HRT and Hair Loss, How to Balance the Two.
I'm 58 and have been on testosterone replacement therapy since 2012 due to various symptoms of low T, including diminished libido, erectile issues, depression, gynecomastia, and obesity. Once I got the testosterone levels adjusted, they settled in the 600-700ng/dl range. My doctor usually focuses on the total T blood test, without considering free T, estrogen, and DHT. I've made lifestyle changes in the past couple of years, losing weight and exercising more, which raised my Free T baseline to 820-900ng/dl. However, I've begun to notice more hair loss, including a receding hairline and male pattern baldness. This is puzzling as it doesn't align with my family's genetics; even my older brother, who looks very much like me, has little hair loss and is not on HRT. Could some of the testosterone be converting into estrogen or DHT, contributing to my hair loss? What's your view on this? If you believe a conversion like this might be happening, are there supplements that could block it and prevent further hair loss? I'd prefer not to lower my total T levels, as I like how I feel at the 800 ng/dl range.
Can you do too much exercise?
Hi Dr Attia. I am a surgeon and big fan of your work. I was wondering what you thought of the below article and its premise that one can do too much exercise. It seems the authors conclude that one can actually do too much exercise. I am particularly interested in Zone 2 exercise. Many thanks. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7431070/
Ways to diagnose & treat decreased conversion of desmosterol to cholesterol?
According to Boston Health (in its Cholesterol Balance brochure), elevated levels of desmosterol may be caused by either increased cholesterol production or decreased conversion of desmosterol to cholesterol. Are further tests available that can determine the reason for one's high desmosterol levels? If the test classifies someone as an over absorber, is it reasonable to conclude that the high desmosterol levels are caused by decreased conversion of desmosterol to cholesterol? The BH brochure also mentions that decreased conversion is associated with a significant increased risk of cognitive decline with aging. For someone with a strong family history of Alzheimer's, can steps be taken to facilitate the conversion of desmosterol to cholesterol? Thanks!
Connection between physical activity and being prone to infections/colds/etc.
Does being physically active increase the probability of a cold, the flu, feeling under the weather, etc.? Or maybe formulated in the inverse: does an increase in physical activity decrease the function of the immune system? In addition, obviously if someone has a fever, he/she shouldn't do sports, but what if one feels just a bit under the weather? Headache, bit of a stuffed nose, a bit lethargic. Does continuing sports make it worse, better, no effect?