How Low Testosterone Affects Health, Mood, and Sex

Researchers are unlocking the mysteries of how low testosterone is related to men's overall health. Along the way, they're uncovering connections between low testosterone and other health conditions.

Diabetes, metabolic syndrome, obesity, and high blood pressure have all been linked to testosterone deficiency. Low testosterone isn't known to cause these health problems, and replacing testosterone isn't the cure. Still, the associations between low testosterone and other medical conditions are interesting and worth a look.

Does Low Testosterone Indicate Poor Health?

In recent years, researchers have noticed general links between low testosterone and other medical conditions. One showed that in 2,100 men over age 45, the odds of having low testosterone were:

• 2.4 times higher for obese men
• 2.1 times higher for men with diabetes
• 1.8 times higher for men with high blood pressure

Experts don't suggest that low testosterone causes these conditions. In fact, it might be the other way around. That is, men with medical problems or who are in poor general health might then develop low testosterone.

Research into the relationship between low testosterone and several other health conditions is ongoing.

Diabetes and Low Testosterone

A link between diabetes and low testosterone is well established. Men with diabetes are more likely to have low testosterone. And men with low testosterone are more likely to later develop diabetes. Testosterone helps the body's tissues take up more blood sugar in response to insulin. Men with low testosterone more often have insulin resistance: they need to produce more insulin to keep blood sugar normal.

As many as half of men with diabetes have low testosterone, when randomly tested. Scientists aren't sure whether diabetes causes low testosterone, or the other way around. More research is needed, but short-term studies show testosterone replacement may improve blood sugar levels and obesity in men with low testosterone.

Obesity and Low Testosterone

Obesity and low testosterone are tightly linked. Obese men are more likely to have low testosterone. Men with very low testosterone are also more likely to become obese.

Fat cells metabolize testosterone to estrogen, lowering testosterone levels. Also, obesity reduces levels of sex hormone binding globulin (SHBG), a protein that carries testosterone in the blood. Less SHBG means less testosterone.

Losing weight through exercise can increase testosterone levels. Testosterone supplements in men with low testosterone can also reduce obesity slightly.

Metabolic Syndrome and Low Testosterone

Metabolic syndrome is the name for a condition that includes the presence of abnormal cholesterol levels, high blood pressure, waistline obesity, and high blood sugar. Metabolic syndrome increases the risk for heart attacks and strokes.

Studies show that men with low testosterone are more likely to develop metabolic syndrome. In short-term studies, testosterone replacement improved blood sugar levels and obesity in men with low testosterone. The long-range benefits and risks are still unknown.

Testosterone and Heart Disease

Testosterone has mixed effects on the arteries. Many experts believe testosterone contributes to the higher rates of heart disease and high blood pressure that tend to affect men at younger ages. By this reasoning, high testosterone might be bad for the heart.

But testosterone deficiency is connected to insulin resistance, obesity, and diabetes. Each of these problems increases cardiovascular risk. Men with diabetes and low testosterone also have higher rates of atherosclerosis, or hardening of the arteries.

A certain amount of testosterone may be necessary for healthy arteries because it's converted into estrogen, which protects arteries from damage. As yet, no studies show that testosterone replacement protects the heart or prevents heart attacks.

Testosterone and Other Conditions

Low testosterone often exists with other medical conditions:

• Depression: In a study of almost 4,000 men older than 70, those with the lowest testosterone levels were more than twice as likely to be depressed. This link remained even after allowing for age, general health, obesity, and other variables.
• Erectile dysfunction (ED): Problems with erections are one of the most common symptoms of low testosterone. Most ED is caused by atherosclerosis. Men with risk factors for atherosclerosis -- diabetes, metabolic syndrome, or obesity -- often have low testosterone, too.
• High blood pressure: The effects of testosterone on blood pressure are many and complex. Men with high blood pressure may be almost twice as likely to have low testosterone as men with normal blood pressure. On the other hand, too much testosterone can increase blood pressure. Testosterone acts in multiple ways on blood vessels, so this may account for the varying effects.

Testosterone Replacement Treatment Options

The question that remains is, does low testosterone cause or worsen medical problems like diabetes? Or are people who develop diabetes, or other health problems, simply more likely to also have low testosterone?

Studies to answer these questions are under way, but it will be years before we know the results. In the meantime, remember that testosterone replacement hasn't been conclusively shown to improve any health condition other than testosterone deficiency and its symptoms. For men with low testosterone levels as measured by a blood test who also have symptoms of low testosterone, the decision to take testosterone replacement is one to make with your doctor.

25 Top Heart-Healthy Foods

25 Top Heart-Healthy Foods

With the help of these nutrition experts from The Cleveland Clinic and the American Dietetic Association, we've put together a list of the "best of the best" heart-healthy foods.

The foods listed here are all top-performers in protecting your heart and blood vessels. We've also got menu ideas -- so you can easily bring heart-healthy foods into your daily breakfast, lunch, and dinner.

1. Salmon

Omega-3 fatty acids.

Grill salmon with a yummy rub or marinade. Save a chunk to chop for a pasta or salad later on.

2. Flaxseed (ground)

Omega-3 fatty acids; fiber, phytoestrogens.

Ground flaxseed hides easily in all sorts of foods -- yogurt parfaits, morning cereal, homemade muffins, or cookies.

3. Oatmeal

Omega-3 fatty acids; magnesium; potassium; folate; niacin; calcium; soluble fiber.

Top hot oatmeal with fresh berries. Oatmeal-and-raisin cookies are a hearty treat.

4. Black or Kidney Beans

B-complex vitamins; niacin; folate; magnesium; omega-3 fatty acids; calcium; soluble fiber.

Give soup or salad a nutrient boost -- stir in some beans.

5. Almonds

Plant omega-3 fatty acids; vitamin E; magnesium; fiber; heart-favorable mono- and polyunsaturated fats; phytosterols.

Mix a few almonds (and berries) into low-fat yogurt, trail mix, or fruit salads.

6. Walnuts

Plant omega-3 fatty acids; vitamin E; magnesium; folate; fiber; heart-favorable mono- and polyunsaturated fats; phytosterols.

Walnuts add flavorful crunch to salads, pastas, cookies, muffins, even pancakes.Catechins and reservatrol (flavonoids).

    7.Red Wine

Toast your good health! A glass of red wine could improve "good" HDL cholesterol.

8. Tuna

Omega-3 fatty acids; folate; niacin.

Here's lunch: Salad greens, fresh fruit, canned tuna. Keep "Salad Spritzer" - a light dressing -- in your office fridge.

9. Tofu

Niacin; folate; calcium; magnesium; potassium.

Tasty tofu is easy: Thinly slice "firm" tofu, marinate several hours, grill or stir-fry.

10. Brown rice

B-complex vitamins; fiber; niacin; magnesium, fiber.

Microwavable brown rice makes a quick lunch. Stir in a few chopped veggies (broccoli, carrots, spinach).

11. Soy milk

Isoflavones (a flavonoid); B-complex vitamins; niacin; folate, calcium; magnesium; potassium; phytoestrogens.

Soy milk is great over oatmeal or whole-grain cereal. Or, make a smoothie with soy milk.

12. Blueberries

Beta-carotene and lutein (carotenoids); anthocyanin (a flavonoid); ellagic acid (a polyphenol); vitamin C; folate; calcium, magnesium; potassium; fiber.

Cranberries, strawberries, raspberries are potent, too -- for trail mixes, muffins, salads!

13. Carrots

Alpha-carotene (a carotenoid); fiber.

Baby carrots are sweet for lunch. Sneak shredded carrots into spaghetti sauce or muffin batter.

14. Spinach

Lutein (a carotenoid); B-complex vitamins; folate; magnesium; potassium; calcium; fiber.

Pick spinach (not lettuce) for nutrient-packed salads and sandwiches.

15. Broccoli

Beta-carotene (a carotenoid); Vitamins C and E; potassium; folate; calcium; fiber.

Chop fresh broccoli into store-bought soup. For a veggie dip, try hummus (chickpeas).

16. Sweet potato

Beta-carotene (a carotenoid); vitamins A, C, E; fiber.

Microwave in a zip-lock baggie for lunch. Eat au naturale, or with pineapple bits.

17. Red bell peppers

Beta-carotene and lutein (carotenoids); B-complex vitamins; folate; potassium; fiber.

Rub with olive oil, and grill or oven-roast until tender. Delicious in wraps, salads, sandwiches.

18. Asparagus

Beta-carotene and lutein (carotenoids); B-complex vitamins; folate; fiber.

Grill or steam slightly, then dress with olive oil and lemon. It's a pretty side dish.

19. Oranges

Beta-cryptoxanthin, beta- and alpha-carotene, lutein (carotenoids) and flavones (flavonoids); vitamin C; potassium; folate; fiber.

Got orange juice? Check out the new nutrient-packed blends.

20. Tomatoes

Beta- and alpha-carotene, lycopene, lutein (carotenoids); vitamin C; potassium; folate; fiber.

For a flavor twist, try oil-packed tomatoes in sandwiches, salads, pastas, pizzas.

21. Acorn squash

Beta-carotene and lutein (carotenoids); B-complex and C vitamins; folate; calcium; magnesium; potassium; fiber.

Baked squash is comfort food on a chilly day. Serve with sautéed spinach, pine nuts, raisins.

22. Cantaloupe

Alpha- and beta-carotene and lutein (carotenoids); B-complex and C vitamins; folate; potassium; fiber.

A fragrant ripe cantaloupe is perfect for breakfast, lunch, potluck dinners. Simply cut and enjoy!

23. Papaya

Beta-carotene, beta-cryptoxanthin, lutein (carotenoids); Vitamins C and E; folate; calcium; magnesium; potassium.

Serve papaya salsa with salmon: Mix papaya, pineapple, scallions, garlic, fresh lime juice, salt and black pepper.

24. Dark chocolate

Reservatrol and cocoa phenols (flavonoids).

A truffle a day lowers blood pressure, but choose 70% or higher cocoa content.

25. Tea

Catechins and flavonols (flavonoids).

Make sun tea: Combine a clear glass jar, several tea bags, and hours of sunshine.

Brest cancer increased risk of Heart Disease

Breast cancer patients who undergo radiation therapy have a slightly increased risk of ischemic heart disease within five years, and the risk persists for at least twenty years, researchers from Oxford University, England, the Karolinska Institute, Sweden, and Copenhagen University Hospital, Denmark, reported in NEJM (New England Journal of Medicine).
The authors added that the risk of developing ischemic heart disease and/or dying prematurely from heart disease is more closely linked to those with other heart disease factors, including diabetes, obesity, and smoking when radiation therapy was administered.

Ischemic (British spelling: ischaemic) heart disease is characterized by ischemia of the heart muscle - ischemia is the restri

ction in the blood supply to tissue. In most cases, ischemic heart disease is caused by coronary artery disease. Overall, in the general population, it is more common among men, people with close relatives with ischemic heart disease, regular smokers, individuals who have high cholesterollevels, diabetes, and/or hypertension (high blood pressure). Ischemic heart disease is also known as myocardial ischemia.

Doctors have always presumed that women with breast cancer who undergo radiation therapy have a higher risk of heart disease later on. However, not much was known about the specifics of the risk and whether susceptibility to ionizing radiation might affect some patients more than others.

In this study, the scientists set out to determine what impact radiotherapy (and its doses) might have on heart disease risk among women who were treated for breast cancer.

The study involved 2,200 female patients who had been administered radiation therapy for breast cancer from 1958 to 2001. The researchers used data from radiotherapy charts and medical records to estimate the mean radiation dosage to the heart. They also gathered and examined data regarding each woman's heart disease risk factors as well as their medical histories.

Radiation dosage influences heart disease risk

The team found a clear association between the radiation dose and ischemic heart disease later in life. Although the risk is real, the authors stressed that it is still small.

A higher risk of heart disease among women receiving radiation therapy for breast cancer was more evident among those with:

• angina
• other heart diseases
• chronic obstructive lung disorder
• diabetes
• obesity
• a short distance between the chest wall and the heart
• and women who smoked

The risk peaked during the first ten years after radiation therapy, and then dropped, but remained higher-than-normal for at least twenty years.

Radiation for breast cancer treatment and heart risk link studied for 40 years

Two scientists published an article in Lab Investigation in 1971 stating that radiation to the breast could damage the capillaries and restrict blood flow to the heart. Over the last 40 years studies have come up with contradictory findings. Another study published in the International Journal of Radiation Oncology/Biology/Physics (May 2007) found that older breast cancer patients with early stage disease who undergo radiation therapy have no increased risk of a heart attack. They added that "Interestingly, pre-existing cardiac risk factors such as diabetes,hypertension and hyperlipidemia do not potentiate the effects of radiation on the heart."

Heart image

5 medication-free strategies to help prevent heart disease

You can prevent heart disease by following a heart-healthy lifestyle. Here are five strategies to help you protect your heart.

1. Don't smoke or use tobacco

Smoking or using tobacco is one of the most significant risk factors for developing heart disease. Chemicals in tobacco can damage your heart and blood vessels, leading to narrowing of the arteries (atherosclerosis). Atherosclerosis can ultimately lead to a heart attack. When it comes to heart disease prevention, no amount of smoking is safe. Smokeless tobacco and low-tar and low-nicotine cigarettes also are risky, as is exposure to secondhand smoke.

In addition, the nicotine in cigarette smoke makes your heart work harder by narrowing your blood vessels and increasing your heart rate and blood pressure. Carbon monoxide in cigarette smoke replaces some of the oxygen in your blood. This increases your blood pressure by forcing your heart to work harder to supply enough oxygen. Even so-called "social smoking" — smoking only while at a bar or restaurant with friends — is dangerous and increases the risk of heart disease.

Women who smoke and take birth control pills are at greater risk of having a heart attack or stroke than are those who don't do either. This risk increases with age, especially in women older than 35.

The good news, though, is that when you quit smoking, your risk of heart disease drops dramatically within just one year. And no matter how long or how much you smoked, you'll start reaping rewards as soon as you quit.

2. Exercise for 30 minutes on most days of the week

Getting some regular, daily exercise can reduce your risk of fatal heart disease. And when you combine physical activity with other lifestyle measures, such as maintaining a healthy weight, the payoff is even greater.

Physical activity helps you control your weight and can reduce your chances of developing other conditions that may put a strain on your heart, such as high blood pressure, high cholesterol and diabetes. It also reduces stress, which may be a factor in heart disease.

Try getting at least 30 to 60 minutes of moderately intense physical activity most days of the week. However, even shorter amounts of exercise offer heart benefits, so if you can't meet those guidelines, don't give up. You can even break up your workout time into 10-minute sessions.

And remember that activities such as gardening, housekeeping, taking the stairs and walking the dog all count toward your total. You don't have to exercise strenuously to achieve benefits, but you can see bigger benefits by increasing the intensity, duration and frequency of your workouts.

3. Eat a heart-healthy diet

Eating a special diet called the Dietary Approaches to Stop Hypertension (DASH) eating plan can help protect your heart. Following the DASH diet means eating foods that are low in fat, cholesterol and salt. The diet is rich in fruits, vegetables, whole grains and low-fat dairy products, which can help protect your heart. Beans, other low-fat sources of protein and certain types of fish also can reduce your risk of heart disease.

Limiting certain fats you eat also is important. Of the types of fat — saturated, polyunsaturated, monounsaturated and trans fat — saturated fat and trans fat increase the risk of coronary artery disease by raising blood cholesterol levels.

Major sources of saturated fat include:

• Red meat
• Dairy products
• Coconut and palm oils

Sources of trans fat include:

• Deep-fried fast foods
• Bakery products
• Packaged snack foods
• Margarines
• Crackers

Look at the label for the term "partially hydrogenated" to avoid trans fat.

Heart-healthy eating isn't all about cutting back, though. Most people need to add more fruits and vegetables to their diet — with a goal of five to 10 servings a day. Eating that many fruits and vegetables can not only help prevent heart disease, but also may help prevent cancer.

Omega-3 fatty acids, a type of polyunsaturated fat, may decrease your risk of heart attack, protect against irregular heartbeats and lower blood pressure. Some fish, such as salmon and mackerel, are a good natural source of omega-3s. Omega-3s are present in smaller amounts in flaxseed oil, walnut oil, soybean oil and canola oil, and they can also be found in supplements.

Following a heart-healthy diet also means drinking alcohol only in moderation — no more than two drinks a day for men, and one a day for women. At that moderate level, alcohol can have a protective effect on your heart. More than that becomes a health hazard.

4. Maintain a healthy weight

As you put on weight in adulthood, your weight gain is mostly fat rather than muscle. This excess weight can lead to conditions that increase your chances of heart disease — high blood pressure, high cholesterol and diabetes.

One way to see if your weight is healthy is to calculate your body mass index (BMI), which considers your height and weight in determining whether you have a healthy or unhealthy percentage of body fat. BMI numbers 25 and higher are associated with higher blood fats, higher blood pressure, and an increased risk of heart disease and stroke.

The BMI is a good, but imperfect guide. Muscle weighs more than fat, for instance, and women and men who are very muscular and physically fit can have high BMIs without added health risks. Because of that, waist circumference also is a useful tool to measure how much abdominal fat you have:

• Men are considered overweight if their waist measurement is greater than 40 inches (101.6 centimeters, or cm)
• Women are overweight if their waist measurement is greater than 35 inches (88.9 cm)

Even a small weight loss can be beneficial. Reducing your weight by just 10 percent can decrease your blood pressure, lower your blood cholesterol level and reduce your risk of diabetes.

5. Get regular health screenings

High blood pressure and high cholesterol can damage your heart and blood vessels. But without testing for them, you probably won't know whether you have these conditions. Regular screening can tell you what your numbers are and whether you need to take action.

• Blood pressure. Regular blood pressure screenings start in childhood. Adults should have their blood pressure checked at least every two years. You may need more-frequent checks if your numbers aren't ideal or if you have other risk factors for heart disease. Optimal blood pressure is less than 120/80 millimeters of mercury.
• Cholesterol levels. Adults should have their cholesterol measured at least once every five years starting at age 20. You may need more frequent testing if your numbers aren't optimal or if you have other risk factors for heart disease. Some children may need their blood cholesterol tested if they have a strong family history of heart disease.
• Diabetes screening. Since diabetes is a risk factor for developing heart disease, you may want to consider being screened for diabetes. Talk to your doctor about when you should have a fasting blood sugar test to check for diabetes. Depending on your risk factors, such as being overweight or a family history of diabetes, your doctor may recommend first testing you for diabetes sometime between ages 30 and 45, and then retesting every three to five years.