Ask Dr. Mike: Testosterone Therapy, Migraine Headaches & Are there Supplements for HIV?

Additional Info

• Segment Number: 5
• Audio File: healthy_talk/1511ht1e.mp3
• Organization: Life Extension
• Guest Website: Healthy Talk MD
• Transcription: RadioMD Presents: Healthy Talk | Original Air Date: March 9, 2015
  Host: Michael Smith, MD
  
  RadioMD. It's time to Ask Dr. Mike. Do you have a question about your health? Dr. Mike can answer your questions. Just email: AskDrMikeSmith@RadioMD.com or call now: 877-711-5211. The lines are open.
  
  So, this first question is a medical myth. It has to do with a medical myth. Let me just state the medical myth and then I'll go into the question that Ryan sent in. Here's the medical myth: testosterone supplementation or testosterone hormone replacement in a man causes prostate cancer.
  
  That is a myth. That myth is just a myth. It's not factual. It's been disproven that testosterone causes prostate cancer. As a matter of fact, the research disproving this goes back many, many years and it comes out of Harvard. Dr. Morgentaler is a Harvard researcher who is a urologist and he did a lot of research talking to thousands of men looking at testosterone replacement, prostate cancer. There's just no link. As a matter of fact, it's low testosterone that tends to cause the problem and if I have a chance, I'll explain that, but let me go to the question Ryan sent in.
  
  "My doctor put me on testosterone a couple of years ago because it was extremely low. Since then, I have more energy and my libido is awesome, but now he wants to stop it because my level is high. He says it could be dangerous to continue. What are your thoughts? Thanks, Ryan."
  
  Well, I mean, I don't know what you mean by your testosterone is high. Now, there is an optimal range and it's not the conventional range that you'll find on the lab report, Ryan. Instead, I like men to have testosterone levels of that when they were in their 20s, you know?
  
  Upper 20s which is somewhere between 500 and 700. So, when you say "high"—and, by the way, the conventional lab reference range that you see on the lab result, that's based on your age. I don't know what your age is, but let's say you're 60. The average testosterone for a 60-year-old man, if you just look at all the 60-year-old men out there, the average testosterone is probably more like 250-450.
  
  So, if you're taking testosterone and you get up in the 500-600 range, your doctor's going to say, "Oh, my god. That's too high." Well, no, I actually think that's optimal. I want you to be more like a 20-year-old. So, that's hard to answer because I'm not really sure what you mean by "high". Now, if you're over 700, 800, 900 and into 1000, then, yes, maybe you do need to take a little break. There is an optimal range. There's an optimal range and dose for everything we do, including hormones.
  
  So, assuming maybe you're high for your age, but you're in the optimal range that we like to see, no, I don't think there's any reason to discontinue it. Pulling from your question, here, your doctor thinks it's "dangerous to continue", and I think I'm making a lot of assumptions because I don't have a lot to go with in the question, but most likely your doctor is following that medical myth that testosterone causes prostate cancer and it doesn't.
  
  That's been well disproven by really good research coming out of Harvard. By the way, we've summarized all of that research at LifeExtension.com. You can just search "testosterone, prostate cancer". Search "Dr. Morgentaler". He's done some great work over the past 20 years on all of this and there's no association of taking testosterone and increasing prostate cancer risk. It's a myth.
  
  As a matter of fact, what we do believe is causing most of the prostate issues with men is not high testosterone, it's actually low. So, the question becomes, "Well, why is a guy's testosterone level low and how is that affecting the prostate?" Well, number one is, we don't make as much testosterone, so we are losing production, but also what happens is testosterone, as a man gets older, tends to convert into the estrogens more and also converts into a very potent form of testosterone called "DHT" or dihydrotestosterone. Most of the research is showing that it's the estrogen and it's the DHT that's affecting the prostate that's causing the problems, not testosterone itself.
  
  Not free testosterone which is actually dropping.
  So, assuming that your doctor is calling it dangerous because of the prostate cancer risk, well, it's just wrong. What I might encourage you to do is print out some of the articles that we've written at Life Extension summarizing Harvard's Dr. Morgentaler's work and take it into your doctor. Say, "Here's the truth of it. What do you think now, doc?" and see what he wants to do about that.
  
  If he still doesn't want to give you more testosterone, maybe you go find another doctor. You are the consumer. So, that's what I would do. I would show your doctor that it's just myth to think testosterone replacement increases prostate cancer risk.
  
  Now, the flip side of that, though, there is a caveat there. If you have prostate cancer—you've been diagnosed with prostate cancer—and you start taking testosterone, well, that's maybe not good because sometimes those prostate cancers require testosterone to grow which is why we often treat prostate cancer with testosterone deprivation therapy or androgen deprivation therapy. So, if you already have established prostate cancer, don't do it. Right? But, it's a myth to think that testosterone increases the risk of developing the cancer in the first place. That's the myth. Okay?
  
  So, maybe you just need to educate your doctor and, hopefully, he's open to that education, Ryan.
  
  Okay. Next question.
  
  "I seem to suffer from migraines without the headache. I experience visual changes. My sight narrows and I see flickering lights for 4-6 hours. Do you think this is migraine?"
  
  You know, that's a really interesting question because I don't know. I don't know if I have an answer for that. We know that migraines and cluster headaches do cause these types of visual auras and stuff like that. Some people get a weird taste in their mouth. Usually, these kinds of things precipitate—come before—the headache.
  
  But, you're not having the headache, so I'm not really sure what that is. You might want to, first of all, just make sure it's not something in your eyes. We know flickering lights and stuff like that could be some retinal issues, like retinal detachment issues, but if this is happening a lot, that's probably not the case.
  
  I'm assuming this is kind of like this aura type thing that people get before a migraine. It does sure sound like it. I guess technically it just maybe never develops into the headache pain, but this is kind of stumping me. I'm not really sure. If it's not bothering you—I mean, I'm sure sight change probably is bothering you--but if it's not bothering you too much, maybe you just let it go. Hopefully, you won't ever develop the actual pain which can be debilitating for people. This is a good one.
  
  I'm not sure and because you're asking me, you've probably have already asked your primary care doctor, maybe even a neurologist, and they probably didn't have an answer for you either, but it is interesting. So, I'm not really sure where to go with this one at this point.
  
  Let's go on to the next question.
  
  "Are their supplements for HIV? I know that a basic multivitamin can help, but is there anything that fights the virus directly?"
  
  Well, there are some interesting things out there, but nothing is going to replace the Triple Therapy, right? Usually, you take 3 different drugs that work on 3 different parts of the virus and that really has saved lives.
  
  There's no doubt about that. Most of them are even just one pill a day now, so that's awesome. I just want to make sure you understand, I do have some information here that's interesting, but none of this stuff would ever replace the prescription therapy, right? So, let's just make sure that's clear. Maybe what you do is, you do this on top of that prescription therapy, but, of course, talk to your own doctor first. First of all, there is evidence that soy protein, specifically, what are called isoflavones, might be able to block the entrance of HIV into the immune cells.
  
  Selenium might be able to block replication of the cell and even some mushroom extracts like reishi may also be able help. So, that's soy, selenium and reishi fighting HIV.
  
  This is Healthy Talk on RadioMD. I'm Dr. Mike. Stay well.
• Length (mins): 10
• Waiver Received: No
• Internal Notes: NO GUEST
• Host: Mike Smith, MD