Prostate Cancer
Testosterone and other male hormones are crucial for the healthy growth, structure, and function of the prostate gland. Research has uncovered specific androgen receptors in prostatic tissue, suggesting the important role of androgens in shaping the body’s genetic expression of diseases of the prostate, as well as their course of development.38,39 Differences in testosterone levels that occur among age, ethnic, and racial groups, as well as in those with clinical conditions, such as diabetes, have been cited as possible causes of variable incidence of prostate cancer.40,41
Studies on the relationship between testosterone and prostate cancer have not always yielded consistent results. However, several recent clinical trials have found high levels of free, unbound testosterone associated with an increased incidence of prostate cancer. A positive correlation has also been established between high testosterone values and metastatic relapse in prostate cancer patients who underwent radiation treatment.42
Certainly, the most prudent course is to prevent supraphysiologic levels through careful monitoring of bioactive testosterone, avoiding excess levels that may promote the development of prostate cancer.
Clinical Studies
Salivary Analysis for Testosterone
A wealth of current literature supports salivary analysis of steroid hormones as the “gold standard” in endocrine assessment. Saliva is a natural filtrate of blood that allows only the bioactive portion of the hormone to permeate, providing a greater correlation with clinical symptoms and conditions. This is crucial because bioavailable testosterone deficiencies may exist even when total serum levels are normal in such conditions as Klinefelter’s syndrome, hyperthyroidism, liver disease, estrogen excess, and advancing age. Because serum levels of sex-hormone-binding globulin increase with age, bioavailable testosterone is a much more sensitive indicator of testosterone decline than total serum testosterone levels, and can detect much earlier testosterone decline associated with aging.43-45
Clinical Studies
Hormone Imbalances
Recent research reveals that the synergistic interplay among testosterone, DHEA, cortisol, and melatonin modulates the genetic expression and pathogenesis of many chronic and degenerative conditions, including rheumatoid arthritis and cancer.
DHEA is a precursor hormone for the production of testosterone. Researchers theorize that one of the primary functions of DHEA-S, the sulfate form of DHEA, is to serve as an allosteric facilitator of the binding of testosterone to albumin, which allows testosterone to attach to receptor sites and initiate physiological responses throughout the body. Cortisol, the body’s potent glucocorticoid and anti-inflammatory, is modulated by levels of DHEA. Melatonin, produced by the pineal gland, is a powerful regenerative hormone linked to sleep cycle, immune modulation, mood regulation, anti-cancer activity, reproductive function, and antioxidant defense.
Conventional Medical Treatment [SH]
Conventional medical treatment of male hypogonadism involves excluding underlying pathologies that may be the cause. Treatment typically revolves around testosterone replacement therapy.
Naturopathic Medical Treatment and Prevention [SH]
Clinical Nutrition
Nutrients that may improve testosterone production include vitamin C, zinc, arginine, vitamin E, essential fatty acids, and Co-enzyme Q10.
Botanical Medicine
Herbs include Panax ginseng, damiano (turnera diffusa)), sarsaparilla (smilax spp.), and puncture vine (tribulus terresteris).
Hormone Replacement
Hormone replacement with the adrenal hormone DHEA may be beneficial, if shown to be depleted. Bio-indentical transdermal testosterone cream can be applied to the scrotum for those whose physiological levels remain below normal.
Oral doses of testosterone are not recommended because of increased detoxification in the liver (“first pass effect”) and therefore concern about the potential of increased risk of liver cancer with long-term use.
