Testosterone and Prostate Cancer

16 02 2011

Historically, testosterone was thought to cause prostate cancer. In fact, if your testosterone level is low, your doctor may still believe that giving you bioidentical testosterone will lead to cancer and he or she may caution you against it. It’s very important to understand the current research regarding hormones and prostate cancer. A recent meta-analysis of 18 prospective studies examined the relationship between hormones and prostate cancer risk. Overall, data from nearly 4,000 men with prostate cancer and more than 6,000 control subjects (men without prostate cancer) was pooled. No association was seen between the risk of prostate cancer and levels of testosterone, free testosterone, or dihydrotestestosterone (DHT). In addition, there was no association with other hormones such as androstenedione, estradiol, or free estradiol.
Curiously, some studies have shown an association between low testosterone levels and prostate cancer. , In addition, other studies have reported that low testosterone levels are associated with more aggressive prostate cancers (advanced pathological stage and higher Gleason score). –

A recent pivotal study strongly suggests that testosterone supplementation does not lead to prostate cancer. In this study, 44 men with late-onset hypogonadism (low testosterone) were randomized to receive testosterone or placebo for 6 months. Prostate biopsies were performed prior to the study to rule out prostate cancer and to determine tissue levels of testosterone and DHT (dihydrotestosterone—the potent metabolite of testosterone) within the prostate gland itself. After six months, the 40 men who completed the study underwent repeat biopsies. Although testosterone treatment led to normal serum testosterone levels (median serum testosterone at baseline was 282 ng/dl versus 640 ng/dl after 6 mos), no significant changes were reported regarding levels of testosterone or DHT in the prostate, and no changes associated with prostate cancer were found.

Prostate cancer prevention

As you now know, one man in six will develop prostate cancer in his lifetime, and the risk increases with age. Most men with prostate cancer do not die from the disease. Prostate cancer may be preventable by following these guidelines:

• Eat more than two servings of lycopene rich foods per week (e.g., tomatoes, carrots, watermelon, and papaya).

• Include at least five servings of cruciferous vegetables (broccoli, cauliflower, mustard greens, cabbage) in your diet every week.

• Keep meat consumption to a minimum (especially charred, barbequed, or processed meat).

• Avoid excess dairy products and saturated fat.

• If you’re overweight or obese, commit to a weight-loss plan. Men who gain a significant amount of weight after age 21 have a higher risk for prostate cancer.

• Supplement with vitamins E and D, selenium, and fish oil.

In Health

Dr. Kathryn Retzler



What to look for when purchasing supplements

1 06 2010

In my practice I’ve seen many patients come in with a shopping bag or tackle box full of pills, proudly showcasing the huge number of supplements they take. Many supplement takers eat an unhealthy diet, skimp on sleep, remain sedentary, and live high stress lives. I’m dismayed that people think taking pills or dietary supplements, natural or pharmaceutical, is a reasonable substitute for a healthy lifestyle and life-affirming diet. Therefore, if you’re hoping to find the magic herbs, supplements or nutrients that will enable you to skip the the first 6 steps to optimal aging and hormone balance as outlined in my new book, you’ll be disappointed to know there aren’t any. If you are already following the first 6 steps as much as possible, there are exceptional quality supplements, often referred to as “nutraceuticals,” that can certainly help in your quest to attain hormone balance and optimal aging.

It’s important to keep in mind that not all supplements are alike, no matter what the manufacturer or label may claim. Make sure the supplements you take are made in facilities that have pharmaceutical certification or are certified for good manufacturing practices (GMP) by the NPA (Natural Products Association), NSF (National Sanitation Foundation International), or TGA (Therapeutic Goods Administration of Australia). This certification ensures that the products you use are of exceptional quality.

Besides coming from GMP-certified companies, ideally the supplements you take should be scientifically evaluated to verify the presence and concentration of active constituents. Few supplement manufacturers conduct clinical trials on their formulas to document safety and effectiveness. This is because research is very expensive to perform. However, purchasing supplements that are documented for safety and effectiveness is a reliable investment in your health.

In addition to quality assurance and evaluation via clinical trials, look for bioavailable forms of nutrients and dosages. Consider the supplements you take to be as important as any medications prescribed by your doctor. In fact, you may consider them to be more important than medications since they can help you prevent the “polypharmacy” that is standard of care for aging Americans (remember, 25% of all Medicare patients use six or more drugs every day).

Using one of the most respected pharmaceutical supplement companies in the country, I have created my own unique anti-aging formula (based on what myself and my husband take every day) that contains what I believe to be the essentials for Optimal Aging and Hormone Balance. This unique daily formula was designed to support adrenal gland function and resistance to stress, and to promote optimal brain, bone, cardiovascular, hormone, and immune function.

These twice-a-day packets contain a multivitamin and mineral supplement and a potent antioxidant “green food” that includes the ORAC equivalent of 4-5 servings of organic fruits and vegetables. Extra vitamin D, bioavailable folate, reduced Coenzyme Q10, fish oil, and resveratrol enhance optimal aging and youthful energy levels.

To find out additional information, please visit my clinic website.

In Health.

Bioidentical Hormone Replacement Therapy

31 05 2010

As a primary care physician who specializes in natural medicine, I think the most important role doctors can play is that of teacher – to provide complete, unbiased information so that patients can make their own informed decisions.

Following is a list of facts I provide my patients when they seek help for hormone imbalance symptoms:

Many women and men have significant symptoms as they age.

No two people are identical in terms of their hormone production or the symptoms of hormone imbalance they experience.

Eating a healthy diet, exercising regularly, minimizing stress, and avoiding environmental toxins are the foundations for preventing and managing hormone imbalance symptoms.

If symptoms of hormone imbalance persist, bioidentical hormone replacement therapy is an option that contains benefits and risks.

People have different medication needs and drug detoxifying capacities. Testing baseline hormone levels and following up with repeat testing after treatment is a reasonable way to determine whether a patient is receiving too much hormone. Symptom improvement usually determines if a patient is receiving enough medication.

Synthetic hormones have been shown to have serious health consequences including increased risk of breast cancer, blood clots, heart disease, and stroke. Synthetic oral testosterone has been shown to increase the risk for liver inflammation and liver cancer.

Bioidentical hormones are identical in structure to those made by the body. There is a large body of research involving the effectiveness of bioidentical estradiol, progesterone, and testosterone. Bioidentical hormones do carry risks, especially when administered in excessive dosages, outside of physiological levels; overall, however, they have a lower risk profile than their synthetic counterparts (this is especially true for bioidentical progesterone vs. progestins, and bioidentical testosterone vs. methyltestosterone). More research about long-term effects of bioidentical hormones needs to be done.

Bioidentical hormones are found in pharmaceuticals (e.g., bioidentical estradiol patches such as Climara or Vivelle, bioidentical progesterone such as Prometrium, and bioidentical testosterone such as Androderm, Androgel, or Testopel) as well as in individual preparations made by compounding pharmacists.

Compounded medications have been available since the 1930s. Organizations such as the Professional Compounding Centers of America (PCCA) provide continuing education seminars for pharmacists and physicians, as well as a source of FDA-approved ingredients subjected to quality assurance standards.

Treating hormone imbalance requires a comprehensive understanding of endocrinology and gynecology, as well as significant clinical experience.

I also share the following opinions with my patients:

It makes sense to test baseline hormone production, and then if low levels and/or hormone imbalance symptoms deem necessary, to prescribe low dosages of bioidentical hormones that eliminate or minimize symptoms, or to bring a patient’s hormone levels to within physiological range. There is no established protocol for such treatment and potential risks exist; therefore, a conservative approach to treatment is most prudent.

Choosing an doctor who listens, provides you with information, and respects your treatment decisions is your right and responsibility. Expect your physician to provide you with available research, benefits, and risks of any treatment you choose. Do not be afraid to question any treatment or to make your own healthcare decisions

For additional information about hormone imbalance symptoms, anti-aging and bioidentical hormones replacement therapy, please visit my clinic website at: