Scouting through the literature today revealed a study in the journal Circulation. This study showed that low testosterone was a predictor for cardiovascular disease in aging men.

Searching the archives of this same journal finds that in 1999, this study found, “Short-term intracoronary administration of testosterone, at physiological concentrations, induces coronary artery dilatation and increases coronary blood flow in men with established coronary artery disease.” The study actually infused testosterone at normal levels into the coronary arteries of men and observed the flow rate effects on the arteries. Italian researchers found that normal testosterone levels improved ischemia in men who already had heart disease according to this study.

This is one journal and 3 studies. All of these show positive findings relative to testosterone levels in aging men. Searching the endocrine literature reveals more of these kinds of studies. Looking back to last week, the bias of JAMA is more apparent the farther one looks into specialty specific journals.

The new issue of the Journal of the American Medical Association has published a Dutch study on the use of testosterone in aging men. This is interesting because the study itself comes to some interesting conclusions. The Dutch researchers concluded that oral testosterone replacement in men improves lean body mass but did not result in weight loss as seen in other studies of the hormone. They also used a quality of life measurement scale that resulted in no measurable quality of life improvement. The study also showed no improvement in cognitive function amongst those in the study. The study is followed by a lengthy comment and literature review.

Several problems with the study appear on even the first reading. While the Dutch researchers checked for low testosterone in the men in the study before starting medication they did not monitor the testosterone levels through the study. It is entirely possible that the doses of testosterone were inadequate to see the kinds of results that have been documented for testosterone before. Also, the study used oral testosterone for supplementation. Oral testosterone is not considered by those in the know to be acceptable for testosterone replacement. Even the Endocrine Society notes that there are risks of negative effects on the liver from oral testosterone only in their clinical guidelines. Additionally, the paper in JAMA refers to itself as being a “large study” despite the fact there were only 237 test subjects. I personally don’t consider anything less 1000 large, but clearly JAMA differs with me on this. Really, there are statistical rules for analyzing data from numbers as small as 30 and extrapolating to larger populations but this is a dangerous game which is also why so many studies are done over and over again.

The AMA also has a history with anti-aging medicine that’s not good. The American Academy of Anti-Aging Medicine (A4M) has on several occasions made official responses to JAMA articles on hormone replacement because JAMA coverage is universally negative despite what makes it into the endocrinology journals. The responses include this one from 2002 and this one from early 2007. JAMA and the AMA have demonstrated what appear to me to be a political bias against hormone replacement as demonstrated by their ongoing choice to publish only negative studies of hormone replacement.

Since JAMA is very widely read by physicians and covered heavily in the mainstream media, it’s important to make sure you find a physician that reads more than just JAMA if you intend to age against the machine.

A major dermatology journal has confirmed what we already knew. It takes more Botox to get the same results in men. This isn’t new information but having a peer reviewed article like this one might help men understand better why it costs so much more for their Botox than it does for women.

Botox is a commodity product that prices out by the unit. Often when a provider charges “per area” they are figuring towards 15-20 units per area of the face. That’s enough to be sure that most women will get a good result. Obviously, with men needing often twice that much it’s much more difficult to price “per area.” Per unit pricing makes more sense for everyone.

Don’t get confused or ripped off with “per area” pricing. Make sure that you’re getting what you are paying for. Here in Las Vegas, the going rate for Botox Cosmetic seems to be about $12/unit. That means that a $240 “area” should be 20 units. Make sure you’re getting what you pay for. Interested in laser treatment? Check out the moxi laser before and after here!

So much of anti-aging and regenerative medicine thinking hinges on the idea of reducing inflammation. Lacking the right hormones or being overweight can lead to inflammatory states that increase the risk of “age related” disease like heart disease, diabetes, atherosclerosis, and even diseases like Alzheimer’s. Because of this, there’s lots of scientific work being put into looking at inflammatory markers and how to control them. The thinking has been since fish oil (specifically the EPA+DHA fatty acids) reduce inflammation to the point they are effective supplements to reduce this inflammatory cascade. This fish oil fraction has been shown to impact things like serum triglycerides in a positive way so the thinking is that they are valuable to supplement.

This month, the Journal of Nutrition has a couple of studies that relate directly to fish oil. Some Japanese researchers demonstrated that fat metabolism is upregulated when the diet of mice is supplemented with fish oil. The same issue also contains a study that demonstrates that weight loss of about 10kg is more effective at reducing inflammatory markers than fish oil supplementation for obese men. A goldmine of fish oil data, the journal also has a piece on human monocytes (cells involved in the inflammatory process) that are inhibited by use of fish oil. The study is a little soft but the effect is definitely there.

The world of supplements is full of plenty of bunkum but the value of fish oil supplementation is clear and getting clearer. The more we understand about fish oil fatty acids and how they impact human metabolism the more refined the recommendations will get to be. For now, some supplementation is probably better than none. Check the contents of your fish oil supplements to make sure they have as much of the EPA+DHA fatty acids as possible since that seems to be where the metabolic action is.

An actual clinical trial of hGH (human growth hormone) was conducted and published here. The trial shows that patients with low IGF-I (the blood factor that we follow for growth hormone) and fibromyalgia saw improvement in their fibromyalgia pain with regular dosing of hGH. This shouldn’t come as a surprise since hGH and IGF-I both are involved in various enzyme cascades including those associated with inflammation. Also, for someone with low levels of hGH to do better when supplemented isn’t a surprise either.