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HORMONES -
THE ROLE OF TESTOSTERONE
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CHAPTER 4: The Role Of Testosterone

Testosterone is our most important anabolic hormone, meaning that it helps cells create energy from the food we eat, builds stronger bones and muscles, and is needed by the brain for normal brain function. Considerable new evidence exists to show that prostate cancer is more likely to occur in men with high estradiol and low testosterone levels. Testosterone is primarily made in the testes, although small amounts are also made in the adrenal glands. Testosterone is responsible for the characteristically male body hair, muscle development and deep voice. From about age 40 on, testosterone levels drop at the rate of about one percent per year.

Although testosterone does play a role in male libido, it isn’t just a sex hormone. Maintaining sufficient levels of the hormone can lower LDL cholesterol, triglycerides and fibrinogen, raise HDL cholesterol and human growth hormone (HGH), lower blood pressure, normalize abnormal heart rhythms and angina, improve insulin resistance, build muscle and decrease body fat. Testosterone deficiency is associated with a higher risk of heart disease and depression. There are more testosterone receptors in the heart than in any other muscle in the body. Testosterone also builds bone, improves wound healing, improves oxygen uptake, and improves immune system function.

Excess testosterone can cause acne, headaches, anxiety, irritability and even rage (thus the expression, “testy”). Because excess testosterone spills over and becomes estrogen, it can cause water retention, breast enlargement, prostate enlargement, atrophy of the genitals, decrease in libido, and cancer. It’s possible that the misconception that testosterone causes prostate cancer has been perpetuated by conventional medicine’s routine use of grossly excessive doses of testosterone and the potent synthetic testosterones.

The Testosterone Fiasco

As I mentioned in the introduction, in 1941, Dr. Charles Huggins showed that castration (orchiectomy) slowed the progression of prostate cancer. Castration removes much of one’s testosterone production. He unfortunately assumed that the reduction of testosterone levels was the operative agent for his beneficial results. He failed to consider that castration also removes one’s estrogen production. Thus it is likely that the estrogen reduction was the real operative agent. Despite these faulty assumptions, Dr. Huggins was given the Nobel Prize for his research. As a result, conventional medicine came to believe that testosterone was the culprit in causing prostate cancer. The prevention and treatment of prostate cancer focused on either removing the prostate gland or reducing testosterone, or both. Techniques were found to castrate men surgically or chemically, as in Lupron, for example. Other doctors opted for radiation. In all of these treatments, all sex hormone production by the testes is stopped or arrested, and undesirable side effects are common. The sad fact is that survival of men with prostate cancer has not improved with these treatments. Further drugs (e.g., flutamide) were developed to block all testosterone receptors (called total androgen blockade), thus eliminating the testosterone effect completely. It is now conceded that survival time is not affected; the men so treated instead developed depression, dementia, and diarrhea before dying right on time.

How did this fiasco come about? A number of different factors are involved. Consider the following:

  • Dr. Huggins, in 1941 had no good means for establishing the extent or grade of the prostate cancer of his patients. Therefore, it suggests that the patients he chose to undergo orchiectomy may have had earlier or lower grade prostate cancer than the control patients.

     
  • Many of the earlier prostate cancer studies did not measure estrogen or progesterone levels. They often measured only the testosterone levels. It is the balance between progesterone and testosterone with estradiol that is key to the effects of the hormones. The range of so-called normal hormone levels is so broad that estrogen dominance can occur even if all the hormones are still in these “normal” ranges.

     
  • The vast majority of early prostate cancer studies used serum levels instead of saliva levels when measuring hormone levels in men (and women). This is a mistake since saliva testing does not discriminate between total “free” and protein-bound hormone. It is the “free” hormone that is bio-active, whereas the protein-bound hormone is not bio-active. Thus serum tests are generally irrelevant since they can not tell you how much of the “free” hormone is present. This means that the thousands of studies done with serum hormone testing are essentially irrelevant.

     
  • Since the doubling time of prostate cancer growth is quite slow compared to breast cancer, doctors are often seduced into thinking that their treatments are working when, in fact, such patients, who are generally older men, die from other causes rather than from their cancer. During the slow latency period of prostate cancer cell growth, conventional medicine claims to be preventing or, at least, slowing the progression of cancer growth. When metastases eventually develop, this is attributed (without any good evidence) to the cancer becoming insensitive to their treatment of testosterone blockade.

     
  • PSA testing is big business and very profitable to doctors and pharmaceutical companies. The PSA test is used to frighten patients into having expensive treatments, regardless of their futility. Treating patients with androgen blockade is very profitable, also, despite its futility. The income derived from these ventures serves as positive reinforcement for continuing these forms of treatment, despite their futility. The example of Pavlov’s dogs comes to mind. Pharmaceutical companies are very clever in their advertisements to doctors. When confronted by difficult treatment problems, doctors tend to be overly optimistic and gullible about believing the advertisements.

     
  • Doctors tend to be very busy with other problems in their practice, and have little time or energy to read all the literature themselves. They therefore rely on supposed authorities to tell them what to do. They like to believe in authorities because it saves the time from having to study to seek out the best treatment options.

     
  • Doctors’ main avenue of learning (besides visiting “refs” from the pharmaceutical industry) is the CME (Continuing Medical Education) seminars. He/she must attend at least 50 hours of accredited CME seminars every three years. He does not know that accreditation is determined by an AMA panel made up of doctors representing pharmaceutical companies. The doctor rarely hears of alternative effective treatments. Pharmaceutical-sponsored seminars are often more convenient and low-cost or free, whereas the unaccredited alternative seminars usually require a little travel and there is a cost for attending.

     
  • Doctors fear the consequences of malpractice. Since the definition of malpractice is deviation from the norm of the local medical community (and not the question of whether one’s treatment is good or bad), the doctor seeks protection by doing what other doctors in the community are doing for their patients. This atmosphere of needing protection against malpractice has the effect of extra unnecessary tests and conforming to standard modes of practice.

Therefore, change in medicine is gradual. While it is true that change comes when brave doctors go against the grain to find better modes of practice, each individual doctor is a bit apprehensive about being the non-conforming one to lead the change, regardless of the benefits it might bring to the health of his/her patients. These factors of conventional medicine are, I believe, delaying true progress in medicine.

Testosterone and Estrogen

The same things that cause breast cancer cause prostate cancer. It is highly unlikely that testosterone is the cause of prostate cancer. The highest testosterone levels in males are made during one’s late teens, at a time when no one gets prostate cancer. Conversely, men’s prostate cancer risk rises when their testosterone and progesterone have fallen, and estradiol has risen. How do conventional doctors ignore this fact? One physician thought that perhaps young men have some sort of strength in fighting off cancer, and this strength is lost somehow in older age. To this I suggest that this greater strength in younger men might derive fro their good levels of testosterone and progesterone, both of which are our major anabolic (energy-providing) hormones.

Back in the 1950’s, when I was in medical school, it was reported by the University of Chicago, as I recall, that researchers trying to create prostate cancer cell skin implants in mice found that pre-treating the mice with testosterone prevented successful implantation. If the cancer cells were implanted and allowed to “take”, and then the testosterone was added, the implants stopped growing and failed to thrive. This is potent evidence that testosterone inhibits prostate cancer cell growth and development. But all this dropped off our radar screens in the rush to castrate men with prostate cancer.

Testosterone is a direct antagonist to estradiol. Women develop full breasts because their estradiol effect is stronger than their testosterone effect. Men make estradiol, but throughout most of the young and middle adult life they make more testosterone, sufficient to block female breast development. Testosterone is the major masculinizing hormone and estradiol is the major feminizing hormone. The ratio of testosterone to estradiol (T/E2) is the major operant factor.

The relationship of estradiol to progesterone is more like Yin and Yang. They are designed to work together by balancing their mutually opposing properties to produce the optimal hormone benefit to both men and women. Unopposed estradiol can be lethal. Thus, the ratio of progesterone to estradiol (the P/E2 ratio) is also very important. Optimal protection against estradiol-induced cancer occurs when the saliva progesterone level is 200 to 300 times that of saliva estradiol level.

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Chapter 4 used with permission from John R. Lee, M.D. (www.johnleemd.com )"Hormone Balance for Men- What Your Doctor May Not Tell You About Prostate Health and Natural Hormone Supplementation".