The limited benefits of the current approved drugs, together with the undesirable adverse side-effects of such agents in long-term management of obesity have contributed to reduced adherence rates and to discontinuation of use . Although lifestyle modifications are highly recommended, as integral part of strategies designed for treatment and management of obesity 5–7, in most patients, such strategies are not always successful in the long term because of high rate of recidivism, in part due to lack of adherence to prescribed regimen 8–11. Treatment of obesity necessitates evidence-based medical interventions 3,4. Lifestyle changes produce modest weight loss in the early stages of weight management strategies, but a high rate of recidivism is observed. The aforementioned improvements are attributed to improved mitochondrial function, increased energy utilization, increased motivation and vigor resulting in improved cardio-metabolic function and enhanced physical activity. I have been with them for over a year now and feel terrific getting my levels in check. For men with low blood testosterone levels and symptoms most likely caused by a low level, the benefits of hormone replacement therapy usually outweigh potential risks. Estrogen therapy increases sex hormone binding globulin and, like aging men, this reduces the amount of free, active testosterone in the body. Following a nutritious diet and healthy lifestyle using some of the tips outlined above can help optimize testosterone levels and promote overall health. Other research suggests that several herbal supplements could also help support healthy testosterone levels, including saw palmetto, ginger, and ashwagandha. Although the potential benefits of multivitamins are hotly debated, certain supplements may be useful for supporting healthy testosterone levels. Additionally, a 2020 review found that taking a vitamin D supplement increased testosterone levels and improved erectile dysfunction. Testosterone therapy increases LBM, reduces fat mass and produces sustained and significant weight loss, reduction in waist circumference and BMI. One may argue that testosterone therapy has been around for more than 75 years and no data have been reported on the effects of testosterone on weight loss, until recently. Long-term testosterone therapy in men with testosterone deficiency produced a significant reduction in total cholesterol, LDL cholesterol, triglycerides, and increased HDL. Testosterone therapy in men with testosterone deficiency with or without diet and physical activity not only produced reduction in fat mass but also improvements in cardiometabolic function and reduced carotid intima media thickness (CIMT), epicardial fat and trunk fat 46▪▪,58▪▪,70. Testosterone therapy in men with testosterone deficiency and differing grade of obesity produces significant and sustained weight loss. For example, did you know that testosterone is a key player in prostate cancer? When you think of testosterone, what comes to mind? Does everyone benefit from cutting saturated fat in their diet? Recently, another challenge was raised suggesting that testosterone therapy causes myocardial infarctions (MIs), stroke and death 112–114. Among the challenges of testosterone therapy is the myth that testosterone causes prostate cancer (PCa). A controlled 5-year study in men with MetS showed significant decreases in weight, waist circumference, BMI, HbA1c, HOMA-insulin resistance, total cholesterol, low density lipoprotein (LDL)-cholesterol, triglycerides, hsCRP, systolic and diastolic blood pressure, and an increase in HDL 46▪▪,70. Testosterone therapy significantly improved Homeostasis Model Assessment (HOMA)-insulin resistance, CIMT and hsCRP, TNF-α, weight, BMI and waist circumference 39,42,43,46▪▪,55,58▪▪,70. The predictors of weight regain are reduced levels of testosterone, retinol binding protein 4, SHBG and MetS 101,102▪. Testosterone therapy for 12 months in men with testosterone deficiency and spinal cord injury significantly improved LBM and resting energy and percentage basal energy expenditure . Reduction in CIMT with testosterone therapy was previously demonstrated 42,71.
