be farther from the truth and is one of the biggest reasons why they aren’t losing weight. Muscle constantly burns calories even when you’re at rest. This makes it very difficult for you to put on weight. Incorporate Power Circuit Training with Jackie Warner into your routine and see your body change like never before.

Friday, July 26, 2013

Fruits, Vegetables, and Herbs and how they relate to the body part(s) they help.


The Law of Signatures

Understanding The Law of Signatures is an intuitive approach to the knowledge of how food relates to our health and well-being.
Here are a few examples:
Walnuts:  the “brain-boosting” nut.  Adding walnuts to your diet may help boost your memory according to a new Journal of Alzheimer’s Disease report. Researchers found that eating walnuts was associated with better memory and brain function. The antioxidants in walnuts may help counteract age-related cognitive decline and even reduce the risk of neurodegenerative diseases, including Alzheimer’s.

Avocados: Resembling the uterus targets the female reproductive system. It takes exactly nine months to ripen an avocado to ripened fruit. According to research, when a woman eats one avocado a week, it helps to balances hormones, sheds unwanted birth weight, and prevents cervical cancers. It is also a good source of folic acid, which decreases the risk of uterine dysplasia—a precancerous condition.


Tomatoes:  Lycopene, the bright red carotene found in tomatoes, decreases the risk of cardiovascular diseases. By adding a bit of fat to your tomatoes—toss them with olive oil or mix with avocado—the amount of lycopene digested by your body will increase tenfold.


Green Grapes:  Very effective for helping asthma, as the assimilatory benefits of grapes make the lungs more moist, opening bronchial tubes and making it far easier to breathe overall. Also helpful for aiding in getting over a cold or cough due to blocked airways, and helps to get rid of and break up mucous in the body while you are sick. Drinking grape juice can open your airways and help improve your lung function either due to asthma-related issues of a cough or cold.


Red Grapes: Help the heart by raising the nitric oxide levels in the blood. This helps to prevent blood clots, which keeps heart attacks and strokes at bay. Furthermore, the antioxidants in grapes help prevent the oxidation of bad cholesterol, keeping it from clogging the arteries to the heart and keeping the heart healthier overall.



Ginger:  Good for your stomach, spleen and intestines.  Ginger is extremely good for a good digestion and the burning of calories. Ginger contains a substance called zingibain.  There is no substance on earth that has such powerful protein digest enzymes as zingibain.



Kidney Beans:  Kidney beans are a rich source of fiber, which is extremely helpful in lowering cholesterol. The National Institute of Health discovered a link between high cholesterol levels and kidney disease.




Olives:  An Italian study found that women whose diets included a lot of olive oil had a 30% lower risk of ovarian cancer. The reasons are unclear, but the healthy fats in the oil may help suppress genes predisposed to causing cancer.


There are several more examples such as carrots are good for eye health, figs are good for testicles, etc.
The idea is to eat a variety of foods and you can cover most of your body parts with everything they need to function optimally.

Eat to Live!!

Make Your Fat Loss Healthy And Sustainable By Avoiding These 4 Common Pitfalls


Thursday, July 25, 2013

Are Probiotics the New Prozac?

By Dr. Mercola
While many think of their brain as the organ in charge of their mental health, your gut may actually play a far more significant role.

The big picture many of us understand is one of a microbial world that we just happen to be living in. Our actions interfere with these microbes, and they in turn respond having more effects to our individual health as well as the entire environment.

There is some truth to the old expression, having 'dirt for brains'.  The microbes in our soil, on our plants, in our stomachs are all a result of our actions.  Antibiotics, herbicides, vaccines, and pesticides, and the tens of thousands of synthetic chemicals we've created all have impacts and result in reactions from these microbes.
Mounting research indicates that problems in your gut can directly impact your mental health, leading to issues like anxiety and depression.
The gut-brain connection is well-recognized as a basic tenet of physiology and medicine, so this isn't all that surprising, even though it's often overlooked. There's also a wealth of evidence showing intestinal involvement in a variety of neurological diseases.
With this in mind, it should also be crystal clear that nourishing your gut flora is extremely important, because in a very real sense you have two brains, one inside your skull and one in your gut, and each needs its own vital nourishment. A recent article1 titled “Are Probiotics the New Prozac?” reviews some of the most recent supporting evidence.

Probiotics Alter Brain Function, Study Finds

The featured proof-of-concept study, conducted by researchers at UCLA, found that probiotics (beneficial bacteria) actually altered participants' brain function. The study2 enlisted 36 women between the ages of 18 and 55 who were divided into three groups:
  • The treatment group ate yogurt containing several probiotics thought to have a beneficial impact on intestinal health, twice a day for one month
  • Another group ate a “sham” product that looked and tasted like the yogurt but contained no probiotics
  • Control group ate no product at all
Before and after the four-week study, participants underwent functional magnetic resonance imaging (fMRI) scans, both while in a state of rest, and in response to an “emotion-recognition task.”
For the latter, the women were shown a series of pictures of people with angry or frightened faces, which they had to match to other faces showing the same emotions.
“This task, designed to measure the engagement of affective and cognitive brain regions in response to a visual stimulus, was chosen because previous research in animals had linked changes in gut flora to changes in affective behaviors,” the researchers explained.
Compared to the controls, the women who consumed probiotic yogurt had decreased activity in two brain regions that control central processing of emotion and sensation:
  • The insular cortex (insula), which plays a role in functions typically linked to emotion (including perception, motor control, self-awareness, cognitive functioning, and interpersonal experience) and the regulation of your body's homeostasis, and
  • The somatosensory cortex, which plays a role in your body’s ability to interpret a wide variety of sensations
During the resting brain scan, the treatment group also showed greater connectivity between a region known as the ‘periaqueductal grey’ and areas of the prefrontal cortex associated with cognition. In contrast, the control group showed greater connectivity of the periaqueductal grey to emotion- and sensation-related regions.
The fact that this study showed any improvement at all is remarkable, considering they used commercial yogurt preparations that are notoriously unhealthy; loaded with artificial sweeteners, colors, flavorings, and sugar. Most importantly, the vast majority of commercial yogurts have clinically insignificant levels of beneficial bacteria. Clearly, you would be far better off making your own yogurt from raw milk—especially if you’re seeking to address depression through dietary interventions.

Yes, Your Diet Affects Your Mood and Mental Health

According to lead author Dr. Kirsten Tillisch:3, 4
“Time and time again, we hear from patients that they never felt depressed or anxious until they started experiencing problems with their gut. Our study shows that the gut–brain connection is a two-way street... 'When we consider the implications of this work, the old sayings 'you are what you eat' and 'gut feelings' take on new meaning.'”
The implications are particularly significant in our current era of rampant depression and emotional “malaise.” And as stated in the featured article, the drug treatments available today are no better than they were 50 years ago. Clearly, we need a new approach, and diet is an obvious place to start.
Previous studies have confirmed that what you eat can alter the composition of your gut flora. Specifically, eating a high-vegetable, fiber-based diet produces a profoundly different composition of microbiota than a more typical Western diet high in carbs and processed fats.

The featured research tells us that the composition of your gut flora not only affects your physical health, but also has a significant impact on your brain function and mental state. Previous research has also shown that certain probiotics can help alleviate anxiety:
  • The Journal of Neurogastroenterology and Motility5 reported the probiotic known as Bifidobacterium longum NCC3001 normalized anxiety-like behavior in mice with infectious colitis by modulating the vagal pathways within the gut-brain.
  • Other research6 found that the probiotic Lactobacillus rhamnosus had a marked effect on GABA levels—an inhibitory neurotransmitter that is significantly involved in regulating many physiological and psychological processes—in certain brain regions and lowered the stress-induced hormone corticosterone, resulting in reduced anxiety- and depression-related behavior. It is likely other lactobacillus species also provide this benefit, but this was the only one that was tested.
It’s important to realize that you have neurons both in your brain and your gut -- including neurons that produce neurotransmitters like serotonin. In fact, the greatest concentration of serotonin, which is involved in mood control, depression and aggression, is found in your intestines, not your brain! Perhaps this is one reason why antidepressants, which raise serotonin levels in your brain, are often ineffective in treating depression, whereas proper dietary changes often help...

Your Gut Bacteria Are Vulnerable to Your Diet and Lifestyle

Processed, refined foods in general will destroy healthy microflora and feed bad bacteria and yeast, so limiting or eliminating these from your diet should be at the top of your list. Following my recently revised nutrition plan is a simple way to automatically reduce your intake of sugar from all sources. Processed foods wreak havoc on your gut in a number of different ways:
  • First, they are typically loaded with sugar, and avoiding sugar (particularly fructose) is in my view, based on the evidence, a critical aspect of preventing and/or treating depression. Not only will sugar compromise your beneficial gut bacteria by providing the preferred fuel for pathogenic bacteria, it also contributes to chronic inflammation throughout your body, including your brain.
  • Many contain artificial sweeteners and other synthetic additives that can wreak havoc with brain health. In fact, depression and panic attacks are two of the reported side effects of aspartame. Preliminary findings presented at the 65th annual meeting of the American Academy of Neurology also report that drinking sweetened beverages―whether they’re sweetened with sugar or artificial sweeteners—is associated with an increased risk of depression.7
  • Processed foods are also typically loaded with refined grains, which turn into sugar in your body. Wheat in particular has also been implicated in psychiatric problems, from depression to schizophrenia, due to Wheat Germ Agglutinin (WGA), which has neurotoxic activity.
  • The majority of processed foods also contain genetically engineered (GE) ingredients (primarily corn and soy), which have been shown to be particularly detrimental to beneficial bacteria. There are several mechanisms of harm at work here. For example:
    • Eating genetically engineered Bt corn may turn your intestinal flora into a sort of "living pesticide factory," essentially manufacturing Bt-toxin from within your digestive system on a continuing basis
    • Beneficial gut bacteria are very sensitive to residual glyphosate (the active ingredient in Roundup). Due to mounting resistance, GE Roundup Ready crops are being drenched with increasing amounts of this toxic herbicide. Studies have already confirmed that glyphosate alters and destroys beneficial gut flora in animals, as evidenced by the increasing instances of lethal botulism in cattle
    • Recent research also reveals that your gut bacteria are a key component of glyphosate’s mechanism of harm, as your gut microbes have the identical pathway used by glyphosate to kill weeds!
Your gut bacteria are also very sensitive to and can be harmed by:
Antibiotics, unless absolutely necessary (and when you do, make sure to reseed your gut with fermented foods and/or a probiotics supplement) Conventionally-raised meats and other animal products, as CAFO animals are routinely fed low-dose antibiotics, plus genetically engineered grains, which have also been implicated in the destruction of gut flora
Chlorinated and/or fluoridated water Antibacterial soap

How to Reseed Your Gut Flora

Considering the fact that an estimated 80 percent of your immune system is located in your gut, reseeding your gut with healthy bacteria is important for the prevention of virtually ALL disease, both physical and mental. The first step is to clean up your diet and lifestyle by avoiding the items listed above. Then, to actively reseed your gut with beneficial bacteria, you’ll want to:
  • Radically reduce your sugar intake. I’m being repetitive here, to drive home the point that you can take the best fermented foods and/or probiotic supplements, but if you fail to reduce your sugar intake you will sabotage your efforts to rebuild your gut flora. This would be similar to driving your car with one foot on the accelerator and one on the brake simultaneously. Simply not a good strategy at all. When you consume sugar at the level of the typical American you are virtually guaranteed to have a preponderance of pathogenic bacteria, yeast and fungi, no matter what supplements you are taking.
  • Eat traditionally fermented, unpasteurized foods: Fermented foods are the best route to optimal digestive health, as long as you eat the traditionally made, unpasteurized versions. Some of the beneficial bacteria found in fermented foods are also excellent chelators of heavy metals and pesticides, which will also have a beneficial health effect by reducing your toxic load. Healthy choices include:
    • Fermented vegetables
    • Lassi (an Indian yoghurt drink, traditionally enjoyed before dinner)
    • Fermented milk, such as kefir
    • Natto (fermented soy)
    Ideally, you want to eat a variety of fermented foods to maximize the variety of bacteria you’re consuming. Fermented vegetables, which are one of my new passions, are an excellent way to supply beneficial bacteria back into our gut. And, unlike some other fermented foods, they tend to be palatable, if not downright delicious, to most people.
    As an added bonus, they can also be a great source of vitamin K2 if you ferment your own using the proper starter culture. We tested samples of high-quality fermented organic vegetables made with our specific starter culture, and a typical serving (about two to three ounces) contained not only 10 trillion beneficial bacteria, it also had 500 mcg of vitamin K2, which we now know is a vital co-nutrient to both vitamin D and calcium. Most high-quality probiotics supplements will only supply you with a fraction of the beneficial bacteria found in such homemade fermented veggies, so it’s your most economical route to optimal gut health as well.
  • Take a high-quality probiotic supplement. Although I'm not a major proponent of taking many supplements (as I believe the majority of your nutrients need to come from food), probiotics are an exception if you don’t eat fermented foods on a regular basis.

Nurture Your Gut for Optimal Health and Mental Well-Being

Foods have an immense impact on your body and your brain, and eating whole foods as described in my nutrition plan is the best way to support your mental and physical health.
Mounting research indicates the bacterial colonies residing in your gut may in fact play key roles in the development of brain, behavioral and emotional problems—from depression to ADHD, autism and more serious mental illness like schizophrenia. Certainly, when you consider the fact that the gut-brain connection is recognized as a basic tenet of physiology and medicine, and that there's no shortage of evidence of gastrointestinal involvement in a variety of neurological diseases, it's easy to see how the balance of gut bacteria can play a significant role in your psychology and behavior.
With this in mind, it should also be crystal clear that nourishing your gut flora is extremely important, from cradle to grave, because in a very real sense you have two brains, one inside your skull and one in your gut, and each needs its own vital nourishment.
Cultured foods like raw milk yogurt and kefir, some cheeses, and fermented vegetables are good sources of natural, healthy bacteria. So my strong recommendation would be to make cultured or fermented foods a regular part of your diet; this can be your primary strategy to optimize your body's good bacteria.
If you do not eat fermented foods on a regular basis, taking a high-quality probiotic supplement is definitely recommended. A probiotic supplement can be incredibly useful to help maintain a well-functioning digestive system when you stray from your healthy diet and consume excess grains or sugar, or if you have to take antibiotics.

Wednesday, July 24, 2013

How to Lose Weight and Lose Fat Fast


There’s nothing wrong with losing weight and fat fast, as long as you do it the right way. But, with all the different fad diets, reality shows, internet gimmicks and commercials telling you different ways how to lose weight and fat fast, which way is the right way, if any? Which approach to weight and fat loss do you trust? How many different approaches do you take to weight and fat loss before you end up back at square one or even heavier?
Doctors, dieticians and the best trainers say in the real world, without all the Technicolor glossy coating, you still can achieve outstanding results in losing weight and fat fast by doing it the right way. They suggest starting with the right mindset, asking questions, look for answers in valuable resources and setting realistic goals.
Let's take a look at what it takes to lose weight and fat fast by doing it the right way.

To Lose Weight and Fat Fast You Need 100% Commitment

70-80% of weight and fat loss will come from changing your diet into clean food habit. The other 30% will be the result from the exercise. In practice what you need to do, is to create caloric deficit. For example if your calorie deficit equals 500 calories per day, by eating fewer calories and increasing energy expenditure by physical activity you can safely expect 1-2 pounds of fat loss a week. If you want to accelerate this rate you need to increase exercise and decrease calories consumption without going below 1,050 to 1,200 and combining it with one hour of exercise a day.
Going below 1,050 to 1,200 calories is unsafe and also can sabotage your results by entering your body catabolic state. Catabolic state will drastically decrease your metabolic rate, and put you in danger of mood swings and cravings. With time your weight and fat loss can start to decent and hit a plateau. That’s where you need to start thinking of new strategies, like hiring a personal trainer or maybe joining a health club.

To Lose Weight and Fat Fast Keep Your Carbs and Protein in Check

Look at your consumption of carbs, not only sugar but also complex, starchy low GI carbs. Break down your meals and try to go for 5-6 meals a day. This will ensure your energy levels are kept throughout the day, so you don't have to look for quick energy fixes.
Protein distributed evenly throughout your eating plan will help maximize fat loss and restore your muscles, in turn increasing basic metabolic rate by forcing you to utilize more energy from fat stores just to maintain lean body.
Your diet for fast weight and fat loss should consist of protein from sources such as:
  • Skin less poultry breast
  • Egg whites
  • Fish 95% lean meat
  • Shellfish
Up your veggies intake, their content of fiber will keep your digestion healthy.
Your diet for fast weight and fat loss can be from veggie sources such as:
  • Broccoli
  • Cauliflower
  • Green beans
  • Sweet potatoes
These veggies are really low in calories but will help you to feel full longer.

Additional Ways to Lose Weight and Fat Fast

  • Cut sodium intake, it contributes to water retention under your skin, and you would be surprised how much of it is hidden everywhere.
  • Always read your food labels.
  • Drink plenty of water. Sometimes we can think we are hungry which in fact a confusing aspect of thirst.
  • Clear your house and cupboards of tempting foods.
  • Always remind yourself of your goals, what are you doing this for, why is it important to you.
  • Weighing yourself daily and keeping food diary will help you stay focused.

Exercise for Accelerated Weight and Fat Loss

Cardio burns a lot of calories. You should commit to an hour a day to cardio. Your cardio intensity will depend on your fitness level. You should aim to break a sweat after warm up and maintain it for the rest of the hour. Moderate intensity is good to start out at. In general your intensity is about 50-70% of your effort. In practice this means the effort you should generate is a bit more intense than your regular paced walk.
In time you may want to shuffle your cardio with High Intensity Interval Training (HIIT). HIIT is a form of cardio training which elevates your cardiovascular capacity to the maximum for short bursts of time. Adding HIIT into your workouts will help you to burn more calories in less time.
You need to realize the misconception that cardio is all it takes for successful weight and fat loss. You should also include some resistance training along with your cardio. Resistance training will not burn fat, as it relies on glucogene (sugar), but it will increase metabolic rate. Your body will burn calories while supplying energy to recover broken down muscle fibers. Include at least 2-3 resistant training sessions a week to maintain muscle tone. Focus on compound movements, which include big muscle groups and multi joints actions such as squats, chest presses, and lat pulldowns. Compound exercises will shock your body and get you the best response you can achieve.

Prioritize what’s Important to You

Life is hectic for most of us. Many of us don’t have time for a rigorous diet and training schedule. But we all can prioritize what’s important to us. Is watching TV after work really more important than taking time out for yourself by going to the gym and meeting like minded people? If you surround yourself with positivity, that soon will change your life and make your ‘Weight and Fat Loss Success Story' a reality.

Bottom Line on Losing Weight and Fat Fast the Right Way

There's no magical fixes on losing weight and fat. You need to commit to your plan, surround yourself with tools of inspiration, and set example for others. Never stop challenging yourself, and always keep in mind ‘Moment on your lips is a lifetime on your hips.’

About the Author Ina Gutowska

Ina Gutowska is a former dancer originally from Poland, who started to explore all different levels of Fitness knowledge while living for 5 years in London.  Ina Gutowska currently resides in Australia where she works as Personal Trainer, Motivational Speaker, Writer and a Fitness Model sharing her deep understanding of psychological barriers and negative body image, as well as biomechanics of the body, nutrition, and supplementation.

What Testosterone Decline in Aging Men Is Normal?

Today there is a lot of talk of Low T in middle age men. With aging babyboomers there is a huge finacial market to market testosterone replacement in middle age to aging men.
However, the clinical importance of declining testosterone levels in older men is unclear. So what testosterone decline in aging men should be considered normal?

Low T and Aging

Serum testosterone levels gradually decline as men age, but the degree to which serum testosterone levels decline, as well as the extent of associated clinical changes (reduced libido, low bone mineral density and height loss, and decreased energy), is variable.
This age-related decline in serum testosterone levels has been confirmed in several cross-sectional and longitudinal studies and results from dysfunction in the hypothalamic-pituitary-testicular axis.2-4 The clinical importance of this decline is controversial, however. Recognizing this variability and understanding what may be considered changes in body function due to "normal aging" versus potentially treatable age-related testosterone (or androgen) deficiency is crucial in the care of older men. The role of evaluating testosterone levels and their clinical significance is reviewed here.
Aging is associated with declines in total serum testosterone concentration, increases in sex hormone-binding globulin (SHBG) concentration, and decreases in free testosterone. In one large cross-sectional study of more than 3000 men ages 40 to 79, serum testosterone concentration fell 0.4% per year, free testosterone concentration 1.3%.3 In another study, of 890 men, total testosterone levels were
Free testosterone is considered the biologically active form of the sex hormone-binding globulin (SHBG). As men age, SHBG level rises, binding more testosterone and leaving less free testosterone available to act on target tissues. There is no uniformity in how aging men respond to this changing hormonal milieu, however. As a result, a controversy exists about whether this is a disease state. When it comes to low testosterone, what is normal senescence? What is illness?
Symptoms and signs suggestive of androgen deficiency in older men include reduced libido, low bone mineral density and height loss, and, less specifically, decreased energy, anemia, depressed mood, reduced muscle strength and bulk, and increased body fat.5 When these signs and symptoms accompany significantly lower levels of both types of testosterone, the patient may be diagnosed with late-onset hypogonadism. Cutoffs for the definition of low testosterone vary, although generally accepted values are =200 or =300 ng/dL of total testosterone.6
Unlike younger men with hypogonadism who present prominently with specific gonadal dysfunction (for example, infertility, incomplete or delayed sexual development), older men have nonspecific symptoms that can frequently be caused by other common disorders. For example, in the largest longitudinal study of testosterone deficiency, researchers found that up to 25% of elderly men who complained of sexual dysfunction, including low libido and erectile dysfunction, had normal-range testosterone levels for their age.7 In light of these findings, what is the best approach to patients who may—or may not—need treatment?
The Endocrine Society updated its clinical guidelines on androgen deficiency evaluation and treatment in 2010.6 It proposed a practical approach to evaluating testosterone deficiency in older men who present with low libido, decreased energy, depressed mood, osteoporosis, or recent fracture. If a clinician suspects testosterone deficiency, the first step should include an early morning total testosterone measurement. If the level is
To date, there are relatively few well-designed, large studies on hypogonadism in aging men. To better understand if this is a distinct clinical syndrome, future trials should be powered to assess whether testosterone deficiency in older men independently predicts important outcomes such as osteoporosis, muscle strength, mood disorders, and sexual dysfunction. This will best inform us as we try to move forward with treatment.
References:
  • Medpage Today, Sanjai Sinha, MD. Testosterone Decline With Aging: What Is Normal? .
  • Feldman HA, Longcope C, Derby CA, et al. Age trends in the level of serum testosterone and other hormones in middle-aged men: longitudinal results from the Massachusetts Male Aging Study. J Clin Endocrinol Metab. 2002;87:589-598.
  • Wu FC, Tajar A, Pye SR, et al. Hypothalamic-pituitary-testicular axis disruptions in older men are differentially linked to age and modifiable risk factors: the European Male Aging Study. J Clin Endocrinol Metab. 2008;93:2737-2745.
  • Harman SM, Metter EJ, Tobin JD, et al; Baltimore Longitudinal Study of Aging. Longitudinal effects of aging on serum total and free testosterone levels in healthy men. Baltimore Longitudinal Study of Aging. J Clin Endocrinol Metab. 2001;86:724-731.
  • Bhasin S, Cunningham GR, Hayes FJ, et al. Testosterone therapy in men with androgen deficiency syndromes: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2010; 95:2536–2559
  • Araujo AB, Esche GR, Kupelian V, et al. Prevalence of symptomatic androgen deficiency in men. J Clin Endocrinol Metab. 2007;92:4241-4247
  • Wu FC, Tajar A, Beynon JM, et al. Identification of late-onset hypogonadism in middle-aged and elderly men. N Engl J Med. 2010;363:123-135