Older men with high levels of testosterone may be at less risk for suffering cardiovascular diseases and stroke than those men with lower levels of this sex hormone. This is according to a recent study which was published in the Journal of the American College of Cardiology.

In the said study, it was shown that about 2,400 Swedish men aged 70 to 80 with the highest testosterone levels were less likely to suffer from heart attack or stroke in the succeeding years, as compared to those men with low levels of the hormone. However, the research group noted that the study does not prove that testosterone is the one solely liable for the decreased risk of heart disease and stroke. They also said that it may be too early to consider hormone replacement for the purpose of lowering the risks for heart disease and stroke.

“What we can say is that elderly men with high testosterone levels are relatively protected against cardiovascular events, and therefore lower testosterone is a marker for increased cardiovascular risk,” said lead researcher Asa Tivesten of the Sahlgrenska University in Goteborg, Sweden.

It is a well established fact that certain diseases and health conditions can lower the levels of the hormone testosterone, as obesity does. In the study, the researchers took into account several factors like the weight of the participants, blood pressure, any preexisting conditions like diabetes, heart diseases or stroke.

The participants were ranked according to their testosterone levels. 21 % of the 604 men at the bottom of the rank (lower quarter) had a heart attack, severe chest pain, or stroke over the next five years. This was compared to the upper quarter (606 men) who started out with higher levels of testosterone who showed 16% rate of suffering from said diseases and symptoms.

When the health factors were accounted for, the men with the highest levels of testosterone was still able to show 30% lower risk of suffering from heart diseases or stroke, as compared to the other three quarters of the participants. However, some medical experts also expressed that the study mustn’t rule out the possibility that factors, other than testosterone, may have brought about this lower risk. This was according to JoAnn Manson, Chief of Preventive Medicine of Brigham and Women’s Hospital in Boston. She also added that “Low testosterone may be a marker of other health conditions that put men at higher risk of cardiovascular disease.”

One of the reasons considered for such effect is that high levels of testosterone equates to less body fats and more lean muscle. Manson further added that “There are many unanswered questions, and I don’t think this means that men should be trying to boost their testosterone with testosterone replacement therapy.”

Prior to 2002, many women used Hormone Replacement Therapy (HRT) with the hopes of warding off diseases like heart diseases and osteoporosis but then it was later found out that these pills containing estrogen and progesterone places women at higher risk for blood clots, heart attack, stroke and breast cancer.

What’s the truth? How can I lower my risk of heart attack?

There are several hundred risk factors for heart disease that are not being evaluated or treated. Addressing only the “traditional” five risk factors—blood pressure, high cholesterol, diabetes, obesity, and smoking—still leaves more than 50% of patients at risk for heart disease. I want to educate physicians and the public about how to measure, prevent, and treat all risk factors for heart disease, which is why I wroteWhat Your Doctor May Not Tell You About Heart Disease. I hope the book will reduce heart disease and save lives.

For decades, we’ve been told that if the five major risk factors for heart disease are kept under control, you’re practically guaranteed not to have a heart attack. And, quite frankly, that’s a lie. The truth is, abnormal cholesterol levels are not the primary cause nor indicator of heart disease. More myths include:

• Consuming a high-cholesterol diet or eating eggs does not significantly raise blood cholesterol levels for most people.
•  All LDL cholesterol is not bad and all HDL cholesterol is not good.
•  A fasting morning blood sugar reading of 99 mg/dL—deemed normal by most labs—is not safe or normal. Instead, it indicates an increased risk of coronary heart disease and heart attack.
•  The blood pressure reading taken in your physician’s office may not be an accurate measure.
•  A normal body weight does not ensure heart health, as it doesn’t reflect the amount of the “belly” fat that promotes heart disease.

So, what is the real reason people have heart attacks? Although high cholesterol is one factor, for many people, the pathways to heart disease of greatest concern are inflammation, oxidative stress, high blood pressure, high blood sugar, and obesity and increased body fat. High blood sugar, in particular, is critically linked to heart health. Elevation in blood sugar damages proteins and enzymes all over the body—essentially, it accelerates aging of the arteries and heart.

What You Can Do

Taking omega-3 fatty acids is number one. I also strongly recommend the following supplements: vitamin K2 (use the MK7 form), garlic, resveratrol, CoQ10, alpha- lipoic acid, selenium, vitamin D, vitamin E (gamma delta tocotrienols), D-ribose, L-carnitine, taurine, curcumin, N-acetyl cysteine, and glutathione.

In terms of diet, I find that eating a low-sodium/high-potassium and high-magnesium diet is extremely beneficial for the heart. I also encourage patients to enjoy red wine. I outline my heart-healthy diet in my book. It’s a compilation of the Mediterranean and DASH diets, focusing on great amounts of fruits and vegetables, healthy fats, and sodium restriction. My diet also incorporates lean meat, fish, and wild game, and it limits the consumption of refined carbohydrates and grains (even whole grains). This may come as a shock to those who are used to the “6-11” servings of grains recommended by the USDA, but grains are simply not foods that our bodies have evolved to consume.

Imagine a world where half the cases of cancer that now exist are suddenly nonexistent.

According to a review published in the journal Science Transnational Medicine, the idea is not at all far-fetched. Graham A. Colditz, MD, PhD, and coauthors at Washington University conclude that we now have the knowledge to bring about widescale prevention of a disease estimated to kill 577,190 men and women this year in the U.S. alone.

Dr. Colditz and colleagues observe that lifestyle choices play a major role in the development of cancer. Smoking is responsible for a third of all US cancer diagnoses and excess body weight for 20%. Diet, exercise levels, alcohol intake, and other controllable factors are also involved.

If our society succeeds in adopting all that is currently known about cancer prevention, these measures will additionally reduce deaths from cardiovascular and other diseases.

Anyone who has ever been on a diet—and there are many of us—knows that there are sensible ways to lose weight. These include balanced diets, exercising and realistic goals.

And then there are reckless ways to shed pounds—fads and diet aids that promise rapid weight loss, but often recommend potentially dangerous practices. These include HCG weight-loss products marketed over-the-counter (OTC) that are identified as “homeopathic” and direct users to follow a severely restrictive diet.

The Food and Drug Administration (FDA) is advising consumers to steer clear of these “homeopathic” human chorionic gonadotropin (HCG) weight-loss products.  They are sold in the form of oral drops, pellets and sprays and can be found online and in some retail stores.

FDA and the Federal Trade Commission (FTC) have issued seven letters to companies warning them that they are selling illegal homeopathic HCG weight-loss drugs that have not been approved by FDA, and that make unsupported claims.

(For the list of manufacturers, distributors and products—and more information about FDA’s concerns about HCG—visit www.fda.gov/hcgdiet.)

HCG Makes Big Claims

HCG is a hormone that is produced by the human placenta during pregnancy.

Products that claim to contain HCG are typically marketed in connection with a very low calorie diet, usually one that limits calories to 500 per day. Many of these popular HCG products claim to “reset your metabolism,” change “abnormal eating patterns,” and shave 20-30 pounds in 30-40 days.

“These products are marketed with incredible claims and people think that if they’re losing weight, HCG must be working,” says Elizabeth Miller, acting director of FDA’s Division of Non-Prescription Drugs and Health Fraud. “But the data simply does not support this; any loss is from severe calorie restriction. Not from the HCG.”

HCG is approved by FDA as a prescription drug for the treatment of female infertility, and other medical conditions. It is not approved for weight loss. In fact, the prescription drug label notes there “is no substantial evidence that it increases weight loss beyond that resulting from caloric restriction, that it causes a more attractive or ‘normal’ distribution of fat, or that it decreases the hunger and discomfort associated with calorie-restricted diets.”

HCG is not approved for OTC sale for any purpose.

A Potentially Dangerous Diet

Living on 500 calories a day is not only unhealthy—it’s hazardous, according to FDA experts. Consumers on such restrictive diets are at increased risk for side effects that include gallstone formation, an imbalance of the electrolytes that keep the body’s muscles and nerves functioning properly, and an irregular heartbeat.

Shirley Blakely, a nutritionist at FDA’s Center for Food Safety and Applied Nutrition, echoes concerns about such restrictive diets. They can be dangerous, she says, and potentially fatal.

Very low calorie diets are sometimes prescribed by health care professionals for people who are moderately to extremely obese as part of medical treatment to lessen health conditions caused by obesity, like high blood pressure. But even then, strict—and constant—medical supervision is needed to ensure that side effects are not life threatening, says Blakely.

Without medical oversight, consumers on very low calorie diets may not be getting enough vitamins, minerals and—most critically—protein.

“In general, the reference (average) calorie level is 2,000,” says Blakely. “If you want to lose weight, reduce your daily intake by 500 calories. Over the course of a week, that equals 3500 calories, which is the loss of a pound. Gradual weight loss is the way to do it.”

Story Started Decades Ago

Miller explains that HCG was first promoted for weight loss in the 1950s. “It faded in the 1970s, especially when it became apparent that there was a lack of evidence to support the use of HCG for weight loss,” she says.

The diet has become popular again and FDA and FTC are taking action on illegal HCG products. “You cannot sell products claiming to contain HCG as an OTC drug product. It’s illegal,” says Brad Pace, team leader and regulatory counsel at FDA’s Health Fraud and Consumer Outreach Branch. “If these companies don’t heed our warnings, they could face enforcement actions, legal penalties or criminal prosecution.”

Elisabeth Walther, a pharmacist at FDA, explains that the agency does not evaluate homeopathic drug products for safety or effectiveness, and is not aware of any scientific evidence that supports homeopathy as effective. However, those that meet certain conditions set by FDA can be marketed. A reference document called the Homeopathic Pharmacopoeia of the United States lists active ingredients that may be legally included in homeopathic drug products.

“HCG is not on this list and therefore cannot be legally sold as a homeopathic medication for any purpose,” Walther says.

FDA advises consumers who have purchased homeopathic HCG for weight loss to stop using it, throw it out, and stop following the dieting instructions. Harmful effects should be reported online to FDA’s MedWatch program or by phone at 800-FDA-1088 (800-332-1088) and to the consumer’s health care professional.

This article appears on FDA’s Consumer Updates page, which features the latest on all FDA-regulated products.

Source: U.S. Food and Drug Administration’s website

Weight management hasn’t had a safe pharmaceutical alternative since 1999. Approved in June by the U.S. Food and Drug Administration (FDA) after two years of trials, Belviq (lorcaserin) shows promise for obese (BMI of 30 or greater) and overweight (BMI of 27 or greater) adults with weight-related conditions such as type 2 diabetes mellitus (T2DM), hypertension, or high cholesterol. Compared to placebo, patients treated with Belviq were twice as likely to lose weight: 47 percent of non-diabetic patients and 38 percent of patients with type 2 diabetes lost at least 5 percent of their body weight — an average of 12 pounds (5.44 kilograms) — whereas only 23 percent of those on placebo did so.

Specifically designed for use with diet and exercise, Belviq is expected to help patients feel full with smaller food portions by activating the brain’s serotonin 2C receptor. This is similar to weight loss drugs of the late 1990s such as fenfluramine and sibutramine, which were withdrawn because of links to heart valve damage.

The FDA recorded little difference in valve abnormalities between Belviq and placebo but suggests caution for patients with congestive heart failure. The manufacturer, Arena Pharmaceuticals GmbH, will need to evaluate what effect Belviq has on risk of heart attack or stroke.

Users of other serotonin-activating drugs are also cautioned. Mixing Belviq with medications for migraine and depression medication can result in serotonin syndrome, a life-threatening drug condition. Pregnant women should completely avoid this drug. Disturbances in memory or attention have also been noted.

Patients with T2DM experienced better glycemic control. Headache, fatigue and nausea may be common side effects; T2DM patients may suffer additional effects such as hypoglycemia, back pain, and cough.  The FDA recommends that users discontinue treatment if they do not lose 5 percent of their body weight in the first 12 weeks.

A huge demand exists on the market for new obesity drugs. According to the U.S. Centers for Disease Control and Prevention, one in three adults is obese.

Dan Kelly / Endocrine News / August 2012

At first glance, Dr. Angela Fitch admits, the numbers don’t seem too impressive. One pill was only 4 percent better than a placebo; the other, 7 to 9 percent better.

But in the battle against obesity, Fitch says, even that is no small achievement.

In the past few weeks, the Food and Drug Administration has given its blessing to both pills, Belviq and Qsymia, the first new weight-loss drugs to win approval since 1999. To Fitch, an obesity specialist at Park Nicollet Clinic, that’s reason to celebrate. “Most of us are very excited,” she said.

Critics, though, see the drugs as a risky gamble — the latest in a string of diet pills that have been plagued by safety questions since the 1990s, when the drug fen-phen was pulled from the market after the Mayo Clinic linked it to heart-valve damage.

One consumer watchdog, the Health Research Group, called the latest FDA approvals “reckless.” Consumer Reports has urged consumers to stay away. “Bottom Line: We recommend avoiding all weight-loss drugs and supplements,” the magazine said in an online post July 18, the day after Qsymia was approved.

The two new diet pills, which are expected to hit the market later this year or early next year, have traveled a rocky path to approval. Both were initially rejected by the FDA in 2010 because of safety concerns. Both will include warnings of potentially risky side effects, including warnings against use by pregnant women. In both cases, the drug makers are under strict rules to monitor the risk of heart disease or stroke among their customers.

At the same time, doctors say the pills can make a significant difference in patients who are dangerously obese.

“It’s not for the everyday 45-year-old woman who wants to lose 30 pounds,” said Dr. Claudia Fox, a specialist in childhood obesity at the University of Minnesota. “We’re talking about the really morbidly obese person who can’t walk well, who might have to use a walker, who has sleep apnea.”

Until now, the medical bag for treating those patients has been pretty small. Only two FDA-approved weight-loss drugs are still on the market: Xenical, which is sold over the counter as Alli; and phentermine, an appetite suppressant that’s been around since the 1950s (it was the “safe” half of the fen-phen combination drug withdrawn in 1997).

“It’s wonderful to have a couple of other options,” said Dr. Roxana Merz, an obesity specialist at Fairview Southdale Hospital in Edina. “A pill can’t make people make lifestyle changes, but a pill can help people get off to a good start.”

Fitch, who treats patients at Park Nicollet’s Melrose Institute for eating disorders in St. Louis Park, says the drugs are just one piece of a large puzzle.

“There’s no wonder drug,” she said, and pills are not a substitute for eating well and exercising. But they can help people by decreasing their appetite or increasing their metabolism as part of a comprehensive weight-management program.

“Everything’s a tool,” she said. “The idea is to take these drugs while you’re making these changes, until these lifestyle changes become your lifestyle.”

Small but important

One of the new drugs, Qsymia (kyu-sim-ee-ah), is a combination of two drugs already on the market: an anti-seizure drug known as topiramate, and phentermine, the appetite suppressor. Fitch notes that she and many other doctors have been prescribing that combination to patients for years, in what’s called an “off-label” use, and that she’s seen a significant effect.

One of her patients, a 37-year-old woman, said her “craving for the carbs” subsided when she started taking topiramate several months ago, and she’s now losing close to a pound a week. She hasn’t told her family she’s on the medication, so she didn’t want her name used, but hopes to lose about 70 pounds in all. “I’m not looking for a quick fix,” she said, “but I’m open to accepting help along the way.”

Even with the pills, most patients won’t lose all the weight they’d like, said Fitch. But medically, even a 5 to 10 percent drop in weight can significantly reduce the risk of heart disease and diabetes.

“I get people in my office all the time, they’re 250 pounds and they want to weigh 150,” she said. “What we are trying to reach is the middle ground, which is to retrain people to think that 5-10 percent is a good thing, and really has a lot of benefits.”

The easy way out?

Brenda Navin, a registered dietician, is skeptical of the new drugs. “I don’t think a drug is going to solve our weight issue,” said Navin, who oversees a weight-loss and wellness program at Woodwinds Health Campus in Woodbury. “People get desperate and they’re looking for anything that’ new.”

Pills may sound appealing, she said, because “people are looking for the easy way.” But given the risks, she recommends a more holistic approach. “Ultimately, when it comes down to it, there is no substitute for just moving your body, eating healthy and proper self-care,” she said. “There’s no pill that’s going to take [the need for] that away.”

Yet obesity specialists like Fox say the new pills — with more in the pipeline — are arriving just as science sheds new light on obesity.

“[People] think OK, obesity is really a choice and you should just pull yourselves up by your bootstraps and say no to the second hamburger,” said Fox, who directs the pediatric weight management program at the university’s Amplatz Children’s Hospital. But some people lack the biological signals to know when to stop eating, she said, and “are chronically hungry; they never feel full.” One, she said, is a teenage patient who weighs more than 400 pounds. “For me to say, ‘Oh, just go home and eat less food and exercise more,’ that’s not going to cut it,” she said.

The new drugs, she said, may provide “a critical piece that has been missing for years.”