Testosterone may be beneficial as a treatment for CAD because testosterone can improve conditions that contribute to heart disease, such as diabetes, obesity, high cholesterol, and triglycerides. Testosterone improves conditions that contribute to heart disease by:
- dilating the arteries, improving circulation, and lowering blood pressure in most studies (Dubey et al. 2002). Because some people get an increase in blood pressure with testosterone therapy, it is very important to monitor blood pressure.
- binding to receptors on the arterial wall. Testosterone receptors have been found within human arteries, including aortic, coronary, pulmonary, and carotid arteries, providing evidence that it can affect the arterial wall (Muller et al. 2004).
- lowering LDL, triglycerides, and Lp(a).
- activating nitric oxide synthase and, thus, increasing nitric oxide-dependent vasodilatation (Jones, Hugh Jones, and Channer 2004).
- converting into estrogen via the aromatase enzyme. Normal levels of estrogen may have a beneficial impact on the arterial wall in men.
If your total testosterone is normal (say, above 350), your free testosterone may still be low. Make sure to ask for total and free testosterone. If you are borderline low, your doctor may be unwilling to prescribe testosterone. Don’t despair, because there are methods for raising the free level with natural treatments that I will discuss below.
Technically, you can legally get a prescription for testosterone if either free or total testosterone is low. The best way to take testosterone is as a cream, implanted pellet, patch, or intramuscular injection. Oral testosterone pills should never be used unless they are bioidentical micronized testosterone. If insurance won’t cover testosterone, ask your doctor to give you testosterone shots; they are much less expensive than all the other options. Shots of 50 to 100 mg per week usually do the trick.
Alternatively, another way to boost testosterone is with human chorionic gonadotropin (hCG). This is a good option if you are younger (under fifty) and don’t want the decrease in sperm count or decrease in testicular size that testosterone therapy can cause. HCG may also increase fertility. HCG and testosterone may be used in conjunction with each other. Intense exercise also boosts testosterone, especially weight lifting, but the effect only lasts a few hours. Never check your testosterone after exercise; it will be artificially high.