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Today’s almonds have been activated by:
Feeling bloated? This usually has less to do with how much you ate and more to do with your body trying to process a meal with insufficient water.
Drink some water to rehydrate and undo the fluid retention your body was doing to try to compensate for dehydration!
⏰ IN A RUSH?
Today’s 30-Second Summary
If you don’t have time to read the whole email today, here are some key takeaways:
Most men’s testosterone levels decline with age, especially after the age of 45.
This comes with an array of adverse symptoms, ranging from sexual to mental and physical health
Testosterone Replacement Therapy can bring T-levels to what they were previously, with assorted benefits—and some risks (see today’s main feature for details)
Do you ever find yourself stuck in a rut in the kitchen, cooking the same few things many times?
Flavours of the Week is a free newsletter offering an inspiring easy-to-make recipe every Sunday. A good way to try something new on a regular basis!
Read on to learn about these things and more…
🤫 A WORD TO THE WISE
 | Alpha, Beta, Theta:What are brain states and brain waves And can we control them? |
👀 WATCH AND LEARN
How To Improve Your Focus Stamina (5:54)
Med student Salim Ahmed has some important insights here! There's a little bit in the middle that's more specific to studying, but the tips before and after are applicable to us all.
And no, it's not "remove distractions" 😉
Want to watch it, but not right now? Bookmark it for later 🔖
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♂️ MAIN FEATURE
The Testosterone Drop
Testosterone levels decline amongst men over a certain age. Exactly when depends on the individual and also how we measure it, but the age of 45 is a commonly-given waypoint for the start of this decline.
(the actual start is usually more like 20, but it’s a very small decline then, and speeds up a couple of decades later)
This has been called “the male menopause”, or “the andropause”.
Both terms are a little misleading, but for lack of a better term, “andropause” is perhaps not terrible.
Why “the male menopause” is misleading:
To call it “the male menopause” suggests that this is when men’s menstruation stops. Which for cis men at the very least, is simply not a thing they ever had in the first place, to stop (and for trans men it’s complicated, depending on age, hormones, surgeries, etc).
Why “the andropause” is misleading:
It’s not a pause, and unlike the menopause, it’s not even a stop. It’s just a decline. It’s more of an andro-pitter-patter-puttering-petering-out.
Is there a better clinical term?
Objectively, there is “late-onset hypogonadism” but that is unlikely to be taken up for cultural reasons—people stigmatize what they see as a loss of virility.
Terms aside, what are the symptoms?
❝Andropause or late-onset hypogonadism is a common disorder which increases in prevalence with advancing age. Diagnosis of late-onset of hypogonadism is based on presence of symptoms suggestive of testosterone deficiency - prominent among them are sexual symptoms like…❞
…and there we’d like to continue the quotation, but if we list the symptoms here, it won’t get past a lot of filters because of the words used. So instead, please feel free to click through:
Source: Andropause: Current concepts
Can it be safely ignored?
If you don’t mind the sexual symptoms, then mostly, yes!
However, there are a few symptoms we can mention here that are not so subjective in their potential for harm:
Depression
Loss of muscle mass
Increased body fat
Depression kills, so this does need to be taken seriously. See also:
(the above is a guide to managing depression, in yourself or a loved one)
Loss of muscle mass means being less robust against knocks and falls later in life
Loss of muscle mass also means weaker bones (because the body won’t make bones stronger than it thinks they need to be, so bone will follow muscle in this regard—in either direction)
See also:
Increased body fat means increased risk of diabetes and heart disease, as a general rule of thumb, amongst other problems.
Will testosterone therapy help?
That’s something to discuss with your endocrinologist, but for most men whose testosterone levels are lower than is ideal for them, then yes, taking testosterone to bring them [back] to “normal” levels can make you happier and healthier (though it’s certainly not a cure-all).
See for example:
(Sorry, we’re not trying to be clickbaity, there are just some words we can’t use without encountering software problems)
Here’s a more comprehensive study that looked at 790 men aged 65 or older, with testosterone levels below a certain level. It looked at the things we can’t mention here, as well as physical function and general vitality:
❝The increase in testosterone levels was associated with significantly increased […] activity, as assessed by the Psychosexual Daily Questionnaire (P<0.001), as well as significantly increased […] desire and […] function.
The percentage of men who had an increase of at least 50 m in the 6-minute walking distance did not differ significantly between the two study groups in the Physical Function Trial but did differ significantly when men in all three trials were included (20.5% of men who received testosterone vs. 12.6% of men who received placebo, P=0.003).
Testosterone had no significant benefit with respect to vitality, as assessed by the Functional Assessment of Chronic Illness Therapy–Fatigue scale, but men who received testosterone reported slightly better mood and lower severity of depressive symptoms than those who received placebo❞
We strongly recommend, by the way, when a topic is of interest to you to read the paper itself, because even the extract above contains some subjectivity, for example what is “slightly better”, and what is “no significant benefit”.
That “slightly better mood and lower severity of depressive symptoms”, for example, has a P value of 0.004 in their data, which is an order of magnitude more significant than the usual baseline for significance (P<0.05).
And furthermore, that “no significant benefit with respect to vitality” is only looking at either the primary outcome aggregated goal or the secondary FACIT score whose secondary outcome had a P value of 0.06, which just missed the cut-off for significance, and neglects to mention that all the other secondary outcome metrics for men involved in the vitality trial were very significant (ranging from P=0.04 to P=0.001)
Will it turn me into a musclebound angry ragey ‘roidmonster?
Were you that kind of person before your testosterone levels declined? If not, then no.
Testosterone therapy seeks only to return your testosterone levels to where they were, and this is done through careful monitoring and adjustment. It’d take a lot more than (responsible) endocrinologist-guided hormonal therapy to turn you into Marvel’s “Wolverine”.
Is testosterone therapy safe?
A question to take to your endocrinologist because everyone’s physiology is different, but a lot of studies do support its general safety for most people who are prescribed it.
As with anything, there are risks to be aware of, though. Perhaps the most critical risk is prostate cancer, and…
❝In a large meta-analysis of 18 prospective studies that included over 3500 men, there was no association between serum androgen levels and the risk of prostate cancer development
For men with untreated prostate cancer on active surveillance, TRT remains controversial. However, several studies have shown that TRT is not associated with progression of prostate cancer as evidenced by either PSA progression or gleason grade upstaging on repeat biopsy.
Men on TRT should have frequent PSA monitoring; any major change in PSA (>1 ng/mL) within the first 3-6 months may reflect the presence of a pre-existing cancer and warrants cessation of therapy❞
Those are some select extracts, but any of this may apply to you or your loved one, we recommend to read in full about this and other risks:
See also: Prostate Health: What You Should Know
Beyond that… If you are prone to baldness, then taking testosterone will increase that tendency. If that’s a problem for you, then it’s something to know about. There are other things you can take/use for that in turn, so maybe we’ll do a feature on those one of these days!
For now, take care!
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📖 ONE-MINUTE BOOK REVIEW
Small Pleasures: Joyful Recipes for Difficult Times – by Ryan Riley
When Hippocrates said "let food be thy medicine, and let medicine be thy food", he may or may not have had this book in mind.
In terms of healthiness, this one's not the very most nutritionist-approved recipe book we've ever reviewed. It's not bad, to be clear!
But the physical health aspect is secondary to the mental health aspects, in this one, as you'll see. And as we say, "mental health is also just health".
The book is divided into three sections:
Comfort—for when you feel at your worst, for when eating is a chore, for when something familiar and reassuring will bring you solace. Here we find flavor and simplicity; pastas, eggs, stews, potato dishes, and the like.
Restoration—for when your energy needs reawakening. Here we find flavors fresh and tangy, enlivening and bright. Things to make you feel alive.
Pleasure—while there's little in the way of health-food here, the author describes the dishes in this section as "a love letter to yourself; they tell you that you're special as you ready yourself to return to the world".
And sometimes, just sometimes, we probably all need a little of that.
Bottom line: if you'd like to bring a little more joie de vivre to your cuisine, this book can do that.
What did you think of today's newsletter?We always love to hear from you, whether you leave us a comment or even just a click in the poll if you're speeding by! |
Wishing you good health and vitality at every age in every way,
The 10almonds Team
