Testosterone replacement therapy (TRT) Benefits

Updated February 14, 2025
from old site;
February 3, 2018

The benefits of Testosterone Replacement Therapy or TRT has an astounding and largely positive effect on men with low testosterone or men looking to boost their testosterone levels. Low levels of testosterone in men have been shown to be connected with type two diabetes, visceral adiposity, dyslipidemia and metabolic syndrome.

Clinical Benefits of TRT

Metabolic Improvements

Testosterone therapy demonstrates significant metabolic benefits, particularly in men with hypogonadism. Studies indicate TRT can improve insulin sensitivity and glycemia control while reducing visceral fat accumulation - key factors in managing type 2 diabetes and metabolic syndrome. Recent research has shown:

• Up to 15% improvement in insulin sensitivity
• Significant reduction in HbA1c levels
• Decreased fasting glucose levels
• Enhanced metabolic flexibility

Body Composition Changes

Through its anabolic effects, TRT promotes lean mass preservation and muscle protein synthesis. Clinical trials show measurable increases in fat-free mass and muscle cross-sectional area, particularly when combined with resistance training. Key findings include:

• 2-5kg increase in lean mass over 6 months
• 10-15% reduction in visceral fat
• Enhanced muscle protein synthesis by up to 27%
• Improved strength and power output
• Accelerated recovery from exercise

Cognitive and Neurological Effects

Emerging research suggests testosterone plays a neuroprotective role, with TRT potentially slowing cognitive decline in aging males. Studies demonstrate improvements in:

• Working memory performance
• Executive function
• Processing speed
• Spatial awareness
• Verbal memory
• Mood stability and reduced anxiety
• Overall cognitive resilience

Cardiovascular Considerations

While historical concerns existed, modern studies indicate TRT may improve cardiovascular risk factors through:

• Reduction of pro-inflammatory cytokines
• Improved lipid profile modulation
• Enhanced endothelial function
• Reduced arterial stiffness
• Lower systemic inflammation markers
• Improved cardiac output
• Better exercise tolerance

Patient Considerations

Proper TRT implementation requires:

1. Comprehensive hormonal panel testing (including free testosterone and SHBG)
2. Regular hematocrit and PSA monitoring
3. Individualized dosing based on symptom response
4. Lifestyle optimization (sleep, nutrition, stress management)
5. Regular blood pressure monitoring
6. Periodic liver function tests
7. Annual prostate examinations
8. Bone density scans when indicated

Just a quick list of the benefits of testosterone with links to studies;

Testosterone replacement therapy improves insulin resistance, glycaemic control, visceral adiposity and hypercholesterolemia in hypogonadal men with type 2 diabetes

Testosterone replacement therapy improves insulin resistance in hypogonadal men

Testosterone as a protective factor against atherosclerosis http://joe.endocrinology-journals.org/content/178/3/373.short

The Effect of Testosterone Replacement on Endogenous Inflammatory Cytokines and Lipid Profiles in Hypogonadal Men https://academic.oup.com/jcem/article/89/7/3313/2844310

Testosterone Replacement Increases Fat-Free Mass and Muscle Size in Hypogonadal Men https://academic.oup.com/jcem/article/82/2/407/2823214

Effects of Testosterone on Cognitive and Brain Aging in Elderly Men http://onlinelibrary.wiley.com/doi/10.1196/annals.1323.014/full

Inflammation and Sex Hormone Metabolism http://onlinelibrary.wiley.com/doi/10.1196/annals.1351.021/full

Testosterone prevents protein loss via the hepatic urea cycle in human http://www.eje-online.org/content/176/4/489.full?sid=a8819cd0-3048-47ec-8759-9043dc75c70a

Clinical Guidance

The current NHS reference range (8.64-29 nmol/L) combines data from adolescents to elderly males, potentially masking age-related decline. Proper biochemical interpretation should consider:

• Age-adjusted reference ranges
• Free testosterone calculations
• Correlation with clinical symptoms
• SHBG levels and their impact
• Estradiol balance
• Diurnal variation
• Impact of concurrent medications
• Stress and lifestyle factors

Check if you are being led astray by your GP, “normal” range is 8 years old to 80, get your levels checked by us, get on the waiting list.

Risks and Considerations

While TRT offers numerous benefits, it’s essential to acknowledge potential risks:

• Prostate Health: While older studies raised concerns about prostate cancer risk, current research suggests TRT does not increase risk and may even be protective. However, regular PSA monitoring is still recommended.
• Cardiovascular Events: Initial concerns about increased cardiovascular risk have been largely refuted by more recent studies. Some data even suggests cardiovascular benefits. However, men with pre-existing heart conditions should be carefully monitored.
• Fertility: TRT can suppress sperm production, potentially impacting fertility. Men considering future fatherhood should discuss fertility preservation options with their doctor.
• Sleep Apnea: TRT may worsen pre-existing sleep apnea in some individuals.
• Mood Changes: While TRT often improves mood and well-being, some men may experience irritability or emotional lability.

Quality of Life Improvements

Recent studies have documented significant improvements in:

• Sexual function and libido
• Energy levels and vitality
• Sleep quality
• Muscle strength and endurance
• Bone mineral density
• Mental clarity and focus
• Emotional well-being
• Work productivity
• Social engagement

Conclusion

Testosterone Replacement Therapy can provide significant benefits for men with hypogonadism, improving metabolic health, body composition, cognitive function, and potentially cardiovascular health. However, it is not without potential risks and requires careful patient selection, comprehensive monitoring, and individualized management. Men considering TRT should have a thorough discussion with a us to weigh the benefits and risks in their specific situation.