There are three hormones which exert significant effects on healing. The most important is Testosterone. Connective tissue healing is directly and strongly Testosterone dependent. This is unfortunate, because the testosterone levels in the general population have been trending strongly downward due to a vast array of environmental factors over the last 70 years—glyphosate (Roundup) directly affects Testosterone production, with permanent effect from limited exposure, hormonally active things to which we are exposed (birth-control pills which cannot be ‘filtered out of’ community water supplies, estrogenic properties of may common plastic products, including the flexible phthalates which line water bottles and are used extensively in hair-care products, for example)—which have produced in 50 year olds an average Testosterone level that is ONE THIRD the level in 1950. Today, the average 50 year old has a level of around 400. In 1950, that level was 1200, with an upper limit of ‘normal’ of 2400. We almost never see a level of 2400 even in teenagers today. So, is it any surprise that THEY were able to win the WWII, while today people are lining up in vast numbers to get joints replaced and backs and necks fused?
Testosterone levels that are below a certain threshold necessary for optimal connective tissue healing cause problems in both males and females. About 70% of females in our practice, including those diagnosed as having ‘fibromyalgia’, have a single factor responsible for ALL of their problem: a low testosterone level. A female needs a testosterone level in the upper 3/4 of the ‘normal female range’ for optimal healing. If this level is not present, this situation is easily remedied by topical bio-identical hormone replacement in most women. In men, the situation is complicated by the current ‘normal’ range when testosterone is tested by family doctors and others who are not aware of the shift in community levels. What does a ‘normal’ lab test mean? Is ‘normal’ a measure of the FUNCTION of what is being measured? No, it is not. It is a measure of statistics. Basically, for any laboratory test, 1000 levels are obtained from a random population. The middle 92% are deemed ‘normal’ (two standard deviations from the mean, in ‘statistical talk’), and the upper and lower 4% are called ‘abnormal’. This presupposes that only 4% of a population has a low enough level to effect function, and this correlates amazingly well with PHYSIOLOGIC FUNCTION in a large number of tests. But not all, and Testosterone is the poster child for this phenomenon. But your primary care physician, or even your Urologist, may not be aware of this. I am, because I am a Urologist who practices for 16 years in a hospital with a HUGE population of ‘heart patients’ (St. Thomas in Nashville), so I probably know more about Testosterone, and how it interacts with cardiovascular disease, for instance, than even the average Urologist. To restore optimal connective tissue healing in males, levels over 700 are generally required. Sometimes, over 1000. If you are 50 years old and your internist saw a Testosterone level of 1250, he would probably have a stroke. But, that is right in the middle of the ‘historical normal’ level. Question: what do you think your body is designed to ‘run best on’—a level in the middle of an ‘unmolested’ population’s levels, or a level right in the middle of a ‘depleted’ population?
What about the risks of Testosterone replacement? That discussion is beyond the scope of this general essay, and should be conducted in person with anyone considering this treatment. However, in general, given the above, what ‘risk’ would there be of having a ‘natural’ hormone in levels that are in the ‘historical normal range’? Did people in the 1950’s have more prostate cancer? No. Did they die more commonly of cardiovascular diseases? Yes, but they also smoked much more than the current population, and they ate a diet that was pretty much designed to kill people at a young age. This is the part of the discussion that needs to happen in person, but there is evidence that a higher testosterone level is actually protective in terms of cardiovascular risk, while a high estrogen level poses the actual risk for both cardiovascular problems and malignancy. In some men, estrogen levels can be increased by giving Testosterone, so this factor may be important to examine. Again, if you are reading this, I am making NO recommendation regarding your personal treatment unless you are my patient and have been fully evaluated, and have had a course of treatment formally recommended. And even in these situations, this treatment, while a good idea in certain people, is not essential, but is an option that a patient may choose to pursue, or may choose not to pursue, at their discretion in light of the available facts and studies.