madman
Super Moderator
Conclusion
Normal concentrations of testosterone are generally a marker of good health. Low serum TT and FT have been associated with increasing BMI and abdominal adiposity. Many of these men suffer from the nonspecific signs and symptoms of hypogonadism, such as fatigue and sexual dysfunction. This is exactly the population that may benefit from noninvasive treatments to increase serum testosterone, by reducing weight and abdominal adiposity rather than administering testosterone therapies. Obesity has several pathophysiologic mechanisms to explain the fall in testosterone. Direct treatment of obesity may have direct cardiovascular disease benefit and indirect improvement in testosterone concentrations. In such individuals, physiologic ways to increase testosterone are deemed appropriate because testosterone treatment may be associated with risk and with increased need for monitoring. Although some controversy still exists between exercise and testosterone concentrations, most available evidence does support a rise in serum testosterone with greater degree of weight loss, although this change is most impressive after bariatric surgery. The direction of future investigation should include large, randomized control trials of longer duration to characterize the benefits of weight loss and exercise on serum testosterone and the signs and symptoms often associated with male hypogonadism. This direction may provide a more physiologic approach to increase serum testosterone concentrations, with the added benefit of reducing weight and improving muscle mass and bone density. The time is right to recommend studies to document the degree of weight loss needed to significantly increase serum testosterone concentrations. The intent would be to improve the symptoms of hypogonadism and provide a safe and effective modality for long-term benefit on overall health.
Normal concentrations of testosterone are generally a marker of good health. Low serum TT and FT have been associated with increasing BMI and abdominal adiposity. Many of these men suffer from the nonspecific signs and symptoms of hypogonadism, such as fatigue and sexual dysfunction. This is exactly the population that may benefit from noninvasive treatments to increase serum testosterone, by reducing weight and abdominal adiposity rather than administering testosterone therapies. Obesity has several pathophysiologic mechanisms to explain the fall in testosterone. Direct treatment of obesity may have direct cardiovascular disease benefit and indirect improvement in testosterone concentrations. In such individuals, physiologic ways to increase testosterone are deemed appropriate because testosterone treatment may be associated with risk and with increased need for monitoring. Although some controversy still exists between exercise and testosterone concentrations, most available evidence does support a rise in serum testosterone with greater degree of weight loss, although this change is most impressive after bariatric surgery. The direction of future investigation should include large, randomized control trials of longer duration to characterize the benefits of weight loss and exercise on serum testosterone and the signs and symptoms often associated with male hypogonadism. This direction may provide a more physiologic approach to increase serum testosterone concentrations, with the added benefit of reducing weight and improving muscle mass and bone density. The time is right to recommend studies to document the degree of weight loss needed to significantly increase serum testosterone concentrations. The intent would be to improve the symptoms of hypogonadism and provide a safe and effective modality for long-term benefit on overall health.
