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See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog There was once a Saturday night live skit that featured one of their actors, Eddie Murphy, teaching how to spell and say Py-ro-man-ia..and every time I see the word sarcopenia, I think of that skit…mostly because it is a word only researchers and doctors use to describe a condition where a person has lost a lot of skeletal muscle, leaving her or him without enough muscle to move around normally. Sarcopenia is considered a side effect of aging….but it is really a condition of low testosterone level in the blood, that occurs with aging and results in disability. For people over 70, this is what happens, you lose your muscles if you don’t take testosterone replacement, and don’t exercise and eat enough protein. At any age your muscle is stimulated to grow by your resistance training, daily exercise, and it must be supplied with the building blocks of muscle which is protein from animal products in your diet. However, you can exercise daily and eat the right amount of animal protein and you will still become sarcopenic if you don’t replace your testosterone to a level that is clinically needed as you age. Muscle is only made in people who have enough testosterone. I am hoping that the next generation of women and men who are 70-year-old now will not be bent over, using walkers, and wheelchairs, and unable to get out of a chair as they age. With long-acting testosterone pellets, in combination with daily exercise, active daily life and sufficient animal protein to make muscle I am working toward a world where humans aren’t put on the shelf because they can’t physically take care of themselves. But muscle mass does more for you as you age than just get you from here to there without assistance. Your muscle mass also is the primary organ in your body that burns 80% of your calories and turns them into energy. The muscle cell itself is like a generator. It takes in blood sugar and burns it to make energy for your cell. The trick here is to maintain enough muscle mass to make enough energy and burn your calories! This takes the three elements above: 1) Young healthy free testosterone blood levels, 2) a diet including a large amount of the proteins needed by your body to make muscle which are found in animal proteins, and 3) exercise! Every day, many times a day you must be active to keep your body healthy and muscled. What happens when free testosterone does not stimulate your muscles to make more muscle? Here is how it works when you are young and have sufficient testosterone and when you replace your deficient testosterone. Every time you move or exercise you use your muscles. Your muscles make heat and energy for you and for your cells. Testosterone sends blood flow to your muscles to stimulate your muscle cells to take in blood sugar and make energy and heat. Testosterone does something more; it directs the muscles to regenerate after they are broken down the 24 hours after exercise and are discarded. The day after exercise, your use your dietary protein to rebuild your muscles. Without the stimulation of Testosterone to rebuild your muscle mass, your muscles break down as usual, but are not built up again! This leads to a never-ending loss of muscle, leading you to lose muscle mass, bone mass, and your best burner of calories! The endpoint is a person who is 75, looks frail, can’t walk fast, who has poor balance and falls and breaks bones. Older people who don’t take testosterone also replace their muscle mass with fat, so their weight may go down (loss of muscle with fat replacement causes the waistline measurement to go up and clothing size to go up, but weight may in fact go down from the lack of testosterone stimulating muscle growth. All of this is well known to doctors yet it is hard to explain in a 15-minute office visit. Now let’s talk about what is new to our knowledge of muscle tissue and the diseases of aging. In a research article from 2023, revealed the relationship between muscle mass and diabetes. Those people who had a high % of muscle for their weight had a lower chance of having insulin resistance and diabetes. Diabetes increases our risk for heart disease and death and requires many drugs and doctor’s visits and increases the risk of an individual’s early mortality. Think of it like this: Replacing T to a premenopausal level in women and to a young healthy youthful level in men increases muscle mass, which uses up blood sugar, which in turn decreases the risk of adult-onset diabetes, which decreases your risk of heart disease and early death! Another study revealed the relationship between muscle mass and early death and found that the more muscle you have the lower your risk of mortality. You and I know that you can’t have great muscle mass as you age, without testosterone but that was not mentioned. They just measured muscle mass and correlated it with the chance of death, and they found that the more muscle mass you have the lower your chance of death. A study done on men only showed that the level of testosterone was associated with thicker cortical bones and estrogen in men decreased the cortical bone strength. Bone must have the tension of muscles to stay thick and healthy, so this indirectly gives us more information about how important weight training and resistance training is to your very life. What Dr Sullivan and I do every day is assist men and women in curing their negative symptoms of testosterone deficiency as well as protecting them from becoming frail also called Sarcopenic as they age. It is not enough to get older if you are not functioning well and are able to take care of yourself!