Boost in Steroid Use Among Older Men

by Dr Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP | Anti Aging

Middle-aged men jonesing for a boost in vitality are turning to steroids in increasing numbers, say researchers and health professionals. Men in their 40s, 50s — even 60s and 70s — are turning to hormones to fight the effects of aging, including weight gain and decreased libido, according to The Guardian.

Joseph Kean, a visiting research fellow at Liverpool John Moores University, said that usage has doubled in the number of men 50 and over in the past five years. He told The Guardian, “Guys are saying they just want to stand a bit taller and feel they can stand alongside the younger generation who are much more aware of how they look.”

But the vision of a buffer, more energized you comes with caveats — including the potential for worsening sleep apnea, heart disease, blood clots, and prostate complications.

Testosterone levels decline early on, starting at around age 30. This drop can lead to any number of unwanted side effects and problems, according to the National Center for Biotechnology Information at the National Institutes of Health. Low-T as it is often referred to, is responsible for much more than just weight gain and decreased sex drive. It is correlated with insulin resistance, low muscle strength and development — even poor cognitive function. So it’s a given that men would want to head off this decline and preserve their vigor for as long as possible.

“We have come across a lot of older men using [steroids]. It’s almost like hormone replacement therapy [for menopause relief] for females. Steroids can help you lose body fat as well,” Julien Baker, an applied physiology professor at the University of the West of Scotland, told The Guardian. “The evidence isn’t there about what the long-term impact is yet. We are not sure what these drugs are doing to you at that age, but everyone perceives it as safe.”

Magazines geared toward rejuvenation through hormone replacement have sprung up, as have clinics that promote testosterone replacement therapy in the United States and abroad.

The Juice Clinic in Sheffield, England, is one such service for people using steroids and image-enhancing drugs. Sid Wiffen, the clinic’s team leader, told The Guardian he has noted an increase in older men asking for help. “Steroid use for older men is often about the youthful effects, and about body image and energy levels. I hear talk of men feeling more pressure now to look good, so they are more likely to go to the gym and dress well,” he said. “It can be dangerous, and it does worry me. Lots of people we see are keen to make an informed decision about their steroid use, but some get information elsewhere and it’s not always good.”

That elsewhere includes the internet of course, where misinformation on the topic flourishes. The healthier, safer route by far is to seek the advice of a physician and get a prescription.

Steroids, officially known as anabolic-androgenic steroids, were first developed for medical use in wasting conditions. Their possession or sale without a prescription is illegal in the United States, though some people are able to get them online or in gyms. Some countries permit legal possession, including the U.K., though it is illegal to supply them there. Steroids come in pill form, injectables (intramuscular), and topical gels.

Baker said while there could be some benefits for older men, the risks should be well understood. “Introducing something your body stopped producing naturally may lead to repercussions or have health implications,” he said. “There’s not enough research out there to look at that. Someone taking steroids at 50 — it’s not clear what might happen to them in the future.”

Once users discontinue the use of steroids, many report withdrawal symptoms such as low mood and anxiety, something men should keep in mind as well.

Good Sleep Gets Tougher With Age

by Dr Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP | Anti Aging

Most people see their sleep habits shift as they age, but a new review suggests that some seniors lose the ability to get deep, restorative rest.

And that can come with health consequences, said review author Bryce Mander, a sleep researcher at the University of California, Berkeley.

Sleep “fragmentation” has been linked to a number of medical conditions, including depression and dementia, Mander said. People with fragmented sleep wake up multiple times during the night, and miss out on the deep stages of sleep.

It is true that medical conditions, or the treatments for them, can cause sleep problems, according to Mander.

But poor sleep can also contribute to disease, he added.

Take dementia, for example. Research suggests there is a “bi-directional” link between sleep disruptions and the dementia process, said Joe Winer, another Berkeley researcher who worked on the review.

That is, dementia often causes sleep problems; poor sleep, in turn, may speed declines in memory and other mental skills. According to Winer, animal research suggests that deep sleep helps “clear” the brain of the amyloid-beta proteins that build up in people with dementia.

So there may be a “vicious cycle,” Winer said, where dementia and poor sleep feed each other.

Similar vicious cycles may be at work with other diseases, too, Mander said. He also stressed, though, that some shifts in sleep habits may be perfectly normal.

Older people are famously prone to being “early to bed, early to rise.” They may also sleep a little less than they used to in their younger days. And that may be fine, the researchers said.

“We don’t want to create a panic that if you’re sleeping a little less than you used to, you’re going to develop dementia,” Mander said.

But, he added, it is important to recognize sleep as one of the lifestyle factors critical to good health — right along with exercise and a healthy diet.

In fact, Mander noted, one reason that regular exercise keeps us healthy is that it can support better-quality sleep.

“Why do some people age more ‘successfully’ than others?” he said. “We think sleep is one of the factors.”

Dr. Sanjeev Kothare, a sleep specialist who was not involved in the study, said poor sleep “clearly” has health consequences.

Sleep apnea is a good example, said Kothare, of the NYU Langone Comprehensive Epilepsy-Sleep Center, in New York City.

Obstructive sleep apnea causes repeated stops and starts in breathing during the night, and it’s linked to major diseases, such as heart disease and diabetes. Research also suggests it can hasten declines in memory and thinking.

Dr. Phyllis Zee is chief of sleep medicine at Northwestern University in Chicago. She said sleep quality is more important than “duration.”

So if older people are sleeping a little less than they used to — or wake up once at night then quickly fall back asleep — that’s probably not a red flag, according to Zee.

But, she said, older adults should talk to their doctor if they routinely sleep less than six hours a night, or lack long “consolidated” blocks of sleep.

In some cases, Zee said, sleep apnea may be to blame.

In other cases, people may need lifestyle adjustments that can improve their sleep. The good news, Zee said, is that “behavioral and environmental changes are powerful.”

Older people can improve their sleep by fitting physical and social activity into their daily routine, Zee said. At night, she suggested they make sure the bedroom temperature is comfortable and limit exposure to artificial light — especially the blue glow of computer and TV screens.

Zee also stressed the importance of getting enough daylight, in the morning and afternoon: That helps keep the body’s circadian rhythms (the sleep-wake cycle) on track.

But people should not wait until old age to care about sleep. According to Mander’s team, people often start losing the capacity for deep sleep in middle age, and that decline continues over the years.

What’s not clear yet, Mander said, is whether good sleep habits earlier in life help protect people from sleep problems in old age.

The review, which analyzed medical literature on the topic of sleep and aging, was published online April 5 in the journal Neuron.