I can’t lose weight or gain muscle. Do I need to take hormone replacement? – 05/03/2022

I’m a cisgender man, I’m over 50 and I’m having trouble burning fat and building muscle mass. Do I need to take hormone replacement?

Only if you have a disorder that impairs your hormone production. Therefore, the first step is to make an appointment with an endocrinologist, or sports doctor, so that the health professional can carry out the request for a test of testosterone in the blood and, thus, identify whether or not there is a deficit in the amount of the hormone circulating in your body.

It is worth knowing that, in general, values ​​between 300 ng/dl and 1,000 ng/dl (nanograms per deciliter of blood) of testosterone in the blood are considered normal. It is a very extensive range, the ideal levels of the hormone vary with age and other factors, which must be evaluated individually by the health professional.

Some symptoms may indicate reduced hormone production, such as low libido, decreased morning erections, loss of body hair, low bone mineral density, gynecomastia and small testicles. What can cause this deficiency are infections, diabetes, tumors, obesity, inflammatory diseases, other hormonal disorders, genetic diseases, among others.

In addition, the risk of testosterone deficiency increases after age 50, as it is normal for the body to produce less hormones over time. This deficit is even accentuated when the man has other diseases, such as obesity, diabetes, cardiovascular and liver diseases, and even psychological disorders, such as depression. Lifestyle, that is, diet, physical exercise, sleep quality, alcohol consumption and smoking, also have a strong influence on the amount of testosterone in the blood.

If hormone replacement is indicated due to a deficiency, the use of these types of medicines can help to increase lean mass (muscles) and decrease body fat. But it is important to know that this treatment can lead to some side effects.

The reactions are varied and can range from increased oiliness of the skin, acne, hair loss, to cardiovascular diseases, prostate and breast cancers and risk of hepatotoxicity (liver damage caused by chemicals).

There may also be an increase in “bad” cholesterol (LDL) and decreased good cholesterol (HDL), mood disorder, with bouts of irritability, nervousness and even depression, as well as infertility and hemoconcentration —when the blood gets thicker, which can be a risk factor for vascular diseases, such as thrombosis and stroke (Cerebral Vascular Accident).

For men over the age of 40, testosterone replacement can stimulate an enlarged prostate, leading to so-called benign prostatic hyperplasia, which can change the flow of urine, with a weaker stream, as the urethral canal is narrowed. This problem can cause discomfort and difficulty urinating.

So, you already know: the first step is to schedule a medical appointment. The characteristics of greater or lesser ease of spending energy (burning fat) and gaining muscle are mainly determined by each person’s genetics. If there is no hormone deficiency, sometimes a simple change in habits can help with body definition.

Invest in adopting good habits such as healthy eating, regular exercise, good amount and quality of sleep, moderation in alcohol intake and smoking cessation, as well as controlling diabetes and lipid disorders (fats and cholesterol). Never use hormones on your own.

Sources: Bruno Gelonezeprofessor in endocrinology at Unicamp (State University of Campinas) and coordinator of LIMED (Research Laboratory on Metabolism and Diabetes), also at Unicamp; Felipe Henning Gaia Duartedirector of the SBEM (Brazilian Society of Endocrinology and Metabology) São Paulo Regional; Roberta Maria Dualibeendocrinologist at HU-UFMA (University Hospital of the Federal University of Maranhão), which is part of the Ebserh Network (Brazilian Hospital Services Company).

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