|How Does Age Affect Risk FOR |
My blood fats are normal. My HDL (good cholesterol) is
high, and I'm approaching 54. I was in my doctor's office for a
checkup and read one of the pamphlets he had available, which
says, with no explanation, that age is the most powerful risk
factor for heart disease, especially congestive heart failure
(CHF). I don't have CHF or coronary artery disease, or heart
disease in general, but because of my age, I am possibly
approaching a catastrophic problem. Can you explain why age is
the most powerful risk factor for heart disease, when other parameters are normal? My doctor
This is a rather involved question, which entails an
involved answer in 3 parts, because with age, 3 things happen:
All 3 of these items have deleterious effects on your
health and your heart.
- Body tissues shrink.
- Levels of important hormones such as
testosterone, estrogen and human growth hormone, fall. Also,
- Breakdown processes in the body begin to outstrip building-up
First, as we age, everything shrinks. Most people assume
just their height shrinks. They lose stature, from 3/4 inch to 1
inch. But if you are shrinking in height as you age, you're also
shrinking in the body tissues, such as muscle, liver, kidneys,
bone mass, and heart mass. For instance, men over age 85 lose
about 25% of their bone mass and are at risk for hip fractures.
Women are at risk at even younger ages. [The New Anti-Aging Revolution, Dr. R. Klatz and R. Goldman, Page 51.]
As these tissues shrink, this means they are also putting
out less protective factors against heart disease and other
illnesses, because the tissues are also losing vitality.
One thing that shrinks in respect to the body shrinkage,
especially the heart, is your coronary arteries. This shrinkage
will magnify any occlusions that are present, and on systole
(when the ventricles of the heart contract to pump blood out),
the coronary arteries also contract. You can see the problem here
with age. Some occlusion of the coronary arteries, along with
shrinkage of the coronary arteries, and with contraction with
each heart beat, can lead to a coronary artery occlusive event,
or spasm, resulting in angina or a myocardial infarction (heart
attack). This occlusion represents what is known as coronary
artery disease. [Matthias Rath, M.D., Why Animals Don't Get Heart Attacks But People Do, Page 276.]
If a clot comes through, you can see the problem the heart
is in for when it's contracting, because less room is available
for the clot to go through and perhaps have a chance to be
dissolved by normal body defenses, such as plasminogen, our
natural clot buster. Remember, less body defenses are being
produced because of this overall body tissue shrinkage with age.
[Eugene Shippen, M.D., & William Fryer, The Testosterone Syndrome, Page 82.]
"With every heart beat, the coronary arteries are squeezed
flat," but during the relaxing phase, diastole, they are open
again. [Matthias Rath, M.D., Why Animals Don't Get Heart Attacks ButPeople Do, Page 276.]
Testosterone and Human Growth Hormone
Two things which help tissues increase back to their
normal, youthful sizes are testosterone and human growth hormone
(hGH). The New Anti-Aging Revolution, by Ronald Klatz and Robert
Coleman, says on page 52 that testosterone "stimulates the growth
and repair of muscles and the heart and immune system."
Testosterone increases heart muscle mass if it has thinned over
the years from lack of testosterone.
The Brewer Science Library website, at
http://www.mwt.net~drbrewer/niep_art.htm, points out that:
influence of testosterone on coronary artery disease has been
largely ignored in men.
K.S. Channer, et al., says that testosterone administration
may help open up blood vessels. Furthermore, low testosterone has
long been associated with
[Channer, KS, et
al. "Cardiovascular effects of testosterone: implications of the
'male menopause?'" Heart 2003 Feb;89(2):121-122.]
- Low HDL,
- High LDL, and
triglycerides, along with
- High blood pressure.
Testosterone may improve exercise tolerance and reduce pain
in men's hearts with coronary artery disease (angina). [English,
KM, et al, "Low-dose transdermal testosterone therapy improves
angina threshold in men with chronic stable angina: A randomized,
double-blind, placebo-controlled study." Circulation. 2000 Oct
According to K.M. English, et al, writing in European Heart Journal, "Men with coronary artery disease have lower levels of testosterone than those with normal coronary angiograms." [Eur Heart J. 2000 Jun;21(11):890-894.]
In older men, low testosterone appears to have a negative
influence on atherosclerosis and may explain increased coronary
artery disease in this age group.
Men don't go into andropause and suddenly have no
testosterone as a woman who goes into menopause and in one or two
years has complete cessation of estrogen production from her
ovaries. In fact, before it was known as male menopause, it was
known as male climacteric, a decrease in the sexual functions in
the male. Many men and their doctors still do not recognize that
the male climacteric is often associated with symptoms of hot
flashes, mood swings, etc. similar to the symptoms of menopause
in women. Some males experience suffocation. Others experience
depression and increased levels of LDL (bad) cholesterol. All
these symptoms are relieved by the administration of
testosterone. [Textbook of Medical Physiology, 9th Ed., Guyton &
Hall, Page 1014.] [Marin P, et. al. "Androgen treatment of
abdominally obese men." Obesity Res 1993;1:245-48.] [Ellyin FM.
"The long term beneficial treatment of low dose testosterone in
the aging male." Proc 77th Meeting of the Endocrine Soc.,
Washington, D.C., 1995;2-127.]
The authors of The Testosterone Syndrome point out on Page 4
that andropause "...creeps in upon them [men] stealthily, until,
at last, they reach a point where they can't help noticing their
muscles shrinking, their energy withering, their self-confidence
crumbling, and their virility taking a tumble." They have entered
the "Gray Zone." This is a time men don't want to discuss, nor do
they understand it. Oftentimes, they have depression which
manifests as anger. They have lost "aggressive energy"--the
ability to solve problems.
The authors continue on Page 5 by pointing out that, "The
time that elapses between the first hesitant signals of the male
change of life, and its full ugly flowering can easily be 10 or
Since a woman has cessation of estrogen during menopause,
but a male may still secrete small amounts of testosterone even
into old age, the male "change of life" is now no longer known as
male menopause, but is now called male andropause.
"In both humans and animals, it [estradiol, one of the 3
estrogen molecules] relaxes arteries and boosts blood flow; it
also minimizes thickening of the carotid artery, an indicator of
atherosclerosis." [Science, "The Great Estrogen Conundrum," Nov.
14, 2002, Page 1136.]
Dr. Shippen, writing in The Testosterone Syndrome, says it is a "well-known fact that estrogen causes increases in clotting factors as well as narrowing of the coronary arteries in men. Recent research has confirmed that high
estrogen levels are associated with increased risk of heart attacks in males--the exact opposite of its effect in females, in
whom it [estrogen] certainly has cardioprotective effects, dilating the coronaries, decreasing clotting factors and revving
up the body's natural clot-busting system."
In Science, the authors feel the problem with the Women's
Health Initiative (WHI) is that
- "the dose [of estrogen] was
too high, a sudden boost for women who had lived with lower
hormone levels for years."
- They also point out that the type
of estrogen and progesterone may be the problem because it was
synthetic and not natural.
"Before menopause, the female body gets only intermittent
pulses of estrogen and progesterone.A constant supply of
estrogen, researchers say, may dull the sensitivity of estrogen
receptors." And herein may lie the problem.
In short, as men and women age, they are losing youthful,
endogenous (natural) hormone levels that appear to protect the
heart and dilate the coronary arteries, testosterone in men and
estrogen in women.
Interestingly, increased estrogen levels in men causes (1)
connective tissue abnormalities, (2) fibrosis (formation of
fibrous tissue) which extrapolates to loss of elasticity, which is
a cause of high blood pressure, and (3) inflammation. [Ray Peat's Newsletter, November, 2003.] [Inflammation is now recognized as a cause of heart disease. See: www.lef.org; Science, November 7, 2003, Vol. 302, p. 965, and U.S. News & World Report, "The End of Heart Disease," December 1, 2003, Vol. 135, #19, Page. 39.]
All three of these things can generate tears in the coronary
arteries or other delicate arteries in the body, setting the
stage for atherosclerosis.
Matthias Rath contends that large amounts of Vitamin C,
spaced throughout the day, along with taurine, lysine and proline
help reduce atherosclerotic plaque in heart disease and has case
studies to prove it.
Testosterone appears to help protect against male
andropause, which in turn, may offer protection from
cardiovascular disease. Life Extension magazine, December, 2003,
page 66, points out,
"Everyone recognizes that the risk of
developing congestive heart failure (CHF) increases with age, but
the fact that the increased risk may be tied to reduced gonadal
testosterone production has not yet been completely accepted by
practitioners of conventional medicine."
In regard to your question, it can be further elucidated
that there is a delicate balance between catabolic (breakdown)
processes and anabolic (build-up or protein synthesis) processes.
- When the anabolic processes are greater than the
catabolic, this implies growth and youthful hormone levels, which
further implies increased or youthful levels of testosterone and
insulin-like growth factor-1 (IFG1), and others.
- But as we age, and the anabolism begins to equal
catabolism, and catabolism goes into increase, we see an
accumulation of too much cholesterol, less efficient carbohydrate
metabolism, and other processes that begin accumulating. This
leads to dysfunction, which leads to disease.
- As catabolism increases, there is a rise in cortisol
and a corresponding decrease in DHEA, hGH, testosterone and other
hormone levels from youthful (desirable) levels.
According to Klatz in The Anti-Aging Revolution, there are
changes in the body mass index and a number of authorities agree
that there is a severe possibility of heart failure. [Anker SD,
Clark AL, Kemp M. et al. "Tumor necrosis factor and steroid
metabolism in chronic heart failure: possible relation to muscle
wasting." J Am Coll Cardiol 1997 30(4):997-1001.] [Muller J.
"Cholesterol, interactions with testosterone and cortisol in
Cardiovascular diseases." Berlin: Springer-Verlag: 1987.]
The main anabolic hormone is testosterone. The main
catabolic hormone is cortisol.
You didn't mention whether your blood pressure is high or
not, but testosterone therapy reduces blood pressure and at the
same time relaxes the brachial arteries where the blood pressure
is taken. It has been shown that injecting testosterone directly
into the coronary arteries produces dilation and increases
coronary blood flow. [Marin P, Holmang S., Jonsson L, et al. "The
effects of testosterone treatment on body composition and
metabolism in middle-aged, obese men." Int J Obes 1992 16(12):991-
7.] [Ong, PJ, Patrizi G, Chong WC et al. "Testosterone enhances
flow-mediated brachial artery reactivity in men with coronary
artery disease." Am J Cardiol 2000 85(2):269-72.] [Webb, CM,
McNeill JG, Hayward CS, et al. "Effects of testosterone on
coronary vasomotor regulation in men with coronary heart disease."
Circulation 1999 100(16):1690-6.]
Testosterone therapy may also improve cardiac function by
relieving stress on the heart muscle during systole and diastole,
and increasing the blood flow through the coronary arteries. We now know that testosterone does--indeed--relax coronary arteries: This keeps down coronary spasms and less use of nitroglycerine.
Dr. Matthias Rath, in his book, Why Animals Don't Get Heart Attacks But People Do, points out in numerous places that many people have averted a heart attack and reduced plaque or cleared it from their coronary arteries by following his method of applying cellular nutrients. These people had been having angina and had coronary artery scans on an ultrafast CT scanner, showing they had occlusions that were generating heart pain. On following his plan of cellular nutrients, they reduced the occlusions, and some of the arteries became patent again.
You can get testosterone in patches, gels, implants, buccal
release, injections and creams. We suggest that the easiest and
safest to use is the natural testosterone cream. Without
elaboration, avoid the testosterone shots, especially methyl
testosterone, as it has been implicated in liver damage.
We also suggest hGH therapy and a host of anti-aging
nutrients you can find discussed at www.lef.org.
Find a knowledgeable doctor who knows how to test for these things, to see where you are, according to age, on the hormonal scale, and who will administer the therapy accordingly. But remember, you need testing--regular testing, when you enter into this kind of therapy.
If you use an internet pharmacy and physician. You will not have a personal or face to face interaction with your physician, unless they are into---some are---web cams. This source is for use by people who are willing to do regular testing to monitor their progress. Some tests you will need to run regularly are Free Testosterone, Total Testosterone, Sex-Hormone-Binding Globulin (SHBG), Estradiol, PSA, and a CBC with a liver panel and regular blood chemistry, including a PSA test. Have these tests performed before beginning therapy, and 6 weeks after beginning therapy. By doing so, you may discover you need less testosterone, save money, and the tests help rule out prostate cancer. These tests may also show your blood fats are being reduced, or are normal, such that you can reduce or stop taking a statin drug you may be on at present. [Life Extension, October, 2003, Page 74.] It would also be advisable to have a digital rectal exam from your doctor.
If your doctor is willing to work with you and is not up on
optimum youthful hormone levels for males versus aging male
hormone levels, then be advised of the following: "...blood test
laboratory reference ranges are age-adjusted to reflect the
anticipated reduction in testosterone production. So, when a
doctor looks at an aging man's free testosterone blood test
result, he often sees it fitting neatly into the standard
reference range for a normal aging man. The problem is that
normal aging men are expected to have lower testosterone levels,
which are far from optimal (youthful) ranges. The optimal
testosterone level for most aging males are those of a healthy
21-to-30 year old." [Life Extension, October, 2003, Pages 65-66; ibid"20-29 year old" (women)...April, 2006, p.54]
What this means is that you want the hormone levels of a
healthy 21-30 year old male. You don't want your doctor saying,
"Oh! You are falling within normal testosterone levels for your
age," and you are falling apart! Get the message? You want
youthful hormone levels to help slow down the aging process.
Coronary artery disease is considered a degenerative, aging
process. So are those subtle symptoms of slowing natural
testosterone production you may be starting to notice: declining
strength and energy, and "a depressive change in personality
quite apparent to wife and friends." [Testosterone Syndrome, Page
And if your doctor still balks, point out to him that
HealthCheck, Inc., (a laboratory testing firm which uses Lab One)
in the state of Texas, in their brochure advertising the blood
tests they offer, points out for the first time: "TESTOSTERONE:
For men and women concerned about osteoporosis, low muscle-mass,
depression, sexual function, and anemia." Testosterone has come of age!
If he's too hard-headed to follow this top lab and their recommendations, then give him a copy of The Testosterone Syndrome, by Eugene Shippen, M.D. and William Fryer, to educate him, and be prepared to find another doctor.
This Update article and its references should also give you
plenty of ammunition when you talk with your doctor about hormone
Remember, androgen therapy is no longer about sex anymore--
- Muscle mass,
- Bone mass,
- Get-up-and-go, and
- Also about helping to prevent heart disease.
I can hear what you're thinking: "If this be so about
testosterone and the heart, why don't more cardiologists use
It is because they are still practicing that portion of
medicine from the 70's and 80's, when it was believed that
testosterone caused heart disease. It is now well known that
testosterone PREVENTS heart disease.
As one retired physician puts it, "Doctors tend to be down
on what they're not up on."
On this matter in regard to cortisol, once you build back
your bone and muscle mass through hard exercise and androgen
replacement therapy, you don't want to lose it at night during
sleep. Why does this happen? Again, it's because of cortisol.
At 2 A.M., the hormone cortisol that is naturally produced
by your body is at its 24-hour zenith. It tells your hard-earned
muscle mass to be turned into amino acids, to be turned into
sugar. There's the difficulty. You are now losing what you spent
time and money building up. Why? Because cortisol shuts down
testosterone and ups myostatin (a protein that prevents muscle
cells from growing). With cortisol riding high when you go to
sleep, testosterone can't bind or stay bound to its receptors.
Your cells pump out myostatin, and with myostatin riding high,
your muscles can't grow.
What's the cure? Dextrose in protein, as well as maltodextrin. These raise glucose levels rather rapidly, and the protein you ingest at night can be broken down by the body and used to rebuild the muscle mass, and these substances can supply cortisol with amino acids, dextrose, and maltodextrin, etc., to be changed into energy. But by taking the proper glucose or maltodextrin and the proper protein in the form as sustained nutrients or extended-release substances such that they last 6 to 8 hours in the system, you cause a biofeedback mechanism to go into effect, telling the adrenals there is enough glucose in circulation and there is no need to chew up tissues of the body.
Doing such, cortisol levels drop down. Therefore, you are keeping your testosterone levels from dropping too low, and you are controlling your cortisol. Remember, stress enhances cortisol secretion Stress is everywhere...exercise, playing, worrying, etc. Try to control excess stress through meditative prayer, relaxation techniques, and you can ingest Cortisol Control by Vitamin Research Products.
Another product we recommend for muscle loss and to feed the stressful situations in your life is Muscle Milk, by CytoSport, available at natural food stores, to be taken before bed. Some delicious flavors are:
These would be excellent also for cancer patients, at night and between meals.
- Banana Cream,
- Cookies and Cream,
- Orange Cream,
- Blueberry Cream,
- Pina Colada, and others.
Testosterone and hGH are not just for men. Everything said here applies to women also.
Men should have their estradiol levels checked by a blood test. An estradiol greater than 30 picograms per milliliter is
too high, and you will need an aromatase inhibitor to keep these levels down. Ask your doctor, or your internet physician, about Arimidex (0.5 mg. twice a week), or take chrysin and bioperine from your natural foods store to keep testosterone from being converted by aromatase enzyme into estradiol. In a man, high estradiol levels cause heart disease. We further recommend T-Bomb II by MHP.
If you combine cellular nutrients from Matthias Rath with testosterone and hGH therapy, you might just clean out your arteries, besides reclaiming youthful hormone levels, feeling more robustful and vigorous.
- Clinical Cardia Rehabilitation, A Cardiologist's Guide, 2nd Ed., Edited by Fredric J. Pashkow, William A. Dafoe, 1999.
- Principles of Anatomy and Physiology, 10th Ed., Tortora, Grabowski, 2003.
- Growing Young with HGH, Dr. Ronald Klatz, 1998.
- Ray Peat's Newsletter, November, 2003, "Vitamin E: Estrogen Antagonist, Energy Promoter, and Anti-inflammatory."
- Life Extension Website: www.lef.org
- Morley JE, et al. "Effects of testosterone replacement therapy in old hypogonadal males: a preliminary study." J Am Geriatr Soc 1993 Feb;41(2):149-52.
- Hajjar RR, et al. "Outcomes of long-term testosterone replacement therapy in older hypogonadal males." J Clin Endocrinol Metab, 1997 Nov;82(11):3793-96.
- Wang C, et al. "Transdermal testosterone gel improves sexual function, mood, muscle strength and body composition parameters in hypogonadal men." J Clin Endocrinol Metab 2000, Aug;85(8):2839-53.
- "Talk to Your Doctor About Arimidex," AstraZeneca Oncology Pharmaceuticals, L.P.