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See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/ Most of you know that when I replace hormones for my female patients, I only use bioidentical estradiol and testosterone in the form of long lasting (3-6 months) subcutaneous pellets. I have limited my practice to this type of delivery system because pellets deliver the most stable dose with the fewest side effects, while supplying a steady supply of testosterone compared to other delivery forms of bioidentical testosterone. However, no medical treatment is perfect for everyone, and it is important to know what the side effects of any treatment is both as a doctor and a patient. There is no medical care that I know of that does not create complaints of some form by patients. Sometimes it is because they have not listened, or not read our literature given them at their appointment. We try to prepare patients for the temporary symptoms of their first Testosterone insertion There are several problems that occur during the first 4 months after the T pellets are inserted. These side effects are treatable and temporary. and usually present during the first 4 months after the first pellet insertion. I will dedicate the accompanying Healthcast to the early side effects of testosterone pellets and what we recommend lessening these effects. Of all the types of testosterone replacement for women, pellet replacement has fewer and less severe side effects than all other forms of testosterone for women. The immediate side effects of this type of testosterone Temporary issues in the first 4 months: • Vaginal Itching-not an infection! • Clitoral enlargement! • Hyper-sexuality • Weight Gain=muscle gain These four complaints compose the most common phone calls we get after treatment with Testosterone pellets, even though we give our patients handouts preparing them for the adaptation changes the female body goes through when readjusting to testosterone blood levels in their bodies. The changes caused by testosterone deficiency occur slowly, so slowly in fact that you may not realize the numbness of the vulva and vagina, the shrinkage of the clitoris and vaginal opening, and lack of libido and muscle mass that accompanies loss of T. It takes several months for reversal of those deficiency symptoms and the adaptation that takes place as everything goes back to the normal you were accustomed to when you were younger, before testosterone became deficient. It is the re-adaptation to testosterone that causes the symptoms during the first 4 months. For a full video describing these issues and the treatments, please go to my website biobalancehealth.com watch the videocast for #601. This presentation will include the slides and audio explaining them. You can also go to You Tube to view the short lectures and slides about the side effects of testosterone pellets in women #600-603.

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How Testosterone Affects Fat Loss: Real Science of Low-T | Thomas DeLauer: I'm sick of the lack of legitimacy behind testosterone, so let's clear some of this up. I work with a lot of men that are battling Low-T by helping them with their lifestyle at http://www.ThomasDeLauer.com As men age, their testosterone levels decline. This is exacerbated by an increase in SHBG (sex-hormone binding globulin), which binds to testosterone and thus reduces the amount of free testosterone in the body. Low testosterone levels have been linked to obesity and many other health problems, including fatigue, memory problems and reduced muscle and bone mass. So what is the impact of testosterone on body fat? Testosterone and energy - low levels of testosterone are linked with low energy levels. Regaining regular testosterone levels can increase energy and lead to weight loss. Studies have found that testosterone supplementation reduces total body fat percentages. Obesity is often correlated with low testosterone levels in men. Just as testosterone therapy is associated with decreased obesity, losing weight is associated with increased testosterone levels. An article published in 2014 in the journal of Current Opinion in Endocrinology, Diabetes and Obesity looked at the existing data regarding testosterone therapy in overweight and obese men with testosterone deficiency (hypogonadism). -Many weight loss supplements have dangerous side effects or are ineffective -Looked at weight loss, BMI, waist circumference and body composition -Evaluated long-term testosterone therapy -About 40% of obese nondiabetic men and 50% of obese diabetic men over 45 have low levels of free testosterone -Many studies have found that testosterone therapy in obese men is correlated with increased lean body mass, weight loss, decreased BMI and reduced waist circumference. -Weight loss is significant and sustained with long-term testosterone therapy Testosterone plays a part in protein, fat and carbohydrate metabolism. -Testosterone is involved with mitochondrial function and thus energy production and utilization -This interference with energy production is likely why those with low testosterone levels experience a lack of energy -Testosterone therapy has been found to increase lipid oxidation and normalize glucose use in the body. It was found to increase energy and motivation. Weight gain is associated with an 88% increase in body fat and a 12% increase in lean body mass (LBM) and weight loss with a 72% decrease in body fat and a 28% decrease in LBM. -With testosterone therapy LBM has been shown to increase. -Increased LBM means increased energy expenditure at rest -Testosterone therapy is also associated with improved cardiometabolic function Testosterone deficiency is linked with a decrease in energy metabolism from fat and an increase in energy metabolism from glucose. -Testosterone therapy has been shown to increase lipid metabolism Safety? Safety is the main concern with testosterone replacement therapy. Possible risks discussed in literature include: -Increased risk of prostate and breast cancer -Liver toxicity and tumors -Sleep apnea exacerbation -Testicular infertility and atrophy It is necessary to talk with your doctor before starting testosterone therapy. Summary: If you are a male struggling to lose weight, testosterone therapy is a promising treatment to help with not only weight loss but body composition, energy levels and overall health. References: 1. Dose-dependent effects of testosterone on regional adipose tissue distribution… http://press.endocrine.org/doi/10.1210/jc.2003-031492?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmed 2. Testosterone and weight loss: the evidence https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4154787/ 3. Effects of testosterone treatment on body fat and lean mass in obese men on a hypocaloric diet… https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5054608/ 4. The benefits and risks of testosterone replacement therapy: a review https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2701485/

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