Men's hormones

Question 1

which comorbidities often contribute to decreased T. with aging?

Answer 1

Chronic pain with opioid use
dm, met syn
hiv

Question 2

SHBG changes with age

Answer 2

increases

Question 3

Primary versus secondary low T

Answer 3

Primary: failure at testes level, Leydig sensitivity to LH falls. Is related to age.
Secondary: gnRH drops, lh falls. “AOH” - NOT related to age

Question 4

Diurnal T pattern change with age

Answer 4

blunts with age over 45

Question 5

prev of low T in erectile dysfunction

Answer 5

Only 19%

Question 6

LABS associated with MET SYN

Answer 6

low T

low shbg

Question 7

fsh in men

Answer 7

sertoi cells, sperm

Question 8

lh in men

Answer 8

leydig cells, T

Question 9

17, 20 lyase inhib

Answer 9

Inflammation
hyper insulin,
stress
licorice

Question 10

17, 20 lyase inhib

Answer 10

Inflammation
hyper insulin,
stress
licorice

Question 11

Enzymes affected by insulin

Answer 11

17, 20 lyase - makes DHEA and andtostenedione
Five alpha reductase - t to dht
Aromatase

Question 12

Percentage of AOH with met syn

Answer 12

70

Question 13

Low T & mitochondrial density

Answer 13

decrease

Question 14

imflamm-aging conditions associated with low T

Answer 14

Type 2 DM
CAD and Vascular Diseases
Psoriasis
RA
SLE
Crohn's
COPD/Asthma
Multiple Sclerosis

Question 15

imflamm-aging conditions with low T

Answer 15

Type 2 DM
CAD and Vascular Diseases
Psoriasis
RA
SLE
Crohn's
COPD/Asthma
Multiple Sclerosis

Question 16

Low T & atherosclerosis

Answer 16

causal!!!

Question 17

Low T & atherosclerosis

Answer 17

YES LINKED

Low tea predicts increased CVD mortality

Question 18

LOW T and mortality

Answer 18

88%higher

Question 19

Lifestyle interventions for low T

Answer 19

Moderate intensity HV aerobic exercise>200
minutes/week produces greater improvements in sexual function, etc
Strength training increases T levels
hiit increases free total t and shbg

Question 20

Botanicals for Low t

Answer 20

•Long Jack 
•Mucuna 
•Ashwagandha 
•Fenugreek 
black cumin

Question 21

Nutraceuticals/vit for low T

Answer 21

vit d (increase in all T), vit A (sperm), zinc, selenium (with cadmium toxicity)

Question 22

lifestyle interventions for prostate health

food

Answer 22

Walking decreases prevalence and severity of prostate cancer.
Exercise increases adiponectin which decreases risk of high-grade prostate cancer.

diet avoid AA and Grill’s food. Mediterranean diet, soy, Green tea, lycopene

Question 23

Micronutrient interventions for prostate health

Answer 23

vit d, vitamin E, vitamin C, zinc, selenium

Question 24

Botanicals for prostate health

Answer 24

B Sitosterol, 
Pygeum africanum  
Rye GrassPollen extract
stinging nettle root**
Not always saw palmetto**
* together equals awesome

Question 25

Lab eval for Low T

Answer 25

total t first, then SHBG and free t, followed by lh/fsh, ferritin estrogen, DHEA, DHT, PSA, cbc t goal >300 ft goal > 6.6-18.1 shbg 30-80

Question 26

SHBG and age

Answer 26

Increases

Question 27

To give for LOW T when you can't give T

Answer 27

DONT give it desiring fertility Can give hCG instead - like lh Clomiphene, increases LHFSH

Question 28

H decreased at 30 yo for men

Answer 28

T, pregnenolone proogesterone age 50

Question 29

H decreased at 30 yo for men

Answer 29

T, pregnenolone proogesterone age 50 DHEA decreases

Question 30

E and DHT

Answer 30

Decreases metabolism so increased DHT levels and also increases DHT receptors at prostate

Question 31

leptin and IR

Answer 31

Insulin resistance leads to TG's which caused leptin resistance

Question 32

side effects of T replacement

Answer 32

``` acne Apnea, PSA >4 four edema, male pattern baldness gynecomastia ```

Question 33

Saw Palmetto

Answer 33

dec 5a reductase, ↓ inflammatory PG2/LT4, (+) apoptosis, ↓E2/DHT receptors. Studies mixed

Question 34

• | Nettle Root

Answer 34

5a reductase inhibition , improves urinary flow; | inflammatory PG/LT & prostatic pain & swelling. Good evidence!

Question 35

Pygeum africanum

Answer 35

((--)5 alpha reductase, ↓inflammatory PG/LT, improves IPSS scores.

Question 36

Rye Grass Pollen

Answer 36

--↓prostate cell growth, inflammation, ↓prostatitis/prostatodynia. Good evidence

Question 37

Maca Root

Answer 37

decreased prostate size in rats improved sperm counts/quality in humans

Question 38

Beta Sitosterol

Answer 38

found in multiple supplements, ( (--) 5a reductase, aromatase

Question 39

zinc

Answer 39

--↓ 5 a reductase, reduces size of prostate, (--) # of DHT receptors on prostate by ( (--) prolactin & estrogen affects

Question 40

Chronic prostatitis

Answer 40

``` Zinc saw palmetto rye grass pollen star Grass agrimony, nettle root, for certain, cranberry, Uva Ursi, marshmallow root, eryngo ```