• Exploring the role of testosterone in the cerebellum link to neuroticism: From adolescence to early adulthood

    Highlights

    • •Cerebellar volumes correlate inversely with neurotic personality traits in adolescents and young adults.
    • •In males, higher endogenous testosterone levels is associated with lower scores on neurotic personality traits and larger cerebellar gray matter volumes.
    • •Testosterone significantly mediates the relation between cerebellar gray matter and measures of neuroticism.

    Abstract

    Previous research has found an association between a smaller cerebellar volume and higher levels of neuroticism. The steroid hormone testosterone reduces stress responses and the susceptibility to negative mood. Together with in vitro studies showing a positive effect of testosterone on cerebellar gray matter volumes, we set out to explore the role of testosterone in the relation between cerebellar gray matter and neuroticism. Structural magnetic resonance imaging scans were acquired, and indices of neurotic personality traits were assessed by administering the depression and anxiety scale of the revised NEO personality inventory and Gray’s behavioural avoidance in one hundred and forty-nine healthy volunteers between 12 and 27 years of age. Results demonstrated an inverse relation between total brain corrected cerebellar volumes and neurotic personality traits in adolescents and young adults. In males, higher endogenous testosterone levels were associated with lower scores on neurotic personality traits and larger cerebellar gray matter volumes. No such relations were observed in the female participants. Analyses showed that testosterone significantly mediated the relation between male cerebellar gray matter and measures of neuroticism. Our findings on the interrelations between endogenous testosterone, neuroticism and cerebellar morphology provide a cerebellum-oriented framework for the susceptibility to experience negative emotions and mood in adolescence and early adulthood.

    Article Source: http://www.psyneuen-journal.com/article/S0306-4530(16)30688-6/abstract?cc=y=

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  • Vitamin D – Why You are Probably NOT Getting Enough

    WHAT VITAMIN DO WE need in amounts up to 25 times higher than the government recommends for us to be healthy?

    What vitamin deficiency affects over half of the population, is almost never diagnosed, and has been linked to many cancers, high blood pressure, heart disease, diabetes, depression, fibromyalgia, chronic muscle pain, bone loss, and autoimmune diseases like multiple sclerosis?

    What vitamin is almost totally absent from our food supply?

    What vitamin is the hidden cause of so much suffering that is so easy to treat?

    The answer to all of these questions is vitamin D.

    Over the last 10 years of my practice, my focus has been to discover what the body needs to function optimally. And I have become more interested in the role of specific nutrients as the years have passed.

    Two recent studies in The Journal of Pediatric s found that 70 percent of American kids aren’t getting enough vitamin D, and this puts them at higher risk of obesity, diabetes, high blood pressure, and lower levels of good cholesterol. Low vitamin D levels also may increase a child’s risk of developing heart disease later in life.

    Overall, 7.6 million, or 9 percent, of American children were vitamin D deficient, and another 50.8 million, or 61 percent, had insufficient levels of this important vitamin in their blood.

    Over the last 5 years, I have tested almost every patient in my practice for vitamin D deficiency, and I have been shocked by the results. What’s even more amazing is what happens when my patients’ vitamin D status reaches optimal levels. Having witnessed these changes, there’s no doubt in my mind: vitamin D is an incredible asset to your health.

    That is why in today’s blog I want to explain the importance of this essential vitamin and give you 6 tips on how to optimize your vitamin D levels.

    Let’s start by looking at the massive impact vitamin D has on the health and function of every cell and gene in your body.

    How Vitamin D Regulates Your Cells and Genes

    Vitamin D has a huge impact on the health and function of your cells. It reduces cellular growth (which promotes cancer) and improves cell differentiation (which puts cells into an anti-cancer state). That makes vitamin D one of the most potent cancer inhibitors — and explains why vitamin D deficiency has been linked to colon, prostate, breast, and ovarian cancer.

    But what’s even more fascinating is how vitamin D regulates and controls genes.

    It acts on a cellular docking station ,called a receptor, that then sends messages to our genes. That’s how vitamin D controls so many different functions – from preventing cancer, reducing inflammation, boosting mood, easing muscle aches and fibromyalgia, and building bones.

    These are just a few examples of the power of vitamin D. When we don’t get enough it impacts every area of our biology, because it affects the way our cells and genes function. And many of us are deficient for one simple reason …

    For example, one study found that vitamin D supplementation could reduce the risk of getting type 1 diabetes by 80 percent.

    Your body makes vitamin D when it’s exposed to sunlight. In fact, 80 to 100 percent of the vitamin D we need comes from the sun. The sun exposure that makes our skin a bit red (called 1 minimum erythemal dose) produces the equivalent of 10,000 to 25,000 international units (IU) of vitamin D in our bodies.

    The problem is that most of us aren’t exposed to enough sunlight.

    Overuse of sunscreen is one reason. While these product help protect against skin cancer – they also block a whopping 97 percent of your body’s vitamin D production.

    If you live in a northern climate, you’re not getting enough sun (and therefore vitamin D), especially during winter. And you’re probably not eating enough of the few natural dietary sources of vitamin D: fatty wild fish like mackerel, herring, and cod liver oil.

    Plus, aging skin produces less vitamin D — the average 70 year-old person creates only 25 percent of the vitamin D that a 20 year-old does. Skin color makes a difference, too. People with dark skin also produce less vitamin D. And I’ve seen very severe deficiencies in Orthodox Jews and Muslims who keep themselves covered all the time.

    With all these causes of vitamin D deficiency, you can see why supplementing with enough of this vitamin is so important. Unfortunately, you aren’t really being told the right amount of vitamin D to take.

    The government recommends 200 to 600 IU of vitamin D a day. This is the amount you need to prevent rickets, a disease caused by vitamin D deficiency. But the real question is: How much vitamin D do we need for OPTIMAL health? How much do we need to prevent autoimmune diseases, high blood pressure, fibromyalgia, depression, osteoporosis, and even cancer?

    The answer is: Much more than you think .

    Recent research by vitamin D pioneer Dr. Michael Holick, Professor of Medicine, Physiology, and Dermatology at Boston University School of Medicine, recommends intakes of up to 2,000 IU a day — or enough to keep blood levels of 25 hydroxy vitamin D at between 75 to 125 nmol/L (nanomoles per liter). That may sound high, but it’s still safe: Lifeguards have levels of 250 nmol/L without toxicity.

    Our government currently recommends 2,000 IU as the upper limit for vitamin D — but even that may not be high enough for our sun-deprived population! In countries where sun exposure provides the equivalent of 10,000 IU a day and people have vitamin D blood levels of 105 to 163 nmol/L, autoimmune diseases (like multiple sclerosis, type 1 diabetes, inflammatory bowel disease, rheumatoid arthritis, and lupus) are uncommon.

    Don’t be scared that amounts that high are toxic: One study of healthy young men receiving 10,000 IU of vitamin D for 20 weeks showed no toxicity.

    The question that remains is: How can you get the right amounts of vitamin D?

    6 Tips for Getting the Right Amount of Vitamin D

    Unless you’re spending all your time at the beach, eating 30 ounces of wild salmon a day, or downing 10 tablespoons of cod liver oil a day, supplementing with vitamin D is essential. The exact amount needed to get your blood levels to the optimal range (100 to160 nmol/L) will vary depending on your age, how far north you live, how much time you spend in the sun, and even the time of the year. But once you reach optimal levels, you’ll be amazed at the results.

    For example, one study found that vitamin D supplementation could reduce the risk of getting type 1 diabetes by 80 percent. In the Nurses’ Health Study (a study of more than 130,000 nurses over 3 decades), vitamin D supplementation reduced the risk of multiple sclerosis by 40 percent.

    I’ve seen many patients with chronic muscle aches and pains and fibromyalgia who are vitamin D deficient – a phenomenon that’s been documented in studies. Their symptoms improve when they are treated with vitamin D.

    Finally, vitamin D has been shown to help prevent and treat osteoporosis. In fact, it’s even more important than calcium. That’s because your body needs vitamin D to be able to properly absorb calcium. Without adequate levels of vitamin D, the intestine absorbs only 10 to 15 percent of dietary calcium. Research shows that the bone-protective benefits of vitamin D keep increasing with the dose.

    So here is my advice for getting optimal levels of vitamin D:

    1. 1. Get tested for 25 OH vitamin D. The current ranges for “normal” are 25 to 137 nmol/L or 10 to 55 ng/ml. These are fine if you want to prevent rickets – but NOT for optimal health. In that case, the range should be 100 to 160 nmol/L or 40 to 65 ng/ml. In the future, we may raise this “optimal” level even higher.
    1. 2. Take the right type of vitamin D. The only active form of vitamin D is vitamin D3 (cholecalciferol). Look for this type. Many vitamins and prescriptions of vitamin D have vitamin D2 – which is not biologically active.
    1. 3. Take the right amount of vitamin D. If you have a deficiency, you should correct it with 5,000 to 10,000 IU of vitamin D3 a day for 3 months — but only under a doctor’s supervision. For maintenance, take 2,000 to 4,000 IU a day of vitamin D3. Some people may need higher doses over the long run to maintain optimal levels because of differences in vitamin D receptors, living in northern latitudes, indoor living, or skin color.
    1. 4. Monitor your vitamin D status until you are in the optimal range. If you are taking high doses (10,000 IU a day) your doctor must also check your calcium, phosphorous, and parathyroid hormone levels every 3 months.
    1. 5. Remember that it takes up to 6 to 10 months to “fill up the tank” for vitamin D if you’re deficient. Once this occurs, you can lower the dose to the maintenance dose of 2,000 to 4,000 units a day.
    1. 6. Try to eat dietary sources of vitamin D. These include:
      1. • Fish liver oils, such as cod liver oil. One tablespoon (15 ml) = 1,360 IU of vitamin D
      1. • Cooked wild salmon. (3.5) ounces = 360 IU of vitamin D
      1. • Cooked mackerel. (3.5) ounces = 345 IU of vitamin D
      1. • Sardines, canned in oil, drained. (1.75) ounces = 250 IU of vitamin D
      1. • One whole egg = (20) IU of vitamin D

    You can now see why I feel so passionately about vitamin D. This vitamin is critical for good health. So start aiming for optimal levels – and watch how your health improves.

    By: Mark Hyman, MD

    Article Source: http://drhyman.com/blog/2010/08/24/vitamin-d-why-you-are-probably-not-getting-enough/

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  • Poor Oral Health May Signal Prostate Issues

    Treating gum disease reduces symptoms of prostate inflammation (prostatitis).

    Prostatitis is a chronic inflammation of the prostate gland that can compromise a man’s quality of life. Naif Alwithanani, from Case Western Reserve University (Ohio, USA), and colleagues studied 27 men, ages 21 years and older, each of whom were diagnosed with prostatitis within the past year (via biopsy and prostate specific antigen [PSA] test). The men were assessed for symptoms of prostate disease by answering questions on the International-Prostate Symptom Score (IPSS) test. Of the 27 participants, 21 had no or mild inflammation, but 15 had biopsy-confirmed malignancies, and 2 had both inflammation and a malignancy. Each of the subjects had at least 18 teeth, and all of them showed moderate to severe gum disease. They received treatment and were tested again for periodontal disease four to eight weeks later and showed significant improvement. During the periodontal care, the men received no treatment for their prostate conditions. But even without prostate treatment, 21 of the 27 men showed decreased levels of PSA. Those with the highest levels of inflammation benefited the most from the periodontal treatment. Six participants showed no changes. Symptom scores on the IPSS test also showed improvement. The study authors write that: “Periodontal treatment improved prostate symptom score and lowered PSA value in men afflicted with chronic periodontitis.”

    Article Source: http://www.worldhealth.net/news/poor-oral-health-may-signal-prostate-issues/

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  • Testosterone Replacement May Lower Cardiovascular Risks

    Testosterone replacement therapy (TRT) is associated with a lower risk of adverse cardiovascular (CV) events among men with testosterone deficiency, according to a new study.

    Researchers led by T. Craig Cheetham, PharmD, MS, of the Southern California Permanente Medical Group, identified a retrospective cohort of 44,335 men aged 40 years and older with evidence of testosterone deficiency. The cohort included 8808 men who had ever been dispensed testosterone (ever-TRT group) and 35,527 men never dispensed testosterone (never-TRT group). The primary outcome was a composite of cardiovascular endpoints that included acute myocardial infarction (AMI), coronary revascularization, unstable angina, stroke, transient ischemic attack (TIA), and sudden cardiac death (SCD).

    After a median follow-up of 3.2 years in the never-TRT group and 4.2 years in the ever-TRT group, the rates of the composite endpoint were significantly higher in the never-TRT than ever-TRT group (23.9 vs 16.9 per 1000 person-years), Dr Cheetham and colleagues reported online ahead of print in JAMA Internal Medicine . After adjusting for potential confounders, the ever-TRT group had a significant 33% lower risk of the primary outcome compared with the never-TRT group. The investigators found similar results when looking separately at combined cardiac events (AMI, SCD, unstable angina, coronary revascularization) and combined stroke events (stroke and TIA). The ever-TRT group had a significant 34% and 28% lower risk of cardiac events and stroke events compared with the never-TRT group, respectively.

    “While these findings differ from those of recently published observational studies of TRT, they are consistent with other evidence of CV risk and the benefits of TRT in androgen-deficient men,” the investigators wrote.

    Previous studies have found an association between low serum testosterone levels in aging men and an increased risk of coronary artery disease as well as an inverse relationship between serum testosterone and carotid intima thickness, Dr Cheetham’s team pointed out.

    The never-TRT and ever TRT groups had a mean age of 59.8 and 58.4 years, respectively. In the never-TRT group, 13,824 men (38.9%) were aged 40 to 55 years, 10,902 (30.7%) were aged 56 to 65 years, and 10,801 (30.4%) were older than 65 years. In the ever-TRT group, 3746 men (42.5%) were aged 40 to 55, 2899 (32.9%) were aged 56 to 65 years, and 2163 (24.6%) were older than 65 years. The groups were similar with respect to race and ethnicity composition.

    The researchers defined testosterone deficiency as a coded diagnosis and/or a morning serum total testosterone level below 300 ng/dL.

    With regard to study limitations, the investigators noted that their criterion for identifying men with testosterone deficiency (a diagnosis or at least 1 morning testosterone measurement) does not meet the strict criteria established by the Endocrine Society. “Therefore some individuals in the study could be misclassified as being androgen-deficient.” In addition, as the study was observational in design, “unmeasured confounding may have had an influence on the results; unmeasured confounders could possibly influence clinicians to selectively use testosterone in healthier patients.”

    In an accompanying editorial, Eric Orwoll, MD, of Oregon Health & Sciences University in Portland, commented that while the study by Dr Cheetham’s group “provides reassuring data concerning the effects of testosterone on cardiovascular health, convincing answers about this question—and other safety issues like prostate health—remain elusive and will require large, prospective randomized trials.

    “At this point, clinicians and their patients should remain aware that the cardiovascular risks and benefits of testosterone replacement in older hypogonadal men have not been adequately resolved.”

    Reference

    1. Cheetham TC, An JJ, Jacobsen SJ et al. Assocation of testosterone replacement therapy with cardiovascular outcomes among men with androgen deficiency. JAMA Intern Med 2017; published online ahead of print. doi: 10.1001/jamainternmed.2016.9546

    Jody A. Charnow, Editor

    Article Source: http://www.renalandurologynews.com/hypogonadism/testosterone-deficiency-treated-trt-may-reduce-cardiovascular-events/article/639486/

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