Hot Flashes and Heart Disease

Hot Flashes and Heart Disease

Written by Kathy Lynch, PharmD – Women’s International Pharmacy

Two recent studies have focused attention on cardiovascular disease (CVD) in menopausal women. The first study is a systematic review of 11 studies with a total of 
19,667 subjects. The researchers assessed the relationship between vasomotor symptoms (VMS), which included hot flashes and night sweats, and CVD risk factors, i.e., blood pressure, cholesterol, body mass index (BMI), and carotid artery measurements. They found that women with VMS had significantly higher blood pressure, BMI, and total cholesterol than women without VMS. The authors concluded that women with hot flashes and night sweats, as compared to women without these symptoms, may have unfavorable risks for heart and blood vessel disease.

The second study evaluated the likelihood of cardiac or stroke death among 332,202 Finnish women who stopped hormone therapy (HT) between 1994 and 2009. Within the first year following HT discontinuation, the risk of death from any cause was significantly elevated. The risk of dying specifically from heart problems or stroke during this first year ranged from 26%-66%. This increased risk was decidedly higher in women who began and then discontinued HT before the age of 60. Contrary to current medical belief, women who started HT after the age of 60 did not seem to be at an increased risk for cardiac death within one year after stopping HT. Current medical guidelines recommend that practitioners encourage discontinuation of HT at annual office visits. The study authors believe the safety of this practice should be reevaluated in light of their results. Further studies are needed.

What conclusions might we draw from these 2 studies? Hot flashes and night sweats are the primary reason women seek menopause-related health care. If women with VMS tend to have more risk factors for CVD, and women who start and then stop HT before the age of 60 are at a significantly increased risk for cardiac and stroke death within the first year, continuing HT might be beneficial for a subset of women with hot flashes, night sweats and CVD risk factors. As always, a thorough medical examination and health history, along with an open-minded discussion with one’s trusted health care professional, can help women decide whether continuing the use of HT might be beneficial for them.

  • Franco OH, et al. Vasomotor symptoms in women and cardiovascular risk markers: Systematic review and meta-analysis. Maturitas. 2015; 81: 353-361.
  • Mikkola TS, et al. Increased cardiovascular mortality risk in women discontinuing postmenopausal hormone therapy. J Clin Endocrinol Metab; press.endocrine.org/journal/jcem.
Hot Flashes and Heart Disease2017-12-12T17:05:57+00:00

Book Review – The Statin Disaster by Dr. David Brownstein

Book Review – The Statin Disaster by David Brownstein, MD

Written by Carol Petersen, RPh, CNP – Women’s International Pharmacy

In this latest of Dr. David Brownstein’s books, he clearly states that statin medications fail to prevent or treat heart disease for nearly everyone who takes them. He also points out the shortcomings of the “cholesterol equals heart disease” theory. Dr. Brownstein is concerned because most busy practitioners do not take the time to fully understand the statistics used in drug studies well enough to critically examine the findings. This leaves practitioners to rely solely on the conclusions presented by the study investigators, who are often funded by pharmaceutical companies interested in bringing new drugs to market. Because of this, we are exposed to exaggerated claims of effectiveness when the actual facts may show otherwise.

What Are Statins?
Statins make up a class of drugs that lower the level of cholesterol in the blood by reducing the production of cholesterol by the liver. Statins reduce production of cholesterol in the liver by blocking an enzyme responsible for cholesterol production.

Statistics
Dr. Brownstein introduces us to a statistical concept known as the “number needed to treat.” This number can be calculated from data provided in studies, telling us how many people need to be treated with a medication for one person to benefit. The ideal number is one. When the number needed to treat is one, every person treated benefits from the treatment. Examples of therapies with a very low number needed to treat include patients with type 1 diabetes using insulin and patients with low thyroid function taking thyroid.

However, many of the drugs currently in use have a high number needed to treat. Numbers of 200 or more are seen regularly in studies using statins. In other words, 200 people need to be treated before one person will benefit. This might be acceptable if statins had no adverse effects and were completely without risk. Unfortunately, this is not the case. Adverse effects associated with statin use include muscle pain and damage, digestive problems, memory loss and confusion, increased blood sugar levels and Type 2 diabetes, and liver damage. These adverse effects may not happen to everyone, but if the number needed to treat for statins is 200, 199 people out of 200 using statins are taking the risk of experiencing an adverse effect while experiencing no benefit at all from the statin drug.

Based on Dr. Brownstein’s evaluation of the studies that have been done using statins, he states statins are effective for approximately 1% who take them. In other words, statins fail 99% who take them.

Is Cholesterol Good Or Bad?
The current perception about cholesterol is that there is “good” cholesterol and “bad” cholesterol. Cholesterol is neither good nor bad. We forget how important cholesterol is to our body’s daily functions. Cholesterol is an essential substance needed by every cell in the body. The human body uses cholesterol to make hormones, vitamins, and substances that help digest foods. If cholesterol levels are too high, our body is telling us something is not right. It would make sense to pay attention to our body’s signals and try to find the underlying cause of the elevated cholesterol levels rather than using medications to artificially lower levels. In addition, driving our cholesterol levels too low may create a whole new host of problems including problems with our immune systems and our resilience to infection.

How Do Hormones Play a Role?
Let’s zero in on hormones. Cholesterol is the source material for all sex hormones including estrogens, progesterone, testosterone, and adrenal hormones such as DHEA, and hydrocortisone. Our brains depend upon the hormones made from cholesterol as much as the rest of our body does. Progesterone and pregnenolone protect the nervous tissue throughout our body. Elevated cholesterol may simply be a signal the body is working hard to replenish these hormones in the event hormone levels are low. Cholesterol levels may also increase when thyroid hormone production is inadequate. Correcting sex hormone deficiencies and hypothyroidism for patients may bring their cholesterol levels down. Dr. Brownstein says he often sees patients in his practice where supplementing with sex or thyroid hormones brings cholesterol levels back into the normal range.

Dr. Brownstein says evidence-based medicine should be used and embraced. He feels the information is out there to expose statins as “one of the greatest failures in modern medicine.” According to Dr. Brownstein, our acceptance of such poor standards is mediocre medicine. We can and should determine what really makes a difference in our health. Reading his book will get us started.

  • Brownstein D. The Statin Disaster. West Bloomfield, MI: Medical Alternatives Press; 2015 www.drbrownstein.com
Book Review – The Statin Disaster by Dr. David Brownstein2017-12-12T17:36:15+00:00

Vitamin K2 – A Missing Link in the Western Diet?

Vitamin K2 – A Missing Link in the Western Diet?

Written by Carol Petersen, RPh, CNP – Women’s International Pharmacy

In 1925 an enterprising dentist, Dr. Weston Price, and his wife began traveling the world and documenting their observations of healthy, remote populations. They observed significant changes in tooth arrangement and mouth and facial structure when people of various cultures strayed from their traditional diet and adopted the Western diet. Traditional diets varied greatly, but all consisted of animal protein and fat in the form of fish, fowl, land animals, eggs, milk and milk products, reptiles, and/or insects. The Western diet introduced processed foods, sugar, and grains. Narrowed mouths, crowded teeth, thin faces, and smaller arches appeared in children whose parents adopted the Western diet. Dr. Price suspected that something specific was missing from the Western diet. He called this mysterious factor Activator X. He demonstrated that Activator X was prevalent in the meat and milk products of animals that grazed on green grasses. He even showed that these facial and dental abnormalities could be reversed in the next generation if Activator X was replaced in the diet. Finally, in 2006, Dr. Price’s Activator X was identified to be vitamin K2.

Confusion With the K’s
There are a number of types of vitamin K, but only two natural forms: vitamin K1 and vitamin K2. Vitamin K1 is present in leafy, green vegetables and is most identified with blood clotting. The drug, Coumadin, works to prevent blood from clotting by inhibiting the action of vitamin K1. The effects of excessive Coumadin may be reversed by administering vitamin K1.

Vitamin K2 exists in a number of distinct active forms. The two most commonly seen are designated as MK-4 and MK-7. MK-4 is present in the organs, milk, eggs and cheese of grass-fed animals. MK-7 is most abundant in a bacterial ferment of soy beans called natto. It is also present in lesser amounts in other fermented foods. Vitamin K2 does not appear to share Vitamin K1’s association with blood clotting.

A Calcium Paradox
Nutritional biochemistry is complicated. In order to learn how various vitamins and minerals work in the body, we often look at the function of one single nutrient at a time. However, when we do this, we fail to understand how nutrients work together. For example, we know that bones need calcium, but supplementing with calcium alone is unlikely to strengthen one’s bones. We need to consider how a number of nutrients work together to contribute to bone health. Each of the fat soluble vitamins, A, D, E, and K, works together synergistically. Vitamin D facilitates calcium absorption into the blood stream. Vitamin K2 converts vitamin D into its active form and also activates the hormone osteocalcin to direct the calcium to the bone. A deficiency of any one of these vitamins may cause malfunctions in the body. Specifically, a deficiency of vitamin K2 may cause calcium to be stored in other tissues rather than being directed to the bone. If calcium settles in the arteries, it can lead to atherosclerosis. Calcium may also cause problems by settling in the joints and in soft tissues like the breasts.

The French Paradox Solved?
Many find it surprising that the French eat a lot of cholesterol and saturated fat and have low rates of death from coronary heart disease (CHD). Some think it’s an ingredient in red wine that keeps them healthy. Perhaps these saturated fats laden with vitamin K2 are the protective factor.

Vitamin K2 in All Parts of the Body

  • Heart Disease: One of the most powerful tools against calcification of the blood vessels is a vitamin K2 activated protein.
  • Osteoporosis: Vitamin K2 activated osteocalcin directs calcium to the bones.
  • Diabetes and Metabolic Syndrome: Vitamin K2 improves insulin sensitivity thus potentially stalling progression to metabolic syndrome and diabetes.
  • Wrinkles and Tissue Laxity: May be due to a vitamin K2 deficiency causing misplaced calcium in the skin and tissues.
  • Varicose Veins: May be due to a vitamin K2 deficiency causing calcium to deposit in the veins.
  • Arthritis: Joint damage may reflect a vitamin K2 deficiency.
  • Dental Health: Vitamin K2 may be useful in treating and preventing dental cavities.
  • Pregnancy: Adequate vitamin K2 promotes the healthy development of fetal teeth and facial structure. Also, labor may be easier when vitamin K2 levels are adequate.
  • Cancer: Vitamin K2 promotes cell differentiation and may protect against metastasis.
  • Nervous System: Vitamin K2 plays a role in nervous system protection, myelin development, and signal transduction.

Vitamin K2 and Hormones
Vitamin K2 has an important relationship with estrogen and bone health. Estrogen and bone density both decline during menopause and postmenopausal women are often markedly deficient in vitamin K2. Bone health may be improved in postmenopausal women by restoring adequate vitamin K2 levels as vitamin K2 acts in the bone loss pathway in a number of areas specific to the loss caused by low estrogen levels. Vitamin K2 also plays a role in estrogen metabolism itself. Additionally, testosterone levels and sperm production may be improved by osteocalcin, the hormone activated by vitamin K2.

Conclusion
It is remarkable that it took decades from Dr. Weston Price’s careful observations and characterization of Activator X to finally identify vitamin K2 and a number of its myriad functions. We are still not sure of the appropriate supplement dose to use or the amount of vitamin K2 rich foods to eat. Tests are being devised to help evaluate our vitamin K2 status. In the near future, we will be able to measure vitamin K2 levels as readily as we test for vitamin D now. Research has only scratched the surface of the potential of this fascinating vitamin!

Vitamin K2 – A Missing Link in the Western Diet?2018-04-05T11:10:21+00:00

Testosterone and Heart Disease

Testosterone and Heart Disease

Written by Kathy Lynch, PharmD – Women’s International Pharmacy

Evidence continues to mount that there is no scientific basis for the assumption that testosterone supplementation causes heart problems. The European Medicines Agency (EMA) recently reviewed the risk of serious cardiac problems in men using testosterone replacement.

EMA’s Pharmacovigilance Risk Assessment Committee (PRAC) looked at major heart problems, particularly heart attacks. PRAC reviewed all recent negative studies plus data from positive studies and available safety data. They concluded that there is “no consistent evidence of an increased risk of heart problems with testosterone medicines.” PRAC also noted that there is evidence that low testosterone can increase the danger of heart problems.

This position has been adopted by the European Union. The EMA does support the conservative position that only men who are low in testosterone should receive replacement. They recommend periodic monitoring of hemoglobin, hematocrit, liver function and cholesterol. They caution that men with severe heart, kidney, or liver disease avoid testosterone altogether. Patients should talk to their doctor or pharmacist for further information.

Testosterone and Heart Disease2018-04-04T17:30:45+00:00

Testosterone Replacement Therapy and Cardiovascular Disease

Testosterone Replacement Therapy and Cardiovascular Disease

Written by Kathy Lynch, PharmD – Women’s International Pharmacy

There have been few medical debates more contentious than the current controversy surrounding testosterone replacement therapy (TRT) and cardiovascular disease (CVD).

Two recent studies highlighted a possible, though far from probable, association between TRT and myocardial infarction (MI) or stroke. However, the Androgen Study Group (ASG), which was formed to respond to inaccurate attacks on TRT by the medical and public media, quickly discovered misreporting that resulted in two published corrections to one of the studies. With support from medical societies, researchers, and scientists around the world, ASG petitioned the Journal of American Medical Association (JAMA) to retract one of the misleading studies.

Dr. Neal Rouzier, a geriatric specialist who routinely prescribes testosterone to his male patients, has also been vocal in his criticism of the JAMA study. He reports that none of the 2,000 male patients he has treated with TRT experienced MI, and he maintains that 40 years of radiologic and laboratory studies demonstrate long-term protection against plaque buildup. Although low levels of testosterone have consistently been associated with an increase in CVD and mortality, Dr. Rouzier supports a cautious approach when prescribing TRT in older men with CVD or significant risk factors.

A new study, presented at the 2013 meeting of the European Association for the Study of Diabetes, found that low testosterone levels are associated with an increased number of acute MIs in diabetic men. Another recently published study found that older men who received testosterone injections did not appear to have an increased risk for MI. In fact, testosterone injections actually appear to be protective in men at high risk for MI. Clinical data compiled from 40 Low T Centers nationwide also found no association between TRT and MI or stroke.

Testosterone Replacement Therapy and Cardiovascular Disease2018-04-03T11:01:06+00:00

Book Review: Heart Attacks, Heart Failure and Diabetes by Mark Starr, MD

Book Review – Heart Attacks, Heart Failure and Diabetes: Prevention and Treatment by Mark Starr, MD(H)

Written by Carol Petersen, RPh, CNP – Women’s International Pharmacy

 

Dr. Mark Starr, the author of a classic book titled Hypothyroidism Type 2: The Epidemic, recently published a book called Heart Attacks, Heart Failure, and Diabetes: Prevention and Treatment.

You may ask, “Why is this relevant to thyroid disease?” The reason is that Dr. Starr relies heavily on the research of Dr. Broda Barnes, a pioneer in the treatment of thyroid disease, for this new book. Dr. Barnes detailed much of his research in Hypothyroidism, the Unsuspected Illness, a book published in 1976 that continues to be a mind opener for anyone interested in thyroid issues. Dr. Barnes also published a lesser known book that same year called Solved: the Riddle of Heart Attacks. (For more information on Dr. Barnes’ life work, visit http://www.brodabarnes.org/.)

One would think that the field of medicine would have evolved significantly since 1976, providing us with more insight and better treatments. Sadly, this is not the case, and we find ourselves revisiting history for enlightenment.

Dr. Starr’s new book is a touchstone back to the very careful research provided by some of the giants in medical observations and research. He goes back as far as 1918 to Dr. Hermann Zondek’s profound work, which demonstrated that the enlarged heart in congestive heart failure can and does shrink back down to normal size when the underlying hypothyroidism is treated.

Dr. Starr notes that hypothyroidism and diabetes also go hand in hand. In fact, he contends that appropriate thyroid treatment can prevent the development of many of the secondary problems of diabetes, such as blindness, atherosclerosis and neuropathies.

One of the highlights of Dr. Starr’s new book is a thorough discussion of the limitations of using TSH (thyroid stimulating hormone) as an indicator of hypothyroidism. The thyroid gland produces 4 thyroid hormones: T1, T2, T3, and T4. The majority of the hormone produced is T4, which has very weak activity. The primary action from thyroid hormones comes from T3. In order to increase the availability of T3, enzymes in the body work to remove an iodine molecule from T4 to create T3.

As it turns out, there are separate enzymes at work in the pituitary gland, where TSH is produced, and the rest of the body. Because of these separate enzyme-producing systems, the amount of active T3 in the pituitary gland can be as much as 1000 times the amount of T3 available to the rest of the body. The production of TSH will stay low until the pituitary T3 is also exhausted. The result is that the body can be in a low thyroid state, with significant symptoms, for a long time before TSH levels are signaled to increase.

There is no better teacher than personal experience. Dr. Starr relates his own health struggle with untreated (at first!) hypothyroidism, and also shares some of his patients’ experiences.

This book serves as a reminder of the fundamental nature of thyroid function in diseases that are of epidemic proportions today. If you happen to start with this book, it will likely whet your appetite for even more of the type of information offered in his first book.

  • Starr M. Heart Attacks, Heart Failure, and Diabetes. Irvine, CA: New Voice Publications; 2014.
  • Starr M. Hypothyroidism Type 2: The Epidemic. Columbia, MO: Mark Starr Trust; 2005.
  • Broda BO. Hypothyroidism: The Unsuspected Illness. New York, NY: Harper; 1976.
  • Broda O. Barnes M.D., Research Foundation Inc. http://www.brodabarnes.org/.
Book Review: Heart Attacks, Heart Failure and Diabetes by Mark Starr, MD2017-12-13T12:44:39+00:00

Homocysteine, Hormones, and Heart Disease

Homocysteine, Hormones, and Heart Disease

Written by Kathy Lynch, PharmD – Women’s International Pharmacy

High levels of homocysteine have been associated with an increased risk for heart disease and other chronic medical conditions. While age, gender, and kidney function are the primary factors that determine homocysteine levels, the B vitamins also play an important role in keeping homocysteine in check, particularly among the elderly.

The role that hormones play in the regulation of homocysteine is less clear. However, it turns out that the same B vitamins that keep homocysteine in check also help the body “methylate” or metabolize and excrete estrogens. And a high homocysteine level also typically reflects a lack of methylation, which can be a significant source of hormone imbalance.

Research suggests that higher estradiol levels in pre-menopausal women may be keeping homocysteine in check. Preliminary studies suggest that testosterone may play a role as well. Further research is needed to fully understand the relationships among homocysteine and hormone levels.

Homocysteine, Hormones, and Heart Disease2018-04-04T14:49:05+00:00

Book Review – The Magic of Cholesterol Numbers by Sergey A. Dzugan, MD, PhD

Book Review – The Magic of Cholesterol Numbers by Sergey A. Dzugan, MD, PhD

Written by Carol Petersen, RPh, CNP – Women’s International Pharmacy

 

Dr. Dzugan may just turn the medical industry upside down with this book. He sets the stage by explaining that—fueled by pictures of seriously clogged arteries—we have bought into the delusion that elevated cholesterol levels signal that cholesterol is on the warpath to attack our arteries. Statins aim to reduce cholesterol levels by interfering with the production of cholesterol, and to do so in a limited fashion; hence, they are currently the most commonly prescribed drug. Dr. Dzugan contends that this approach is not viable, and asks the question: Why does cholesterol get such a bad rap?

First of all, he says it is because cholesterol is a steroid, which in and of itself carries negative connotations. We immediately think of the synthetic testosterone-like hormones abused by body builders. Or maybe we think about prednisone, which is close enough to hydrocortisone and cortisone to relieve inflammation but does so at the cost of other severe side-effects. Dr. Dzugan believes that there is no place in the human body for these man-made hormone mimics. Cholesterol, on the other hand, is so prevalent in and important to the brain that it is formed independently in the brain. Thankfully, statin drugs cannot pass the blood brain barrier to interfere with that process!

The term “steroid” simply refers to the shape of the molecule. Hormones made by the testes, ovaries and adrenal glands are all called steroids. Vitamin D, which is produced in the skin, is a steroid. Bile, which is made in the liver to emulsify and promote absorption of fats, is a steroid. Cholesterol is essential to our body function, in and of itself, as well as being a building block for other hormones.

Dr. Dzugan also asks: Why don’t people question the basis of the so-called LDL and HDL cholesterol numbers? These are simply measures of lipoproteins (fat combined with protein) that help shuttle cholesterol around the body to where it is needed. Total cholesterol is calculated as the sum of LDL plus HDL plus triglycerides divided by five. Triglycerides are not cholesterol but are used to estimate VLDL (very low density lipoproteins), which carry about 20% cholesterol. The LDL consists of approximately 50% cholesterol and the HDL is shuttling about 30%. However, the percentage of cholesterol that each is carrying is not accounted for in the total cholesterol equation. If we were to view figuring out our true cholesterol level as a typical math word problem, we would most likely be perplexed as to how to determine the correct answer. And if we did, just exactly what would the answer mean?

Somehow, medical research has not yet answered the question: What does it mean when cholesterol levels rise? When a woman is pregnant, her cholesterol levels skyrocket. This is because a pregnant woman needs to create an astonishing amount of hormones. When cholesterol levels are high outside of pregnancy, it is possible that something is blocking the creation of the hormones made from cholesterol. When cholesterol levels are low, it is possible that there is a problem with hormone formation.

Dr. Dzugan’s theory (backed by clinical case studies and two published reports) is that high cholesterol occurs when normal hormone production is failing, and that by identifying and replenishing the deficient hormones with bioidentical hormones, cholesterol levels fall and the patient’s health improves. He believes that the cardiac risk factors associated with high cholesterol are not because of the cholesterol levels, but because of the underlying hormone deficits. Dr. Dzugan notes that changing diet rarely succeeds in lowering cholesterol levels, but restoring hormones does.

Dr. Dzugan practices what he calls “hormone-restorative therapy” rather than lipidology (a new medical practice specialty). He notes that, by restoring hormone balance, HDL levels may decrease rather than increase because higher amounts of lipoproteins are no longer needed to shuttle cholesterol back to the liver.

Dr. Dzugan is not the first to draw this connection between cholesterol levels and hormone balance. Dr. Jens Moeller reports on normalizing cholesterol levels by treating low testosterone levels in his landmark book Cholesterol: Interactions with Testosterone and Cortisol in Cardiovascular Diseases. And Dr. Broda Barnes reported in his book, Hypothyroidism: The Unsuspected Illness, that high cholesterol levels were the best blood indicators for low thyroid; he also found that high cholesterol numbers fell when those patients went through thyroid hormone therapy.

Imagine! What if the next time you visited your medical practitioner, they measured not only your cholesterol numbers but also your hormone levels and adjusted accordingly? If Dr. Dzugan’s theories ring true, this could be in your future.

Book Review – The Magic of Cholesterol Numbers by Sergey A. Dzugan, MD, PhD2017-12-14T12:14:19+00:00

Melatonin and the Heart

Melatonin and the Heart

Written by Kathy Lynch, PharmD – Women’s International Pharmacy

Melatonin is becoming more widely accepted by the scientific community as a beneficial hormone for heart health. It appears that melatonin decreases inflammation and positively affects blood pressure and cholesterol. Melatonin has also been identified as a powerful antioxidant.

Not only have low melatonin levels been observed at various stages of coronary heart disease, but the role melatonin plays in normal heart function is well established. Human coronary arteries have melatonin receptors on them, though their exact function has yet to be fully determined.

Melatonin is currently being studied to see if oral doses can protect against damage done when blood returns to a heart previously deprived of blood flow, for example, after a heart attack. Because melatonin has low toxicity and has been proven safe in varying strengths, both oral and intravenous, scientists are interested in studying melatonin for the treatment of heart disease.

For additional information on hormones and their relationship to heart health, please see our publication: Matters of the Heart.

Melatonin and the Heart2017-12-12T17:14:43+00:00

Testosterone: A Heart-Healthy Hormone?

Testosterone: A Heart-Healthy Hormone?

Written by Carol Petersen, RPh, CNP – Women’s International Pharmacy

In Maximize Your Vitality and Potency, Dr. Jonathan Wright calls testosterone “the healthy heart hormone.” His book is well referenced and he has the clinical experience to back it up. The medical literature is also full of studies indicating the importance of testosterone to the heart.

For more information on testosterone and male hormones fill out this form to receive our free packet of information on male hormone therapies.

Yet, a paper entitled “Adverse Events Associated with Testosterone Administration” published in the June 2010 New England Journal of Medicine seems to tell a different story. In this study involving a group of 209 subjects, those that were treated with testosterone had a higher rate of cardiac events than the non-treated group, and they had also begun the study with a high prevalence of hypertension, diabetes, high cholesterol, and obesity. Based on this, should we question the heart healthy benefits of testosterone?

Not so fast … in an article in Life Extension magazine, Dr. Steven Joyal, pointed out some of the study’s flaws. For one, those that had already exhibited the worst cardiovascular indicators were placed in the treated group. Second, the testosterone treatment was twice the normal starting dose. And third, no attention was given to evaluate the estrogen status of these men before, during, or after the study. No one monitored whether or not the testosterone converted directly to estrogen.

And why might that be a concern? Dr. Eugene Shippen, one of the earliest heralds of the dangers of excess estrogens in men and author of The Testosterone Syndrome, notes that elderly men may actually have more estrogen than their female counterparts of the same age. Dr. Shippen cited such factors as zinc deficiency and the use of diuretic drugs as contributing to increased estrogens in men as they age.

William Faloon, also writing in Life Extension magazine, points to a May 2009 study published in the Journal of the American Medical Association that the men in the study with chronic heart failure who also had balanced estradiol levels (not low, nor high) were the least likely to die during the three-year study. The estradiol levels in the successful group varied between 21.8 and 30.11 pg/ml, which gives us some guidelines for acceptable levels of estradiol in men.

Dr. Thierry Hertoghe points out in The Hormone Handbook that a weak heartbeat is a symptom of low testosterone, and that high estrogen levels have been associated with myocardial infarction. Excess estrogens also make a progesterone deficiency worse, further contributing to hormone imbalance, and translating into muscle tension, anxiety, nervousness, and difficulty with sleep.

So maintaining optimal testosterone levels remains at the center of heart health for men, recognizing that estrogens and progesterone also play their part.

When discussing testosterone therapy, our staff routinely suggests including either progesterone or chrysin, for example, to prevent excessive conversion of testosterone to estrogens. Our staff also recommends that men consult with their practitioners for careful monitoring of their hormone levels.

For more information on testosterone and men, follow this link to receive our Male Hormone Therapies Information Packet.

  • Wright JV. Maximize Your Vitality and Potency. Smart Publications, Petaluma, CA; 1999.
  • Basaria S, et al. Adverse Events Associated with Testosterone Administration. NEJM 2010 Jul:363(2):109-122.
  • Joyal S. Mainstream Doctors’ Ineptitude Put on Display in the New England Journal of Medicine. Life Extension. November 2010.
  • Shippen E, Fryer W. The Testosterone Syndrome: The Critical Factor for Energy, Health, and Sexuality – Reversing Male Menopause. M. Evans and Company, New York, NY; 1998.
  • Faloon W. Why Estrogen Balance is Critical to Aging Men. Life Extension. May 2010.
  • Hertoghe T. The Hormone Handbook. 2nd Edition. International Medical Publications, Walton-on-Thames, Surrey, UK; 2006.
  • Jankowski EA, et al. Circulating Estradiol and Mortality in Men with Systolic Chronic Heart Failure. JAMA 2009, May 13;301 (18) 1892-901.
Testosterone: A Heart-Healthy Hormone?2018-04-09T14:31:13+00:00