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Testosterone, Men and Health: lo que necesita saber
You probably know testosterone (T) plays an important role in how boys physically develop into men. But is that all you know? What happens when a man's T levels are off? Are there symptoms men should look for? And what are the treatment options? Dr. Bobby Kahlon, MD, Renown Medical Group provides answers in a Testosterone Q&A. What does testosterone do for men? "Testosterone is known as the 'manly hormone' for a reason," says Dr. Kahlon. "Though women also naturally produce small amounts of it, men produce testosterone at much higher concentration levels. And it affects men in more physical and obvious ways. How much hair a man has on his chest, how deep his voice is, or how muscular he is are all attributable in some way to testosterone. It's also responsible in large part for sex drive and bone strength and affects how men think, learn and experience their surroundings." Testosterone in men: Powers virilization (male physical characteristics) and sexual function Builds muscle mass and strength Supports bone density Improves cognition T Trivia: Discover Magazine reveals that “manly” testosterone and other sex hormones evolved long before we did — 500 million years ago — from the ultimate “female” hormone, estrogen. Can you have too much or too little testosterone? Though high testosterone isn't a concern for most men, low testosterone or low T occurs more frequently and develops for two primary reasons. Dr. Kuhadiya explains, "Subnormal testosterone concentrations occur either due to pituitary or testicular failure and the causes for each need to be discussed with your physician." Pituitary failure: Approximately one-third of men with obesity, type 2 diabetes, or metabolic syndrome (which includes increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels) have low free — or "bioavailable" — testosterone. These health conditions can cause the pituitary gland to "fail" to release follicle stimulating hormone (FSH) and luteinizing hormone (LH) which are essential for triggering testosterone and sperm production. And that can cause low testosterone (hypogonadism). Testicular failure: Though less common than pituitary failure, testicular failure may also be responsible for low T. It's caused by diseases or illnesses affecting the testicles, injury or trauma to the testicles, or certain medicines and treatments such as chemotherapy or opioid pain medication. Providing your complete medical history to your doctor is always the first step toward a proper diagnosis. What are the symptoms of low T? The following indicators could be a sign that you have low T, say the doctors. Lack of motivation and determination, including mild depression Loss of physical endurance and muscle strength Loss of or diminished early morning erections Reduced libido (sex drive) Erectile dysfunction (ED — difficulty achieving or maintaining an erection) Gynecomastia (male breasts) Small testes T and Time: T levels in men naturally begin to decline by about 1% a year starting at age 30. How do you test for low T? "There are different methods for testing testosterone levels," says Dr. Kuhadiya. "Each approach uses a blood sample to evaluate total testosterone, which includes free and attached testosterone that combines with proteins albumin and sex hormone-binding globulin (SHBG). For the most accurate results, testing is based on samples collected in the morning after fasting, and from tests on two different days." What treatment options are available? "Well, your best natural option may be YOU," says Dr. Kahlon. "Men with pituitary failure are often able to treat their low T by losing weight to increase levels of the hormone. And even if you don't lose weight, exercise can help boost your testosterone. Unfortunately, if you have testicular failure, weight loss and exercise may not have the same effect." So, are there other options? "You may want to consider Testosterone Replacement Therapy (TRT)," says Dr. Kuhadiya. "TRT is only available to men who are hypogonadal — with a clinical diagnosis of low T. Injection, gel, skin patch and nasal spray are available TRT options. The best option is the one that works best for the patient. Convenience, insurance coverage and cost are all factors to consider." Dr. Kahlon's TRT preference? Daily gel treatments, which are applied directly to the skin. On the other hand, Dr. Kuhadiya recommends intramuscular injections, which take place once a week or every two weeks. But both doctors agree on this: physicians and their patients need to weigh the benefits and risks of TRT before proceeding with treatment — especially if your low T condition may require lifelong treatment. "In my clinical practice, I have seen some very good long-term results with an improved quality of life," says Dr. Kuhadiya. "However, in certain situations, TRT may increase the risk of heart disease and is not recommended for men with a history of prostate cancer." Dr. Kahlon adds, "Patients receiving any type of hormone therapy need to be closely monitored throughout the treatment process for any changes in their health." How do you feel about steroids and T boosters? "I don't recommend them, certainly not for hypogonadism," advises Dr. Kahlon. "There is no evidence to support anabolic-androgenic steroids or testosterone boosters as a safe or effective treatment for low T in men." "In fact, there continues to be emerging evidence they may lead to side effects that could potentially harm the liver and the pituitary and endocrine functions of the body," warns Dr. Kuhadiya. "And that damage may be irreversible."
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Researchers at Renown Seek Convalescent Plasma Study Participants
Physician researchers seek to understand how the immune system responds to COVID-19 and create a healthier Nevada. During the early stages of the pandemic, convalescent plasma was considered the only viable treatment option available for patients with COVID-19. Convalescent plasma is the component of the blood from recovered patients that may contain COVID-19 antibodies that help fight the infection. The National Institutes of Health has since developed treatment guidelines for COVID-19 based on clinical trial data and many studies are still underway worldwide assessing various additional treatment options. Convalescent plasma was in high demand but difficult to locate for COVID-19 patients in the northern Nevada area. A 24-year-old nursing assistant, Austin Meegan, was hospitalized and spent weeks staving off kidney and lung failure before learning he was eligible for an experimental blood transfusion that showed promise in treating COVID-19. Los médicos estimaron que Meegan solo tenía un 3 % de posibilidades de encontrar un donante compatible con su raro tipo de sangre. A COVID-19 survivor, Thomas Gibson, a Texas resident with the same blood type, traveled to Reno to donate his viral antibodies and a convalescent plasma donation credited with helping to save Meegan’s life. Physician clinical researchers and scientists at Renown and the University of Nevada, Reno School of Medicine (UNR Med) knew they needed to create better options for patients and physicians. Clinical researchers developed a study to help other patients like Austin, and pleaded for donations from recovered COVID-19 patients to donate their convalescent plasma. The researcher teams looked to understand how the body’s immune system responds to the virus over time, to aid them in developing new treatments for COVID-19. “The world’s capacity to get through the COVID crisis will depend on four things — science, technology, innovation and partnerships, says Tony Slonim, MD, DrPH, President and CEO of Renown Health. “Taking lab bench discoveries to the bedside of patients in an efficacious and timely manner is not easy, but with UNR Med and our partners, we are making great strides in advancing clinical research which has the power to save lives and to create a healthier Nevada.” “It’s tremendously promising to partner on clinical research that will not only help us better understand the disease, but help inform treatment for those combatting COVID-19 that has had such a devastating impact on Nevadans, our nation and the world,” says UNR Med Dean Thomas L. Schwenk, MD. Renown, UNR Med and other area health care partners collaborated with Vitalant to collect plasma from recovered donors for a study on the treatment's efficacy. Los donantes elegibles tenían al menos 18 años, pesaban más de 110 libras y estaban sanos. Donors had fully recovered from a confirmed diagnosis of COVID-19. Project coordinators at the Renown Research Office were overwhelmed by the community’s support and plasma blood donations. Las asociaciones adicionales con el Distrito de Salud del Condado de Washoe, el estado de Nevada y la Oficina del Gobernador, Saint Mary’s Medical Center, Northern Nevada Medical Center, Carson Tahoe Health y VA Sierra Nevada Health Care System, junto con muchos proveedores de atención médica del área, ayudaron al equipo a alcanzar sus objetivos de inscribir a 120 participantes elegibles en el estudio. “Our success in this study rests heavily on the support of our great community, as well as the innovation and collaboration demonstrated by Renown and UNR Med,” said Sara Healy, MD, MPH, principal investigator of the study and a pediatric infectious disease physician at Renown Children’s Hospital and UNR Med. “We are proud to be at the forefront of conducting essential research during such a pivotal time in history, and look forward to our continued partnership as we continue this important work.” “The control of COVID-19 in our communities relies on testing. The study that is being launched to develop a sensitive, specific and easier way to collect specimens (blood) is advancing the field and brings promise towards getting to our common goal of having the right diagnostic test for the right clinical situation at the right time,” says Mark Riddle, MD, DrPH, FISTM, associate investigator of the study and associate dean for clinical research and professor at UNR Med's Department of Internal Medicine and Medical Research. The research team is now asking area residents to participate in a study to analyze the efficacy of two COVID-19 tests. Participants will undergo two blood tests: one being a finger stick to provide results for a rapid test, and the other is a traditional venipuncture draw confirming the presence or absence of COVID-19 antibodies. This study is a collaboration with InBios International, Inc., a leading biotechnology company based in Seattle. Researchers are seeking: Individuals who have confirmed positive for COVID-19 and who have recently recovered from the virus. Los participantes del estudio deben estar en un período de entre 7 y 28 días posteriores al inicio de sus síntomas. Individuals who have recently tested negative for COVID-19 and have never tested positive. Los interesados en participar en el estudio pueden ponerse en contacto con los coordinadores del proyecto en la Oficina de Investigación de Renown al (775) 982-3646, o por correo electrónico a covidplasmascreening@renown.org, de lunes a viernes, de 7:30 a.m. a 5:00 p.m. Se anima a las personas de entre 18 y 75 años con buena salud en general a que consideren la posibilidad de participar en este estudio en curso. There is no cost to participate in this study and participation is voluntary. An individual’s decision to participate will not affect their current or future relations with their health care provider(s), health district, or the community. Those who decide to participate are free to withdraw at any time. “Time is of the essence with COVID. If we can get test results to people and their clinicians in a more timely way, we can make a faster diagnosis of a patient's condition, says Christopher M. Kozlowski, MD, MHA, Renown's institutional research officer and Medical Director/VP of Renown Institute for Heart & Vascular Health. “As we refine the accuracy of our testing; we are applying sensitivity and specificity testing for true negative and true positive results. This provides people with more timely and accurate results and better quality care.” Acerca de Renown Health Renown Health es una red de atención médica integrada de administración local y sin fines de lucro que brinda servicios al norte de Nevada, Lake Tahoe y el noreste de California. Renown es uno de los mayores empleadores privados de la región y cuenta con una fuerza laboral de más de 7,000. It comprises three acute care hospitals, a rehabilitation hospital, the area’s most comprehensive medical group and urgent care network, and the region’s largest and only locally owned not-for-profit insurance company, Hometown Health. Renown tiene una larga trayectoria y un compromiso de larga data con la mejora de la atención y la salud de nuestra comunidad. About the University of Nevada, Reno School of Medicine The University of Nevada, Reno School of Medicine (UNR Med), Nevada’s first medical school, is a community-based, research-intensive medical school with a statewide vision for a healthy Nevada. Fundada en 1969, la UNR Med está mejorando la salud y el bienestar de todos los residentes de Nevada y sus comunidades mediante excelencia en la educación estudiantil, capacitación de posgrado y atención clínica, investigación con impacto local, nacional y global y una cultura de diversidad e inclusión. For more information, visit med.unr.edu.
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7 Important Vasectomy Questions for Your Doctor
If you and your partner are looking for a more permanent birth control method, you might consider a vasectomy. Although vasectomies are common, knowledge about them isn’t quite as common or talked about. If you are considering a vasectomy, talking with your primary care doctor is a great way to learn more and start the process. We consulted with Dr. Aurosis Reddy a primary care doctor with Renown Health – South Carson, about key topics to discuss with your doctor when considering a vasectomy. What is a vasectomy? A vasectomy – also called male sterilization – is a form of male birth control that blocks sperm from reaching semen, according to the American Urological Association (AUA). How effective and safe are vasectomies? Vasectomies are one of the most effective methods of birth control with a long-term success rate of over 99%. A vasectomy has been a safe and successful birth control method for many years. More than 500,000 men elect to have vasectomies every year in the U.S., and the number is rising. A vasectomy is also generally a low-risk procedure with a low complication rate ranging between 1-2%. What does the recovery period look like? A vasectomy is typically a quick procedure that takes under thirty minutes and can be performed in an outpatient setting under local anesthesia. Recovery from a vasectomy is also considered relatively easy. After a vasectomy, most can: Resume everyday activities within two to three days Resume normal exercise in one week Start engaging in sexual activity again in one week Your doctor can provide more details on what your individualized recovery process will look like.
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