Category Archives: 12. Hormones for Men

Testosterone and the Risk of Alzheimer’s in Men

Testosterone and Risk of Alzheimer’s in Men

Reference: Moffat Neurology 2004,

Testosterone, all about men’s sexual health, right?   Well, that is true, and it certainly is what most men think is most important, but it’s certainly not all. And here we have today a reference study of the importance of testosterone to men’s brain health.

The Baltimore Longitudinal Study of men’s health started in 1958 and followed men for a mean of 19.1 years, and as long as 37 years. They had physical exams with neurological testing and blood work every other year.   Five hundred and seventy four men were included in the Alzheimer’s and testosterone study group.   That is a pretty strong sample group, for a pretty long time, so this study should have something valid to say.   After accounting for all possible confounding variables, like diabetes, cancer, smoking, age, education, hormone supplements and the like, they were left with the connection between testosterone levels and risk for Alzheimer’s.   Total testosterone and sex hormone binding globulin didn’t seem to have any connection with Alzheimer’s, but free testosterone did.   In fact, for every 10 nmoles increase in free testosterone, there was a 26% reduction in risk for the development of Alzheimer’s.

What is free testosterone? It is the proportion of testosterone in your blood that is available for your tissue to actually use.   Here is the explanation.   Testosterone is built from the cholesterol molecule.   Cholesterol is in the fat family, meaning it is not water soluble. If it isn’t water soluble, it can’t be moved around the body in the transport system we call blood. Blood is made of water and fat doesn’t dissolve in water. The human body has come up an ingenious method of moving it. Sex hormone binding globulin is that method. It is a protein, made in the liver, that has an internal pocket that welcomes fat; it is “hydrophilic”.   High levels of insulin and growth hormone lower it, whereas estrogen and thyroxine raise it. It needs zinc to hold itself together in the form that binds it.

These other hormones don’t need to change it much to have a big impact.   Considering that you only have about 0.1-0.3% of your total T as the “free” stuff, it only takes a small shift to alter your natural free T. There is some debate as to what a proper free T should be, but this is where the rubber meets the road. Many physicians consider a free T3 of 8 pg to be enough.   Well, I have come to recognize that it takes at least 35 pg to feel really good.   Many good things happen then? Remember the male brain?

Now, if we apply that metric to the above study, we will find that the house of medicine will give you a clean bill of health with a free T of 8 pg. But it we raise you to 38pg, that is 3 notches of 10 pg each, and that will lower your risk of Alzheimer’s by 78%.

Well, wait a minute.   The above study shows that men who have higher free T on their own have less risk of Alzheimer’s.   That is not to say that we can prove that raising it by outside means will lower your risk. It isn’t the same thing. There may be other reasons you have high free T3 and those other reasons then account for your lower risk. And giving you T may not provide those other reasons.   So, it’s not yet proven, and likely will never be because there is no money in it. But you will either feel better, or not care because your brain is happy.

www.What Will Work for Me?   I’m interested in this. I have a mother with Alzheimer’s.   I want my free Testosterone to be optimal. It’s something every man should be paying attention to.


Pop Quiz


  1. For every 10 pgram increase in Testosterone, men have a 26 percent increase in risk for Alzheimer’s Disease? T or F

False. You didn’t read the article. That’s backwards. DECREASE

  1. Optimal Levels of Free T3 in a man are around 8 picograms. T or F

False. We want you at least 32 picrograms

  1. Sex Hormone Binding Globulin can muck things up by making your free T3 be all bound up? T or F


  1. You can raise SHBG by having too much estrogen. T or F


  1. You have have too much estrogen by being overweight? T or F


Statins Lower Testosterone Levels in Men

Statins Lower Testosterone Levels in Men

Reference: Endokrnyologia Polska Dec 2014

Statins are the number one drug prescribed in the world.   The power of big pharma to influence policy has led to suggestions that we put statins in the water, such is the enthusiasm of their advocates.   Their utility has been “magnified” and exaggerated by the confusion of the general public, and doctors between relative and absolute risk.   Example, if your risk of death from a heart attack is 2.3%, and it gets lowered to 1.9% if 100 people take the drug for 5 years, it sounds like a 30% reduction instead of a 1.4% reduction.   When you say 30%, it sounds impressive.

Given that, a full exploration of some of the real long term damage done by statins has not been rigorously pursued.   That is curious because the statins are, in fact, a blunt instrument. They block the production of cholesterol. Cholesterol is the entry point for most of the important hormones in your body:   estrogen, progesterone, cortisol, DHEA, the mineralocorticoids and testosterone. That’s quite a portfolio of hormones that are being block.   Well, are they blocked?

The answer is YES! This article is nicely done. It looked at a population of 237 men and examined the effect of statins on those already taking them, versus not.   The total T was 14.9 vs. 16.35 nmol/L, free testosterone 32 vs. 39 pmol/L, and bioavailable T 32 vs. 39 pmol/L in age matched controls, with controls for body weight.   The P values (statistical significance) reached over 0.01 in all measures.   This should be alarming. Statins lower your testosterone.   There goes muscle strength, immune function, libido, brain vitality, bone health…..and all the myriad beneficial functions of statins.

I’m going to reiterate my interpretation of what your blood cholesterol represents.   You can keep your testosterone and lower your cholesterol in just a few weeks. It’s simple.   The LDLs in your blood represent your body’s inability to process and burn the carbohydrates you are ingesting. You are eating too many “high glycemic” foods from potatoes and rice, to bread and anything made from flour or corn. The carbohydrates spill over and turn on insulin.   Insulin instructs your liver to make fat, which it obediently does. Your liver can’t store much of that fat, though it tries. The rest it puts into little transport packages to move the fat cells. You have to do the moving in your blood.   The LDLs in your blood represent just that, eating too many high glycemic carbs. That’s what we call those little transport packages: LDLs.   So, it’s eating carbs that raise your blood fats, and in not eating them that you lower them. Fat is insulin neutral. You can have all the fat you want and it won’t affect the dangerous small LDLs that cause cardiac disease.   It’s those LDLs that are in turn “glycated” by your high blood glucose floating around.   Those glycated LDLs are the real trouble-makers. Your immune system thinks they look like bacteria invading your blood stream and put out a torrent of immune markers to mobilize the white cells to kill off those invading bacteria. (All natural bacteria have sugar markers on their surface.   The immune receptors that line your blood vessels can’t tell the difference between an LDL glycated by your eating too many carbs, and an invading streptococcus.   Now, you have glycation and inflammation running amuck. But the cause was eating too many carbs.   You don’t have a statin deficiency, you have a carb super-sufficiency.

www. What will work for me.   Seeing as just about every male in America has lower testosterone as a consequence of all the “xeno-estrogens”, we don’t need yet another challenge. Taking a statin makes sense only if you can’t push away the next donut, bagel, baked potato, cookie or sundae. Want to prove it for yourself? Stop by and let us draw your blood and conduct a two week experiment of no carbs. Measure again and we will prove to you the truth of this column. And then, keep your own testosterone. Voila!


Pop Quiz


  1. Testosterone is a hormone your body manufactures from cholesterol? T or F


  1. The statin class of drugs inhibits the production of all cholesterol? T or F


  1. This paper showing that statins reduce testosterone should not be a surprise. T or F


  1. You should take a statin if you can’t change your life style of eating lots of carbohydrates.   T or F

True, if 1.4% change in risk for heart disease scares you silly.

  1. Most men in America already have lower testosterone than 50 years ago? T or F





Low Free T3 in the “Normal” Range Predicts Death in Elderly Patients

Low Free T3 in the “Normal” Range Predicts Death in Elderly Patients

Reference: JCEM Iglesias Oct 2013 PubMed Abstract Reverse T3 and Mortality

There is lot’s of talk about thyroid and how important it is for your general well-being. It acts as the idle on your engine, generating power for your body to turn into energy and vitality.   Just how important it is?   Well, this study gives us a clue.   404 patients, over age 65 were admitted into the study when they were admitted into the hospital. They didn’t necessarily stay in the hospital but their overall survival was followed for the next 7years. Their TSH, T4 and T3 were measured. (Not reverse T3).   In that time period, 303 of those patients died (80%). Low free T3 on admission was highly predictive of death in the hospital. The lowest quarter of patients with low free T3 lived only 3 months when their free T3 was less than 3.1 pmols. In the US we use picograms and the conversion is to less than 2.1 pgms. That is low, even in the USA, and is just below the normal range.   But folks in the next third were in what we call normal and their mortality was still greater than the folks in the top third. They only lived 13 months compared to 19 months for folks at the top.

About a third of the patients died of heart disease and they too fit the pattern of predictive deaths with low free T3.   In fact, low free T3 appeared to by particularly important for predicting cardiac mortality.

Now, confounding all this is that the same pattern also matched low TSH. Remember, TSH works inversely to T3.   A low TSH would suggest that your body thinks you are getting more than you need of thyroid. TSH is usually high if free T3 is low. If free T3, T4 and TSH are all low, and predictive of mortality, it may mean your whole system is just giving up and shutting down. If free T3 was low, and your natural systems were working, your TSH should be climbing to raise up your T3 and subsequent free T3.   This particular pattern may be identifying those folks whose whole integrated system of checks and balances is going down.

The conundrum could have been explained by measuring the REVERSE T3.   Remember the adage, “Reverse T3 reverses T3”? This study may be a confirmation that reverse T3 is not an inactive metabolite but rather an active blocker of free T3.   We believe that reverse T3 is induced with stress. Being sick and hospitalized is a great way to induce stress.

The best explanation of the “big picture” would be as follows.   The older you are, the less you can deal with stress. Your mechanisms for adjusting to it are less robust than when you are younger. (Surprised?) If you are sick, you want to have energy available for immune function and repair, so it would be helpful to shift fuel from metabolism to immune function. Reverse T3 would help do that. Makes perfect sense when you are doing things like hibernating, or dealing with infections. But it becomes counterproductive when your body is tasked with a new sort of stress like heart attacks. Then, you just spiral down into a gyre of self-reinforcing trouble. You can’t even make TSH to stimulate your thyroid any more. Without that basic hormone to sustain life, you spiral into death.

The authors of this study warn that this does not prove that treatment prolongs life. We just see an interesting association.   But what would you do?

WWW. What will work for me.   I’m really interested in this. I believe the Free T3 should be monitored in all of us and we should aim to keep it in an optimal range. That may be even more important for us as we age.   That optimal range may be a little higher than we thought. The lower half of our “normal range” may still have higher mortality.   Is treating it helpful? The jury is still out on that one.

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Pop Quiz

  1. Elderly folks with low free T3 have a much higher mortality than those with normal free T3.   T or F

Yup. In a nutshell

  1. Treatment with T3 will reverse that, T or F

Nope. Not proven at all, but intriguing and maybe.

  1. TSH, thyroid stimulating hormone, also can predict mortality. T or F

True – but in contradictory pattern – backwards

  1. Reverse T3 is induced by stress. T or F


  1. Understanding reverse T3 and free T3 might be useful

Seems to be a good argument for that.