This is great. I’ve been on CHRT for one year, which includes a small amount of testosterone. I look forward to my next DEXA scan which now will include TBS. The hospital near me now has the capability.
I worked in Critical care ICU for 20 years, also was the code blue team in our 360 bed hospital. After 15 years, and I be male 50 years old, my testosterone levels were below low level recommended ( (220) , got treated with testosterone gel patches, but a few years later I had a serious accident on my back, osteoporosis was so severe I had a 60% compression fracture on L1-L2…… I firmly believe the testosterone levels and stress over years led to the osteoporosis. I went to my family doc gor 8 years complaining of back pain and every time it was thought to be “ cardiac “ in nature. No back X-rays, but treadmills with contrast showed good cardiac function….. my Dr said I was “ getting older” and had back pain…,, hence prescribed Hydrocodone/ acetaminophen 325 mg. I told him I can’t take opiates while at work. This same scenario happened many times. End result MEN are not looked at seriously for a diagnosis of osteoporosis or osteopenia in America.
Thank you for sharing this. Yes, it is very unfortunate. I appreciate you watching these videos, it sounds like you would greatly benefit from our next Bone Foundations masterclass session in a few weeks. Checkout the information on this page, you can also register here if you are interested --> www.optimalbonehealth.com/bone-foundations-master-class
I think everyone can receive poor or less than thorough care in the US. As a woman I was just given muscle relaxants for back pain. The only people I got info that I had back arthritis from were privately pain chiropractors.
Very interesting, although this raises more questions than it answers. Why did so many men in the first study quit, when the common narrative about testosterone is that it makes you feel better? I have heard that increased exogenous testosterone in males increases bph. Is this true? Why would density increase in the hip but not in the femur neck? How low would your free testosterone need to be to see benefit from an outside dose, and how long would this take to occur? I guess more research is always the goal.
Hello, Great questions and nice insight. Let me see if I can help on a few of them. Men quit testosterone for several reasons but a few I see are: 1. Doses through patches are too low to see benefit 2. Injections hurt 3. They are not managed well and over convert to estradiol which causes negative side effects. BPH may increase with testosterone use and observation with physical exam and PSA is recommended. Either you misunderstood me or I misspoke. Femoral neck and hip are nearly synonymous terms. DEXA will use "total hip" to describe the anatomy around the neck but changes are likely to be similar. I prefer using femoral neck as that is what often breaks in a hip fracture. Most studies don't measure or report Free T so this answer is difficult to know. Duration? These studies were all under 12 months so changes should occur over months. Hope that helps!
Hi Dr Doug. Thanks for this video. Some very useful information. I'm 43, and recently got diagnosed with Low T, after several symptoms and investigations. Including Osteoprenia. My total T was only 7.6 nmol. You said in your video that commercial products aren't able to bring up T levels to where they should be. I've been prescribed Gel of 60mg Testosterone daily. Would this amount not be sufficient?
Great question! Checkout our health span nation if you have not yet, you get exclusive access to me and a community of people pursuing health and longevity. These are things that we discuss in there and it allows us to go into detail rather than doing short chats through this platform. You can find more information here --> www.drdouglucas.com/healthspan
Do you happen to have any thoughts on the secondary findings of the TRAVERSE study? It suggested T supplementation increased fracture risk? “Testosterone Treatment and Fractures in Men with Hypogonadism” (Snyder et al. 2024). (I apologize if you’ve covered this elsewhere, and I just haven’t found it.) Thanks!
Great question! Checkout our health span nation if you have not yet, you get exclusive access to me and a community of people pursuing health and longevity. These are things that we discuss in there and it allows us to go into detail rather than doing short chats through this platform. You can find more information here --> www.drdouglucas.com/healthspan
I am a recent uterine cancer survivor with two cancer free CT scans. I’m a 67 yr old post menopausal woman non diabetic or prediabetic. My treatment plan included chemotherapy and radiation therapies. Although I am grateful to be cancer free, the side effects led to neuropathy in my feet, low blood count and osteoporosis (my last CT scan revealed a small fracture in my spine, which my radio-oncologist said radiation treatments contributed significantly to that diagnosis). While under treatment, I contracted COVID (am unvaxxed) that did some damage to my kidneys. I recovered in ten days from COVID Omicron without any medical drugs but with vitamin D3, K2, Zinc, low dose vitamin C and Tumeric-black pepper- ginger combo pill. After completing my last chemo in January 2023, I put myself on a modified Keto diet with limited protein to a daily intake of 4 1/2 oz (per my Nephrologist request), intermittent fasting to continue in losing weight (went from 223 to 160) and build health. In addition I’ve added vibration therapy and began an exercise program to include resistance training, walking and high impact exercise. I recently spoke with my gyno-oncologist about hormone replacement therapy to aide in building back my bones. He said that because high levels of estrogen in my body was a major contributing factor in developing stage 3 uterine cancer, he discourages that treatment plan. As you can see, I am threading a lot of needles to gain as much optimal health as possible. I’m thinking of going to a bone specialist to get their opinion. What are your thoughts and have you come across osteoporosis studies with cancer survivors?
Hi Nancy, Thank you for sharing your story. Cancer survivors are a population which limited evidence to treat. Hormone sensitive cancers cause concern with BHRT as your oncologists pointed out. This is debatable but in general we follow these guidelines too. When estrogen is not an option there are still lots of tools to consider. Sign up for our masterclass or consider our programs for some assistance in your journey. Congratulations on being cancer free!
I'm curious if muscle has been removed within the spine at the upper torso could that cause instability in the spine making spine collapse more of a risk?
not sure if you mean 'removed' as interpreted by doc below, or atrophied as in old age muscle loss. If you mean the latter then yes, and both testosterone supplements and physical therapy can help address that instability.
Hi Dr. Doug. Thank you for all of your informational videos. I am 55 years old and just got diagnosed with osteoporosis in my hips and osteopenia in my spine. All my sex hormones are very low, byt neither my Doctor nor my gyno ologist will prescribe testosterone as they are not allowed here in Denmark. Would a drug with androgen effect like Livial (Tibolone) help with the osteoblast function? Which commercial testosterone product will you recommend?
Hello, Testosterone is such a funny drug/hormone. It carries such stigma and resistance worldwide. Unfortunately, there are almost no available commercial products. I hear there is one in Australia..... In the US we can compound controlled substances and prescribe them that way. The only way to get them would be to travel on a regular basis to somewhere that it could be prescribed. Tibolone is an intersting drug. It's not available in the US and I don't know much about it. A quick search reveals it breaks down into products that stimulate all three sex hormone receptors. My concern here is that this is synthetic and probably doesn't provide adequate blood levels to do what we want the hormones to do. More to learn on this topic for sure. Thanks for bringing it up.
@@Dr_DougLucas Thanks so much for your reply, I really appreciate it. I got Livial online via an UK Doctor service and it was very expensive, but I cannot either find any info about it, only some Indian UA-cam videos. My Gyno will only give me Activelle, Utrogestan and estrogen gel, but no testosterone. She told me that the Danish Healt h Board do not recommend Tibolone because of something with the heart, but when I checked their recommendation it is on the list. Yes, I can see that it is synthetic, but maybe better to take this for the androgen component, than getting no testosterone at all. Thank you so much, I have binged on your videos since I got the diagnose and feeling very lost as my Doctor is not of any help at all!
Hi Doctor, im a 36 year old male with low T (2 nmol/L). Took my first short of Nebido 6 weeks ago. This week I was diagnosed with osteoporosis in the spine and osteopena in the hip ... 2 bad news after each other. What must I do to reverse the osteoporosis? And will the Nebido every 12 weeks be enough dosage to reverse the T levels? Thanks
Hello, I'm sorry to hear of your challenges! TRT is becoming more common in younger men and we do a lot of replacement for this reason. I'm a fan of more frequent dosing of a more bioidentical product. It creates a more natural rhythm of hormone delivery. TRT does improve bone as indicated in multiple studies. It may not be enough on it's own though. Consider joining our master class for more information on this topic.
What specialty of medicine or type of doctor is the best one to see with osteoporosis diagnosis as the only option my internist offered was Fosamax. He has a specialty in geriatrics. I plan to ask for a referral to physical therapy to learn as much as I can about doing resistance training properly. I'm rather fit for my age.
Great! PT is a good way to go to get individualized recommendations. As far as specialist in the field? We are the only practice like ours that I know of. Dr Doug
![[UA] Team Vitality проти NAVI | IEM Cologne 2024](http://i.ytimg.com/vi/wttO1zVRTC0/mqdefault.jpg)
This is great. I’ve been on CHRT for one year, which includes a small amount of testosterone. I look forward to my next DEXA scan which now will include TBS. The hospital near me now has the capability.
Thank you for sharing, glad you enjoyed this video!
I worked in Critical care ICU for 20 years, also was the code blue team in our 360 bed hospital. After 15 years, and I be male 50 years old, my testosterone levels were below low level recommended ( (220) , got treated with testosterone gel patches, but a few years later I had a serious accident on my back, osteoporosis was so severe I had a 60% compression fracture on L1-L2…… I firmly believe the testosterone levels and stress over years led to the osteoporosis. I went to my family doc gor 8 years complaining of back pain and every time it was thought to be “ cardiac “ in nature. No back X-rays, but treadmills with contrast showed good cardiac function….. my Dr said I was “ getting older” and had back pain…,, hence prescribed Hydrocodone/ acetaminophen 325 mg.
I told him I can’t take opiates while at work.
This same scenario happened many times. End result MEN are not looked at seriously for a diagnosis of osteoporosis or osteopenia in America.
Thank you for sharing this. Yes, it is very unfortunate. I appreciate you watching these videos, it sounds like you would greatly benefit from our next Bone Foundations masterclass session in a few weeks. Checkout the information on this page, you can also register here if you are interested --> www.optimalbonehealth.com/bone-foundations-master-class
I think everyone can receive poor or less than thorough care in the US. As a woman I was just given muscle relaxants for back pain. The only people I got info that I had back arthritis from were privately pain chiropractors.
Very interesting, although this raises more questions than it answers. Why did so many men in the first study quit, when the common narrative about testosterone is that it makes you feel better? I have heard that increased exogenous testosterone in males increases bph. Is this true? Why would density increase in the hip but not in the femur neck? How low would your free testosterone need to be to see benefit from an outside dose, and how long would this take to occur? I guess more research is always the goal.
Hello,
Great questions and nice insight. Let me see if I can help on a few of them.
Men quit testosterone for several reasons but a few I see are:
1. Doses through patches are too low to see benefit
2. Injections hurt
3. They are not managed well and over convert to estradiol which causes negative side effects.
BPH may increase with testosterone use and observation with physical exam and PSA is recommended.
Either you misunderstood me or I misspoke. Femoral neck and hip are nearly synonymous terms. DEXA will use "total hip" to describe the anatomy around the neck but changes are likely to be similar. I prefer using femoral neck as that is what often breaks in a hip fracture.
Most studies don't measure or report Free T so this answer is difficult to know.
Duration? These studies were all under 12 months so changes should occur over months.
Hope that helps!
Hi Dr Doug. Thanks for this video. Some very useful information. I'm 43, and recently got diagnosed with Low T, after several symptoms and investigations. Including Osteoprenia.
My total T was only 7.6 nmol. You said in your video that commercial products aren't able to bring up T levels to where they should be. I've been prescribed Gel of 60mg Testosterone daily. Would this amount not be sufficient?
Great question! Checkout our health span nation if you have not yet, you get exclusive access to me and a community of people pursuing health and longevity. These are things that we discuss in there and it allows us to go into detail rather than doing short chats through this platform. You can find more information here --> www.drdouglucas.com/healthspan
Does insurance ever cover use of TRT for osteoporosis in males?
Also a great question! These are things that we discuss in Healthspan nation as well! --> www.drdouglucas.com/healthspan
Do you happen to have any thoughts on the secondary findings of the TRAVERSE study? It suggested T supplementation increased fracture risk?
“Testosterone Treatment and Fractures in Men with Hypogonadism” (Snyder et al. 2024).
(I apologize if you’ve covered this elsewhere, and I just haven’t found it.)
Thanks!
Great question! Checkout our health span nation if you have not yet, you get exclusive access to me and a community of people pursuing health and longevity. These are things that we discuss in there and it allows us to go into detail rather than doing short chats through this platform. You can find more information here --> www.drdouglucas.com/healthspan
I am a recent uterine cancer survivor with two cancer free CT scans. I’m a 67 yr old post menopausal woman non diabetic or prediabetic. My treatment plan included chemotherapy and radiation therapies. Although I am grateful to be cancer free, the side effects led to neuropathy in my feet, low blood count and osteoporosis (my last CT scan revealed a small fracture in my spine, which my radio-oncologist said radiation treatments contributed significantly to that diagnosis).
While under treatment, I contracted COVID (am unvaxxed) that did some damage to my kidneys. I recovered in ten days from COVID Omicron without any medical drugs but with vitamin D3, K2, Zinc, low dose vitamin C and Tumeric-black pepper- ginger combo pill.
After completing my last chemo in January 2023, I put myself on a modified Keto diet with limited protein to a daily intake of 4 1/2 oz (per my Nephrologist request), intermittent fasting to continue in losing weight (went from 223 to 160) and build health. In addition I’ve added vibration therapy and began an exercise program to include resistance training, walking and high impact exercise.
I recently spoke with my gyno-oncologist about hormone replacement therapy to aide in building back my bones. He said that because high levels of estrogen in my body was a major contributing factor in developing stage 3 uterine cancer, he discourages that treatment plan.
As you can see, I am threading a lot of needles to gain as much optimal health as possible. I’m thinking of going to a bone specialist to get their opinion. What are your thoughts and have you come across osteoporosis studies with cancer survivors?
Hi Nancy,
Thank you for sharing your story. Cancer survivors are a population which limited evidence to treat. Hormone sensitive cancers cause concern with BHRT as your oncologists pointed out. This is debatable but in general we follow these guidelines too. When estrogen is not an option there are still lots of tools to consider. Sign up for our masterclass or consider our programs for some assistance in your journey. Congratulations on being cancer free!
I'm curious if muscle has been removed within the spine at the upper torso could that cause instability in the spine making spine collapse more of a risk?
Interesting question. I can't say I know much about the impact of this type of procedure.
not sure if you mean 'removed' as interpreted by doc below, or atrophied as in old age muscle loss. If you mean the latter then yes, and both testosterone supplements and physical therapy can help address that instability.
Hi Dr. Doug. Thank you for all of your informational videos. I am 55 years old and just got diagnosed with osteoporosis in my hips and osteopenia in my spine. All my sex hormones are very low, byt neither my Doctor nor my gyno ologist will prescribe testosterone as they are not allowed here in Denmark. Would a drug with androgen effect like Livial (Tibolone) help with the osteoblast function? Which commercial testosterone product will you recommend?
Hello,
Testosterone is such a funny drug/hormone. It carries such stigma and resistance worldwide. Unfortunately, there are almost no available commercial products. I hear there is one in Australia.....
In the US we can compound controlled substances and prescribe them that way. The only way to get them would be to travel on a regular basis to somewhere that it could be prescribed.
Tibolone is an intersting drug. It's not available in the US and I don't know much about it. A quick search reveals it breaks down into products that stimulate all three sex hormone receptors. My concern here is that this is synthetic and probably doesn't provide adequate blood levels to do what we want the hormones to do. More to learn on this topic for sure. Thanks for bringing it up.
@@Dr_DougLucas Thanks so much for your reply, I really appreciate it. I got Livial online via an UK Doctor service and it was very expensive, but I cannot either find any info about it, only some Indian UA-cam videos. My Gyno will only give me Activelle, Utrogestan and estrogen gel, but no testosterone. She told me that the Danish Healt h Board do not recommend Tibolone because of something with the heart, but when I checked their recommendation it is on the list. Yes, I can see that it is synthetic, but maybe better to take this for the androgen component, than getting no testosterone at all. Thank you so much, I have binged on your videos since I got the diagnose and feeling very lost as my Doctor is not of any help at all!
@@bodyyoga4158 Tough call. It's a shame that testosterone is so limited worldwide. We use it when appropriate and are seeing great success.
Grateful to have you and your team on my team 🙏💪🏻 🦴🌈 💜
Same here! Thank you for being here with us!
Hi Doctor, im a 36 year old male with low T (2 nmol/L). Took my first short of Nebido 6 weeks ago. This week I was diagnosed with osteoporosis in the spine and osteopena in the hip ... 2 bad news after each other. What must I do to reverse the osteoporosis? And will the Nebido every 12 weeks be enough dosage to reverse the T levels? Thanks
Hello,
I'm sorry to hear of your challenges! TRT is becoming more common in younger men and we do a lot of replacement for this reason. I'm a fan of more frequent dosing of a more bioidentical product. It creates a more natural rhythm of hormone delivery. TRT does improve bone as indicated in multiple studies. It may not be enough on it's own though. Consider joining our master class for more information on this topic.
@OptimalBoneHealthwithDrDoug thanks Doc. I will join the Master Class next. My big regret is that I'm not based in the USA.
@@user-jz1ji3uq6p That's okay. We have options for international clients.
What specialty of medicine or type of doctor is the best one to see with osteoporosis diagnosis as the only option my internist offered was Fosamax. He has a specialty in geriatrics. I plan to ask for a referral to physical therapy to learn as much as I can about doing resistance training properly. I'm rather fit for my age.
Great! PT is a good way to go to get individualized recommendations. As far as specialist in the field? We are the only practice like ours that I know of.
Dr Doug