Health Maintenance

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THE FOUNDATION OF THE LIFE MAINTENANCE SYSTEM  

  Georges DEBLED

THE FOUNDATION OF THE LIFE MAINTENANCE SYSTEM 

TESTOSTERONE AND SEXUAL INVOLUTION IN MEN 

TESTOSTERONE AND METABOLISM 

TESTOSTERONE AND AGEING ILLNESSES 

MATURITY-ONSET DIABETES 

OBESITY 

  AMYOTROPHY 

ARTERIOSCLEROSIS, ATHEROSCLEROSIS AND HYPERTENSION 

BLOOD HYPERCOAGULABILITY 

VARIX, HEMORROIDS AND THROMBOSIS 

ANEMIA 

CARDIOVASCULAR RISK 

STIFNESS, LIMITATION OF THE MOVEMENTS AND ARTHROSIS 

BONE-ARTICULATION ILLNESSES 

OSTEOPOROSIS 

LOSS OF PULMONARY ELASTICITY AND REPIRATORY IMPAIRMENT

SKIN ATROPHY 

FALL IN IMMUNITY 

TRANSFORMATION OF THE SILHOUETTE 

RENAL FAILURE 

VISION AND AUDITION TROUBLES 

NERVOUS DEPRESSION 

CONCLUSION 

Bibliography 

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The life maintenance system is made up of all the biological factors produced by each organism to ensure its normal working.

The production of biological factors indispensable to the maintenance of a normal physiology decreases with age.

  Ageing illnesses basically represent the consequences of the failure of the life maintenance system.

The organism's glandular system is an essential part of the maintenance system both for men and for women. The glands progressively stop functioning.

 

The main hormones are secreted by the ovaries, testicles, thyroid,  pancreas, pituitary and the epiphisis.

These secretions diminish year to year after forty (and sometimes even before).

The cells manufacture other hormones. The liver secretes a specific growth factor (IGF).

The kidney secretes a hormone, erythropoietin, that causes the manufacture of red cells by the bone marrow.

In the United States of America, the biotechnological industry already produces harmless somatotropic hormones through genetic engineering.

Today specific hormones also manufactured through genetic engineering allow for the manufacture of red cells, white cells and platelets. These products will be given intravenously in vain to people who have not looked after their life maintenance system, especially from the age of forty on.

  On the other hand, genetically engineered products will have a maximum effect on those who have looked after their biological system.

No one can today say what the length of life will be for men and women who have looked after the life maintenance system.

 

THE FOUNDATION OF THE LIFE MAINTENANCE SYSTEM

  Menopause signifies the stopping of periods. The male climacteric the progressive cessation of male sexual activity. These obvious signs in reality hide a fundamental phenomenon : the diminution of the secretion of female hormones and of testosterone in women (adrenopause), and of male hormones (androgens) in men.

  Testosterone, protein hormone, is necessary to the building of all the organism's proteins. The organism deteriorates when it is lacking.

In 1992, at an international congress on ageing in Dallas, Dr Georges DEBLED presented his theory, based on twenty year's clinical experience, according to which the fall in testosterone secretion is responsible for male climacteric and ageing illnesses (1-2).

  The Paris publishing house Maloine had in 1988 already published a work by Dr Georges DEBLED titled : " The male climacteric, cause, consequences and remedies" (L'Andropause, cause, conséquences et remèdes) (3). 

These works have brought to attention the consequences caused by the diminution in testosterone secretion with age (4).

  In 1849, Berthold demonstrated that the capon's crest recovers all its characteristics when the testicles are implanted in an other part of the body. This experience proves that the testicles secrete a substance which acts at distance on the voice, the plumage and the crest.

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TESTOSTERONE AND SEXUAL INVOLUTION IN MEN 

  Testosterone secretion decreases with ageing (5-6-7-8).

This fact demonstated by numerous studies leads to sexual involution in men characterized by weak libido, poor frequency of sexual intercourse, impotency, ejaculation's problems, sclerosis of the penis and sometimes gynecomastia.

The lack of regulation of the biological androgens chain induce or aggravate prostate illnesses: atrophy, adenoma and cancer.

  Prostate adenoma may involve with the biological monitoring  of the androgens chain. This therapy concerns only doctors specialised in this field.

  Prostate cancer is not an hormonal disease. It is a genetic illness. It develops with antiandrogens therapy (9).

 

TESTOSTERONE AND METABOLISM

  When the word testosterone is used you think immediately of the sexual activity of this hormone which stimulate the male characteristics. But testosterone is first a leading  hormone for the metabolism.  Curiously, this concept is rarely considered in the medical practice while it is of the most importance.

Testosterone is implicated in the metabolism of all proteins of the body. It regulates the sugar metabolism and through this pathway it influences the fat metabolism.

The main phenomenon of the male climacteric is a lack of male hormone and the "sexual concept" is too restrictive because, in fact, when testosterone is missing, all structures of the body involve progressively through different biochemical and pathological mechanisms.

Universality of the androgen receptor

The androgen receptor is identified in a variety of organs : the  seminal vesicles, the hair follicle, the sebaceous glands, the foreskin glands and more generally all secondary sexual organs, the testicles and the epididymis, the uterus and the ovary, the kidney, the submaxillary glands, definite cerebral areas as the hypothalamus, the pituitary gland and the cerebral cortex, the elevator ani muscle and the skeletal muscle, and the bone marrow. In reality small quantities of androgens' receptors have been observed in numerous organs (10).  

 

Protein metabolism

The trophic action of androgens upon the skeletal muscle is well known for many years. It is spectacular with body-builders taking androgens.

According to several authors, experimental studies have proved the effects of androgens on the incorporation of amino acids into muscle proteins (11-12-13-14-15).

Research on rats treated with testosterone have shown a significant incorporation of marked leucine in the proteins and of marked uridine into ribonucleic acid in some muscles of those animals.

 

Sugar metabolism

 Already in 1947,  the professor Giuseppe Pellegrini, director of the Institute of Pathology from the Univerisity of Pavia in Italy, described  the influence of androgens on the sugar metabolism of 68 patients in an report entitled : " L'azione antidiabetica degli ormonali sessuali maschili nel quadro della fisiopathologia del diabete" (16). An  intramuscular injection of 5 to 25 milligrams of testosterone propionate provokes a significant decrease of glycemia within the two or three hours following the injection and its action lasts four or five hours. The reduction of glycemia is about 1 gram per litre with diabetics and glucosuria is reduced. In normal man the glycemia falls to inferior plasmatic levels and not more because the hormonal balance is normal.

The regulation power of testosterone on sugar metabolism  acts for a long time : after an androgenic treatment the glycemia of diabetics is reduced during a few days and rises after to the initial levels.

 

Fat metabolism

Through the pathway of sugar metabolism testosterone influences the fat metabolism . When you have too much glucose in the blood, it can't be burned enough through the Krebs' cycle (the capacity of burning is limited) and you have an overproduction of acetyl-coenzyme A which is the initial compound for making cholesterol and lipids.

Because every man, some time or other, will have a lack of testosterone production after forty, the values for triglycerides and of cholesterol will increase in the blood with age.

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TESTOSTERONE AND AGEING ILLNESSES

The most noticeable phenomenon in the field of health concerns the massive and deteriorating ageing of the entire population. One French person in four dies before the age of 65. Average life for men is about 73 years. Women live on average for 81 years.

 

After fifty, mortality is mainly caused by :

1. Cardiovascular illnesses.

2. Senility.

3. Cancers.

 

These illnesses are characterized by cellular deterioration.

Deterioration of the arteries and the heart muscle,

deterioration of the cerebral nervous fibres,

deterioration of immunity cells encouraging cancers.

 

Death generally occurs after a 20 year period of deterioration. The consequences of deteriorating illnesses provoke recurrent disability.

Deregulation of sugar, fat and proteins' metabolisms have a devastating effect on the organism

 

MATURITY-ONSET DIABETES

 

They are actually 200 millions cases of diabetes in the world. This number will be multiplied by two in the beginning of the third millenary.

The decrease of male hormone with age lead to a chronic intolerance to glucose and to diabetes.

Chronic lack of testosterone with ageing is a leading cause of the maturity-onset diabetes after forty years (17-18-19-20-21-22).

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OBESITY

 

Accumulation of fat leads to overweigth and obesity .

 

Glass and coll. from the department of medicine from the UCLA School of Medicine in California reported, in 1976, that plasmatic testosterone levels are decreased in obese men (23-24-25-26-27).

 

LOW PLASMA TESTOSTERONE IN MASSIVELY OBESE MEN

 

 

Plasma Testosterone in nanograms/100 ml.

Obese group (200 to 280 % of the ideal body weight)

223

Control group  (85 to 135 % of the ideal body weight)

599

 

Table 1.

According to Glass and coll.

 

In 1990, Zumoff and coll. from the division of Endocrinology  and Metabolism from the Beth Israel Medical Centre in New York, reported  that free and total testosterone levels are clearly subnormal in obese men. The degree of subnormality is proportional to the degree of obesity and the authors conclude : "Hormonally speaking, the distinction between morbid obesity and lesser degrees of obesity would seem to have no validiyy; the decline of free, non-SHBG-bound, and total testosterone levels in obese men represents a continuum, observable at any degree of obesity" (28).

Because the decrease of testosterone secretion with age is seems logical to believe that this phenomenon is a leading cause of fat deposits everywhere in the body and that overweight is a clinical sign of andropause.

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AMYOTROPHY

 

The metabolism of the muscle is influenced by testosterone which increases the quantity of specific contractile proteins as seen above. Testosterone increases also the input of glycogen into the muscle cells. Glycogen constitutes fuel or energy for the muscle's contraction. The link between glycogen and testosterone during exercise is reported by F. Plas from the University Hospital Pitié-Salpêtrière in Paris, in 1978 (29).

During andropause the muscles are weak and exercise aggravates the loss of testosterone. In this situation any intensive sport is dangerous even the jogging. The heart which is also a muscle is deprived of its fuel and heart attacks and even sudden death may occur at any moment!

 

ARTERIOSCLEROSIS, ATHEROSCLEROSIS AND HYPERTENSION

 

According to the "Vital Statistics Report" of the National Centre for Health Statistics, the cardiovascular diseases are the first cause of death in the world and in the United States (30).

The arteries are involved by two different phenomenons, arteriosclerosis and atherosclerosis, which occur often simultaneously.

The pathology of arteriosclerosis is characterized by the replacement of the muscular fibres of the artery by collagen tissue which is inelastic. Muscular fibres need testosterone to maintain  their activity. With the loss of testosterone the muscular fibres became weak and are replaced by fibrous tissue.

The pathology of atherosclerosis is characterized by fat and cholesterol involvement of the arterial wall. This phenomenon is the consequence of cholesterol and lipid accumulation in the body through the impaired sugar and fat metabolism when testosterone is missing.

Arteriosclerosis and atherosclerosis are two general involution phenomenons increasing with the decrease of testosterone secretion. It is probably the reason for the elevation of blood pressure with age.

 

BLOOD HYPERCOAGULABILITY

 

The main question about blood is not " how it coagulates" but "how it remains fluid". Thrombosis and embolism are common complications of cardiovascular diseases usually treated by

anticoagulant agents as heparin or dicoumarin. The use of those substances can produce haemorrhages.

The dissolution of the blood clot is under the influence of fibrinolytic agents. On the other hand, a normal blood level of antithrombine III guarantees a good blood fluidity without risk of bleeding.

Fibrinolitic agents of the blood are under the influence of testosterone as reported in the Lancet of the 21 July 1962 by Fearnley and coll. (31).

Claire Bonithon-Kopp and coll. from the Broussais hospital in Paris, who demonstrated in 1988 that low plasmatic levels of male hormone contributes to hypercoagulability and to ischemic heart disease (32).

 

VARIX, HEMORROIDS AND THROMBOSIS

 

Veins like arteries are constituted by muscular fibres. Loss of testosterone produces always an involution of their muscular tissue.

 

ANEMIA

 

The number of red blood cells is  decreased from 10% in castrated men. This is often so in men with low testosterone plasmatic levels. The ischemic heart disease is of course aggravated by this phenomenon.

In 1981, Najean and coll. reported in the American Journal of Medicine the improvement of anemia in a serial of 137 patients when treated by male hormones. Anemia recurs when the therapy is stopped and improve again with androgens (33).

On the other hand, patients with polyglobulia may constitute a problem for therapy with androgens. The normal account of red blood cells varies normally (5,4 + 0,9 millions/millilitre) (34). So patients with 6,3 millions red blood cells/millilitre and presenting a failure in the life maintenance system can be carefully treated with an appropriate monitoring of the androgens without increasing of the number of their red blood cells. Those cases are rare.

 

CARDIOVASCULAR RISK

 

The muscle cells of the rat heart contain a specific receptor to androgens as demonstrated in 1978 by Michael Krieg from the  Department of Clinical Chemistry from the University of Hamburg in Germany (35-36). In 1956, Ruth Blasius, from the Medicine  Department of the University of Munich in Germany, demonstrated the increase of contractile proteins in the heart of animals under the influence of testosterone (37).

 

Angina pectoris  

 

Ch. Breier, from the Department of Internal Medicine from the University of Innsbruck in Austria, and his collaborators reported the 1 June 1985 in the Lancet the positive correlation between coronary heart disease and the increase of plasma levels of total cholesterol, low density lipoproteins (LDL) and triglycerides and the decrease of testosterone plasma levels. HDL-cholesterol is correlated negatively with coronary heart disease (38).

 

High level of

Correlation with coronary heart disease

Total cholesterol

+

LDL- Cholesterol

+

Triglycerides

+

HDL- Cholestérol

-

 

Table 2.

 

According several authors the coronary heart disease is correlated  positively with a decrease of total testosterone, free testosterone and dihydrotestosterone  plasma levels and with an increase of estradiol plasma levels (39-40-41-42-43).

 

 

Hormone

 

Plasma level

Correlation with coronary heart disease

Total testosterone

Low

+

Free testosterone

Low

+

Dihydrotestosterone

Low

+

E

Elevated

+

                                                       

Table 3.

 

In 1946, Lesser demonstrated the benefit of testosterone therapy  in one hundred cases of angina pectoris (44).

In 1984, Jens Moeller, President of the European Organization for the Control of Circulatory Diseases and Helge Einfeldt published a book Testosterone Treatment of Cardiovascular Diseases, edited by Springer Verlag, according an experience of more than thirty years in Copenhagen (45).

 

Myocardial infarct

 

Jaffe(46), Geisthövel (47), Conrad Swartz (48), demonstrated a link between low testosterone levels in the blood, angina pectoris and myocardial infarct.  

 

In 1997, Unit U-21 of INSERM of France confirmed  the

"Association between plasma total testosterone and cardiovascular risk factors in healthy adult men" in a study published in the U.S.A in the Journal of Clinical Endocrinology and Metabolism (Vol 82, N° 2, p. : 682- 685). The study known as the Telecom study, was conducted during 8 years comparing two groups of men.  

The first group had a well balanced blood testosterone during the 8 years and did not showed any increase of the cardiovascular risk during this period.

The second group had a decrease in blood testosterone during the 8 years and showed a significant increase of the cardiovascular risk (49).

 

Gangrene

 

The spectacular effects of testosterone on gangrene are shown by pictures in the Moeller's book Testosterone Treatment of Cardiovascular diseases (45). The testimonies of numerous doctors having visited the clinic of Moeller in Copenhagen are unanimous to certify the efficacy of testosterone treatment upon gangrene (50-51-52-53).

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STIFNESS, LIMITATION OF THE MOVEMENTS AND ARTHROSIS

 

With aging the connective tissue loss its elasticity and its constitution is changed in a worse structure.

According to Ladislas Robert, Research Director at the CNRS and Director of the Laboratory of biochemistry of the connective tissue from the Medicine Faculty of Paris-XII, the elementary fibres of collagen are linked by chemical bridges. The increase of the resistance of collagen with aging is the consequence of an increase of the quantity of  bridges or from an  alteration of their structure. This phenomenon is increased by the chemical affinity of glucose for the collagen tissue (54). The loss of male hormone lead to hyperglycemia as we have seen above. There is why the sweetened

middle aged man becomes stiff.

At the same time the ground substance of the connective tissue is altered and the oxygenation of the connective cells is compromised. The rarefaction of the normal ground substance is the consequence of the loss of male hormones as demonstrated, in 1958, by Harry Sobel and Jessie Marmorston, from the University of Southern California in Los Angeles (55).

Those phenomenons added with overweight lead to arthrosis.

 

BONE-ARTICULATION ILLNESSES

 

In France, occupational doctors diagnosed an explosion of bone diseases between 1991 and 1994, with growth of 160 % compared to preceding years.

 

Back trouble, which is a major cause of disability, accounts for six million consultations a year, a third of rehabilitation prescriptions, 13 % of occupational accidents, 7% of work stoppages due to illness and 2,5% of non-hospital prescriptions. The deterioration of the muscular-bone-articulary system is continually ignored.

 

OSTEOPOROSIS

 

In 1978, Daniel Baran and his collaborators, from the department of Medicine and Pathology, Division of Bone and Mineral Metabolism from the Washington University School of Medicine, reported the positive effect of testosterone therapy on bone formation in a hypogonadic male wity osteoporosis (56).

In 1981, Delmas and Meunier from the Research Laboratory on histodynamics of the bones and the Alexis Carrel Faculty of Lyon in France, reported eight cases of osteoporosis in eight men with low levels of male hormones (57).

In 1983, Gérard Milhaud from the University hospital Saint Antoine in Paris, has reported the fragility of the bones in climacteric women but also in climacteric man accordig studies on the mineral constitution of their bones (58). The rapidity of the mineral loss in man is slower than in women.

The same year, Doctor Foresta and his collaborators reported in the scientific revue Hormone Metabolic Research the linear relation between testosterone plasmatic levels and bones' density (59).

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LOSS OF PULMONARY ELASTICITY AND REPIRATORY IMPAIRMENT.

 

Normal breathing is the result of a good elasticity of the connective tissue of the lungs. Respiratory muscles in good condition are also necessary for a good respiration. Connective tissue deterioration and amyotrophy of respiratory muscles in low testosterone conditions leads to breathing problems.

 

SKIN ATROPHY

 

The altered connective tissue is also responsible for skin aging and phimosis. This condition leads to chronic skin infection.

 

FALL IN IMMUNITY

 

Testosterone stimulates immunity (60-61-62). A decrease of androgens' secretion induces a lack of production of lymphocytes leading to chronic infections and cancer. Testosterone therapy can be of the most importance in HIV viral illnesses (AIDS) when the patient is weak, stressed and deprived of lymphocytes.

 

TRANSFORMATION OF THE SILHOUETTE

 

The silhouette of the climacteric men is often typical, with overweight and abdominal ballooning, consequence of the weakness of the bowel's muscles. An increase of male hormones is also responsible for breast enlargement which is very common in old men (fig.1). 

 

 

The regressive man's silhouette

 

The progressive man's silhouette

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RENAL FAILURE

 

The kidney insufficiency is the consequence of three great         mechanisms. The first is the lack of trophic influence on the renal parenchyma. The second is the impairment of the kidney function by hypertension in the ureteral cavities secondary to the hypertrophy of the uretero-trigonal musculature which is the consequence of the bladder outlet obstruction created by  prostate diseases.

The third is the arteriosclerosis of the renal arteries. All those phenomenons are aggravated by loss of testosterone.

 

VISION AND AUDITION TROUBLES

 

The small bones of the ear and their ligaments, the connective tissue of the eye, its vascularization and its metabolism are damaged by the loss of testosterone. This phenomenons lead

to troubles of audition and vision.

 

NERVOUS DEPRESSION

 

It accounts for 100 million consultations a year worldwide. Aggravated by stress, it can announce future deterioration in the nervous system.

 

The influence of testosterone on the nervous system are numerous.

In 1971, Harold Persky, a researcher from the National Institute of Mental Health of the US Public Health Service, reported in the revue Psychosomatic Medicine the relation of psychological measures of aggression and hostility to testosterone production in man (63).

The plasma levels of testosterone were studied in young men and in older men. In young man there is a correlation between testosterone plasma levels and measures of aggression and hostility. This equation was not valid for older men.



RELATION OF PSYCHOLOGIC MEASURES OF AGGRESSION AND HOSTILITY TO TESTOSTERONE PRODUCTION IN MAN

 

 

Age

Plasma testosterone in nanograms/ 100 ml.

 

   Reactions

22  ( range 17-28)

685

 +

45,1 ( range 31-66)

404

 -

                                                       

                                               Table 4.

 

According to Persky H., Smith K.D. et Basu G.K.

 

In 1974, Joel Ehrenkrantz, from the Department of Psychiatry from the Yale University School of Medicine, New Haven, Connecticut, and his collaborators reported the correlation between testosterone plasma levels with aggressive behaviour and social dominance in man (64).

 

PLASMA TESTOSTERONE : CORRELATION WITH AGGRESSIVE BEHAVIOUR AND SOCIAL DOMINANCE IN MAN

 

Behaviour

Plasma testosterone in nanograms / 100 ml

 non agressive

   599 

 socialy dominant

    836

 aggressive

  1 010

                                                 

                                                  Table 5.

 

According to Ehrenkrantz J, Bliss E. et Sheard M.H.

 

When you consider the statistics of deaths by accident of the National Centre for Health Statistics, you see immediately that, under 65 years, men are dying threefold more than women, after 65 years the death rate is the same for women and men who have lost their male hormones and their aggressivity.

 

NUMBER OF DEATH BY ACCIDENT REGISTRATED IN U.S.A. IN 1982

 

 

Under 65 years

 

 

More than 65 years

Men

Women

Men

Women

54 000

17 000

12 000

11 000

                                                       

                                                 Table 6.

 

According to the National Centre for Health Statistics, Vital Statistics Report, Final Mortality Statistics, 1982.

 

According to the World Health Organisation 100.000.000 persons are suffering each year from nervous breakdown.

Nervous breakdown is a great symptom of the middle age crisis. In 1979, Mauvais-Jarvis and Bruno de Lignières, from the Necker Hospital in Paris, reported  the correlation between nervous breakdown and low plasma testosterone levels (65).

 

 

LOW PLASMA TESTOSTERONE AND NERVOUS BREAKDOWN

 

 

Men consulting for impotency

 

Number of patients

Plasma testosterone at  9 a.m. in nanograms/100 ml.

Depressed

8

205

Non depressed

9

645

                                                       

                                               Table 7.

According to Bruno de Lignières and Mauvais-Jarvis.

 

BRAIN DETERIORATION