1. SARA DEMPSEY DOCTOR OF PHARMACY CANDIDATE PART 1 OF 3 Testosterone and Diabetes

2. Overview Background information on testosterone Reason for decline in testosterone Effects of low testosterone Diabetes and low testosterone Foods, drugs, and exercise: their effect on testosterone How to treat low testosterone Testosterone replacement therapy options Benefits and risks of testosterone replacement

3. Background Information on Testosterone http://www.huvepharma.com/products/view/182

4. Testosterone Hormone produced mainly in the testes Controlled by the hypothalamus and pituitary  Gonadotropin-releasing hormone (GnRH) is secreted from the hypothalamus  Luteinizing hormone (LH) secretion from the pituitary is stimulated by GnRH  LH stimulates the secretion of testosterone from the testes Bowen, R. "Gonadotropins: Luteinizing and Follicle Stimulating Hormones.". N.p., 13 May 2004. Web. 20 Jan 2013.. "Mayo Clinic." Testosterone therapy: Key to male vitality?. Mayo Foundation for Medical Education and Research, 10 Apr 2012. Web. 20 Jan 2013..

5. Why we need testosterone Testosterone plays a role in maintaining the mass and strength of muscles, distribution of fat in the body, and bone density Testosterone also helps with production of sperm and sex drive "Mayo Clinic." Testosterone therapy: Key to male vitality?. Mayo Foundation for Medical Education and Research, 10 Apr 2012. Web. 20 Jan 2013..

6. Testosterone timeline Testosterone levels rise drastically during puberty years In early adulthood testosterone levels reach their peak Testosterone then decreases gradually after age 30  ~1% a year "Mayo Clinic." Testosterone therapy: Key to male vitality?. Mayo Foundation for Medical Education and Research, 10 Apr 2012. Web. 20 Jan 2013.. "Low Testosterone (Low T).". MedicineNet, 12 Sept 2012. Web. 20 Jan 2013.. www.physiciansagemgmt.com

7. Testosterone levels Normal testosterone level  ~300-1000 ng/dL Circulating testosterone  Amount of bound testosterone ~98%  Amount of free testosterone ~2% ”Low Testosterone (Low T).". MedicineNet, 12 Sept 2012. Web. 20 Jan 2013.. Matsumoto, A. "Fundamental Aspects of Hypogonadism in the Aging Male." Rev Urol.. 5.(Suppl 1) (2003): S3-S10. Print.

8. Low Testosterone http://www.whatcausesthis.com/what-causes-low-testosterone/

9. Hypogonadism Diminished production of testosterone  Primary hypogonadism  Insufficiency in production of testosterone in the testes  Secondary hypogonadism  Pituitary is insufficient in regulation of testosterone  Tertiary hypogonadism  Hypothalamus is insufficient in regulation of testosterone "Low Testosterone (Low T).". MedicineNet, 12 Sept 2012. Web. 20 Jan 2013..

10. Why testosterone declines with age Reasons for decline in testosterone due to aging  Decreased secretion of LH and GnRH  Decreased production of testosterone by the testes  Reduction in the amount of free testosterone due to protein binding with sex hormone binding globulin (SHBG)  SHBG increases with age  More testosterone bound to SHBG = less free testosterone available to tissues "Mayo Clinic." Testosterone therapy: Key to male vitality?. Mayo Foundation for Medical Education and Research, 10 Apr 2012. Web. 20 Jan 2013.. "Low Testosterone (Low T).". MedicineNet, 12 Sept 2012. Web. 20 Jan 2013.. Matsumoto, A. "Fundamental Aspects of Hypogonadism in the Aging Male." Rev Urol.. 5.(Suppl 1) (2003): S3-S10. Print.

11. The effects of low testosterone Low testosterone can cause:  Decrease in sexual desire  Disturbances of sleep  Emotional changes such as depression or low self confidence  Physical body changes  Body fat increase  Reduction in bone density  Decrease in muscle strength  Lower energy levels "Mayo Clinic." Testosterone therapy: Key to male vitality?. Mayo Foundation for Medical Education and Research, 10 Apr 2012. Web. 20 Jan 2013..