“T-Therapy” [Testosterone] Under the Microscope



A government committee discovered that, among a sample of nearly a quarter million men, as many as 21% had been given a prescription for testosterone despite not being tested for low-T.

In other words, physicians simply asked patients how they were feeling, and if the answer was anything like “I don’t seem to have the same energy I had at 17…” they got the drugs.


In 2013, over 2 million people were prescribed T-therapy.

In 2014 the number doubled, and Androgel alone reaped $1.4 billion in sales.

In 2014 testosterone products, in general, reached $2.1 billion in sales.

Last year, 6.5 million prescriptions were written for or testosterone products. You can do the math yourself.

Late last year, a joint FDA advisory committee examined the therapy and its potential association with cardiovascular therapy, among other burgeoning issues and abuses.

The findings were shocking. In addition to not being tested for Low-T, 57% of men on T-therapy were also taking either one or several other cardiovascular medications, such as anticoagulants, antihypertensives, anti-platelet therapies, statins, and nitrates. How these medicines work together in the body is not known.

After the preliminary findings were in the FDA voted 20-to-1 to revise the labels of T drugs, including AbbVie’s AndroGel and Lilly’s Axiron to make it abundantly clear that the products should only be prescribed to men who seriously need it.

According to Bloomberg, this is having an effect on sales. For example, IMS Health’s sales alone have plummeted 6% in the first half of 2014 in the same period from the year before.

The National Institutes of Health is sponsoring a short trial comparing men on T with those on a placebo. These results should be quite interesting, as they’ll include information about sexual function and bone health.

I’ll keep you posted on this.


Keep these things in mind the next time you hear a TV or radio ad telling you to “talk to your doctor about low-T.” Even more importantly, pay attention when Physicians or “health” Clinics themselves run ads claiming that testosterone replacement for all aging men is the wave of the future, alongside healthy eating, exercise and a month a year in Aspen to reduce stress.

What these companies [and individuals] fail to mention in these ads is that lower testosterone levels is a natural part of aging, not a medical condition, and that there are very real, life-threatening side effects to these products.

According to Drug Recall Attorney’s Blog, millions of men bought the marketing gimmick, asking their doctors for prescriptions for testosterone products. Michael Seaburn was one of them. He started using Testim and AndroGel topical testosterone treatments. Within two years after starting these treatments, Seaburn had two heart attacks, suffering immense pain and anguish, loss of life’s pleasures, and significant economic losses.

Seaburn, like millions of other men, was not told testosterone treatments had strong links to heart complications, strokes and death. He claims companies like AbbVie purposefully encouraged men to view the normal signs of aging as a “condition,” that could be treated with products like AndroGel.

Sound familiar?

According to the article, “Not only were these companies investing in mass marketing, they were also paying for continuing medical education courses (CME), which doctors are required to take. Pharmaceutical companies and medical device manufacturers support CME programs regularly, to the chagrin of Congress and public advocates. A series of investigations between 2007 and 2009 revealed that these CME courses often acted as aggressive promotions of off-label drug uses (such as promoting testosterone therapy for men without diagnosed hypogonadism). Today, about one-quarter of CME income ($676 million) is from drug/device companies, who create course curriculum and hire faculty.

A review by Journal Sentinel and MedPage Today looked at 75 drug industry-funded testosterone therapy CME courses. Researchers found that a majority of the courses’ faculty were already on drug company payroll for speaking, consulting, and advising roles. These testosterone courses are another part of the effort to turn the natural aging process into a medical condition. Eli Lily alone spent $1.8 million to fund more than 25 testosterone-related CME courses between 2011 and 2014.

CME courses are supposed to be free of bias, but drug companies clearly use the platform as an opportunity to market products directly to doctors for off-label uses. The FDA has stridently stated testosterone products are not to be used in men with low testosterone due to aging, but doctors are prescribing them exactly for this use based largely on CME material. CME courses not only encourage off-label prescribing, but also downplay or completely conceal drug risks.”

At this writing, thousands of lawsuits have been filed against testosterone products companies, and the numbers continue to climb at an alarming rate.


Testosterone therapy can contribute to…

1] Sleep apnea — a potentially serious sleep disorder in which breathing repeatedly stops and starts

2] Acne or other skin reactions

3] Noncancerous growth of the prostate (benign prostatic hyperplasia) and growth of existing prostate cancer

4] Enlarged breasts

5] Limitations in sperm production and testicle shrinkage

6] Increased risk of a blood clot forming in a deep vein (deep vein thrombosis), which could break loose, travel through your bloodstream and lodge in your lungs, blocking blood flow (pulmonary embolism)

7] Increased risk of heart disease.



At my health club, it is considered perfectly normal – even enlightened – to take pharmaceutical grade testosterone, either in pill form, gels or injectables.

As one man said to me “I lost belly fat without having to workout all day. I put on more lean mass just getting out of bed. I have a six pack I never knew I had. And my sex drive has become so strong that I now have a hooker on speed dial.” 

If you’re living in the moment, the side-effects of drug use pale in comparison to the short term results.

If this is your mindset, there’s a dealer on every street corner in Houston.

Remember that Testosterone use for many is like drug addiction.

In fact, many drug addicts, alcoholics and men with related compulsive personality disorders simply swap one addiction for another.

All are in complete denial about side effects until they hit rock bottom.

Before that happens – and it will happen – any good news that can siphoned from the flood of bad is used to justify their addictions.

See, it really doesn’t matter what the addiction is [i.e., drugs, sex, gambling, alcohol…etc].

What matters is how long you can keeping shuffling the deck before you run out of cards.




How To Avoid “Old Man Flat Butt”

RL0Zov6Nothing quite says old like a flat butt!

I can’t help but visualize a hole drilled into a sheet of plywood.

Anyway, I’ve discussed this issue on more occasions than I care to count because I see more of this than I care to see.   


Okay, we all age and die.


Now that that’s out of the way, let’s get started.


There are many reasons why men suffer flat butts.

Here are a few:

1] Low Testosterone Levels

Among other things, Low T decreases sex drive, and thus, the motivation to look one’s best.

Why would a guy with Low T focus on the shape of his butt when his biggest concern is how to get through the rest of his life without joint pain?

Looking good in a pair of designer jeans is not his objective. 

But raise his T levels and all of a sudden he’s back in the gym, visiting a divorce attorney and signing on to an Internet dating service.

2] The Endurance-Sports-Addicted

You’ll notice that as men age they many do more endurance sports, like triathlon where they swim, bike and run.

The reason for this is simple: They aren’t ballistic. You can swim, bike and run into a freaking trance until there’s nothing left of you but skin and bones.

Soon, testosterone levels flatten out along with any and all body fat, and suddenly, the butt disappears.

While these guys tend to look great in the pool, put them in clothing and it’s like – where did he go?

3] The Clinically Depressed

Some men are more accepting of life’s changes and just go with the flow. Their wives are old and fat and they’re resigned to a life of the just happy to be alive mentality.

What they’re happy about I don’t know.

These are men who are shocked to meet someone like me who dares point out that none of this is inevitable, that they can do something about their deteriorated conditions and fading relevance that reinforces their decline.

Unfortunately, no matter how hard I try to get through, many have lived for so long in this depressive and vegetative mindset that no matter what anybody says to them, it’s like a dream that vanishes the second they open their eyes and see that same old world.

It’s like Stockholm Syndrome where they keep going back to what’s familiar.

It bears noting that many older men accept depression as a normal part of aging and life in general, and therefore, cannot fathom a world in its absence.


1] As men age, total testosterone levels decline. Free testosterone (testosterone not bound in the blood to sex hormone-binding globulin (SHBG)) levels decline more rapidly than total testosterone. Studies have shown that total testosterone decreases by approximately 30% in healthy men between the ages of 25 and 75. Free testosterone levels decline even more significantly with decreases of approximately 50%. However, only about 1 in 5 men have a total testosterone level that falls below the normal range. Fortunately, many healthy lifestyle choices, such as heavy resistance training and aerobic exercise, quality sleep, and a healthy diet can actually increase testosterone production naturally.

Will Testosterone Replacement Therapy Cure All of the Ailments Associated with Aging?


Testosterone replacement therapy will not make up for poor diet, lack of exercise, and a generally unhealthy lifestyle. It is not a magic bullet, nor will it reverse aging.

For those with low testosterone, combining proper diet, exercise, good sleep, and other positive lifestyle modifications with testosterone replacement therapy can make you stronger and leaner and feel better.

Of course, it’s kind of a Catch-22, because when your levels are low you’re not motivated to make changes in your lifestyle unless you’re surrounded by people who believe that life doesn’t end at 60.

2] Studies consistently show that high-volume endurance exercises reduces baseline androgen hormones by 20-40 percent. The androgen hormones include testosterone, estrogen, and DHEA.

Endurance exercise leads to larger acute elevations of the key stress hormones cortisol. Excess cortisol has a catabolic effect on muscle tissue, breaking it down and leading to persistent inflammation.

In other words, you can’t put on a tight, round butt when your hormones are flat.

3] Depression as normal.

Feeling sad or emotional is the main symptom of depression. But for many men that isn’t the primary depression symptom. For example, headaches, digestive problems, fatigue, irritability or chronic pain can sometimes indicate depression.

You may not recognize how much your symptoms affect you, or you may not want to admit to yourself or to anyone else that you’re depressed. But ignoring, suppressing or masking depression with unhealthy behavior won’t make it go away.

From my experience, many older men simply accept depression as a normal part of the aging process. Why would being older not make one depressed?

For one thing, you look worse than you did when you were young.

But what many men fail to see is that you don’t have to look like twigs from dried shrubs glued together and then coated in a thin sheet of rubber.



See a primary care physician for a blood test, a psychiatrist for a clinical diagnosis and a personal trainer to keep you out of a nursing home.

Then do what women do and wear that butt with pride.

They’ll thank you for it, trust me.


1] Squats

2] Gluteus kickbacks

3] Pelvic tilts

4] Lunges

5] Bridges

6] Deadlifts

7] Step-ups

8] Deep leg presses

You’re welcome.

Steroid Use Among Boomers Goes Airborne [Apparently]


Me at 60, sans steroids… [aka., testosterone, anabolic steroids, Human Growth Hormone, et al…]

I’m a sort of freak where fitness is concerned.

I train with guys half my age are usually dead, metaphorically speaking.

But this does require a bit more qualification: No one who is “all natural” can keep up with me.

In gym parlance, “all natural” means that the individual in question does not take pharmaceutical grade testosterone and/or anabolic steroids.

Men my age who do take Testosterone and/or anabolic steroids have an edge over me in both recovery and endurance.

Their recovery is twice as fast and their raw strength is well above 30% of what it would be without the needles, and I use that percentage conservatively.

With this as a snapshot of human life in the fast lane, understand that the pressure capitulate to what’s become the status quo is tougher than ever before.

Why the popularity of drug use?

1] We’re older, and thus, have less time to enjoy the time we have left.

2] We have the funds necessary to afford the drugs.

3] We’re vain.

4] We’re easily addicted. The concept of life outside the gym is about as ridiculous as trying to convince a junkie that lemon juice and water is a healthier alternative to heroin and vodka.

So everyone’s a “lifer.”

Is there hope?


My generation will continue to buy and promote drug use because it’s faster and easier than spending 5 hours in the gym – and still walking away with a distended midsection.

It all gets down to what’s quick, easy and purchasable under the law.

I get it.

But like everything else in life that makes – and to some extent – delivers on great promises, there is a darker side.

But what the hell … live for the moment, die the next…it’s all good.

Fading away just isn’t an option.

In my case, I have to work harder, take more time to recover, eat perfectly...and most importantly, have a full life outside the gym.

I realize my priorities are warped, particularly the last one.

Psychopathology of the Pot Belly


Allow me preface this discussion with the following: I do not personally know anyone my age who looks like the individual in the above photograph.


Yesterday I was standing in the meats section of a grocery store when I noticed a man in his mid-50’s sporting what is commonly referred to as a “pot belly.”

In the upper thresholds of obesity, it most closely resembles that of a pregnant woman at full term, which is 39 weeks to 40 weeks and 6 days.

Like women in such a condition, the protuberance is surprisingly hard, and as round as a basketball at 4 times regulation size, but similar pressure.

As I stood there waiting for him to finish ordering his 22 pounds of heavily marbled red bloody meat, I couldn’t help but wonder what would happen if the butcher hacked it all off in one fell swoop.

Would the man thank him?

See, if it weren’t for the Volvo-sized anomaly situated at his midsection, the balance of his anatomy would appear completely normal.

This is why people think these things.

Kids do it all the time with Legos, so stop judging.

Without formal medical analysis, I feel comfortable speculating that he and men like him suffer type-2 diabetes, impotence, high blood pressure, high cholesterol and depression, the later of which having paved the way for the aforementioned 4.


With this in mind, some people eat when they’re depressed.

Why they do this is beyond me.

When I was depressed I would run, swim, bike, and lift weights – sometimes all day – and often, night – until the demons went back to bed.

Not only was this a successful ritual, but I came out of it looking and feeling better.

Of course, this has been my ritual for the better part of my life, including all of it.

So what the hell happened to the guy next to me?

Medical Realities

After age 40, the natural reduction in testosterone means excess calories are often stored as visceral fat. We also naturally lose muscle mass as we age, the key word here being ‘naturally,’ because if you do nothing we will lose everything. This also applies to money, if this helps.

If we exercise, however, we can pretty much check that one off the list.

Unfortunately, most men don’t exercise regularly, so they lose muscle mass, and their metabolisms stop burning at a solid rate. When you lose muscle — about 1 pound per year after age 30 — your metabolism declines, and it becomes easier to gain fat, which often goes straight to the belly in men.

The Psychopathology

With these facts in mind, if a man were largely [no puns] inactive his entire life, and at age 40 his testosterone levels started to slip, he’d get hit like a bag of bricks.

Not only would he have no lean muscle mass to keep pace with the hormonal attrition, but the necessary adjustments to his lifestyle would be as tough as substituting heroin for treadmills in the mind of a junkie.

I do know a couple of large men who are big enough overall to pull it off without completely embarrassing themselves.

One of them, in particular, was a collegiate athlete with a commanding presence.

He, like Chris Christie, is an achiever with an otherwise full life.

This is rare. But in spite of their relatively healthy self-esteems, health still takes a hit. A big one.

I once heard a Bariatric surgeon say that fat is genetic, and therefore, men who are obese can’t help themselves without lap-band surgery.

At this writing he is anorexic after beating his own fat addiction.

I assume genetic includes psychiatric predispositions.


1] Contrary to popular opinion, the first order of business is to seek guidance from a psychiatrist.

2] The second order of business is to find a good Internist who will run complete blood analysis followed by a stress EKG and heart scan.

3] Third order of business is to go back to the psychiatrist and give him or her the results. You will start from a low baseline from which you will rebuild what has been lost since childhood.

4] Your spouse will not understand any of this and in many cases pay a hit man to kill you if any of this starts to work and you rethink your living will [and marriage]. Understand that part of your therapy will involve your life choices, including your choice in mates. It’s all tied together.

5] Once you get a handle [no puns] on who you are – and as a result, what happened along the way – you will realize that while your genetics played a role in all of it, your mental health sealed the deal.

Dennis Quaid at 61


Dennis Quaid is 6’0″, #175 at what looks to be well below 10% body fat.

By comparison, I’m 6’1″, #230 at 13% body fat, which places me in the top 1% of my age group.

Most people consider this extraordinarily fit.

But I’m not shredded like a slab of turkey jerky, and herein lies the rub.

See, in order to put on – and hold – lean muscle mass at less then 10% body fat [at age 61!], you’ll need help of the preternatural kind.

To wit, Quaid has more lean, angular mass on his shoulders and arms than any man his age can normally produce without “help.”

I’m not accusing him of steroid use because I don’t know him. Maybe he’s a genetic freak. I’ve seen a few in my day.

For everyone else, pulling off tons of lean mass with low body fat is impossible without tinkering with testosterone levels.

What? You think we’re immortal?

Since when do men our age look like Quaid?

Some of you may consider him too lean, too small…kind of ragged, wasted even.

But for men who want this look, it can be acquired at “wellness” clinics and individual physicians operating throughout the United States.


1] If you want to perform at levels similar to what you achieved at age 30, you will need a lot more than hard work coupled with a hope and a prayer. 

2] I’m not judging, just exposing the truth.

3] You have to decide if the consequences of steroid use are worth the risks.

4] Denial is the mother of delusion.

5] I don’t care how Dennis Quaid chooses to live his life. His job is to entertain, not inspire.

Just trying to keep it real around here.