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The Effects of Elevated Homocysteine Levels on Health and Well-Being

Written by Dr. Di Santo, Published on 06 November 2018

What Is Homocysteine?

Homocysteine is an amino acid byproduct resulting from the breakdown of protein via metabolism. Escalated levels of Homocysteine in the bloodstream are associated with a heightened incidence of stroke and heart attack. Medical researchers are still unsure of the exact reasons for this increased risk, but it's hypothesized that high concentrations of Homocysteine adversely affect arterial walls, leading to damage which encourages the formation of dangerous plaque. It's also believed that excess Homocysteine can impact blood platelet composition, potentially leading to problems related to the creation of clots.

At this point, researchers don't know for sure whether high homocysteine levels increase the risk of cardiovascular disease. It's possible that elevated Homocysteine levels are a byproduct of some other factor that increases cardiovascular risk, or may also be a warning sign of existing issues without being a direct contributor to damage. This is similar to how Elevated levels of Prostate-Specific Antigen (PSA) are a warning sign of Prostate Cancer but do not actually contribute to cancer risk.

We're still learning a lot about how Homocysteine Levels affect health, but it's also hypothesized that high Homocysteine Levels may double the risk of Alzheimers Disease among aging individuals.

Who Is Most Likely to Experience High Homocysteine Levels?

Elevated Homocysteine Levels are generally the result of diet. Diets high in meat and low in veggies and fruits tend to produce the highest Homocysteine Levels. High animal protein intake creates lots of Homocysteine and the absence of B Vitamins (including folic acid) slows down the rate at which the body can evacuate Homocysteine from the blood.

The human body can also produce its own Homocysteine. Methionine is comprised of a methyl group attached to a Homocysteine molecule. Methionine promotes cellular reactions by donating its methyl group to other molecules, which leaves an independent Homocysteine. Vitamin B6 and Folic Acid reduce Homocysteine Levels by giving a methyl group to Homocysteine, restoring it to Methionine.

While there is some sort of correlation between elevated Homocysteine Levels and cardiovascular issues, there is no overwhelming evidence that high Homocysteine contributes to increased risk of stroke and heart disease.

Study Shows No Link Between Homocysteine Gene Mutation and Heart Disease

In the year 2012, a broad study was published in the Public Library of Science which evaluated Homocysteine's influence on heart disease risk. This study collected the medical information of 116,000 patients that had received genetic testing regarding the presence of a genetic mutation which leads to increased Homocysteine Levels. They found that individuals with this particular mutation had 20% higher levels of Homocysteine than those without the mutation. In spite of these increased Homocysteine Levels, the subjects experienced no elevated risk of Heart Disease.

On the other hand, a single study does not breed a consensus. Another study released in 2006 by the New England Journal of Medicine found that women struggling with heart disease experience quadruple the mortality risk compared to women with normal levels of Homocysteine. While the risk associated with elevated Homocysteine Levels is apparent, no conclusive evidence was provided by the study which could blame Homocysteine for Heart Disease. In relationship to the 2012 survey, high Homocysteine Levels could be a symptom of Heart Disease rather than a contributing factor.

Symptoms of High Homocysteine Levels

Elevated Homocysteine Levels are not known to directly contribute to any adverse health symptoms, though Vitamin B12 Deficiency (which leads to an increase in Homocysteine Levels) is associated with symptoms such as dizziness, fatigue, and pale skin. There are some medical issues which are related to Elevated Homocysteine, though it's likely not the root cause of them. These conditions include Alzheimers, Dementia, Stroke, Coronary Artery Disease, Heart Attack, Blood Clots, Atherosclerosis, and Osteoporosis.

What Leads to Increased Homocysteine Levels?

While the body's internal mechanisms have an impact on your Homocysteine Concentrations, there are other factors associated with diet and medication which affect Homocysteine Levels. If your Folic Acid Intake is less than 400 mcg daily your risk of High Homocysteine Levels increases. Regular coffee drinkers are more likely to test positive for elevated Homocysteine Levels, as are individuals that suffer high levels of stress. Stress increases Homocysteine Concentrations because it leads to the increased release of norepinephrine and epinephrine, both of which borrow methyl groups from methionine. If you're under a lot of stress, you should strongly consider increasing your Folic Acid intake. Thyroid Deficiency can also lead to increased Homocysteine, as well as psoriasis and kidney disease.

How Are Homocysteine Levels Evaluated?

Homocysteine Levels can be analyzed via blood test. While these blood tests aren't commonly performed, they can be beneficial for certain at-risk patients. Individuals at elevated risk for Heart Disease are sometimes tested for underlying Homocysteine Concentrations. The normal range for Homocysteine is from 4.4-10.8 umol/l.

What Can Be Done to Regulate Homocysteine Levels More Effectively?

The best ways to control Homocysteine are to manage stress and eat lots of foods high in B Vitamins. Some great options for folic acid include folate derived from beans, orange juice, and green vegetables. A quality multivitamin is a smart choice to shore up any B-Vitamin Deficiency caused by diet. You should choose a supplement which provides at least 400mcg of folic acid. You may also opt to reduce your consumption of animal protein to control your Homocysteine Levels. Many have found it highly beneficial to take a day or two off per week from meat consumption, or simply limit your daily intake of animal protein.

While there's little evidence that Homocysteine Levels lead to negative health outcomes among patients, controlling your Homocysteine Concentrations does have ancillary benefits because these changes do reduce your risk factors for other conditions which can negatively impact your health, even though the reduction in Homocysteine Levels may be an arbitrary benefit.

What Are Normal Testosterone Levels for Men and Women Throughout Life?

Written by Dr. Di Santo, Published on 15 October 2018

What Are Normal Testosterone Levels for Men and Women Throughout Life?

Testosterone Levels are dependent upon a variety of diverse factors. Most logically, Testosterone is dependent upon gender, but it is also contingent on age, health, lifestyle, and genetics. Males almost always have more Testosterone than women unless influenced by external factors such as Hormone Therapy or Hormone Suppression.

Testosterone belongs to a collection of critical hormones known as Androgens. Androgen is the catch-all term for sex hormones that are associated with male function and form. Although Androgens are expressed in higher concentrations in men, women also produce Androgens like Testosterone, though in much lower levels.

The opposite is also true. Men need Estradiol and other Estrogens for normal function but produce far less of the feminine Hormones. The majority of Testosterone produced by a woman's body is transformed into Estradiol. While the Adrenal glands produce small amounts of Testosterone for both men and women, the testes and ovaries are responsible for the majority of Testosterone secretion.

What Does Testosterone Do for Men?

Testosterone is central to the development of primary and secondary sex characteristic in men. It's responsible for the formation of the sex organs during fetal development and is responsible for spurring the maturation of the sex organs during puberty. Testosterone also plays an essential role in libido, metabolism, strength, energy level support, and reproduction.

What Does Testosterone Do for Women?

For women, Testosterone encourages fertility and facilitates libido while also promoting the creation of red blood cells and maintaining Hormone Homeostasis. Both sexes report issues with fertility and sex drive associated with Low Testosterone Levels.

What Are Healthy Testosterone Levels?

Testosterone is incredibly important, and the body thrives when Testosterone Levels are in the healthy range. While it is possible for men and women to have naturally high Testosterone Production, Low-T is the far more prevalent condition, and most people have Testosterone circulating within the healthy range, though men and women are more prone to issues related to diminishing Testosterone as they age. Testosterone is calculated using nanograms per deciliter by most physicians. Testosterone Levels are assessed via blood sample.

Abnormally Low Testosterone Levels during gestation can interfere with male fetal development. Suppressed Testosterone Levels during adolescence can delay or slow pubertal development. High Testosterone in boys can trigger early puberty.

Normal Testosterone Levels by Age

Early Development In Boys In Girls

0-5 Months Years 75-400 ng/dl 20-80 ng/dl

6 Months-9 Years Less than 20 ng/dl Less than 20 ng/dl

10-11 Years Less than 130 ng/dl Less than 44 ng/dl

During Puberty In Boys In Girls

12-13 Years Less than 800 ng/dl Less than 75 ng/dl

14 Years Less than 1200 ng/dl Less than 75 ng/dl

15-16Years 100-1200 ng/dl Less than 75 ng/dl

During Adulthood In Men In Women

17-18 Years 300-1200 ng/dl 20-75 ng/dl

19+ Years 240-950 ng/dl 8-60 ng/dl

Tanner Scale for Measuring Adolescent Development

While the guidelines above are generally correct, many physicians choose to evaluate Testosterone Levels in children and adolescents according to visual phase of development. In order to do this, doctors refer to a clinical schema known as the Tanner Scale. This scale is useful because children reach puberty and mature at different rates.

Stage I on the Tanner Scale is associated with the period before puberty, and Stage II is reached when visible signs of puberty first appear. The following provides information regarding the Testosterone Levels related to Tanner Stage in both boys and girls:

Tanner Stage In Boys In Girls

Stage I Less than 20 ng/dl Less than 20 ng/dl

Stage II 8-66 ng/dl Less than 47 ng/dl

Stage III 26-800 ng/dl 17-75 ng/dl

Stage IV 85-1,200 ng/dl 20-75 ng/dl

Stage V 300-950 ng/dl 12-60 ng/dl

What Are the Symptoms of Testosterone Deficiency in Men?

  • Low Sex Drive

  • Thin, Easily Damaged Skin

  • Issues with Concentration and Memory

  • Fatigue

  • Thinning Hair on Head, Face, and Body

  • Weight Gain

  • Depression and Anxiety

What Are the Symptoms of Testosterone Deficiency in Women?

  • Low Fertility

  • Osteopenia/Osteoporosis

  • Low Libido

  • Missed or Irregular Periods

  • Sexual Lubrication Issues

Polycystic Ovary Syndrome and Testosterone Levels

One of the most common reasons for excessive Testosterone in women is Polycystic Ovary Syndrome. Women struggling with PCOS experience elevated Testosterone Levels, which can lead to issues such as the development of facial and body hair, acne, oily skin, and absent or irregular periods.

Steroid Use and Testosterone Levels

Steroids are anabolic organic compounds which share similarities with Testosterone. Steroids are commonly used to increase body mass and build muscle. They are often utilized illicitly by men and women looking to bulk up. Steroid use and abuse can have a dramatic effect on natural Testosterone Production.

When guys abuse steroids, it can cause Testosterone Levels to drop precipitously, leading to low libido, temporary infertility, increased body/facial hair, acne, and testicular shrinkage.

In women, Steroid abuse can disrupt fertility and period timing while also causing baldness, acne, unfortunate hair growth, and deepening of the voice.

Testing for Testosterone-Related Issues in Men and Women

If an individual believes that they are having issues related to Low-T or Elevated Testosterone Levels, they should strongly consider reaching out to a doctor or Hormone Specialist for evaluation.

When evaluating for Testosterone Abnormalities, it is common for physicians to follow some general guidelines. For example, opiates have a dramatic effect upon the body's ability to produce Testosterone, so they will likely ask about prior opiate use along with the use of steroids. Men will often be measured for waist circumference, BMI, prostate/testicle size, and evaluated for signs of baldness. Women will be assessed for symptoms of masculation and also for acne and menstrual function.

How Are Testosterone Levels Tested?

Free and Total Testosterone Levels are evaluated using a blood test. To provide the most accurate results, Serum Testosterone is best tested during the morning hours, which gives the doctor the best idea regarding your peak Testosterone Production. The established Low-T Threshold for men varies depending upon the source, but most medical professionals consider Testosterone Deficiency to be associated with Testosterone Production lower than 230-350 ng/dl. Healthy women should have Testosterone Levels registering at 15-75 ng/dl.


The Relationship Between Night Sweats, Hot Flashes, and Testosterone

Written by Dr. Di Santo, Published on 20 September 2018

The Relationship Between Night Sweats, Hot Flashes, and Testosterone

Hot flashes and night sweats are two of the many signs of Hormone Imbalance. While night sweats have long been associated with Menopause, these annoying night-time events are also related to Testosterone Deficiency. Men go through a change similar to women, commonly known as Andropause. While women experience the effects of Menopause suddenly and rapidly, Andropause is a relatively slow change in comparison. As Testosterone Levels fall, the frequency and severity of symptoms increases.

What Causes Night Sweats?

Night sweats are a very common issue which impact a large portion of men and women. Around 1/3rd of patients report night sweats in the last thirty days to their doctor. There are a wide variety of causes, including some scary things like cancer, addiction, withdrawal, and infection. Even consuming spicy foods, caffeine, or hot drinks before bed can contribute to night sweats.

Some medications contribute to night sweats, such as prescriptions for diabetes and depression. While night sweats are something you should talk about with your doctor, there's no need to panic! Some of the issues most strongly correlated with night sweats are breathing issues during sleep, stress, anxiety, numbness in the feet and hands, fever, poor sleep, and anxiety attacks.

Age-Related Hormone Imbalance Among Strongest Factors Which Contribute to Night Sweats

During Menopause, 7 out of 10 women experience hot flashes. The frequency of this symptom is strongly correlated with the severity of Estrogen decline resulting from the change. While Testosterone Levels fall continuously and slowly beyond age thirty in men, once Testosterone Production falls beneath a certain threshold, men are more likely to experience some of the same symptoms as women, including low libido, hot flashes, night sweats, depression, and unhealthy changes in body composition.

This propensity for hot flashes associated with Low Testosterone Levels is displayed clearly among those receiving treatment for prostate cancer. One of the primary components of prostate cancer is a drug that suppresses the release of Androgens into the blood stream. Severe androgen deficiency leads directly to a massive increase in reports of night sweats and hot flashes.

Even having children may lead to an increase in night sweats among vulnerable males. When couples have children, the male experiences a drop in Testosterone during the partner's pregnancy and during the early development of the child. This decline in Testosterone Production occurs in order to promote the father to devote more energy and resources toward protecting and raising the child than to trying to find a mate. While this Testosterone drop isn't enough to contribute to night sweats on its own, men that display more risk factors for Low-T are more likely to develop hot sweats and night flashes during this period.

Why Does Low-T Increase the Incidence of Night Sweats and Hot Flashes?

While there is a strong correlation between Testosterone Deficiency and the increased incidence of hot flashes, researchers haven't quite figured out how Low-T triggers night sweats. What we do know is that the Hypothalamus is almost certainly a central aspect of this process, because the Hypothalamus is responsible for bioregulation, which includes controlling the body's temperature.

Upon registering that the internal temperature of the body is too high, the Hypothalamus coordinates the dilation of blood vessels which speeds up blood flow to the skin. The transfer of this heat to the skin is followed by the release of sweat which helps cool the body down. Of course, even though the end goal of this process is a cooler body, it is interpreted by the mind as an increase in heat followed by the clammy chill of a night sweat.

It's hypothesized that Low-T triggers the hypothalamus to release the signal for night sweats during sleep, even when temperature regulation isn't an issue, causing men to wake up cold, sweaty, and uncomfortable. For men with Testosterone Deficiency, night sweats are one of the more common symptoms, and patients do report significant reduction in night sweats while taking Testosterone Replacement Therapy for relief from Low-T.

Testosterone Deficiency Relief with Hormone Replacement Therapy

Though night sweats don't pose any dangers to health, they are annoying and frustrating, and may be a sign of other issues. If you're experiencing night sweats in combination with fatigue and low libido, this is a powerful sign that you are currently suffering from Testosterone Deficiency. Our Board-Certified American Hormone Clinic can help you determine if Hormone Imbalance is contributing to your declining quality of life and we can determine whether Testosterone Replacement can help you overcome night sweats, increase strength and energy, and restore sexual desire and function.

Our Fully-Licensed HRT Clinic has helped hundreds of guys throughout the country feel better about their lives. Generations of research and refinement have vastly increased the safety and effectiveness of Bio-Identical Testosterone Therapy. If you'd like additional information about starting a quality Testosterone Regimen with a trusted Hormone Provider, our HRT Specialists are available to respond to your questions and concerns!


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Correctly performed testosterone therapy can be your ticket to health.

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If your doctor only prescribes testosterone by itself, you will probably have a rough ride. The tendency is for you to feel great the first couple months, while you increase testosterone levels, followed by a slow deterioration, once your estrogen creeps up.

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