The Role of Testosterone Therapy in Age Management

By George Gillson MD PhD CCFP

We are gaining a better understanding of the life-prolonging genes that are involved in how we age and how we might regulate those genes up or down as needed, with as-yet-developed therapies. Tech billionaires like Jeff Bezos are investing in companies undertaking this type of research ( )
This is the good news. The bad news (and there’s always bad news) is that we are still a decade or two away from perfecting these new anti-aging strategies. So meanwhile, what do we do? Well, let’s start with Bezos:

I don’t know how old he was when this picture was taken. He’ll be 60 in early January 2024. My point is that somewhere along the way in his fifth decade he got fairly jacked and fairly trim. (If you want the Coles Notes from the hyperlink, he changed his diet, started getting more sleep, worked with a trainer and took up kayaking. Lord knows he could afford a world-class trainer, not that I’m bitter.) I suspect he also might have had some hormonal help but more on that in a minute.

He also acquired a girlfriend who is five years younger than he is and that always helps keep a fellow younger than his age. But here’s my other point: people can still build muscle at any time in their 60’s through their 90’s. Just Google some images for yourself if you don’t believe me. This lady, Joan MacDonald, only got to looking like this when she turned 70:

It’s all about muscle-and I don’t mean muscle for the sake of looking buff. Maintaining or developing good muscle mass in older age is key to enjoying  20, 30  or maybe 40 more years of healthy, active life. Turns out that muscle sends signals to many other body structures: to build bone, regulate blood sugar, prevent obesity, preserve cognitive function, stave off depression, prevent (often-fatal) hip fractures and last-but-not-least, muscle acts as a source of energy during critical illness. Your store of muscle could literally save your life.

Male or female, we can all use “a little help from our friends” in building muscle and that’s where some judicious testosterone therapy can enter the picture.  We’re not talking mega-doses here. Older men only need a few milligrams of testosterone per day and women typically only need a fraction of what the men need.

In the Integrative/Functional Medicine approach, testosterone therapy is initiated only after a thorough workup including physical exam and laboratory testing, looking at insulin-glucose balance, inflammation, thyroid status and nutritional status. Therapy is monitored by repeat testing of levels to detect early buildup of excess estrogen in males and testosterone metabolites in females.

Prostate health is also monitored although risk of increased prostate problems is minimal with proper dosing and usually, prostate health is improved with therapy.  Female urinary complaints often disappear or are greatly improved with testosterone therapy.

The EvolveWell clinic has long experience with hormone replacement and also offers dietary/nutritional planning and weight-loss guidance. This expert team of practitioners is waiting for your call!

P.S. I forgot to mention some of the other  “side effects” of testosterone therapy which can include younger-looking skin, more energy, better mood, not to mention more (and better) sex.

What’s not to like?

George Gillson MD PhD

Author: George Gillson, MD, PHD, CCFP
EvolveWell Medical Director