Tuesday, December 22, 2009

Anti Aging: Red Bull? Try some Testosterone instead!

Men, as you get older, are you feeling that you are always tired and that your body isn't performing as well as it was when you were twenty one? Well, one of the things that happen as you age is that your testosterone levels drop and that might be the cause of your problem.

Dr Suren specializes in this area and we are starting Anti Aging Clinics where we can help you maintain vitality as you age. Of course we will also be looking at menopausal issues and helping women age gracefully, but for today, we will talk about men first.

Below is an article by Dr Suren on what happens when men age.

Testosterone: It is not just about SEX

Testosterone is the main sex hormone produced by the testes. Testosterone together with it's derivatives, estradiol(E2) and dihydro testosterone (DHT) act directly on diverse target organs such as the sex organs, bones, muscles, blood-forming tissue, the brain,skin and hair. Thus, testosterone has a vital role in proper function of multiple systems in our body.

As men age, the levels of testosterone will fall. At age 70 the testosterone level is only 30% of the peak at age 25. Late onset hypogonadism, also known as andropause usually starts after age 40. It is characterized by symptoms such as fatigue, lack of energy, low mood. There can be loss of muscles, increase of fats especially in the abdomen, decreased exercise capacity and endurance. Of course there can be loss of sexual interest and erection difficulties.

Andropause is now recognized as a serious health problem. The good news is that we are able to treat it and reverse many of the above problems.

Prevalence of hypogonadism ( Low levels of testosterone)

The prevalence of andropause is from 6 to 13% in those aged between 40 – 69 years old. Prevalence increases with age. (1)

Testosterone deficiency is associated with Diabetes

Testosterone deficiency plays a central role in the cause of Type 2 diabetes, Metabolic Syndrome and Insulin Resistance. It contributes to the accumulation of abdominal fat. This abdominal fat is an active endocrine organ producing chemicals (cytokines) that cause inflammation such as causing abnormal lining of the blood vessels. Testosterone treatment of hypo gonadal men improves diabetes.(2)

Testosterone restoration improves muscle strength

Replacement of testosterone increased fat-free mass, muscle size and strength in hypo gonadal men. (3) Oral testosterone treatment in diabetic men with deficiency improves body composition, decrease abdominal fat, improves glucose homeostasis and improves erectile dysfunction. (4)

Optimal testosterone levels associated with better cognitive function

One study showed that older men with high testosterone and low estrogen level performed better in several tests of cognitive function. (5)

Low testosterone is associated with poor cholesterol and potential risk to heart health

Low testosterone is associate with high total and bad (LDL) cholesterol. The lining of the blood vessels are also slightly damaged, making it prone to accumulate fatty plaques. Also due to the association with obesity and poor glucose control, low testosterone can affect the heart health.(6)

Should you have testosterone restoration?

There is convincing evidence of the benefits of testosterone replacement. Before starting we recommend that you speak to us, so that we can ascertain that you do indeed have andropause. We will then do a blood test of your hormones for confirmation.

Are there any risks of restoration?

Some researchers have warned that restoration can be a risk of aggravating prostate cancer. As we become more familiar with testosterone replacement we belief the risk of prostate cancer is very low. There is no scientific evidence that testosterone supplement increased the risk of prostate cancer.(7) Nevertheless we will still do a blood test before and after treatment to make sure that we do not put the patient at any risk.

Testosterone restoration can also increase the red blood cell count. This is easily detected and effectively treated without any risk to the patient.

What do I do now, if I want to check for andropause?

Dr Suren Baskaran now conducts special clinics for this condition. If you wish to check for andropause, just call us for an appointment.


1. Araujo Ab et al. Prevalence and incidence of andropause deficiency in middle aged and older men. J Clinical Endocrinology Metabolism 2004 Dec;89(12):5920-6.

2. Traish. The dark side of testosterone def II. J Androl 2009;30:23-32.

3. Bhasin S. et al. Testosterone replacement increases fat-free mass and muscle size in hypo gonadal men. J Clin Metab. 1997 Feb;82(2):407-13.

4. Boyanov MA et al. Testosterone supplementation in men with T2D, visceral obesity and partial androgen deficiency. Aging Male. 2003 Mar;6(1):1-7

5. Barrett-Connor E et al. Endogenous sex hormones and cognitive function in older men. J Clin Endocrinology Metab 1999 Oct;84(10):3681-5

6. Traish et al. The dark side of Testosterone deficiency III. J Androl 2009;30:477-94

7. Morgentaler A. Testosterone replacement therapy and prostate risks. Can J Urol.2006 Feb;13 Suppl 1:40-3

Tuesday, December 08, 2009

H1N1 Vaccine is now approved for kids from 6 months of age

MOH has just approved the use of the H1N1 vaccine for children from 6 months onwards.

Children from 6 months to 3 years of age will need 2 half doses one month apart.

Those from 3 yrs to 10 years will need 2 full doses one month apart.

We currently have stock of the Panvax H1N1 vaccine which is the individual shots that do not contain mercury. These are $30 nett. The Panvax H1N1 vaccine is the one that the MOH has approved for use in children as they are satisfied with the safety of the vaccine.

You can read more about the announcement on Channel News Asia.

Thursday, December 03, 2009

H1N1 Vaccine: New Stock has arrived

By now you would have heard that the H1N1 vaccine has been approved for 10 year olds and above and the good news is that our new stock of vaccines have just arrived so we have enough for walk in patients.

There has been some concern about the safety of the vaccines. This pertains to the older 10 doses per vial vaccine. The vaccine we stock is Panvax from CSL labs which is the individual vaccine that does not contain mercury. So far, we have received little complaints from our patients. I personally have administered the vaccine to my own left arm and all I had was a bit of pain over the injection site for 2 days. (Yes, I did it Rambo style and injected myself)

The other question that often gets asked is whether you should take the seasonal flu vaccine or the H1N1 vaccine. The best answer is that you should take both. Both vaccines can be given at the same time. If you have to choose one, I would advise young adults to take the H1N1 vaccine because there has been some concern that the H1N1 virus is somehow more virulent amongst young adults with several deaths occurring amongst otherwise fit young adults.

Our price for the Panvax is $30. Do ring up first to check for stock availability.