Esquire: Hormone Replacement Therapy For Men: A Review
In his in-depth article on Human Growth Hormone (HGH) which appeared in the March 29, 2012, issue of Esquire magazine, Craig Davidson takes a fair and level-headed approach to this controversial topic.
He begins by clearing up the misconception about hormones: performance enhancing drugs (PED’s) and testosterone and growth hormone replacement therapy are lumped together in the minds of the casual observer.
Athletes are continually in the news for abusing anabolic steroids, testosterone and growth hormone. This not only causes many to feel that they are illegal (not true; all of these substances are legally available by prescription), but most people fear them as well.
But we tend to fear the things that we are ignorant of, and Davidson presents the other side of growth hormone replacement therapy: the new generation of doctor’s that are using synthetic hormones as a weapon in the battle against the hideous disease of aging. In short, when used correctly, they are nothing short of a miracle.
He flashes back on memories of his young father recklessly pulling off athletic feats that would result in the usual scrapes and bruises, which would heal quickly.
And now, he can’t help himself from thinking about the contrast of his dad’s youthful vigor with his current physical condition.
Davidson knows that it’s natural. After all, his father has hit his mid-sixties, and Davidson himself is feeling the effects of aging in his mid-thirties. But he can’t imagine the world without his beloved father in it.
Davidson knows that the conventional wisdom is to “shut up about getting old.” But he has been delving into the world of medical advancements, and holds out hope…however slim…that the monster of aging and all its afflictions can be kept at bay. He, therefore, begins to share with his dad what he has learned.
The hospital’s mission is combating andropause, which is the male counterpart to menopause. The clinic specializes in testosterone replacement therapy since that is one of the main hormones that men lose as they age.
The decline begins at around age 30 and continues its march to destruction at approximately 10% per decade.
The consequences of male hormone loss are devastating: Inability to experience a night of deep, restorative sleep, mental fog and impaired memory, few if any morning erections, flabby, sagging muscles, constant joint aches and pains, chronic fatigue, and the deep-seated depression that often sets in as men see their masculinity recede.
Dr. Komer sees these symptoms simply as a sign of hormone deficiency and is, therefore, a treatable condition.
But unlike the majority of MD’s, he does not immediately reach for the prescription pad. Instead, he replaces the diminished hormones.
The word hormone is of Greek origin, and means “stir up.”
A good way to understand them is this: they are our bodies messengers, and they influence every single cell, tissue, organ, and function in our bodies.
Their importance cannot be over-emphasized. Every hormone is the equivalent of a key; without a companion lock, it won’t work.
Here’s the problem. When men reach a certain age, where growth stops and fertility is not required, we don’t produce as many hormones.
And even if we did, our hormone receptors become less sensitive as we age. The keys no longer work on the locks. When this happens on more and more cells, with more and more hormones, disease gains a foothold.
Davidson next reminds us that hormone replacement is nothing new. It is a topic that has intrigued scientists for centuries.
In spite of their early and mostly futile efforts, they had some of the puzzles figured out, in essence setting the stage for our modern era.
Back to the clinic.
After a series of tests, including current levels of total testosterone, bioavailable testosterone, estradiol, prolactin, luteinizing hormone, PSA, thyroid-stimulating hormone, DHEA, live enzymes, and cortisol, an individualized treatment program is planned.
When reminded that this is nature’s plan, he retorted “So we must contest nature.”
After the patient receives his treatment plan, he is sent off with detailed instructions concerning the treatment protocol and will be seen again in six weeks. The treatment regimen is anything but a “cookie-cutter, one-size-fits-all” approach.
Davidson touches on the “lingering stigma” associated with hormone replacement therapy.
This is due to its being tied in with steroids being abused by professional athletes. In the minds of most people, using PED’s is both cheating and illegal.
PED use is against the rules of the individual sport sanctioning bodies, and violations of the rules are punished, at times severely. But when the average person uses HGH or testosterone under the supervision of a medical professional and acquired legally by prescription, it is not illegal.
Also, most of the damage from these substances is directly due to abuse, taking far more than the recommended dosage.
It is responsible for the growth of our bones, muscles, tissues and the breakdown of fat. But, similar to testosterone, growth hormone also slows down at approximately age 30 and continues its decline at around 10% a year.
Davidson recalls the decade of the 1980’s when HGH was harvested from dead bodies.
This was extremely dangerous and led to many incidents of Creutzfeldt-Jakob disease, which is a rogue protein that eats up your brain.
But now, it is manufactured synthetically.
One user of HGH (a professional wrestler) spelled out the difference between HGH and steroids: “with steroids, you feel something.
An increase in sex drive, changes in your musculature. But with HGH it’s more about what you don’t feel. Aches and pains disappear.
Energy levels come up. It speeds healing time. I sleep so deeply. As my career progresses further into my forties…I need it, man.”
As Davidson points out: “The image is somehow wrong. Like seeing an absurdly muscled child: Human beings on either end of the age spectrum only shouldn’t look that way.”
“Sure, some people think it’s fake,” says Dr. Life, who was seventy-two at the time of the picture.
“Until they meet me.” Dr. Life emphasizes that he uses controlled amounts, never prescribing anything near the levels that professional athletes inject. And this makes it perfectly legal.
However, Dr. Life is quite clear about growth hormone not being a quick fix. He had to make drastic changes to his diet and exercise routine to get the results he did. This meant hard-core weight-lifting, swallowing dozens of vitamins and other supplements daily, and cutting out trans fats from his diet.
Even with all this, Dr. Life is, according to Davidson, showing signs of the wear and tear that aging brings.
His skin has a few wrinkles, and his body has a few sags. However, he is still in remarkable condition and is a walking testimonial to the effectiveness of HGH replacement therapy.
“I’ve been working with female hormones for more than thirty years,” he says.
“Male hormones are similar. It’s nothing but a mental step sideways.”
Women were at the forefront of hormone replacement therapy. In the 1990’s, postmenopausal women were given hormone replacement therapy to lessen the side effects they were dealing with.
However, it apparently increased the risk of breast cancer. This is where so much of the wariness and scrutiny about male hormone replacement came from.
But there is an explanation. All too often, estrogen was handed out in a “one-size-fits-all” manner, with little or no attention given to the individual woman.
As long as the person is treated as an individual, and the HGH program is tailor-made just for them, hormone replacement therapy is safe and can deliver benefits bordering on miraculous.
Dr. Komer is an advocate of “interventional medicine.” In other words, start hormone replacement therapy before illness strikes. He points out that many doctors are unaware of the importance of hormones.
He says that “Doctor’s only see things from the point of view of their specialization…patients are a bowel, a heart, a brain. There’s little sense of the linkages between them. Hormones are that link. Too often the only cure is pharmacological intervention: Give the patient a pill. If all you’ve got is a hammer, everything starts looking like a nail, right?”
Davidson next introduces us to another advocate of hormone replacement therapy: Dr. J. Matthew Andy, who is the host of The Dr. Andy Show on News Talk FM 95.5 from Bloomington, Illinois.
Dr. Andy states that “The modern medical model holds that you get sick, then a doctor tries to fix you.
Here’s a crazy idea: Why don’t we avoid letting you get sick in the first place?”
According to Dr. Andy, many conditions: menopause, diabetes, thyroid disease, and contraception require the regulation of hormones.
Why, he asks, should testosterone be any different? He goes on: “Instead of taking Wellbutrin for your mood, Lipitor for your cholesterol, Cialis to give your poor penis a lift, and Lunesta to fall asleep, why not try something that helps with all of that?”
Homeostasis is the key, according to Dr. Andy.
The Webster’s dictionary definition of the word is the tendency toward a stable equilibrium. He feels that physicians should seek to achieve natural harmony in patients.
“Humans don’t age symmetrically, parts,” he says. “Parts of us survive longer than other parts. We live longer than our glands do. We die in pieces.”
This is nothing new. The medical establishment, like any other large organization or group, has historically been slow to adopt change, even something as straightforward and basic as hand washing after seeing a patient.
To be fair, Davidson astutely points out that at times, this is the safest way to go.
We don’t know the long-term effects of hormone replacement, just like we don’t know the long-term effects of several other medical procedures, too numerous to list.
But there are short-term possible side effects of hormone replacement therapy: Thickened blood and blood clots, spikes and dips in cholesterol, hypertension, sleep apnea, irritability, aggression, suicidal thoughts, hypersexuality, infertility, testicular atrophy, acne, greasy skin, excessive sweating and body odor.
However, these almost always occur when a patient exceeds his dosage or doesn’t show up for his follow-up appointments. But the fact remains that testosterone carries the potential for abuse, and should not be taken lightly.
Davidson discusses aging. Human life spans follow a predictable arc. We are born, grow up, grow stronger and smarter, hit our peak, then the decline begins.
Next, he delves into the question of “why do our cells have to age?”
Some say it is due to an accumulation of rogue molecules called free radicals, which release toxins in our bodies and attack our immune systems.
Others believe our genes have a built-in kill switch.
Our body’s a giant auditorium which is hosting a wild party. Then, at the given hour, the janitor shows up, announces that the party’s over, then turns off the lights.
Whatever the cause, the inevitable outcome of aging is what these doctors are determined to battle.
Davidson mentions one less than rosy fact: if they succeed, and our life spans are several hundred years or even a thousand years long, birth rates would drop astronomically, which leads to an unintended consequence.
To quote Davidson: “a bunch of doddering, mothball-smelling, millennium-year-olds tottering about in a world cleansed of children’s laughter. A bit creepy, for sure. But so many people are willing to try to stick around and see what that world would be like.
Davidson finishes with the completion of his letter to his dad. He flashes back on his childhood memories of all the cool things his dad taught him, and his father’s strict upbringing.
He feels that maybe the janitor is starting to turn dad’s lights out one by one. And Davidson knows that may be true. But he wants his father to be as healthy as possible until that last day.
He urges his father to consider hormone replacement therapy: “If you do it under a responsible physician, it won’t harm you, and there’s a good chance it may even help you. A lot, maybe. We’ve discovered how to safely introduce only a handful of hormones. As our knowledge advances, we may be able to implement the entire hormone spectrum, the results of which could be extraordinary.”
With love, Craig
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